Recent years have witnessed a substantial increase in the number of seric determinations of vitamin D, in a worldwide basis. At Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo that increase reached 700% over the last four years. Nevertheless there are many controversies on the literature about the role of vitamin D in conditions unrelated to the musculoskeletal system. In this study the metabolism, sources and actions of vitamin D on the body are reviewed. Observational studies, clinical trials, systematic reviews and metanalysis which focused on the relationship between the vitamin and conditions such as cancer, cardiovascular disease, diabetes and falls were searched on the literature, analyzed and discussed. Results are presented as quiz and answer, tables and a figure. The role of vitamin D on the above-mentioned conditions is discussed, and the controversial issues stressed.
C-reactive protein (CRP) is an acute-phase protein whose requests have been growing exponentially in several countries, including Brazil. In this study, the use of CRP in several clinical situations was reviewed by a group of physicians comprised by specialists in internal medicine, medical emergencies, intensive care, screening, and laboratory medicine, aiming to analyze the applicable literature and to propose guidelines for a more rational use of this laboratory test. The result was the creation of flowcharts guiding CRP request, adjusted to four different healthcare environments, namely, intensive care units, emergency room, wards, and outpatient clinics. These flowcharts, as well as a more detailed discussion on several clinical recommendations for the test, are presented in this study.
High-pressure infusion of normal saline into the biliopancreatic duct of rats results in significant pancreatic and lung alterations. These changes are worse in the presence of sodium taurocholate.
O Aprendizado Baseado em Problemas (ou “Problem Based Learning – PBL”) é uma técnica de ensino que utiliza problemas (que podem ser casos clínicos, problemas epidemiólogicos, dilemas éticos etc) a serem discutidos em um grupo relativamente pequeno de alunos. Em aplicação em vários centros universitários desde a década de 1960, dois grandes centros são referência no mundo todo: asuniversidades de McMaster, no Canadá e a de Maastricht, na Holanda. Nesses grupos, chamados grupos tutoriais, todos dão sua contribuição e, ao final, objetivos de estudo são delimitados. Depois, fora do grupo tutorial, os objetivos são estudados utilizando os meios à disposição (biblioteca, consulta a especialistas, Internet) sendo rediscutidos em outro grupo tutorial. Currículos baseados nessa técnica deensino são habitualmente estruturados em blocos e não mais em disciplinas tradicionais, além de contarem com espaços livres na grade curricular para que o aluno possa estudar. Apesar das vantagens sobre os métodos tradicionais como por exemplo tornar o aluno mais independente na busca do conhecimento, permitir maior integração entre as disciplinas, implicar em capacitação constante do corpo docente,aparentemente os alunos formados por esse método não apresentam vantagens sobre os alunos de métodostradicionais nas provas e concursos realizados imediatamente ao final do curso médico, mas alguns estudos sugerem maior retenção do conhecimento após um ano.
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