RESUMO
We conducted a national survey of medical schools to determine the frequency of the awarding of honors to third-year clinical clerks and fourth-year subinterns in internal medicine. Of 126 schools surveyed, 86.5% responded. Of those responding, 66% award honors to their junior clerks and 47% award honors to their fourth-year students rotating on the internal medicine service. Consistent criteria do not exist among programs and even within some programs for such awards. The number of students receiving the awards or the percentage of the class that is felt to qualify for honors is also highly variable. The attainment of honors is an important criterion for residency selection as well as a positive predictor of future performance of candidates. The writing of the dean's letter, residency selection, and the date of the National Residency Matching Program results announcement are now occurring later in the academic year than previously, thus making the results of the fourth-year medicine rotations available to residency selection committees by the time choices have to be made. We conclude, therefore, that it seems useful for all medical schools to award honors not only to third-year clerks but also to senior students.
Assuntos
Distinções e Prêmios , Estágio Clínico , Educação de Graduação em Medicina , Estudantes de Medicina , Estados UnidosRESUMO
We describe a patient with panhypopituitarism whose only clinical symptoms were related to Raynaud's phenomenon. Previously described patients with Raynaud's phenomenon due to hypothyroidism had Hashimoto's thyroiditis, an autoimmune disease associated with multisystem autoimmune disorders. The occurrence of Raynaud's phenomenon in hypothyroidism without thyroiditis and its prompt disappearance with thyroid replacement therapy demonstrate that decreased thyroid function per se is a cause of this vasospastic syndrome. Raynaud's phenomenon may be an early clue to the diagnosis of hypothyroidism.
Assuntos
Hipotireoidismo/complicações , Doença de Raynaud/etiologia , Feminino , Humanos , Hipopituitarismo/complicações , Hipotireoidismo/etiologia , Pessoa de Meia-IdadeAssuntos
Diabetes Mellitus/terapia , Acetoexamida/uso terapêutico , Idoso , Clorpropamida/uso terapêutico , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/tratamento farmacológico , Dieta para Diabéticos , Ingestão de Energia , Pé , Educação em Saúde , Humanos , Higiene , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Fenformin/uso terapêutico , Compostos de Sulfonilureia/efeitos adversos , Compostos de Sulfonilureia/uso terapêutico , Tolbutamida/uso terapêuticoRESUMO
Two patients with Raynaud's phenomenon were found to be hypothyroid and their symptoms disappeared with thyroid replacement therapy. Vascular reactivity studies in one patient demonstrated decreased vasomotor tone after therapy. Raynaud's phenomenon may be an expression of altered autonomic function in hypothyroidism.
