Thorax ultrasound in the management of pediatric pneumonias complicated with empyema

The aim of this work is to prospectively study the value of thoracic ultrasound (US) before pleural drainage in children with parapneumonic effusion (PPE). All children hospitalized for PPE, identified by thoracic radiography, underwent US to assess pleural loculation, echogenicity, and pleural fluid quantity. From August 2001 to July 2003, 52 children were examined. US was performed on 48 of these children, of whom 35 received chest tube drainage and 13 only received clinical treatment. US identified 38 patients with free flowing and 10 with loculated pleural fluid. About 25 of the free flowing (65.8%) and 10 (100%) of the loculated patients received chest tube drainage. Echogenicity was anechoic in 13, echoic without septations in 17 and echoic with septations in 18. Chest tube drainage was required in 6 anechoic (46.15%), 14 echoic without septations (82.35%), and 15 echoic with septations (83.33%). Quantity of fluid estimated by US varied from 20 to 860 ml. Effusion volume was higher in patients that were echoic with septations and loculated effusions. Pleural glucose and pH were lower, and LDH was higher in loculated PPE patients. In conclusion, US is an auxiliary exam for determining whether thoracic drainage is needed in parapneumonic effusion; loculated or echoic effusion should be drained, and free anechoic fluid needs further investigation.

Complicated pneumonias with empyema and/or pneumatocele in children

To investigate the incidence, procedure type, characteristics of pleural fluid and pneumatoceles, and evolution of pneumonia complicated with empyema and/or pneumatoceles. Review of 394 pediatric pneumonia in patients at S (a) over capo Paulo State University Hospital during 2 years. We studied those with complications such as pleural effusion and pneumatocele. There were 121 (30.71%) with complications such as pleural effusion and pneumatocele; these were significantly higher in infants. One hundred and six children were needle aspirated, of these 78 underwent drainage, and 15 observation only. From the drained, seven needed thoracotomy or pleurostomy. Fluid was purulent in 50%, and pneumatoceles were seen in 33 cases (8.3%) with spontaneous involution in 28 (85%). Pleural fluid culture was negative in 51% cases; in positive cultures, Streptococcus pneumoniae was the most common agent. Complicated pneumonia incidence was higher in the second year of life and more than 70% occurred before 4 years of age. Closed thoracic drainage was effective in over 90%. Large effusions and mediastinal deviations were submitted to more aggressive procedures. Pneumatoceles predominated in the under 3s and were generally evident in the first chest X-ray. Most cases had spontaneous pneumatocele involution, and in almost half the cases were still present at drain tube removal.

Pneumonias

Pneumonia is an infectious disease with great morbidity and mortality worldwide. According to the current guidelines recommendations the authors reviewed the treatment of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). In this paper will be presented data about etiology, clinics and diagnostic tools. © Copyright Moreira Jr. Editora.

Pneumonias

Pneumonia is an infectious disease with great morbidity and mortality worldwide. According to the current guidelines recommendations the authors reviewed the treatment of community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP). In this paper will be also presented data about etiology, clinics and diagnostic tools. © Copyright Moreira Jr. Editora.

Pesquisa em educação ambiental: a atividade de campo em teses e dissertações

Pós-graduação em Educação - IBRC

A dimensão valorativa da educação ambiental na formação continuada de professores apresentada em teses e dissertações brasileiras

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A ética ambiental na produção teórica (dissertações e teses) em educação ambiental no Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Os projetos de Educação Ambiental desenvolvidos nas escolas brasileiras: análise de diissertações e teses

Pós-graduação em Educação - IBRC

Análise da produção acadêmica constante no banco de teses da Capes segundo o assunto educação de surdos (2005-2009)

Pós-graduação em Educação Escolar - FCLAR

Compreensões elaboradas pelo campo da educação ambiental sobre o tema mudanças climáticas: análise de dissertações e teses brasileiras

Pós-graduação em Educação - IBRC

A representação do ato de ensinar: continuidades e rupturas da concepção de ensino na pedagogia tradicional, na psicologia histórico-cultural e na pedagogia histórico-crítica : uma análise a partir das teses e dissertações no Portal da CAPES

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

As práticas das professoras alfabetizadoras como objeto de investigação: teses e dissertações de programas de pós-graduação em educação do estado de São Paulo (1980 a 2005)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O uso de jogos no ensino e aprendizagem de Matemática nos anos iniciais do Ensino Fundamental: levantamento de teses e dissertações

Pós-graduação em Educação - FCT

Dissertações e teses da pós-graduação em educação na Unesp-Campus de Marília: um estudo das citações e cocitações (2004 a 2009)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)