326 resultados para Medicina baseada na evidência
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Ciência e Tecnologia de Materiais - FC
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A presença de doenças sistêmicas, uso de medicamentos, e uso de próteses removíveis, entre outros fatores, podem alterar o equilíbrio fisiológico da cavidade bucal favorecendo o estabelecimento de diversas alterações e/ou patologias bucais. Assim, o estudo das prevalências destes fatores, nos pacientes odontológicos, tornam-se importantes pois devem ser considerados para elaborar o diagnóstico e definir a conduta terapêutica. Com o objetivo de delinear um perfil, avaliamos os prontuários de 500 usuários de próteses removíveis atendidos no Serviço de Medicina Bucal da Faculdade de Odontologia de Araraquara - UNESP. Analisamos os dados referentes a: características da população e das próteses removíveis, prevalência das doenças sistêmicas, uso de medicamentos e diagnóstico final das patologias ou alterações bucais. Os resultados obtidos nos permitem concluir que a maioria (74%) dos usuários de próteses removíveis eram mulheres brancas; metade da população pertencia a faixa etária de 41 a 60 anos e, quase a metade (49,2%) usava a combinação de prótese total superior e inferior. As doenças sistêmicas foram relatadas por 57,2% da amostra e a prevalência maior foi de doenças do sistema cardiovascular (25,4%). A maioria (60,4%) da população relatou uso de medicamentos e, dentre os mais freqüentes, a prevalência maior foram dos cardiovasculares (26,4%). A prevalência de patologias ou alterações bucais foi de 99,6%, sendo as relacionadas ao uso de próteses removíveis as mais freqüentes. Dentre estas, a candidose crônica atrófica ocorreu em 81,8% da população estudada e a hiperplasia fibrosa em 29,2%.
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A redução da dose de radiação ao paciente é aceita em Radiologia Odontológica, com a finalidade de diminuir os riscos associados ao exame radiográfico. Para atingir este objetivo, além do avanço tecnológico ocorrido nas últimas décadas, devemos considerar a importância do Critério de Seleção para o paciente e da prescrição radiográfica na indicação correta do tipo de radiografia necessária para cada um deles. O objetivo deste trabalho foi avaliar a prescrição radiográfica de pacientes atendidos pelo Serviço de Medicina Bucal da Faculdade de Odontologia de Araraquara - UNESP durante o período de 1989 a 1993. Selecionamos 396 prontuários que constituiu a totalidade dos que continham exames radiográficos. Para a análise da prescrição radiográfica, consideramos as informações obtidas da ficha clínica e da interpretação das radiografias, utilizando os Critérios de Seleção e a análise de decisão clínica. Os resultados demonstraram um alto índice de pacientes com prescrição incorreta (44,0%); tendo em 24,7% dos pacientes ocorrido mais de uma radiografia prescrita incorretamente. Com relação ao tipo de técnica com prescrição incorreta, em 31,6% dos pacientes foi realizada a radiografia panorâmica, vindo a seguir a oclusal (28,7%), outro (17,2%) e a associação da panorâmica e oclusal (12,6%). Pacientes portadores de doenças e alterações de tecido mole tiveram a mais alta freqüência de prescrições incorretas, seguidos pelos portadores de doenças das glândulas salivares (13,5%) (incluindo os tumores); outros (10,1%); distúrbios da A.T.M. (9,0%); inflamação e infecção dos maxilares (6,8%); tumores benignos (5,6%) e tumores malignos (5,6%). Em 62,9% dos pacientes, o exame radiográfico contribuiu para o diagnóstico e tratamento. A alta porcentagem de prescrição incorreta encontrada evidencia a necessidade de... (Resumo completo, clicar acesso eletrônico abaixo).
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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.
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Health care waste (HCW) is the type of waste that results from activities performed in health care services during care provision to humans or animals. Presently, according to RDC 306/04, issued in 2004 by Anvisa, and Resolution no. 358/05, by CONAMA, waste groups have the following classification: Group A (biological waste), Group B (chemical waste), Group C (waste containing radionucleotides), Group D (common waste) and Group E (piercing and cutting waste). In Brazil, 149 tons of wastes are collected every day, and HCW corresponds to approximately 1% to 3 % of that total. An efficient way to adequately manage HCW is through the Health Care Waste Management Plan (HCWMP), and it is possible to reduce the risk posed by certain materials in addition to ensuring disposal in an ecologically correct and economical fashion. According to the Pan-American Health Organization (PAHO), the management process enables health care establishments to adequately manage waste. Hence, there is greater control and reduction in the health risks caused by infectious or special waste, in addition to facilitated recycling, treatment, storage, transport and final disposal of solid hospital waste in an environmentally safe fashion. To evaluate the management of HCW of Groups A and D from the Intensive Care Unit of the University Emergency Hospital - FMB - UNESP in the city of Botucatu according to the guidelines presently in force. The waste flow was followed up, and during four random days in the month of September 2011, waste was quantified by estimating daily and monthly values, according to its classification. : In 2011, the University hospital has produced an average of 57,676.8 kg/month of biological and common waste. By adding Groups A and D, during the four days, approximately 209.8 Kg of waste (202.2 Kg of Group A and 7.6 Kg of Group D) were produced in the establishment under study, which... (Complete abstract click electronic access below)
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Ultrasound is the term that describes the sound waves with higher frequencies than human hearing. Ultrasound used in medical diagnosis is a modality based on the use of sound energy and the acoustic properties of the various parts of the body to produce images of stationary and moving tissues. However, despite the ease of use and security that this modality offers for not using ionizing radiation, one should ensure the accuracy and optimum performance of the equipment, which results in precise diagnoses. To accomplish that, periodic quality control tests must be performed, which include: physical and mechanical inspection of the equipment, image uniformity, depth of penetration/visualization, accuracy of distances, axial and lateral resolution, dead zone and doppler sensitivity. This work intends to study a computerized method for calculating the depth of penetration of ultrasound, comparing it to the observerdependent method currently used. The images were collected during the quality control tests of ultrasound equipment. The results of the comparison between the visual and computerized methods were not conclusive for selecting the safest methodology for obtaining the depth of visualization
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This paper will address the main concepts os modern marketing: marketing in businnes analysis, internal marketing, marketing plan, and relationship marketing and personal, always drawing a parallel with the reality of the veterinarian
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Vários estudos comparativos entre os sexos masculino e feminino comprovaram o fato de que o primeiro é mais vulnerável às doenças, sobretudo às enfermidades graves e crônicas e que morre mais precocemente. A despeito da maior vulnerabilidade e das altas taxas de morbimortalidade, os homens não buscam, como as mulheres, os serviços de atenção básica. O presente estudo buscou compreender como os homens freqüentadores de uma Unidade Básica de Saúde (UBS) se comportam em relação aos cuidados com a sua saúde. Foi realizado em um Centro de Saúde Escola (CSE), Unidade Auxiliar de uma Universidade de uma cidade do interior do Estado de São Paulo, inserido na rede Municipal de Saúde do município. Trata-se de uma pesquisa descritiva, qualitativa e quantitativa. A organização dos dados qualitativos foi baseada na Análise de Discurso do Sujeito Coletivo (DSC), sendo que a obtenção dos discursos ocorreu através de uma entrevista semi-estruturada. Na parte qualitativa, a constituição da amostra foi por conveniência e foram selecionados 15 sujeitos do gênero masculino, maiores de 18 anos, que compareceram na UBS para um atendimento eventual ou para um atendimento pré-agendado. Na parte quantitativa, a constituição da amostra foi ao acaso, sendo sorteados 459 prontuários de usuários do sexo masculino, com 18 anos ou mais, que foram atendidos no período de Janeiro a Dezembro de 2009 para serem analisados através da estatística descritiva. Além disso, foram utilizadas as planilhas referentes às campanhas de vacinação contra a Gripe Pandêmica (H1N1) e Gripe Sazonal (Influenza) para a obtenção do número dos usuários do sexo masculino, de 20 anos ou mais, que participaram dessas campanhas no período de Janeiro a Julho de 2010. Em relação aos dados de caracterização dos indivíduos da amostra selecionada observamos que a faixa etária foi de 50 a 59 ano... (Resumo completo, clicar acesso eletrônico abaixo)
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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)
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The Nuclear Medicine is a medical specialty which uses different radioisotopes for diagnostic and therapeutic purposes. The isotopes are radioactive elements which are administered in vivo and present distribution to specific organs or cell types. The knowledge of radioactivity and notions related to ionizing radiation allow to contextualize the radiological protection measures to be taken in Nuclear Medicine. So it is possible to minimize unnecessary exposure to patients, the public, and individuals occupationally exposed and the environmental. For this it is necessary to relate the physical and technological bases apply to this mode with the standards established by regulatory agencies, including the CNEN (National Nuclear Energy Commission) and ANVISA (National Agency for Sanitary Vigilance). In this scenario, it is important that the theoretical endorse the activities which are periodically audited for verification of compliance with the standards that aim to radioprotection. One role of the Medical Physicist in these services is, therefore, act as Radiation Protection Supervisor exerting numerous activities and ensuring compliance with these standards. In this context the stage in the area of Nuclear Medicine was developed in many customers of the enterprise Rad Dimenstein & Associados LTDA, among them the hospitals Israelita Albert Einstein (HIAE), Nossa Senhora de Lourdes (HNSL), Santa Paula (HSP), Cruz Azul (CRAZ), Grupo Fleury, among other clinics. Following the routine and then carrying out various activities pertaining to the Medical Physicist in the area, it was noted that the measures and actions are extremely effective and fundamental in terms of radiological protection
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With the increase of stakeholders and consequently increase of amount of nancial transaction the study of news investment strategies in the stock market with data mining techniques has been the target of important researches. It allows that great historical data base to be processed and analysed looking for pattern that can be used to take a decision in investments. With the idea of getting pro t more than the real indexs' gain, we propose a strategy method of transactions using rules built by algorithm classi cation. For that, diary historical data of Ibovespa index and Petrobras stocks are organized and processed to nding the most important attribute that act decisively when taking a investment decision.To test the accuracy of proposed rules, a non real portfolio management is created, showing the decisions' performance over the real index and stocks' performance. Following the proposed rules, the results show that the strategy of investment give me back a high return that Stock market's return. The exclusive characteristics of algorithms maximize the gain inside the analysed time allowing to determine the techniques' return and the number of the days necessary to double the initial investment. The best classi er applied on the time series and its use on the propose investments strategy will demand 104 days to double the initial capital
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The metropolitan region of São Paulo is the most populous of the country, this happens because of its great importance in the national economy and the job opportunities that are offered to the population. These factors result in intense population growth and urban expansion, reaching some non-habitable places of the metropolis, as areas of pipelines, which are very important for the transportation of natural gas, oil and its derivatives. Before the population growth of the region, these sites were unoccupied, do not presenting problems for the population. However, with the disorderly occupation is generated great anthropogenic pressure on the pipeline stitches, causing risks to people who are around them. Therefore it is extremely important to monitor the strip of pipelines through products and techniques of remote sensing and geoprocessing, enabling, through high spatial resolution images, identification of objects or phenomena that occur on Earth's surface that can alter the functioning and safety of pipelines. Therefore, this study aims to monitor a stretch of the area of the pipeline mesh GASPAL/OSVAT and Capuava Refinery (RECAP), located on the outskirts of the metropolitan area of São Paulo in the city of Mauá, who suffer great human pressure, proving thus the techniques of remote sensing and geographic information system (GIS) as effective tools for monitoring phenomena occurred in urban areas of great complexity. The monitoring was done by object-based classification applied in orbital images Ikonos II and RapidEye, of high spatial resolution and, image processing, detection of objects, segmentation, classification and editing were developed through the eCognition and ArcGis softwares. To determine the statistical accuracy of the mapping of the land cover of the stretch of pipeline in Maua, the results were analyzed by error matrix... (Complete abstract click electronic access below)