[Importance of schedule in medical graduation: the example of Faculdade de Medicina da Universidade de São Paulo (FMUSP)]. / A importância da carga horária na graduação médica: o exemplo da FMUSP.

Results of educational research which were realized in 1996 are presented. The effective use of available schedule in each discipline of medical curriculum in FMUSP was registered by previously prepared students. In global analysis 13.9% of available hours were not utilized. Research results were compared with those ones registered in Curricular Evaluation Program (PAC); final figures revealed that better utilization in available schedule is correlated with better assessment in PAC model.

[Research and teaching in medical education]. / Pesquisa e ensino em educação médica.

A list of citations of scientific papers of Brazilian researchers published from 1981 to 1993 and prepared by Institute for Scientific Information identified almost 8000 titles; 37.4% of this total number include medical area subjects publications. The author analyses also the relevant importance of teaching activities in medical education process, specially with reference to ethical aspects included in it.

Alteraçöes histopatológicas do intestino delgado após preservaçäo hipotérmica com as soluçöes da Universidade de Wisconsin e Euro-Collins. Estudo experimental / Histopathological changes of the small bowel after hypothermic preservation with University of Wisconsin and Euro-Collins solutions. Experimental study

Existe interesse em prolongar o tempo de isquemia hipotérmica do intestino delgado (ID) com o uso de soluçöes de preservaçäo. OBJETIVO. Oobjetivo deste trabalho foi comparar as alteraçöes do ID isolado sob preservaçäohipotérmica com as soluçöes da Universidade de Wisconsin (UW) e Euro-Collins (EC) utilizando método de análise histopatológica. MÉTODO. Utilizaram-se 40 ratos Wistar (250-300g) cujo ID foi retirado por meio de técnica microcirúrgica e tratado com soluçäo UW ou soluçäo EC. Realizaram-se biópsias do jejuno proximal e íleo distal periodicamente, de 8 em 8 horas, a partir da retirada do ID (tempo 0) até 48 horas. Classificaram-se as alteraçöes histopatológicas encontradas no ID, quantitativamente, em 4 graus de gravidade de lesäo. De acordo com a progressäo de degeneraçäo hidrópica na vilosidade, os resultados obtidos foram analisados por estatística näo-paramétrica (p<0,05). RESULTADOS. Observou-se aumento significante da freqüência do acometimento do ID por lesöes isquêmicas ao longo dos períodos de tempo analisados para ambos os grupos. A freqüência e a gravidade das lesöes foram significantemente maiores no grupo EC do que no grupo UW, para os segmentos jejunais no tempo 8 horas, no jejuno e íleo no tempo 24 horas, e no jejuno e íleo no tempo 48 horas. CONCLUSÄO. concluiu-se que a soluçäo UW näo impediuo aparecimento de lesöes isquêmicas do ID, porém apresentou melhor açäo protetora, ao longo do tempo, nos segmentos jejunal e ileal, reduzindo a gravidade e a freqüência das lesöes histopatológicas, quando comparada com a soluçäo EC

[Histopathological changes in the small intestine after hypothermic preservation with University of Wisconsin and Euro-Collins solutions. Experimental study]. / Alterações histopatológicas do intestino delgado após preservação hipotérmica com as soluções da Universidade de Wisconsin e Euro-Collins. Estudo experimental.

PURPOSE: The objective of this study is to compare small bowel histopathologic alterations under hypothermic preservation with University of Wisconsin (UW) and Euro-Collins (EC) solutions. METHODS: In 40 Wistar rats (250-300g) the small bowel was microsurgically withdrawn and randomly treated with UW solution or EC solution. Periodic intestinal biopsies were taken from the proximal jejunum and distal ileum each 8 hours after small bowel withdrawing (time 0) until 48 hours. The histopathologic alterations were semiquantitatively classified in 4 degrees of severity and the obtained results were analysed statistically by appropriated tests (p < 0.05). RESULTS: There was a significant increase of the small bowel ischaemic lesions over the time for both experimental groups. The lesions frequency and severity were significantly more increased in the EC group than in the UW group, for jejunal segments at 8 hours, in jejunal and ileal segments at 24 and in jejunal and ileal segments at 48 hours. CONCLUSION: The UW solution did not avoid the development of small bowel ischaemic lesions but, with time, it protected better jejunal and ileal segments, decreasing frequency and severity of histopathological alterations, when compared to EC solution.

[Curriculum evaluation program of the University of São Paulo Medical School--results for 1993 and a 5-year analysis]. / Programa de avaliação curricular da Faculdade de Medicina da Universidade de São Paulo--resultados de 1993 e análise quinqüenal.

The following report contains the results of the "Curricular Evaluation Program" of University of São Paulo Medical School pertaining to the year of 1993 and to the five-year period between 1989 and 1993. This evaluation of all undergraduate courses was made by students, responding to questionnaires supplied at the end of each program. In 1993, 60.6% of programs were considered as very good programs. In relation to 1989-1993 period, are presented the results of a disciplines group of the 4th year and a internship stages of the 5th year.

[Nutritional and energy metabolism changes in abdominal irradiation--experimental study]. / Alterações nutricionais e do metabolismo anergético na irradiação abdominal-estudo experimental.

In this study the effects on nutritional status and energetic metabolism due to abdominal irradiation were analysed. Adult male Wistar rats (48), were divided in two groups Control (C) and Radiated (R). The rats were maintained all time in metabolic cages. The study was done in two periods: Period 1 begun at 0 day, where rats adapted to cages and oral diet, had food and water "ad libitum". At the day 4 indirect calorimetric measurements were performed (calorimetry I). At Period 2, group R rats abdominal radiation at a 300cGy/day rate, for 5 consecutive days, and group C started a pair feeding process linked individually to R rats and suffered application of simulated-radiation. Two other calorimetric measurements (II,III) were performed during Period 2. After radiation the last calorimetry was performed (IV). At sacrifice (day 14) blood was collected for determination of hemoglobin, haematocrit, albumin and transferrin. There were no statistical differences among groups C and R during Period 1 (p < 0.05). Great reduction in food intake and weight variation were found in Period 2, but weight loss was significantly higher in R rats. Nitrogen balance decreased in Period 2, but without difference among the groups (p < 0.05). Serum albumin was significantly lower in R rats. Respiratory quotient decreased in both groups during Period 2, but R rats kept it lower (p < 0.05). The energy expenditure level decreased after radiation in Group R. During Period 2 total substrate oxidation decreased in R rats. Radiation decreased glucose and protein oxidation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Medical staff of teaching hospitals and the medical education process]. / O corpo clínico dos hospitais de ensino e o processo de educação médica.

At the in S. Paulo University Medical School (FMUSP), 39% of physicians that work there take some part in teaching work ten percent of these professionals had completed the mastership, 25% concluded the doctorship and 5% are free professors.

[Intra-institutional operative diagnosis of medical schools]. / Diagnóstico operacional intra-institucional de escolas médicas.

The difficulties for the establishment of operative diagnosis of a high-educational institution such as a medical school are examined by the author. The importance of the implementation of the evaluation patterns of the school is stressed. A set of different evaluative parameters is indicated. They concern: teaching-learning process; teaching and administrative resources; research activities; and general administration. The procedure is exemplified by data from the Medical School of the University of São Paulo.

[The effect of lipid emulsions on the mechanisms of organic defense in infectious injury]. / Efeito de emulsões lipídicas sobre mecanismos de defesa orgânica na agressão infecciosa.

For treatment of metabolic derangements in infective states intravenous lipidic emulsions have been used. Their use is however not harmless existing reports on fat inhibiting the function of blood polymorphonuclear leukocytes and macrophages. The purpose of the research reported herewith was to study in rats the effect of new intravenous lipidic emulsions containing medium chain triglycerides and long chain triglycerides and compare it with the effect of long chain triglycerides emulsion on function of polymorphonuclear leukocytes (chemotaxis, phagocytosis and bactericidal activity). The intraperitoneal implant of an E. coli capsule was used for the study. The transfusions of both lipidic emulsions in septic rats have not altered functions of polymorphonuclear leukocytes when compared with saline infusion. However there was found hepatic steatosis, hypertrophy and presence of fat globules in the Kupffer cells in rats infused with medium chain and long chain triglyceride emulsions. Sequential blood cultures obtained from rats infused with the emulsions showed increased bacterial growth with medium chain triglyceride emulsion. There was no significant difference between the rats that received both lipid infusions and those that received saline infusions as to the mortality. Our experimental study suggests that the use of fat emulsions in infective states be done with care and monitoring of seric triglycerides and steroids.

[Profile of Brazilian medical schools in 1991]. / Perfil da escola médica brasileira em 1991.

On hand of an inquiry carried out by Interinstitutional Commission for Evaluation of Medical Education (CINAEM) in 76 medical schools an outline of Brazilian medical education in 1991 was prepared. The positive aspects included active participation in "IDA--Integração Docente-Assistencial" programs, existence of pedagogical support and considerable assistential activity at the school hospitals. There were however also some negative aspects: insufficient research activity of teachers, existence of too many schools, small titular index of teachers and exaggerated clinical practice at the school-hospital. The importance of individual evaluation of each medical school in the future work to be done by CINAEM is emphasized.

[Medical schools in Brazil]. / As escolas médicas no Brasil.

In the 1970-1980 period there was a considerable increase in the number of institutions of higher education in Brazil which are located mostly in the Southeast region of the country. The distribution of medical schools is not correlated with the distribution of population. In 59 out of 76 medical schools the internship has a duration of two semesters, in five schools three, and in 12 schools four semesters. The medical residence programs are, with 68% of 9,644 total vacancies, considerably concentrated in the Southeast region.

[Energy metabolism and experimental malignant tumor development]. / Metabolismo energético e desenvolvimento de tumor malígno experimental.

Weight loss in cancer can be attributed to anorexia and/or increased energy expenditure. In order to understand the contribution of these variables, 36 Wistar rats fed regular diet were randomly distributed in 3 groups: T (12) bearing Walker 256 carcinosarcoma; PF (12) pair fed with T group and C (12) as control group; another group--D (12)--in which rats were fed with low protein (1%) diet. Caloric intake, body and tumor weight were measured daily. Indirect calorimetry was done sequentially each 4 days. After 2 weeks of tumor growth there was significant reduction of caloric intake and carcass weight in T group compared to those of C group. There was no difference in carcass weight between T and PF group. After 3 weeks it was significantly reduced in T group (55.7 Kcal/m2/h against 75.0 of N and 65.1 of PF group). Walker 256 carcinosarcoma is an hypometabolic tumor and the host weight loss associated to its development is due to anorexia.

[Curricular evaluation program of the Medical School of the University of São Paulo]. / Programa de avaliação curricular da Faculdade de Medicina da Universidade de São Paulo.

The authors present a feed-back evaluation of the curriculum of the University of São Paulo Medical School, made by the students that attended the course. History, methodology, implantation and illustrative results are presented.

[Profile of former students of the Medical School of the University of São Paulo]. / Perfil do ex-aluno da faculdade de medicina da universidade de São Paulo.

The authors present results of an inquiry involving 3,309 physicians graduated at the University of S. Paulo School of Medicine in the 1958-1989 period. Concerning sex, there were 79% male and 21% female students (6% female in 1958-1963 period and 38% in 1958-1989). Medical residence (1-4 years) were done by 91% of all inquired physicians. Postgraduate education was performed by 26% of the graduates in master degree and by 29% in doctorate degree. In reference to professional work, 26% exert surgical specialties, 20% clinical specialties, 13% pediatric specialties, 9% gynecology and obstetrics, 9% psychiatry and 5% neurology. Eighty por cent of them perform their activity as non employed professionals, sometimes associated with some other form of work; of those, 40% earn more than 60% of their total income as non employed professionals. Three different curricular structures were analyzed in this inquiry. In the period 1958-1980 (traditional curriculum), the areas considered more attractive and important were: medical and surgical clinics, pediatrics, anatomy, physiology and pathological anatomy. The less motivating were: legal medicine, psychiatry, phthisiology. In the experimental curriculum (1974-1980) the more attractive areas were: biochemistry, pediatrics, surgical and pediatric internship, general pathology and medical clinics. The less motivating areas were: mathematics, statistics, medical deontology, preventive medicine, ophthalmology and psychiatry. In the unified curriculum (1980-1989), the preferred areas were: general pathology, medical and surgical propedeutics, infantile-maternal, clinical and surgical internship. The less motivating ones were: preventive medicine, otorhynolaringology, anesthesiology, genetics and statistics.

[Evaluation of medical schools]. / Avaliação de escolas médicas.

The author presents the project for evaluation of medical schools prepared by a commission of teachers in medicine on behalf of Brazilian Medical Association (A.M. B.). The selected parameters of evaluation were: institutional and educational objectives; facilities and equipment, both in school and hospital; financial funds disponibilities; teaching (docente resources; academic and administrative structure; curricular structure; teaching methodology, including planning and systematic; evaluation proceedings, in both discent and docente aspects; docent-assistant integration; scientific production.

[Effects of protein malnutrition on the metabolic response to trauma]. / Efeitos da desnutrição protéica sobre a resposta metabólica ao trauma.

An experimental study was carried out in rats with the purpose to evaluate post-traumatic metabolic changes in the animals submitted to proteic malnutrition. Rats fed with diets with different contents were submitted to a standardized osteomuscular trauma and had nitrogen balance and body composition parameters analysed. After 21 days of feeding with normoproteic diet chow (N) or hypoproteic diet (D) all the animals were submitted to a dorsal skin wound (subgroups NJ (6) and DJ (6). Besides the skin wound part of the rats suffered also the osteomuscular trauma (subgroups NF (6) and DF (6). After 14 days of osteomuscular trauma all the rats were sacrificed and the carcasses were prepared for body composition measurements. Body weight, food intake, fecal and urinary total nitrogen were measured daily. It was observed that in rats with normoproteic diet the osteomuscular trauma promoted a decrease of food intake and loss of weight; in animals on hipoproteic diet it was observed an increase in total urinary nitrogen output and reduction of nitrogen balance. However, there was no reduction of food intake, loss of body weight and changes in composition of body compartments.

[Effects of parenteral nutrition on tumor growth: experimental aspects]. / Efeitos da nutrição parenteral sobre o desenvolvimento tumoral: aspectos experimentais.

There still exist controversies about the effect of parenteral nutrition on cancer growth. For elucidation of this question the development of Walker 256 carcinosarcoma in rats submitted to parenteral nutrition (PN) was studied. Thirty-five Wistar rats were randomly distributed in three groups: OT group (11), tumor-bearing animals always under oral feeding for 14 days; PC group (14), tumor free animals under PN for 7 days; PT group (10), tumor-bearing rats under PT for 7 days. PT solution contained 15% glucose, 3% aminoacids and essential micronutrients. Body and tumor weight (in OT and PT groups) were evaluated daily. Carcass weight was obtained by the difference between the body and tumor weight. The rats of the PC group had an initial body weight loss that became stabilized afterwards at a lower plateau level. The rats of the PT group also presented an initial body weight loss recovered progressively afterwards. This difference is probably due to tumor mass expansion in PT animals, since PT rats carcass weight remained similar to that of body weight in PC group. The tumor growth has shown no difference between the oral and parenteral feeding groups, particularly when tumor weight/carcass weight ratio was considered. It is concluded that parenteral nutrition does not favor tumor growth in detriment to carcass weight development.

[Curriculum of the Brazilian medical schools: quantitative analysis]. / Currículo das escolas médicas Brasileiras: análise quantitativa.

The curricula of Brazilian medical schools show four distinct patterns. The first pattern (North and Northeast regions of Brazil) has basic disciplines in the first and second graduation year. The same fact characterizes also the curricula of the Southeast I region. In other patterns the basic disciplines are present only from the third year onward. The fourth pattern (South and Centerwest regions) present a very variable curricular structure when compared with the other ones. The internship is concentrated in the sixth graduation year in the first, second and fourth patterns, but in the third pattern it begins in the fifth year.

[Body composition changes in cancer: an experimental study]. / Alterações da composição corpórea no câncer: estudo experimental.

With the aim to study body composition changes in tumor bearing rats submitted to different nutritional conditions, Wistar rats were separated in three diet groups: regular chow, aproteic diet and regular chow after three weeks of aproteic diet. Afterwards the animals were divided in two subgroups: Waler 256 carcinossarcoma bearing rats and tumor free controls. After the sacrifice body composition measurements by the carcass analysis method were performed. Tumor bearing rats presented significant waste of total body fat, body cell mass and increase of Na/K ratio without relation to the nutritional regimen. From this data we conclude that Walker 256 carcinosarcoma causes protein caloric malnutrition even in already depleted rats. After adequate refeeding, body composition rebuilding was obtained in tumor bearing malnourished rats.

[Influences of antitumoral chemotherapy on body composition and nitrogen balance: experimental study]. / Conseqüências da quimioterapia antitumoral sobre a composição corpórea e o balanço nitrogenado: estudo experimental.

An experimental study was carried out with the purpose to examine the 4-epidoxorubicine (4-EPI) action on malignant tumor development and its repercussion on nutritional conditions of the host. Cancer and chemotherapy can generate malnutrition. In order to study the nutritional repercussions, 48 host Wistar rats were divided into 5 groups: Group C: 12 control rats; Group T: 5 rats bearing Walker-256 carcinosarcoma; Group TE: 11 rats given 4-epidoxorubicine (4-EPI) EV simultaneously with tumor implantation; Group T6E: 8 rats given 4-EPI 6 days after the tumor implantation; Group E: 11 rats given only 4-EPI. Tumor and carcass weight and nitrogen balance (by measuring total nitrogen ingested and excreted) were determined daily; the animals were sacrificed on the 20th day of the experiment and material was collected for determination of body composition parameters. A variance analysis was made and the differences were considered to be significative at p less than 0.05. A loss of food during a period following the 4-EPI injection was reflected by carcass weight loss. The accumulated nitrogen incorporation was lower in Groups TE and T6E in the periods of 0-5 days, 0-14 days, and 0-20 days. As for body composition it was verified that free fat solids and total body fat were reduced in Groups T ant T6E when compared to group C. However, 20 days after the use of 4-EPI there were no significative changes in the body composition. In rats bearing Walker-256-carcinosarcoma 4-EPI was effective.(ABSTRACT TRUNCATED AT 250 WORDS)