In the October 2005 issue of Clinics

EDITORIAL

In the October 2005 issue of Clinics

Mauricio Rocha-e-Silva, Editor

Hospital das Clínicas, Faculty of Medicine, University of São Paulo – São Paulo/SP, Brazil. E-mail: [e-mail]

In this fifth issue of CLINICS, we highlight a study by Tomic et al. on progress testing, a longitudinal tool which evaluates the learning curve of medical students through their medical school years. Identical tests were administered twice a year from 2001 to 2004 to 1^st to 6^th year students at the School of Medicine, University of São Paulo and show cognitive gains to be a continuous variable throughout the course (highly significant for trend) for basic sciences, clinical sciences, and clerkship rotation. There was no difference between the performance of men and women. Overall averages hint at early gains in basic sciences, with no loss throughout the course and at a strong terminal increment for clerkship rotation knowledge. Progress testing has now become a routine procedure, applied twice a year, as a tool for internal control of quality.

Benvenutti et al. investigated different patterns of atherosclerotic remodeling in the thoracic and abdominal aorta through the relationship between the vascular diameter and the extent and histological characteristics of the aortas of 19 patients who died of atherosclerotic disease. The extent of plaques, calcification, ulceration, thrombosis, and the amount of fat in the plaques were evaluated semiquantitatively. Atherosclerosis was more severe in the abdominal than the thoracic aorta; thoracic aorta atherosclerosis was associated with fat deposition in the plaques, inducing arterial dilation, while in the abdominal aorta, atherosclerosis can either have a similar evolution or be associated with less fat deposition, which would result in more rigidity, hindering compensatory arterial enlargement.

Zerati et al. studied the immediate and late results obtained with the implantation of permanent vena cava filters in 50 patients with an association of cancer and deep venous thrombosis who underwent interruption of the inferior vena cava and conclude that the endoluminal filter is associated with a low rate of complications, and may be described as a safe and efficient measure for preventing pulmonary embolism in cancer patients who have deep vein thrombosis of the lower limbs. It should however be reserved for individuals unable to receive any type of anticoagulant drug.

Szwarcwald et al. studied HIV-related risk behavior among 30,970 Brazilian Military Conscripts, over 1997-2002 and found increased regular condom use, decreased sexual risk behavior, and unchanged HIV infection prevalence rate. Risk was higher in the south east of the country, among young men with incomplete education and among "men who have sex with men". The most important predictor of HIV infection was to be positive for syphilis.

Andrade Alegre at al. analyzed the effects of surgical treatment of traumatic esophageal perforations in 10 patients, caused by gunshot (7), blunt trauma (1) and foreign body (2). Four patients were treated within 24 hours of injury (early treatment), 6 patients were treated 60 to 168 hours after the injury (delayed treatment). Early treatment resulted in primary repair, delayed treatment resulted in various forms of secondary treatment; a longer stay in hospital and 1 death. It was concluded that every effort should be made to diagnose these injuries early, and that treatment should be aggressive and expeditious.

da Silva et al. developed a dynamic splint connected to a dynamometer and measured the flexing force in the proximal interphalangeal joint of the middle finger at various angles of flexion in 40 healthy male and female volunteers. Force was found to be maximal at the start of flexion, and to decreases as the angle of joint flexion increases. Force is related to finger length, stature, arm span, and gender. It is easily measurable and should have a place in the monitoring of rehabilitation procedures.

Baracat et al. report results on the treatment of complications (vesical and urethral perforations) following tension-free vaginal tape (TVT^®) procedure performed in 11 female patients with stress urinary incontinence. Endoscopic resection of the polypropylene tapes resulted in the complete and permanent relief of the symptoms.

Avakian et al. describe the perceptions (analyzed through a questionnaire) of 84 patients regarding their surgery for second eye cataract and found that before surgery, 60.7% complained about moderate or marked visual impairment; after surgery, 92.8% had no difficulty. Routine activities, mobility, and leisure activities were significantly improved (P =.001).

Ruano et al. review the main randomized control trials on the prevention of preeclampsia with low-dose aspirin and Da Luz et al. review the noninvasive detection of coronary artery disease. We also publish two case reports.

Publication Dates

• Publication in this collection
  24 Oct 2005
• Date of issue
  Oct 2005