Background: Histological grading typically reflects the biological behavior of solid tumors, thus providing valuable prognostic information. This is also expected in Hepatocellular Carcinoma (HCC), although limited access to biopsy samples and a lack of standardization might hinder its full predictive value in this cancer. Objectives: In order to better understand the current practices of histological grading in HCC, we examined the latest publications addressing its impact on the outcome of patients following surgical treatment. Methods: We searched the PubMed (MEDLINE) database under the headings “hepatocellular carcinoma”, “grade OR grading”, and “prognosis”. Qualitative and quantitative assessment of publications was performed according to the reference they used to grade their tumors (e.g. Edmondson-Steiner, World Health Organization). Results: We reviewed a total of 216 articles: 114 enclosed adequate information and were included herein. Among those, we found divergences as well as inaccuracies in the histological grade assessment of this cancer, which might have led to a non-standardized grade distribution, with further impact on data analysis. Nevertheless, in most of them, poor tumor differentiation correlated with worse prognosis, expressed by lower overall and/or disease-free survival. Conclusions: While histological grading of HCC has an important prognostic role, there is an unsatisfactory heterogeneity on the microscopic assessment of this tumor, urging for a movement towards standardization.

To determine the reasons for choosing the medical profession by interviewing freshmen medical students from the Faculty of Medicine, University of São Paulo and investigating their socio-economic and psychological profiles, as well as to determine whether there are gender differences. One hundred and sixty three freshmen medical students answered a questionnaire regarding their socio-economical profile. Of those, 30 female and 30 male students underwent a face-to-face interview regarding the career choice, the Thematic Apperception Test (TAT) and the 16 Personality Factor Questionnaire (16 PF). The results were analyzed qualitatively and by Mann-Whitney, chi2, Fisher's Exact, and r(p) coefficient tests. Most students were middle class, catholic, and had physicians in their families. Students of both genders had made an: early choice of the medical career and a persistence in taking exams many times, even after being discouraged. They also showed an awareness of the difficulties and limitations in developing their careers. The study revealed a strong valuation of the humanistic aspects of medicine; openness to new experiences; a deep personal identification with the choice of profession; a critical need for fulfillment in their careers; and conscious and unconscious desires to help people and be recognized for their usefulness, without being narcissistic. Female students were more sensitive (P <.001) and less imaginative (P = .005) than male students, who were more utilitarian and less grounded; female students tended to present greater emotional maturity while male students presented a greater tendency towards competition, and were more ambitious. Students of both genders have similar socio-economical profiles and features regarding their motivations for choosing the medical profession. Slight differences were found regarding some psychological aspects.

Objective: To evaluate the effectiveness of acupuncture for fibromyalgia. Methods: Fifty-eight wome...

OBJECTIVE: It is an accepted fact that confinement conditions increase the risk of some infections related to sexual and/or injecting drugs practices. Mathematical techniques were applied to estimate time-dependent incidence densities of HIV infection among inmates. METHODS: A total of 631 prisoners from a Brazilian prison with 4,900 inmates at that time were interviewed and their blood drawn. Risky behavior for HIV infection was analyzed, and serological tests for HIV, hepatitis C and syphilis were performed, intended as surrogates for parenteral and sexual HIV transmission, respectively. Mathematical techniques were used to estimate the incidence density ratio, as related to the time of imprisonment. RESULTS: Prevalence were: HIV -- 16%; HCV -- 34%; and syphilis -- 18%. The main risk behaviors related to HIV infection were HCV prevalence (OR=10.49) and the acknowledged use of injecting drugs (OR=3.36). Incidence density ratio derivation showed that the risk of acquiring HIV infection increases with the time of imprisonment, peaking around three years after incarceration. CONCLUSIONS: The correlation between HIV and HCV seroprevalence and the results of the mathematical analysis suggest that HIV transmission in this population is predominantly due to parenteral exposure by injecting drug, and that it increases with time of imprisonment.