Chalcone derivatives targeting mitosis: synthesis, evaluation of antitumor activity and lipophilicity.

This study describes the synthesis of a series of chalcones, including pyrazole and α,ß-epoxide derivatives, and evaluation of their cell growth inhibitory activity in three human tumor cell lines, as well as their lipophilicity using liposomes as a biomimetic membrane model. Structure-activity and structure-lipophilicity relationships were established for the synthetized chalcones. From this work, nine chalcones (3, 5, 9, 11, 15-19) showing suitable drug-like lipophilicity with potent growth inhibitory activity were identified, being the growth inhibitory effect of compounds 15-17 associated with a pronounced antimitotic effect. Compounds 15-17 affected spindle assembly and, as a consequence, arrested cells at metaphase in NCI-H460 cells, culminating in cell death. Amongst the compounds tested, compound 15 exhibited the highest antimitotic activity as revealed by mitotic index calculation. Moreover, 15 was able to enhance chemosensitivity of tumor cells to low doses of paclitaxel in NCI-H460 cells. The results indicate that 15 exerts its antiproliferative activity by affecting microtubules and causing cell death subsequently to a mitotic arrest, and thus has the potential for antitumor activity.

Metodologias ativas de ensino-aprendizagem no processo de ensino em saúde no Brasil: uma revisão narrativa / Active teaching-learning methodologies in the teaching health process in Brazil: a narrative review

Nas últimas décadas, a formação dos profissionais de saúde tornou-se um ponto importante a ser discutido. O novo profissional desejado pelas últimas reformas curriculares dos cursos da área da saúde tem perfil humanista, crítico e reflexivo, para atuar em todos os níveis de atenção à saúde. Apesar disso, a educação dos profissionais de saúde ainda é, na maioria das vezes, baseada em um modelo fragmentado do saber, desconsiderando as necessidades de atuação na prática. Neste contexto, surgem as metodologias ativas de ensino-aprendizagem (MAEA), que propõem desafios a serem superados pelos estudantes, possibilitando-lhes ocupar o lugar de sujeitos na construção do conhecimento. O objetivo deste estudo foi revisar artigos disponíveis em periódicos científicos que exemplificassem o uso de MAEA no processo de ensino nos cursos de graduação da área da saúde, com ênfase na realidade brasileira. A busca foi realizada através das bases de dados PubMed, SciELO e BVS, nas quais foram selecionados artigos científicos de relatos de experiência em português. Os resultados relatados nos artigos foram positivos em relação ao uso das MAEA no processo de ensino em saúde durante a graduação (AU)

In the last decades, the training of health professionals has become an important point to be discussed. The new professional required by the latest curricular reforms in health courses has a humanist, critical and reflective profile, to work at all levels of health care. In spite of this, the education of health professionals is still mostly based on a fragmented model of knowledge, disregarding the needs of action in practice. In this context, active teaching-learning methodologies (ATLM) propose challenges to be overcome by students, enabling them to act as subjects in the construction of knowledge. The aim of this study was to select and categorize articles available in scientific journals that exemplify the use of ATLM in the teaching process in undergraduate courses in the health area, with focus on the Brazilian reality. The search was carried out through PubMed, SciELO and BVS databases, from which scientific papers presenting experience reports in Portuguese were selected. The results reported in the articles were positive regarding the use of ATLM in the health teaching process during undergraduate studies (AU)

Componentes Determinantes na Escolha da Especialização em Novos Profissionais Médicos / Decisive Factors in the Career Choices of New Medical Professionals

Na edição de volume 38, número 2, versão online desta revista, Corsi e colaboradores apresentaram um texto muito elegante sobre os fatores que influenciam os alunos na escolha da especialidade médica. Este tema vem sendo abordado com grande frequência nas discussões do nosso Curso de Prática Educativa em Medicina, da Universidade Federal do Rio Grande do Sul, coordenado pelos professores Manfroi e Machado. A respeito deste assunto, temos algumas considerações sobre a nova geração de profissionais médicos e sua relação com o autodesenvolvimento profissional.

In volume 38, number 2, of the online version of this magazine, Corsi et al. presented a very elegant piece about the factors that influence students in their choice of medical specialty. This issue has been frequently addressed in discussions on our Course in Education Practice in Medicine at the Federal University of Rio Grande do Sul, coordinated by professors Manfroi and Machado. Regarding this matter we have some thoughts on the new generation of medical professionals and their relationship with professional self-development.

Aplicación de la Psicoterapia Sistémica en la Atención Primaria de Salud Municipio de Las Tunas / Application of Systemic Psychotherapy in Health Primary Attention Las Tunas Municipality

Se realizó un estudio de intervención con un grupo de pacientes neuróticos en tratamiento ambulatorio, del municipio de Las Tunas, donde se empleó como modalidad terapéutica la Psicoterapia Sistémica de Modificación de Predisposiciones, con el objetivo de modificar las actitudes y los síntomas básicos. En la consulta externa de psiquiatría se seleccionaron a los pacientes que integrarían el grupo de psicoterapia, entre los meses de octubre a diciembre del año 2009, con las características de tener un coeficiente intelectual normal, que no presentaran síntomas obsesivos, ni organicidad cerebral. El grupo de trabajo estuvo formado por psiquiatras, un psicólogo clínico, psicometristas y una enfermera psiquiátrica. A todos los pacientes se les realizó una entrevista, con los objetivos de selección y diagnóstico, se les llenó una encuesta teniendo en cuenta los objetivos propuestos y se les indicaron pruebas psicológicas. El grupo se reunió con una frecuencia semanal, empleando un tiempo de hora y media, durante seis meses, de enero a junio de 2010. Se logró la modificación de los síntomas básicos en los pacientes del estudio con esta forma de psicoterapia, valorando también la modificación de actitudes en relación a las problemáticas fundamentales. Se recomienda el tratamiento en este medio, teniendo en cuenta sus características y lo que se quiere lograr, donde los enfermeros y técnicos de salud tengan un papel activo y que además de la modificación sintomática, se mejore la forma de actuar en la vida ante situaciones de conflicto (AU)

A study of a group of neurotic patients was carried out in ambulatory treatment in Las Tunas municipality; the systemic psychotherapy of modification of predispositions was the therapeutic form used with the objective of modifying their attitudes and basic symptoms. The patients for the psychotherapy group were selected from October to December, 2009, with the characteristics of having a normal intelligence quotient and not showing obsessive symptoms or organic mental disorder. The group of work was made up by psychiatrists, a medical psychologist, psychometry technicians, and a psychiatric nurse. All the patients were applied an interview by the members of the team with the objective of selection and diagnosis; a survey was filled in with the objectives proposed, and they were indicated psychological tests. The group gathered together for an hour and a half once each week for a period of six months, from January to June, 2010, considering it necessary to achieve the objectives proposed. The patients basic symptoms were modified with this kind of psychotherapy, also valuing the attitude modifications in relation to the main problems. This type of treatment is recommended, having into account its characteristics and what is to be achieved, where nurses and health technicians have an active role, and where, at the side of the symptomatic modification, the way of acting in life situational conflicts is also improved (AU)

Long-term outcome of patients after a single interruption of antiretroviral therapy: a cohort study.

BACKGROUND: To describe the long term outcome of patients who interrupted highly active antiretroviral therapy (HAART) once, identify the variables associated with earlier need to re-start HAART, and the response when therapy was resumed. A retrospective observational cohort of 66 adult patients with HIV-1 infection who interrupted HAART with a CD4+cell count ≥ 350 cells/µL and undetectable viral load (VL) was performed. The pre-established CD4+ cell count for restarting therapy was 300cells/µL. Cox regression was used to analyse the variables associated with earlier HAART reinitiation. RESULTS: The median follow-up was 209 weeks (range, 64-395). Rates of HIV-related or possible HIV-related events were 0.37 (one case of acute retroviral syndrome) and 1.49 per 100 patient-years, respectively. Two patients died after re-starting therapy and having reached undetectable VL. Three patients suffered a sexually transmitted disease while off therapy. Fifty patients (76%) resumed therapy after a median of 97 weeks (range, 17-267). Age, a nadir of CD4+ <250 cells/µL, and a mean VL during interruption of >10,000 copies/ml were independent predictors for earlier re-start. The intention-to-treat success rate of the first HAART resumed regimen was 85.4%. There were no differences by regimen used, nor between regimens that were the same as or different from the one that had been interrupted. CONCLUSIONS: Our data suggest highly active antiretroviral therapy may be interrupted in selected patients because in these patients, when the HAART is restarted, the viral and clinical response may be achieved.

Paralelo entre a relação professor-aluno e a relação médico-paciente / A comparision between teacher-student and physician-patient relations

A relação professor-aluno e a relação médico-paciente têm vários pontos em comum, na medida em que ambas são caracterizadas como relações humanas. Pontos notórios que permeiam os dois tipos de interação são as questões do trabalho sobre o outro, da relação de poder e da onipotência, que são exploradas ao longo do texto

Alcoholismo y homicidio: presentación de un caso / Alcoholism and homicida: a case presentation

La influencia del alcohol en las conductas delictivas se hace evidente por los efectos nocivos del tóxico a nivel de la conciencia, favoreciendo la pérdida de control, con cambios conductuales que generan impulsividad y agresividad, lo que puede conducir al delito. Se hace la presentación integral de un caso interesante en la práctica médica, con énfasis en la clínica y los antecedentes, los que se recogen a través de un estudio profundo en el paciente y su medio. Con el objetivo de realizar su examen y evaluación, después de la solicitud de peritaje, se procedió al peritaje legal psiquiátrico, donde se le realizó Historia Clínica Psiquiátrica y examen psiquiátrico directo. Se le realizó una batería de pruebas psicológicas por un equipo de Salud Mental, formado por dos psiquiatras, un psicólogo, un especialista de Medicina Legal, psicometristas y trabajadora social, así como un electroencefalograma, utilizando como instrumento pericial la autopsia psicológica de un paciente con un terreno meioprágico cerebral, que después de la ingestión de bebidas alcohólicas cometió el homicidio de un tío e hirió a otro familiar más. Para el alcoholismo se realizó el Cuestionario de Indicadores Diagnósticos y se dio por resultado un Consumo Perjudicial. Se concluyó el caso como un Alcoholismo Primario, sin dependencia, en un Síndrome Cerebral Orgánico Crónico; siendo importante en el manejo integral de estos pacientes, la prueba de alcoholemia en sangre el día en que se comete el delito y la valoración integral del caso por Psiquiatría y Medicina Legal(AU)

The incidence of alcohol in criminal behaviour becomes evident by the harmful effects of this toxic substance at the conscience level. It favours the loss of control, with behaviour changes that provoke impulsiveness and aggressiveness that can lead to crime. The integral presentation of a case with medical practice interest is made, marking emphasis on the clinical method and the antecedents. They were collected by means of a deep study of the patient and his environment. In order to carry out the examination and evaluation, after the experts report request, the psychiatric experts report was made taking the Psychiatric Clinical History and making the direct psychiatric examination. A set of psychological tests were applied by a mental health team composed of two psychiatrists, a psychologist and a social worker. An electroencephalogram was used as well as the psychological autopsy as the expert instrument, in a patient with a cerebral meiopragia, who, after the consumption of alcoholic beverages, killed an uncle and injured another relative. To check alcoholism, the Questionnaire of Diagnostic Indicators was carried out resulting in Damaging Consumption. It was concluded that the case was of primary alcoholism, without dependence, in a Chronic Organic Cerebral Syndrome, being the most important tools in the management of this patients the test of blood alcohol level on the day when the crime is committed, and the integral evaluation of the case by Psychiatry and Forensic Medicine(AU)

A extensão universitária na Famed/UFRGS: cenário de formação profissional / Academic extension activities at the UFRGS school of medicine: a professional training scenario

Este estudo objetiva desenvolver e aplicar uma metodologia de pesquisa que oportunize a análise das ações de extensão realizadas pelos docentes da Famed/UFRGS no período de 2000 a 2004. A pesquisa, qualitativa, utiliza estudo de caso, análise do conteúdo de entrevistas e documentos, e faz um mapeamento das ações quanto a plano acadêmico, relação universidade/sociedade e produção acadêmica. Os resultados obtidos explicitam a prática da extensão desenvolvida pelos docentes que participaram do estudo neste período como um espaço de interação entre professor/aluno/comunidade em cenários de produção/construção do conhecimento, contribuindo para formar um profissional comprometido com a realidade social, como preconizam as diretrizes curriculares da saúde e da medicina em particular. A metodologia proposta propiciou conhecer os cenários onde se desenvolvem as atividades e a interação presente nas ações de extensão com a graduação, a pós-graduação e a pesquisa.

This study aimed to develop and apply are search methodology allowing the analysis of extension activities by faculty members from the School of Medicine of the Federal University in Rio Grande do Sul, Brazil, from 2000 to 2004. This qualitative research used a case study approach and content analysis of interviews and documents, besides mapping the activities in relation to the course plan, the relationship between the university and society, and the school's academic output. The results reveal the extension activities practiced by faculty members participating in the study during this period as a space for interaction between faculty, students, and the community in scenarios involving the production and construction of knowledge, contributing to the training of physicians committed to the social reality, as recommended by health curriculum guidelines and specifically those for medicine. The proposed methodology helped shed light on scenarios in which the extension activities take place, as well as on the interaction between extension, undergraduate and graduate studies, and research.

O papel do preceptor no ensino médico e o modelo preceptoria em um minuto / The preceptor's role in medical teaching and the one-minute preceptor model

O ensino médico é extremamente importante na determinação da qualidade técnica dos futuros profissionais. Embora o Brasil apresente legislação específica sobre o tema, observamos discrepâncias no processo de aprendizado, o que, muitas vezes, compromete a formação dos futuros médicos. Além disso, métodos de ensino tradicionais, baseados fundamentalmente no diagnóstico de problemas, são ainda praticados em várias faculdades. Estes métodos relegam preceitos educacionais e, muitas vezes, colocam os estudantes em papel secundário. Nessa perspectiva, apresentamos um promissor método de ensino médico chamado Preceptoria em um Minuto (One-Minute Preceptor), salientando seu papel voltado ao profissional em formação. Destacamos também a importância deste método por permitir o ensino em tempo relativamente limitado, frente à crescente demanda por atendimentos.

Medical teaching is extremely important for determining the quality of future professionals. Although Brazil has specific legislation on the subject, discrepancies have been observed in the learning process, often jeopardizing the training of future physicians. Furthermore, traditional teaching methods, based mainly on the diagnosis of problems, are still practiced in various medical schools. These methods ignore fundamental rules of education and relegate students to a secondary role. From this perspective, we present a promising method for medical education called the One-Minute Preceptor, emphasizing its role for in-training medical professionals. We also emphasize its importance for teaching in a time-limited scenario, due to the growing demand for care.

Estratégias para a implementação de um projeto de pós-graduação em Educação e Saúde na Faculdade de Medicina da Universidade Federal do Rio Grande do Sul / Strategies for implementation of a Graduate Program in Education and Health in the Medical School of the Federal University of Rio Grande do Sul

Descrevem-se as estratégias empregadas para implementar uma linha de pesquisa em Educação e Saúde nos nove programas de pós-graduação já consolidados na Faculdade de Medicina da UFRGS. A linha está centrada na organização do trabalho pedagógico nos processos de ensinar e de aprender e capacitar docentes para atender às necessidades de formação multiprofissional. A curto prazo, objetiva atender às necessidades das Diretrizes Curriculares no curso de graduação em Medicina; a médio prazo, à titulação e qualificação do corpo docente nestes campos temáticos; a longo prazo, à implementação de um programa de pós-graduação em Educação e Saúde, em nível de mestrado e doutorado. A primeira turma ingressou em agosto de 2004 (seis alunos de mestrado e seis de doutorado), e seus estudos vêm sendo realizados, tanto na teoria como na prática, com base na análise de experiências em Educação e Saúde.

The authors describe the strategies used for establishing a research line in Education and Health in addition to the nine master's and doctorate programs already existing in the Medical School of the Federal University of Rio Grande do Sul. The research line is centered on organizing the pedagogical activity as refers to the teaching and learning processes as well as on qualifying teachers for meeting the demands of multi-professional education. The Project aims at meeting, in the short run, the need for Curricular Guidelines in the undergraduate medical course; in the middle run at qualifying the teaching body for these subjects; and in the long run, at implementing a Graduate Program in Health and Education on master and PhD levels. The first group of students was selected in August 2004 and their studies are being conducted, both theoretically and practically, based on the analysis of experiences on Education and Health.

Effects of oxymorphone and hydromorphone on the minimum alveolar concentration of isoflurane in dogs.

OBJECTIVES: To quantify the change in the minimum alveolar concentration (MAC) of isoflurane (ISO) associated with oxymorphone (OXY) or hydromorphone (HYDRO) in dogs. DESIGN: Randomized crossover study with at least 1 week between assessments. ANIMALS: Six young, healthy, mixed-breed dogs (1-3 years old), weighing 24.7 +/- 4.70 kg. METHODS: Following mask induction, anesthesia was maintained with ISO in 100% O(2) using mechanical ventilation. The dogs received 0.05 mg kg(-1) OXY, 0.1 mg kg(-1) HYDRO, or 1 mL saline (control) IV. Following equilibration (15 minutes) at each percentage ISO tested, a supramaximal electrical stimulus was applied to the toe web and the response was assessed. Two separate MAC determinations were carried out during 4.5 hours of anesthesia, with completion of the evaluations at 1.5-2 and 4-4.5 hours after drug administration. A two-factor anova was used to determine whether there was a time or treatment effect on MAC and a Tukey test compared the drug effects at each time. Significance is reported at p < 0.05. RESULTS: The mean MAC values (+/-SD) were 1.2 +/- 0.18 and 1.2 +/- 0.16% for control, 0.7 +/-0.15 and 1.0 +/- 0.15% for OXY, and 0.6 +/- 0.14 and 0.8 +/- 0.17% for HYDRO. The initial MAC with OXY and the MAC determined at both times with HYDRO were significantly different from the control MAC values. CONCLUSIONS: Both OXY and HYDRO significantly reduced the MAC of ISO in dogs at 2 hours. At approximately 4.5 hours, HYDRO had a significant MAC-sparing effect, whereas OXY did not. CLINICAL RELEVANCE: Although both OXY and HYDRO resulted in a significant reduction in the MAC of ISO at approximately 2 hours, HYDRO may be preferred for procedures of long duration and rarely needs repeated dosing before 4.5 hours.

Dos variantes de tratamiento comunitario del paciente alcohólico / Two variants of communitarian treatment of the alcoholic patient

Se realizó un estudio prospectivo sobre pacientes alcohólicos en la comunidad, comparando dos variantes de tratamiento, midiendo su efectividad con relación al tiempo de abstinencia del alcohol y la incorporación laboral de los mismos. A un grupo se le aplicó tratamiento en la forma tradicional en el Policlínico, sin instrumentos específicos, con psicoterapia individual y psicofármacos para los que presentaban alteraciones psíquicas. Al otro atendido en el Centro de Salud Mental, el tratamiento radicó en la utilización de instrumentos con enfoque psicológico, psicoterapia individual y de grupo, dinámicas de familia y psicofármacos para los que tenían alteraciones psíquicas. El grado de significación estadística estuvo dado por el test de Chi Cuadrado y P menor que 0,05. La efectividad del tratamiento del paciente alcohólico en la comunidad se logró en relación a perfeccionar su atención específica en forma sistemática, con lo que se obtuvo mayor tiempo de abstinencia y mejor incorporación laboral. Se comparan grupos y se presentan los resultados en tablas. Por la complejidad del tratamiento ambulatorio del paciente alcohólico, se recomienda esta modalidad en la atención primaria(AU)

Evaluation of induction by use of a combination of oxymorphone and diazepam or hydromorphone and diazepam and maintenance of anesthesia by use of isoflurane in dogs with experimentally induced hypovolemia.

OBJECTIVE: To compare induction with hydromorphone and diazepam (HydroD) or oxymorphone and diazepam (OxyD) followed by maintenance with isoflurane in dogs with induced hypovolemia. ANIMALS: 6 healthy mixed-breed dogs. PROCEDURE: The study used a crossover design. Measurements were obtained in normovolemic dogs during isoflurane. Hypovolemia was induced (blood loss of 30 mL/kg) and measurements repeated following recovery from anesthesia, after HydroD (hydromorphone, 0.1 mg/kg; diazepam, 0.2 mg/kg; i.v.) or OxyD (oxymorphone, 0.05 mg/kg; diazepam, 0.2 mg/kg; i.v.), after another dose of the same opioid, during administration of isoflurane (end-tidal concentration, 0.9%), and after glycopyrrolate (0.01 mg/kg, i.v.). Significant changes were identified. RESULTS: Induction effect was evident within 1 minute. All dogs were intubated after the second dose of opioid. No significant differences were found between inductions. The HydroD decreased heart rate (mean +/- SEM, -41 +/- 9.8 beats/min), whereas both inductions increased stroke index (0.4 +/- 0.09 mL/kg/beat) and caused moderate respiratory depression. Cardiac index was decreased (-30.2 +/- 6.04 mL/kg/min) and there was minor metabolic acidosis during isoflurane following HydroD, compared with values for anesthetized normovolemic dogs. Glycopyrrolate increased heart rate (50 +/- 8.6 beats/min) and decreased systolic blood pressure (-23.2 +/- 4.87 mm Hg) in dogs induced with HydroD and decreased stroke index (-0.3 +/- 0.08 mL/kg/beat) for both inductions. CONCLUSIONS AND CLINICAL RELEVANCE: Similar effects were detected after administration of HydroD or OxyD in hypovolemic dogs. Either combination should be safe for use in hypovolemic dogs. Administration of glycopyrrolate was not beneficial.

Ver, sentir, perceber: o Instituto de Pesquisas Jardim Botânico do Rio de Janeiro na visão de seu associado

Este estudo se desenvolve no Jardim Botânico do Rio de Janeiro, e tem por objetivo analisar a percepção ambiental e a interpretação ambiental de um tipo específico de público, uma vez que este público usufrui regularmente das dependências do JBRJ e desenvolve com ele, uma relação muito próxima, visando entender: (1) o papel da Instituição na conservação ambiental e; (2) porque o JBRJ foi o escolhido como uma área de lazer, saúde e contemplação e não uma outra área verde similar existente nas proximidades do bairro. O público selecionado são os sócios da Associação de Amigos do Jardim Botânico do Rio de Janeiro e a metodologia adotada consiste no levantamento das percepções do grupo através de entrevistas semi-estruturadas e questionários. Esse método foi adotado por caracterizar uma relação de interação onde ambos os atores, pesquisador/pesquisado, se influenciam mutuamente. A entrevista permite que a comunicação flua livremente e carregue, agregada a ela, uma gama variada de informações captadas imediatamente. Este método qualitativo de análise atende aos objetivos desta pesquisa, por ser considerado flexível, pois permite melhor aproveitamento dos dados de campo para avaliar o quê, como, porquê e quando o JBRJ é procurado por seus associados. Este estudo poderá, portanto, contribuir para incrementar as várias ações a que não só o JBRJ se propõe, mas outras instituições similares, ou seja, conhecer o seu público, torná-lo um indivíduo ativo e participativo dentro de seus limites, e alcançar a tão almejada meta, - tornar o indivíduo comum um agente participativo nas ações voltadas à conservação ambiental e disseminação do conhecimento científico (AU)

Intervención familiar sobre la conducta suicida en la policlínica “Manuel Piti Fajardo año 2002 / Family intervention on suicidal behaviour at Manuel Piti Fajardo Policlinic 2002

Se realizó un estudio de intervención para precisar la eficacia de una estrategia de intervención familiar en la atención de individuos con intentos suicidas, de edad mayor o igual a 18 años en la Policlínica “Manuel Pity Fajardo” del municipio las Tunas, la muestra estuvo constituida por 25 individuos. Se realizaron acciones de salud sobre el individuo: tratamiento de las enfermedades físicas y mentales subyacentes a través de psicofármacos y psicoterapia breve. La familia: se mejoró el funcionamiento mediante la psicoterapia de familia. A los resultados se le realizaron pruebas de significación estadísticas (Test de Análisis de Proporciones). Con la intervención se reajustaron los factores desencadenantes de la conducta suicida, modificación de actitudes respecto al conflicto (76 por ciento). El funcionamiento familiar mejoró significativamente (Test de Percepción de funcionamiento familiar). La evolución de los pacientes dispensarizados fue favorable en el 88(AU)

The need for pedagogical qualifications for teaching cardiology to undergraduate students.

OBJECTIVE: To report a training program in cardiology emphasizing changes in its pedagogical practice. These changes were put into practice by some teachers at the Medical School of Porto Alegre of the University of Rio Grande do Sul (FAMED/UFRGS) aiming to make faculty and student activities more dynamic and to promote more efficacious learning. The training program is directed at 5th semester medical students and aims at a behavioral change in teachers and students to promote more interaction, to favor exchanges, and to make the teaching-learning process easier, always maintaining the patient in the center of the medical activity. METHODS: The program emphasizes the definition of general and specific objectives for each activity to be developed by the students, with training in the area of admission to the cardiology service, with special emphasis on behavioral change in the cognitive, motor, affective, and attitudinal areas. Knowledge was developed by means of interactive seminars with initial and final assessment tests to identify students' and teachers' performance. The students were evaluated in an immediate, continuous, and progressive way in their daily activities and through comparison of the results of 2 tests, one applied at the beginning of the training and the other at its end. These 2 tests contained the same questions. RESULTS: We systematically assessed 560 students over 4 years. The mean grades of the tests performed prior to and after the 244 seminars were 7.38+/-1.66 and 9.17+/- 0.82, respectively (p<0.0001). For the tests applied at the beginning and at the end of the training, the mean grades were 5.61+/-1.61 and 9.37+/-0.90, respectively (p<0.0001). CONCLUSION: The program proved to be efficient both for the students' learning and for assessing their performance in a systematic and objective way.

The need for pedagogical qualifications for teaching Cardiology to undergraduate students / Necessidade de referências pedagógicas para o ensino de Cardiologia, no curso de graduação

OBJECTIVE: To report a training program in cardiology emphasizing changes in its pedagogical practice. These changes were put into practice by some teachers at the Medical School of Porto Alegre of the University of Rio Grande do Sul (FAMED/UFRGS) aiming to make faculty and student activities more dynamic and to promote more efficacious learning. The training program is directed at 5th semester medical students and aims at a behavioral change in teachers and students to promote more interaction, to favor exchanges, and to make the teaching-learning process easier, always maintaining the patient in the center of the medical activity. METHODS: The program emphasizes the definition of general and specific objectives for each activity to be developed by the students, with training in the area of admission to the cardiology service, with special emphasis on behavioral change in the cognitive, motor, affective, and attitudinal areas. Knowledge was developed by means of interactive seminars with initial and final assessment tests to identify students' and teachers' performance. The students were evaluated in an immediate, continuous, and progressive way in their daily activities and through comparison of the results of 2 tests, one applied at the beginning of the training and the other at its end. These 2 tests contained the same questions. RESULTS: We systematically assessed 560 students over 4 years. The mean grades of the tests performed prior to and after the 244 seminars were 7.38±1.66 and 9.17± 0.82, respectively (p<0.0001). For the tests applied at the beginning and at the end of the training, the mean grades were 5.61±1.61 and 9.37±0.90, respectively (p<0.0001). CONCLUSION: The program proved to be efficient both for the students' learning and for assessing their performance in a systematic and objective way

Meio de contraste ioversol em neuroradiologia canina / Ioversol contrast medium in canine neuroradiology

O ioversol, contraste iodado hidrossolúvel näo iônico, na concentraçäo de 320mg 1/ml foi utilizado para a realizaçäo de 26 estudos neuroradiográficos contrastados (mielografias, epidurografias, e ventriculografia cerebral) em 23 cäes. Devido à rápida absorçäo do contraste, as melhores radiografias foram obtidas nos primeiros 30 minutos. O produto ofereceu apropriadas radiopacidade, tempo de permanência, difusäo e miscibilidade no líqüor, facilitando os diagnósticos, assim como mínima ocorrência de reaçöes indesejáveis durante e após o procedimento radiológico. Apesar de terem sido utilizados para a anestesia, as associaçöes zolazepam-tiletamina e levomepromazina; xilazina ou diazepam-tiopental sódico, nenhum paciente desenvolveu convulsöes. A apresentaçäo do ioversol em frasco ampola foi também outra vantagem, por diminuir o desperdício e facilitar a reesterilizaçäo do excedente na altoclave.

Papel del hueso en la fisiopatologia de la hipercalciuria idiopatica: efecto del aminobisfosfonato alendronato / Role of the bone in the physiopathology of idiopathic hypercalciuria: effect of amino-bisphosphonate alendronate

Estudios previos de nuestro laboratorio han demonstrado una disminución del contenido mineral del hueso y una correlación entre la disminución del contenido mineral y la producción de distintas citoquinas que intervienen en el proceso de resorción ósea. Al mismo tiempo, observamos que el tratamiento a corto plazo con alendronato produce una disminución del calcio urinario en pacientes con hipercalciuria idiopática. En el presente estudio analizamos los efectos del alendronato a largo plazo (10 mg/día por un año) sobre el calcio y la hidroxiprolina urinaria y el contenido mineral óseo en 18 hipercalciúricos y 8 normocalciúricos con litiasis urinaria. Las características clínicas, así como la distribución por edades y sexo fue similar en ambos grupos. En calcio urinario disminuyó significativamente al final del primer mes y continuó bajo posteriormente (277 + 28, antes vs. 202 + 26 mg/g creatinina, después de 12 meses con alendronato, p<0.01). La hidroxiprolina urinaria disminuyó significativamente durante el estudio (125,5 + 32.1 vs. 39.66 + 17.5 mg/g creatinina, p<0.05). El calcio sérico, la filtración glomerular y el sodio urinario no se modificaron durante el estudio. La densidad mineral ósea en columna lumbar, determinada por densitometría por rayos X, se incremento significativamente el primer año de 1.162 + 0.231 a 1.197 + 0.248 g/cm2 (p<0.01). No se observaron cambios en la densidad mineral del cuello de fémur. Estos cambios se asociaron a una disminución en la transcripción del mRNA para IL-1 alpha, determinados por la reacción en cadena de polimerase (PCR), en células mononucleares no estimuladas. Los sujetos normocalciúricos no demostraron cambios significativos en la excreción urinaria de calcio. En resumen, los cambios observados en el calcio urinario y otros parámetros metabólicos óseos sugieren un papel importante del hueso en la fisiopatología de la hipercalciuria idiopática.

Papel del hueso en la fisiopatologia de la hipercalciuria idiopatica: efecto del aminobisfosfonato alendronato / Role of the bone in the physiopathology of idiopathic hypercalciuria: effect of amino-bisphosphonate alendronate

Estudios previos de nuestro laboratorio han demonstrado una disminución del contenido mineral del hueso y una correlación entre la disminución del contenido mineral y la producción de distintas citoquinas que intervienen en el proceso de resorción ósea. Al mismo tiempo, observamos que el tratamiento a corto plazo con alendronato produce una disminución del calcio urinario en pacientes con hipercalciuria idiopática. En el presente estudio analizamos los efectos del alendronato a largo plazo (10 mg/día por un año) sobre el calcio y la hidroxiprolina urinaria y el contenido mineral óseo en 18 hipercalciúricos y 8 normocalciúricos con litiasis urinaria. Las características clínicas, así como la distribución por edades y sexo fue similar en ambos grupos. En calcio urinario disminuyó significativamente al final del primer mes y continuó bajo posteriormente (277 + 28, antes vs. 202 + 26 mg/g creatinina, después de 12 meses con alendronato, p<0.01). La hidroxiprolina urinaria disminuyó significativamente durante el estudio (125,5 + 32.1 vs. 39.66 + 17.5 mg/g creatinina, p<0.05). El calcio sérico, la filtración glomerular y el sodio urinario no se modificaron durante el estudio. La densidad mineral ósea en columna lumbar, determinada por densitometría por rayos X, se incremento significativamente el primer año de 1.162 + 0.231 a 1.197 + 0.248 g/cm2 (p<0.01). No se observaron cambios en la densidad mineral del cuello de fémur. Estos cambios se asociaron a una disminución en la transcripción del mRNA para IL-1 alpha, determinados por la reacción en cadena de polimerase (PCR), en células mononucleares no estimuladas. Los sujetos normocalciúricos no demostraron cambios significativos en la excreción urinaria de calcio. En resumen, los cambios observados en el calcio urinario y otros parámetros metabólicos óseos sugieren un papel importante del hueso en la fisiopatología de la hipercalciuria idiopática. (AU)