661 resultados para Multidisciplinary Residency
em Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP)
Resumo:
This paper presents a rational approach to the design of a catamaran's hydrofoil applied within a modern context of multidisciplinary optimization. The approach used includes the use of response surfaces represented by neural networks and a distributed programming environment that increases the optimization speed. A rational approach to the problem simplifies the complex optimization model; when combined with the distributed dynamic training used for the response surfaces, this model increases the efficiency of the process. The results achieved using this approach have justified this publication.
Resumo:
Purpose: To evaluate prospectively the actual bladder perforation incidence during transurethral resection of bladder tumor (TURB) performed by residents and to identify possible predisposing factors to such condition. Patients and Methods: Thirty-four patients with bladder tumor were submitted to TURB in our academic institution in April 2006, and were prospectively studied. Procedures were all done by senior residents under an attending direct supervision. All patients had a cystograms performed after the procedure by the injection of 400 mL of saline-diluted contrast solution with low-pressure infusion through the Foley catheter. The cystograms were evaluated blindly by a single radiologist. All patients were examined by cystoscopy and/or CT every 3 months for the first 2 years postoperatively. Results: The cystogram showed contrast leaking compatible with bladder perforation in 17 (50%) cases. None of the perforations were recognized intraoperatively by the surgeon. All perforations were extraperitoneal and managed conservatively. There was no significant correlation between the incidence of bladder perforation and the patient age (p = 0.508), the tumor stage (p = 0.998), the tumor grade (p = 0.833), the number of lesions (p = 0.394), and the tumor size (p = 0.651). The only factor that had impact on the development of bladder perforation was tumor localization at the bottom of the bladder (p = 0.035; OR, 6750; 95% CI, 1.14, 39.8). Conclusion: Asymptomatic perforations of the bladder wall occur very frequently after a TURB procedure performed by residents in training and, most of the time, are not noticed by the surgeon. Localization of the tumor at bladder dome was the only factor that negatively influenced perforation rates.
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An anterior open occlusal relationship and diastemata may negatively interfere with the harmony of the smile, often requiring a multidisciplinary intervention. This clinical report presents an integrated orthodontic, periodontal, and restorative solution for an anterior open occlusal relationship associated with multiple diastemata and discusses the most relevant aspects related to Its etiology and treatment planning.
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Cytogenetic data have provided important clues that the Astyanax fasciatus populations from the Upper Parana River basin could be a part of a more diverse fish group, usually included on the same taxa. Samples collected in Cachoeira de Emas, SP, in Mogi-Guacu River basin, show two major cytotypes presenting 2n = 46 and 2n = 48 chromosomes, with distinct karyotypic formula, despite the fact that the molecular data suggested some degree of gene flow between these cytotypes. Cytogenetic and morphometric analyses were performed in this species, aiming to contribute to the understanding of the natural history from such fish group. Two allopatric populations with distinct standard cytotypes were analysed, and the data obtained suggest the separation into two groups. (c) 2008 The Authors Journal compilation (c) 2008 The Fisheries Society of the British Isles.
THE EXTENT OF MULTIDISCIPLINARY AUTHORSHIP OF ARTICLES ON SCIENTOMETRICS AND BIBLIOMETRICS IN BRAZIL
Resumo:
The publications in scientometrics and bibliometrics with Brazilian authorship expanded exponentially in the 1990-2006 period, reaching 13 times in the Web of Science database and 19.5 times in the Google Scholar database. This increase is rather superior to that of the total Brazilian scientific production in the same time period (5.6 times in the Web of Science). Some characteristics to be noticed in this rise are: 1) The total number of articles during this period was 197; in that, 78% were published in 57 Brazilian journals and 22% in 13 international journals. 2) The national and international articles averaged 4.3 and 5.9 citations/article, respectively; two journals stood out among these, the national Ciencia da Informacao (44 articles averaging 6.7 citations/article) and the international Scientometrics (32 articles averaging 6.2 citations/article). 3) The articles encompass an impressive participation of authors from areas other than information science; only one-fourth of the authors are bound to the information science field, the remaining ones being distributed among the areas of humanities/business administration, biology/biomedicine, health and hard sciences. The occurrence of adventitious authors at this level of multidisciplinarity is uncommon in science. However, the possible benefits of such patterns are not clear in view of a fragmented intercommunication among the authors, as noticed through the citations. The advantages of changing this trend and of using other scientometric and bibliometric databases, such as SciELO, to avoid an almost exclusive use of the Web of Science database, are discussed.
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Social and economical development is closely associated with technological innovation and a well-developed biotechnological industry. In the last few years, Brazil`s scientific production has been steadily increasing; however, the number of patents is lagging behind, with technological and translational research requiring governmental incentive and reinforcement. The Cell and Molecular Therapy Center (NUCEL) was created to develop activities in the translational research field, addressing concrete problems found in biomedical and veterinary areas and actively searching for solutions by employing a genetic engineering approach to generate cell lines over-expressing recombinant proteins to be transferred to local biotech companies, aiming at furthering the development of a national competence for local production of biopharmaceuticals of widespread use and of life-saving importance. To this end, mammalian cell engineering technologies were used to generate cell lines over-expressing several different recombinant proteins of biomedical and biotechnological interest, namely, recombinant human Amylin/IAPP for diabetes treatment, human FVIII and FIX clotting factors for hemophilia, human and bovine FSH for fertility and reproduction, and human bone repair proteins (BMPs). Expression of some of these proteins is also being sought with the baculovirus/insect cell system (BEVS) which, in many cases, is able to deliver high-yield production of recombinant proteins with biological activity comparable to that of mammalian systems, but in a much more cost-effective manner. Transfer of some of these recombinant products to local Biotech companies has been pursued by taking advantage of the Sao Paulo State Foundation (FAPESP) and Federal Government (FINEP, CNPq) incentives for joint Research Development and Innovation partnership projects.
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TEMA: o hipotireoidismo congênito é uma alteração metabólica que traz conseqüência graves para indivíduos não tratados e mesmo as crianças que realizam o tratamento podem apresentar distúrbios do desenvolvimento. O Programa Nacional de Triagem Neonatal, instituído pelo Ministério da Saúde, prevê o acompanhamento longitudinal de indivíduos com equipe multidisciplinar. Entretanto, a Fonoaudiologia não é incluída nesta equipe. Deste modo, considerando a ocorrência de distúrbios da comunicação nestes indivíduos, realizou-se levantamento bibliográfico nas bases de dados Lilacs, MedLine e PubMed, no período de 1987 a 2007, referente às alterações em habilidades do desenvolvimento decorrentes do hipotireoidismo congênito. OBJETIVO: verificar, na literatura científica, presença de alterações do desenvolvimento em indivíduos com hipotireoidismo congênito e refletir sobre a importância da atuação fonoaudiológica, em conjunto com equipe multidisciplinar especializada, no acompanhamento dos mesmos. CONCLUSÃO: a literatura relata alterações nas habilidades do desenvolvimento (motoras, cognitivas, lingüísticas e de autocuidados) e destaca que crianças com hipotireoidismo congênito são de risco para alterações no desenvolvimento lingüístico e, portanto, necessitam do acompanhamento longitudinal do desenvolvimento comunicativo. Torna-se evidente a importância da atuação do fonoaudiólogo nos Programas de Triagem Neonatal credenciados pelo Ministério da Saúde. Ressalta-se ainda a necessidade de investigações referentes às outras alterações metabólicas contempladas nestes programas, nas quais o fonoaudiólogo pode atuar de modo a prevenir, habilitar e reabilitar os distúrbios da comunicação, contribuindo para o trabalho em equipe, promovendo saúde nesta população.
Resumo:
The dentist can offer athletes improvement in their physical performance through the maintenance of oral health, preventing and treating any and all changes in the stomatognathic system, such as dental malocclusions, that compromise the athletes' performance. The objective of this study is to research the presence of dental malocclusions in athletes of the category between 13 and 20 years of age, from the São Paulo Football Club. 84 athletes participated in this study, dealing with the following topics: molar relation (Angle's classification); presence of overbite; underbite; overcrowding; abnormal spacing; open bite; and anterior, posterior, bilateral and unilateral crossbite; midline deviation and facial type (mesofacial, brachyfacial and dolichofacial). Only one table was made, showing percentages. In regard to Angle's molar relation, 89% are in Class I, 8% in Class II, 3% Class III, 9% of the athletes had overbite, 4% had underbite, 13% had overcrowding and 21% had abnormal spacing. In regard to the bite, 11% presented anterior open bite. In regard to crossbite, 7% presented unilateral crossbite on the right side and 2% on the left side; 5% presented posterior crossbite and 4% anterior crossbite. In regard to midline deviations, 4% presented deviation in the maxilla and 33% in the mandible. In regard to facial type: 39% are dolichofacial, 4% brachyfacial and 57% mesofacial. Based on the results shown, proposals for the implementation of dental, phoniatric, and Ear, Nose and Throat (ENT) practices are already being discussed with the multidisciplinary team of the club involved.
Resumo:
PURPOSE: Apert syndrome is a rare type I acrocephalosyndactyly syndrome characterized by craniosynostosis, severe syndactyly of the hands and feet, and dysmorphic facial features. Presents autosomal dominant inheritance assigned to mutations in the fibroblast growth factor receptors gene. The oral cavity of Apert patients includes a reduction in the size of the maxilla, tooth crowding, anterior open-bite of the maxilla, impacted teeth, delayed eruption, ectopic eruption, supernumerary teeth, and thick gingiva. The mandible usually is within normal size and shape, and simulates a pseudoprognathism. CASE DESCRIPTION: A female patient, 13 years old, with diagnosis of Apert syndrome, attended a dental radiology clinic. The clinical signs were occular anomalies, dysmorphic facial features, syndactyly and oral features observed clinically and radiographically. The patient was referred to a specialized center of clinical care for patients with special needs. CONCLUSION: Because of the multiple alterations in patients with Apert syndrome, a multidisciplinary approach, including dentists and neurosurgeons, plastic surgeons, ophthalmologists and geneticists, is essential for a successful planning and treatment.
Resumo:
A produção de desenhos em grupo e o método de Rorschach foram utilizados ao longo do tratamento de um paciente com esquizofrenia, acompanhado em Centro de Atenção Psicossocial. O referencial proposto para a compreensão do caso é o método fenômeno-estrutural que busca acessar o modo de ser e de vivenciar a doença que afeta o paciente, a partir do que ele revela nas imagens e na linguagem. Aos desenhos de cores acromáticas e conteúdos humanos deformados, o paciente insere cores, representantes da expressão afetiva, e figuras humanas integradas, denotando disponibilidade nas relações. O Rorschach indica contato mais adequado com a realidade, dado a diminuição da distorção da percepção da forma e de figuras fantasiosas. Após diminuição da sintomatologia persecutória e isolamento social, o paciente recebeu alta. O uso desses instrumentos tem contribuído na difícil tarefa diagnóstica e no acompanhamento da evolução de pacientes, nos cuidados interdisciplinares em saúde mental.
Resumo:
The objective of the study was to estimate the frequency of recurrent falls and identify the main associated risk factors. The BRAZOS is the first epidemiological study performed on a representative sample of the Brazilian population. Anthropometric data, living habits, previous fractures, falls, dietary intake, physical activity and quality of life were evaluated in 2,420 individuals aged 40 and older. Recurrent falls were reported by 15.5% of men and 25.6% of women. Among women, the risk factors significantly associated to recurrent falls were age, previous fracture, sedentary lifestyle, poor quality of life, diabetes mellitus and current use of benzodiazepine. In men, the risk factors were age, poor quality of life, intake of alcoholic beverages, diabetes mellitus, previous fracture and use of benzodiazepine. A greater intake of vitamin D had a protector effect on the risk of recurrent falls. These findings demonstrated the high prevalence of recurrent falls and emphasize that a multidisciplinary approach is necessary to minimize recurrent falls and their consequences, including osteoporotic fractures.
Resumo:
FUNDAMENTO: Maior conhecimento sobre o estado nutricional e a ingestão de energia e nutrientes é necessário para auxiliar no tratamento de pacientes com insuficiência cardíaca (IC). OBJETIVO: Verificar o estado nutricional e analisar a adequação da ingestão de energia, macro e micronutrientes de pacientes com IC em atendimento ambulatorial. MÉTODOS: Foram coletados dados antropométricos e de ingestão alimentar habitual de 125 pacientes (72% homens, 52,1±9,8 anos, IMC 26,9±4,4 kg/m²). As variáveis antropométricas foram comparadas entre os sexos, e analisou-se a adequação da ingestão de energia e nutrientes perante as recomendações. RESULTADOS: Depleção ou risco de depleção das reservas musculares estava presente em 38,4% dos pacientes (associação com sexo masculino; p < 0,0001). Em 69,6% dos casos, a ingestão média de energia foi menor que as necessidades energéticas (p < 0,0001). Entre os micronutrientes analisados, magnésio, zinco, ferro e tiamina apresentaram prevalências de inadequação importantes, e a maioria dos pacientes teve consumo de cálcio e potássio abaixo da ingestão adequada e consumo de sódio acima. CONCLUSÃO: Pacientes ambulatoriais com IC apresentam depleção de reservas musculares, com ingestão inadequada de energia e diversos nutrientes. Não se observou associação significante entre quantidade de energia proveniente da dieta habitual e o estado nutricional. O acompanhamento multiprofissional deve ser estimulado para avaliar melhor o estado geral desses pacientes.
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A bulimia nervosa é um transtorno alimentar caracterizado por compulsões alimentares e métodos compen-satórios recorrentes. Os pacientes apresentam ingestão alimentar inadequada e comportamentos alimentares disfuncionais. O adequado tratamento do transtorno requer uma equipe multiprofissional e terapia nutricional especializada. Compreender as características desse transtorno, os padrões de consumo e o comportamento alimentar, bem como atentar para as atitudes alimentares dos pacientes, é fundamental para o planejamento e para a adequada condução da abordagem nutricional. A terapia nutricional para esse transtorno é diferenciada, exigindo do nutricionista maiores habilidades de aconselhamento nutricional. Educação nutricional e acon-selhamento nutricional, com ênfase na abordagem de atitudes alimentares e insatisfação corporal, são o foco da terapia nutricional. Para o atendimento eficaz desses pacientes e o sucesso no tratamento nutricional, é importante que o profissional se mantenha atualizado sobre nutrição e transtornos alimentares e procure especialização e experiência nessa área do conhecimento.
Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003
Resumo:
Problematiza-se a afirmação de que não são válidas as estimativas sobre as condições de saúde bucal da população brasileira geradas pelo SB Brasil 2003. Criticam-se os elementos que pretendem sustentar esse ponto de vista com base apenas em conceitos estatísticos, sem prova empírica. Identificam-se reduções decorrentes da abordagem epistemocêntrica que recusa peremptoriamente outras formas de conhecimento e não reconhece o caráter multidisciplinar da epidemiologia. Reconstituem-se informações sobre a realização do levantamento e seu impacto na produção de conhecimento. Faz-se uma analogia entre ciência e arte, argumentando-se que, nas imagens obtidas por ambas, os saberes gerados a partir do objeto cognoscível assumem feições variadas e, portanto, o reconhecimento de sua validade requer amplo domínio do objeto e operações com adequados critérios de valor. Conclui-se pela cientificidade, validade e relevância da produção acadêmica desenvolvida a partir da base de dados do levantamento SB Brasil 2003.
Resumo:
O Grupo Poéticas Digitais foi criado em 2002, no Departamento de Artes Plásticas da ECA-USP, com a intenção de gerar um núcleo multidisciplinar, promovendo o desenvolvimento de projetos experimentais e a reflexão sobre o impacto das novas tecnologias no campo das artes. O Grupo é um desdobramento do projeto wAwRwT, iniciado em 1995 por Gilbertto Prado e tem como participantes professores, artistas, pesquisadores e estudantes. O objetivo deste texto é apresentar algumas experimentações recentes de projetos poéticos como Desluz, de 2009/2010, e Amoreiras, de 2010.