Characterization of the clonal profile of MRSA isolated in neonatal and pediatric intensive care units of a University Hospital

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

Intraoperative and Anesthesia-Related Cardiac Arrest and Its Mortality in Older Patients: A 15-Year Survey in a Tertiary Teaching Hospital

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Proliferating cell nuclear antigen immunoreaction in adrenal-tumors

Aims mid background: We studied, retrospectively, 33 cases of adrenal tumors of children at the Pediatric Endocrinology Unit, Children's Institute, Sao Paulo State University Medical School, from 1975 to 1993. Ail patients had at least 2 years of follow-up with a few exceptions. Methods: Clinical follow-up data were correlated with histopathologic review, laboratory data and cell kinetic evaluation (based on detection of proliferating cell nuclear antigens). Results: With one exception, all the patients had presented signs of androgen production and had high levels of dehydro-epiandrosterone-sulfate. Tumor weight evaluation represented a good parameter of neoplasm evolution: of 19 cases weighing less than 250 g, 17 had no evidence of disease after surgery, and 2 had an unfavorable prognosis. Of 14 cases weighing more than 250 g, only 1 had no evidence of disease and 13 had an unfavorable evolution. Conclusions: Proliferating cell nuclear antigen (PCNA) was not helpful to evaluate adrenal neoplasm evolution: our study did not show any correlation between PCNA score and prognosis.

Competência de juízo moral dos estudantes de medicina: um estudo piloto

The authors conducted a cross-sectional short-term study using Lind's Moral Judgment Test (MJT) to compare the moral judgment competence (C-score) among students in the first and eighth semesters from a medical school in the Northeast region of Brazil. This study also evaluated the influence of such factors as age and gender on moral competence. A difference equal to or greater than 5.0 points (absolute effect-size) on the C-score was considered significant. A regression of moral judgment competence among the students in their eighth semester in relation to the students in the first semester (C-score: 20.5 and 26.2 points, respectively) was observed. In the analysis of the students' performances in terms of MJT dilemmas, the phenomenon of moral segmentation was observed in both semesters, and the students performed better on the worker's dilemma than on the doctor's dilemma. Among students in the same semester of study, older students had lower C-scores. When comparing performance by gender, there was no significant difference between men's and women's C-scores. The finding of regression or stagnation in moral competence among the medical students demands deep reflection by those who work with the political-pedagogical projects of medical schools and by the entire faculty, in order to seek strategies to reverse this condition.

Necessidades especiais de escolares com diabetes mellitus tipo 1 identificadas por familiares

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Caracterização da demanda do pronto socorro do Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP

The demand for health services can be understood as an application needs the user has. The inability to use the outpatient services and limited supply of these make it possible for users to browse sites that focus attention on a greater possibility of entry doors, in which first-aid centers and hospital emergency match this profile, distorting the flow of patients in the network through an inverse demand of the movement hierarchy. Added to this, the burden of care in these services results in overcrowding and poor quality of care. Evaluate the demand of the visits occurred in the Emergency Room of the Hospital of the Medical School of Botucatu / UNESP (PS - HC - FMB / UNESP) during June-July 2010. A transversal, descriptive and retrospective. For data collection sheet was used in the proposed Service unit and the data it was filled out the form with the necessary items for the search. Made an exploratory analysis and frequency distributions for categorical variables of the form. Females predominated (56%) and aged 61 years or older with 30%. 96.5% were owned by DRS VI, and 62.5% of Botucatu. The attendance by the physician on duty and corresponded to 57.7% among the 23 medical specialties, Gastric (7.0%), Cardiology (4.5%), Medical (4.4%), urology (4.2%) and Pulmonology (4.1%) were the ones that stood out. The medical procedures performed that stood out were X-ray (46.4%) and electrocardiogram (ECG) (42.3%) and in most specialty care occurred, only the daily consultation with the patient. It was possible to characterize, so the demand for PS - HC - FMB / UNESP for the period June- July 2010, The predominance of the elderly shows that come along with aging diseases and addictions, causing a greater need for health services. Moreover, this study showed that the high number of visits is related to both the daily demands that the tertiary hospital has the same transformation... (Complete abstract click electronic access below)

Reflexão sobre prevenção de acidentes à criança no âmbito doméstico

The aim was to reflect what action to prevent accidents used by caregivers / participants in the home. This is a prospecive cross-sectional descriptive study conducted at the Pediatric Inpatient Unit, Hospital of the Medical School of Botucatu – Unesp, during the months from May to August 2010.A questionnaire was used in the form of check list (Annex I) on measures to prevent accidents. The participant chose two alternatives taking into consideration the order of priority in the prevention of accidents. This study shows that for the age group from 29 days to 2 years, the companions chose these preventive measures for falls, burns, poisoning and drowning, “do not put near the windows mobile” (27.8%), “no access the match, lighter and appliances (22.2%), leave toxic substances out of reach and sight of children (41.7%) and empty buckets, tubs and pools after use (27.8% ). Regarding the age group 2-6 years, the measures for these types of accidents were not put near the windows mobile (26.5%), do not have access to matches, lighters and household appliances (20.9% ), leave toxic products out of reach and sight of children (27.9%) and maintain tanks, tanks and wells or struck with some protection (20.2%). For ages 6 to 10 years, the measures chosen to more such accidents were dry liquid spilled on the ground (23.5%), do not have access to matches, lighters and household appliances (22.5% ), leave toxic products out of reach and sight of children (31%) and keep tanks, tanks and wells or struck with some protection (23.5%). One fact that attracted our attention was that the preventive measures most frequently used by caregivers, regardless of age, show results that differ in few alternatives. It is essential to the understanding of the escorts / participants on the importance of injury prevention. Even today is predominantly defined as accident, injury must be addressed through measures

Polimorfismo do gene IL6 candidato à predisposição à rotura prematura de membranas pré-termo e ao trabalho de parto pré-termo

Introduction: Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) cause severe complications for both mother and fetus. Among the risk factors associated with preterm labor and PPROM, genetic predisposition has been gaining importance. However, the association between polymorphic genes and the pathogenesis of PTL and PPROM remains elusive. A better understanding of the genetic mechanisms underlying these adverse pregnancy outcomes may enable the identification of high risk patients and allow new approaches to minimize the deleterious effects of prematurity. Aim: To determine the association between maternal IL-6 polymorphism gene and the occurrence of PTL and PPROM. Patients and Methods: The study included 109 patients with prior history of PL and/or PPROM that delivered prematurely at the Obstetrical Unit Care of Botucatu Medical School, UNESP between 2003 and 2012. The control group consisted of 68 patients that delivered at term, matched to the case group by age, ethnicity, and sex of the newborn. Oral swabs (Cath-AllTM – Epicentre Biotechnologies) were collected for analysis of genetic polymorphisms by PCR. Statistical tests were performed to compare genotype, clinical and socio-demographic data from the groups. A p-value of <0.05 was considered significant. Results: The sociodemographic characteristics in both groups were homogeneously distributed. The frequency of the polymorphic allele C, associated with less production of IL-6, and therefore thought to be protective against PTL and PPROM, was 32,5% in the study group and 30,9% in the control group, without statistically significant differences. Conclusion: Considering the sample size included in this study, the frequency of the mutated allele is similar in pregnant women who delivered at term and gestational complications as PTL and PPROM

Avaliação de métodos de triagem e de detecção fenotípica de ß-lactamase de espectro ampliado (ESBL)

The catalytic function of extended-spectrum β-lactamases can result in high degrees of bacterial resistance to β-lactamic antimicrobials and in the emergence of ESBL among the members of Enterobacteriaceae family, especially Klebsiella pneumoniae and Escherichia coli. This occurs due to the dissemination and emergence of new variants of these enzymes caused by the high utilization of antibiotics like broad-spectrum cephalosporins. The ESBL are β-lactamases capable of conferring bacterial resistance to the penicillins, 1st, 2nd and 3rd generation cephalosporins, and aztreonam (but not cephamycins and carbapenems) through the hydrolysis of these antibiotics. In view of this phenomenon, the exact screening and detection of the producers of ESBL are essential for the appropriate selection of the antimicrobial therapy. The purposes of this study were to evaluate the best antimicrobial for the selection of ESBL producers and to determine the best method for the detection of such microorganisms. We evaluated 200 sequential bacterial samples including the species Klebsiella pneumoniae (56.5%), Escherichia coli (34%), Proteus mirabilis (8.5%) and Klebsiella oxytoca (1%), previously characterized as ESBL producers between February and September 2008 in the Laboratory of Microbiology, Botucatu Medical School - UNESP, Botucatu, São Paulo State, Brazil. To select the ESBL-producer bacteria, we used the disks recommended by CLSI 2008, aztreonam (ATM), cefpodoxime (CPD), ceftriaxone (CRO), cefotaxime (CTX) and ceftazidime (CAZ), besides cefepime (FEP). ESBL production was confirmed by three methods: double disk screening, ESBL Etest®, and Vitek® automated system. The disks employed in the double disk screening were: penicillin associated with β-lactamase inhibitor, amoxicillin-clavulanic acid, and two β-lactamic antibiotics, ceftazidime and cefotaxime...(Complete abstract click electronic access below)

Distribuição e dispersão dos níveis radiométricos do setor técnico de medicina nuclear do hospital das clínicas da faculdade de medicina de botucatu

Nuclear medicine uses non-sealed sources for exams and treatments, because the movement of these sources, source of patients injected or not, involve a wide range of environmental radiometric levels. To better control of these levels this study was aimed at monitoring points strategically distributed in all environments Sector Technical Nuclear Medicine, Hospital of the Botucatu Medical School, performing two measurements at random times daily for a period of three months, sampling the normal routine of the sector. The detector Geiger-Muller was used for the acquisition of exposure rates of the points, efficiency and reprodutibility test have shown good performance of this equipment for this purpose. The results allowed to make a projection of annual dose for each environment indicating higher risks for Occupationally Exposed Individuals as well as Public Individuals compared with the limits established by the National Commission of Nuclear Energy. Was developed a spatial map of dose that can be used as a visual warning to the regions with the highest exposure to ionizing radiation, enabling reduced risk of a potential exposure

Diagnósticos de Enfermagem Prevalentes de Pacientes em Pós-Operatório de Cirurgia Bariátrica em uma Unidade de Terapia Intensiva

The goal of this study is to characterize the clinical outline of patients in postoperative of bariatric surgery attended in an Intensive Care Unit and identify the nursing diagnosis presented by these patients in accordance to Taxonomy II of North American Nursing Diagnosis Association (NANDA). This is a transversal, descriptive and prospective study that was desenvolved at the Intensive Care Unit of the Clinical Hospital of Botucatu Medical School – UNESP. The population was composed by all the patients who were submitted to the bariatric surgery and were attended at the Intensive Care Unit in the period between June and August of 2010, totalizing 13 patients. The data were collected based on the Nursing History that is composed by the Anamnesis, Physical Examination and Complementary Exams. The results were worked out: a) among the 13 patients studied, 10 are women (76,9%) and 3 men (23,1%); the majority is between 30 and 40 years old; 11 people of 13 are morbid obese, which means that they have Body Mass Index higher than 40 kg/m2; b) It was identified 22 nursing diagnosis and 14 of these were found in 100% of the patients. They belong to the dominions of Activity/Rest, Comfort, Elimination and Changing, Security and Protection, Functions and Relationships. Therefore, in relation to the factors, it was conclude that nursing diagnosis help nurses to understand the unsettled human answers or the risks to disturbance in an individual way, which contributes to plan specific interventions to these patients. It was possible to verify that the stage of the nursing diagnosis that is part of the nursing process should be executed by the nurses systematically, because it has been realized by the nurses’ clinical idea, but not in a systematical way

Acidentes na infância atendidos no pronto socorro de pediatria do Hospital das Clínicas de Botucatu que motivaram internação

Accidents represent a major public health problem as they are frequent, preventable, and account for high morbidity and mortality rates. Children are the most vulnerable to accidents due to their inherent characteristics, and as a result of their physical, sensorial, psychomotor and cognitive limitations, which will only develop with time. Watchfulness and careful attention are of paramount importance, especially as children develop locomotor skills that are accompanied by curiosity about their surroundings. Child accidents, particularly those that could have been avoided, are the accidents most commonly seen in emergency and urgency departments. Urgency and emergency departments are the greatest allies in the attention to pediatric accidents as they offer adequate, immediate and specific high complexity care to patients at risk, viewing their vital stabilization. Investigating the causes and consequences of this insult is essential to establish a diagnosis and to contribute for the adoption of measures of prevention, control, and assistance. To identify the epidemiologic characteristics of the accidents involving children that received care at the pediatric emergency department of Botucatu Medical School Hospital and required hospitalization. This quantitative, retrospective, descriptiveanalytic epidemiologic study included all children aged 0-14 years who had had an accident and were seen at the Pediatric Emergency Department of Botucatu Medical School Hospital of São Paulo State University/UNESP between January 1/2008 and December 31/2009. A total of 227 medical charts were reviewed and 178 (78.4%) patients were included in this study. Of these, 116 (65.1%) were males and 62 (34.8%) were females. Children aged 5 - 9 years (38.9%) were the most affected, followed by those aged 10 - 14 years (37.5%). Fractures occurred in 138 (77.5%) of the cases, followed by foreign bodies... (Complete abstract click electronic access below)

Estudo do remodelamento da lâmina própria da laringe relacionado ao processo de senilidade

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

Risco de Farmingham e evento cardiovascular em mulheres com síndrome dos ovários policísticos

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Conhecimento e atitudes da área da saúde frente ao risco de contaminação por hepatites ao fazer as unhas

Pós-graduação em Saúde Coletiva - FMB