Progesterone increases glomerular filtration rate, urinary kallikrein excretion and uric acid clearance in normal women.

In pregnancy there is a rise in glomerular filtration rate (GFR), plasma aldosterone levels, uric acid clearance and urinary kallikrein excretion. In toxemia all the above parameters tend to decrease. Progesterone has a diuretic effect which is usually related to aldosterone antagonism. We administered progesterone to normal women and observed that GFR, uric acid clearance and kallikrein excretion increased significantly, GFR from 103.0 +/- 13.7 ml/min to 118.0 +/- 18.0 ml/min (P less than 0.01), uric acid clearance from 9.0 +/- 3.6 ml/min to 14.3 +/- 4.0 ml/min (P less than 0.01), and urinary kallikrein excretion from 165 +/- 156 mU to 432 +/- 220 mU (P less than 0.01). Natriuresis and potassium excretion also increased from 15.9 +/- 6.4 mEq to 33.4 +/- 10.9 mEq (P less than 0.01) and from 7.6 +/- 2.7 mEq to 14.0 +/- 5.4 mEq, (P less than 0.01), respectively, suggesting that in this situation aldosterone antagonism is not relevant to explain the diuretic effects of progesterone.

[Evaluation of graduates in medicine, in knowledge considered basic by faculties, at the end of the course of the Escola Paulista de Medicina]. / Avaliação dos formandos em medicina, em conhecimentos considerados fundamentais pelos docentes, ao final do curso da Escola Paulista de Medicina.

A growing consensus exists in Brazil about the need of a qualification work prior to medical practice. On the other hand, some members of the faculty and student body of medical schools are against this kind of skill control because they think that their teaching and learning is effective. At the Escola Paulista de Medicina, one of the best ranking Schools of Medicine in Brazil, we asked to 39 departments of the Course of Studies of Medicine to provide 6 questions about concepts that the faculty considered fundamental knowledge for medical practice. Then, an examination with 234 questions was applied to 82 volunteers out of the 100 graduates of the Medical School. All the volunteers presented correct answers to more than 50% of the questions, and 90% answered correctly to more than 60% of the questions. Such results suggest that the students retained a good proportion of the concepts considered essential for practice by the faculty. Even so, almost 100% of them applied for residence training programs.

[Some ultrastructural aspects of the cardiac muscle of albino rat during the acute stress produced by formaldehyde (author's transl)]. / Alguns aspectos ultra-estruturais da fibra muscular cardíaca do rato albino sob a influéncia do "stress" agudo provocado pelo formol.

The authors studied ultrastructurally the influence acute stress, produced by formaldehyde, has on some aspects of the cardiac muscle metabolism in albino rats. The results showed that the cardiac muscle was induced to develop additional work, represented ultrastructurally by an increase in the number of lipid droplets and increased concentration and volume of mitochondria.

[Nutritional assessment of chronic renal patients in hemodialysis programs. A multicenter study]. / Avaliação nutricional em pacientes renais crônicos em programa de hemodiálise. Estudo multicêntrico.

The food intake and the nutritional status of 100 chronic renal failure patients on maintenance hemodialysis in 10 facilities in the city of São Paulo were studied. The average food intake obtained through 3 days of dietary diaries showed a caloric intake of 26.6 +/- 10kcal/kg/day (mean +/- SD), 24% below the minimum daily caloric intake recommendation and a protein intake of 1.03 +/- 1.4g/kg/day which averaged the minimum recommended for chronic renal patients on hemodialysis. The average intakes of calcium (418.6 +/- 294.9mg), phosphate (813.5 +/- 335.2mg) and iron (10.5 +/- 4.9mg) were also low. Mean serum albumin was 3.9 +/- 0.7g/dl and only 3.1% of the patients had albumin levels below 3.0g/dl. There was no difference between the real and ideal body weight. On the other hand 69% of women and 25% of men had the triceps skin fold (TSF) in the 5th percentile while 24% of women and 79% of men exhibited values of the muscle arm circumference (MAC) in the same percentile. Moreover there were inverse and significant correlations between the time on dialysis and TSF for women (r = -0.19) and the time on dialysis and MAC for men (r = -0.16). This study shows that our patients on hemodialysis have a poor food intake, with marked reduction of fat and muscle stores. The undernourished state observed tended to be more pronounced with the duration of the dialysis treatment and could influence negatively on the morbidity and mortality of these patients.