Distribuição de bivalve invasor Limnoperna fortunei (Dunker, 1857) na Bacia do Rio Prata após vinte anos (1991-2014) de sua introdução na America do Sul

Pós-graduação em Ciências Biológicas (Zoologia) - IBB

Desenvolvimento de um modelo experimental de hidrocefalia por neurocisticercose

Pós-graduação em Bases Gerais da Cirurgia - FMB

Perfil clínico de crianças com indicação da cirurgia das tonsilas em um hospital terciário universitário

The indications for adenotonsillectomy in pediatric patients have changed considerably during the 90th decade. Local or systemic complications of the adenoid or tonsil hypertrophy itself have now been substituted by signs of obstructive ventilatory disturbances, including obstructive sleep apnea as the major indications for surgery. Objective: This study analyses the clinical profile of children submitted to adenotonsilectomy in their pre and postoperative state, at Botucatu Medical School-State University São Paulo, UNESP. Methods: 332 children of both genders, aged 1 to 12 years, who underwent adenotonsillectomy between 1999 and 2004, were studied, focused on epidemiological profile, pre and postoperative (1 month) symptoms, obtained from medical records. Height and weight were compared to brazilian normal age related values. Results: We found a predominance of the male gender, except in he group aged from 10 to 12 years. Considering wheight and height, we found important failure to thrive, mostly for height deficit. Among clinical aspects, we found a significant reduction in obstructive symptoms like snoring or apneia (p<0001) in the postoperative period. Conclusion: Our results were similar to the literature findings of patients clinical profile. The major indication for adenotonsillectomy in our service was clinical diagnosis of obstructive sleep apnea.

Disturbios neuropsicológicos e síndrome da apneia do sono em crianças

Obstructive Sleep Apnea Syndrome (OSAS) is characterized by snoring and / or repetitive pauses in breathing during sleep associated with hypoxemia and hypercapnia. Affects approximately 1-3% of children, especially preschoolers. There is an association of OSAS with negative impact on neurocognitive development. However, there are few studies using protocols to assess cognition and behavioral disorders in children with OSAS. The objective of this study was to analyze the major studies related to the topic within the last two decades. The main studies published between 1995 to 2011 were identified through MEDLINE and LILACS databases. We selected the most relevant for OSAS in children, neurocognitive effects and association between obstructive disorders / OSAS in the target population (children). It was concluded that the studies analyzed showed that there is strong evidence regarding the overlapping of OSAS in children with neurocognitive disorders and that treatment of OSAS has positive impact on neurocognitive development.

Administração peridural de morfina e fentanil em um felino: relato de caso

Um felino macho, sem raça definida, pesando 3,6 kg com 10 anos de idade foi atendido no Hospital Veterinário “Luiz Quintiliano de Oliveira”, apresentando obstrução uretral com indicação para uretrostomia perineal. Ao exame físico geral, observou-se freqüência cardíaca (FC) de 240 bat.min-1, taquipnéia, temperatura retal (TR) de 38,4oC, mucosas normocoradas, tempo de preenchimento capilar de um segundo e desidratação de aproximadamente 5%. Como medicação pré-anestésica, administrou-se cetamina (6mg.kg-1), midazolam (0,15mg.kg-1) e morfina (0,15mg.kg-1) pela via intramuscular. A veia cefálica foi canulada com cateter 24G para administração de Ringer com Lactato de sódio (10mL.kg-1.h-1) e a indução foi realizada por meio da administração de propofol (4,4mg.kg-1) pela via intravenosa. Seguiu-se a intubação orotraqueal com sonda no 4,0 conectando-se a um circuito sem reinalação de Baraka, sendo a manutenção anestésica efetuada com isofluorano em fluxo diluente de oxigênio a 100%. Em seguida, realizou-se a técnica de anestesia peridural com o paciente em posição esternal e membros pélvicos estendidos cranialmente. Após localização do espaço entre as vértebras L7 e S1, introduziu-se uma agulha 13x4,5 percutaneamente até atingir o espaço peridural, administrando-se morfina (0,1mg.kg-1), fentanil (3mcg.kg-1) e lidocaína a 1% com vasoconstritor (1,8mg.kg-1), perfazendo um volume total de 0,25mL.kg-1. Durante o procedimento anestésico, monitorou-se a FC, freqüência respiratória (f), pressão arterial sistólica (PAS), pressão parcial de dióxido de carbono ao final da expiração (ETCO2), temperatura esofágica (TE), saturação periférica da hemoglobina (SpO2) e plano anestésico. O tempo total de anestesia e cirurgia foi de 65 e 50 minutos, respectivamente. O plano anestésico manteve-se estável, sem a necessidade de resgate analgésico. A SpO2, concentração de isofluorano e TE mantiveram-se em 97±2%, 1,3±0,1% e 36,7±0,4oC, respectivamente. Durante a anestesia, observou-se um momento de hipotensão, provavelmente devido ao bloqueio simpático decorrente da anestesia peridural. Tal evento foi tratado com bolus de solução de Ringer com Lactato de sódio (5mL.kg-1) promovendo o retorno da PAS aos valores de normalidade. A recuperação anestésica do animal foi isenta de complicações inerentes ao procedimento anestésico. O emprego de opióides pela via peridural é recomendado em procedimentos cirúrgicos abdominal, torácico, genito-urinário e ortopédico, principalmente em pacientes de alto risco, obesos e idosos. Em humanos, a associação da morfina e fentanil pela via peridural demonstra analgesia pós-operatória superior à promovida pelo uso isolado da morfina. Conclui-se que na espécie felina, a associação de morfina e fentanil pela via peridural pode ser uma boa alternativa para realização de protocolos de anestesia balanceada para uretrostomia.

Trauma traqueal associado à fratura mandibular: relato de caso

Introduction: The mandibular injuries account for about 20% to 50% of cases of facial fractures. Some consider the jaw the second most commonly fractured bone of the skull, and is the only mobile bone of the facial framework, which results in decreased stability compared to the trauma. When one takes into account the degree of airway obstruction in patients with facial fractures, the problem becomes much more serious since it is one of the most troubling complications of trauma. Objective: the relevance of the topic is aimed to report a case of a patient victim of mandibular fracture associated with trauma to the trachea. Case report: Case report: Patient 24 years old patient with tracheal trauma concomitant mandibular fracture surgically treated in conjunction with the thoracic surgeon. After 5 months postoperatively, the patient is in good condition general, no complaints. Final comments: This form is observed that the key to proper treatment of tracheal trauma associated with facial fractures is the knowledge of the type of injury, and an accurate diagnosis multidisciplinary.

O uso de drogas anticoagulantes e antiplaquetárias orais em pacientes cirúrgicos ambulatoriais: revisão de literatura

The oral anticoagulants (AOC) and platelet antiagregants are drugs used for the prevention of thromboembolic phenomena, such as pulmonary embolism in patients with atrial fribrilation heart valves, thrombosis and pulmonary embolism. For patients who are undergoing surgical procedures-dentistry were asked to discontinue the use of anticoagulants until the value of the INR remained = 2.0, that in order to avoid trans and hemorrhages in the postoperative period. However, the AOC can cause the formation of a clot, leading to obstruction of blood pathways. Thus, it became doubtful the medicine for surgery, in which local hemostatic measures would be sufficient to promote hemostasis. Thus, the objective of the review was to evaluate the risk of bleeding in patients AOC users that are subjected to surgical procedures, through a bibliographical survey carried out in relevant clinical studies published between 1990 and 2012, by the MedlinePubMed data. In this review of literature was concluded that the benefit of thromboembolism prevention overcomes the risk hemorrhage, therefore, it is recommended to keep the dose of anticoagulant therapy unchanged for patients undergoing oral surgery and implant dentistry, using appropriate INR levels with the assistance of local hemostatic. In addition, a refined surgical technique should be performed in these patients. With respect to the most invasive oral surgery, with a risk of bleeding, treatment may be necessary in conjunction with the medical staff.

Risco da síndrome da apneia obstrutiva do sono em amostra populacional da cidade de Botucatu - SP

The most common sleep disorder is obstructive sleep apnea syndrome (OSAS), that is characterized by repeated pauses in breathing during sleep, resulting in partial or complete obstruction of the upper airway. It is associated with systemic arterial hypertension and obesity. Objective: To assess the frequency of OSAS in the adult population of Botucatu by the Berlin questionnaire. Method: Transveral study was performed in which the sample size was estimated at 385 individuals. The Berlin questionnaire was administered to adults randomly on the streets, supermarkets and local shops. Data were analyzed taking into account age, gender, "high risk for OSAS", hypertension, obesity and correlations for OSAS. Results: 468 people interviewed were aged between 18 and 95 years, average of 59 years. 166 (35.25%) individuals were identified as "high risk for OSAS", being more frequent in the population above 40 years. Obesity was present in 23.3%, more common in women (60.2%). 83.5% of the population obese also had a "high risk for OSAS". Hypertension was observed in 27.3%, of these 71.9% were at "high risk for OSAS". Conclusion: The study showed a high frequency of "high risk for OSAS" in the adult population. Despite the dissemination by the media about sleep apnea, patients are not investigated, even under medical care for hypertension.

Considerações atuais da sialolitíase de ducto de glândula submandibular

The sialolithiasis is characterized by the formation of calcified structure called sialolith within the salivary ductal system. Although its etiology is unknown, it is believed that is from the deposition of calcium salts around an accumulation of organic leftovers in the lumen of the duct or be resulted by chronic sialadenitis and partial obstruction. In this study, the authors describe a case of a male patient, 46 years old, brown, who presented the complaint “pain under the tongue.” The presence of a hardened nodule located in the left sublingual fold was observed through intra-oral exam. Current considerations about treatment, clinical and radiographic characteristics were addressed in this work.

Relaxamento progressivo, stress, enfrentamento e qualidade de vida em pessoas com apneia obstrutiva do sono

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Sobre certas teorias de cohomologia de grupos e aplicações

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

Síndrome da apnéia obstrutiva do sono: diagnóstico e tratamento

The Syndrome Obstructive Sleep Apnea (OSA) is defined by recurrent episodes of a total or partial obstruction of the airway during sleep, considered apnea and hypopnea respectively. Considered to be increasing by increasing the number of individuals with a disorder breathing, Being continually increasing the number of individuals with a respiratory disorder, OSA can be considered a public health problem that deserves greater attention in relation to diagnoses and treatments that are being conducted. The objective of this study is through a literature review which should be evaluated during the diagnosis and etiology, consequences and treatment of respiratory disorders not adequately treated. The etiology is multifactorial and may be associated with exogenous factors or pathological and anatomical factors. In addition to the own symptoms interfere with the quality of life of the individual, depending on the intensity, OSA can trigger more serious complications. This is a complex syndrome which may have varying degrees and irreversible consequences to the body. The choice of treatment should be based on clinical conditions, the severity of the apnea, the degree of urgency of treatment and the patient's preferences, but the treatments available will not be fully effective if there are no changes in lifestyle of it. The respiratory disorders can range from a simple nasal obstruction and intermittent obstruction more severe, emphasizing the importance of a complete diagnosis, which must be multidisciplinary, through a team relationship between doctor and dentist.

Avaliação da qualidade térmica de espaços de transição do tipo linear externo

Pós-graduação em Arquitetura e Urbanismo - FAAC

Valor prognóstico da avaliação urodinâmica e da força do assoalho pélvico na incontinência urinária pós prostatectomia radical

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