Detecção da transmissão vertical do S. mutans e S. sobrinus e relação com o micro-ambiente bacteriano, índice de cárie e cuidados maternos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito imediato e prolongado da administração precoce de óxido nítrico inalatório em crianças portadoras de síndrome do desconforto respiratório agudo

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

Contribuições ao desenvolvimento curricular da Faculdade de Medicina de Botucatu: descrição e análise dos cursos de Pediatria e Saúde Coletiva como iniciativas de mudança pedagógica no terceiro ano médico

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

Níveis séricos de IgE total em crianças infectadas pelo vírus da imunodeficiência humana

Pós-graduação em Pediatria - FMB

Avaliação do perfil de mutações e resistência aos inibidores de transcriptase reversa e protease em pacientes pediátricos infectados pleo HIV-1

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Evolução temporal das definições de síndrome do desconforto respiratório agudo

OBJECTIVE: to review the evolution of acute respiratory distress syndrome (ARDS) definitions and present the current definition for the syndrome. DATA SOURCE: a literature review and selection of the most relevant articles on ARDS definitions was performed using the MEDLINE®/PubMed® Resource Guide database (last ten years), in addition to including the most important articles (classic articles) that described the disease evolution. DATA SYNTHESIS: the review included the following subjects: introduction; importance of definition; description of the first diagnostic criterion and subsequently used definitions, such as acute lung injury score; definition by the American-European Consensus Conference, and its limitations; description of the definition by Delphi, and its problems; accuracy of the aforementioned definitions; description of most recent definition (the Berlin definition), and its limitations; and practical importance of the new definition. CONCLUSIONS: ARDS is a serious disease that remains an ongoing diagnostic and therapeutic challenge. The evolution of definitions used to describe the disease shows that studies are needed to validate the current definition, especially in pediatrics, where the data are very scarce.

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

Percepção da criança sobre a hospitalização

Regardless of their age, hospitalized children suffer from being separated from their mothers or their attachment figures. Hospitalization is a process that is difficult for children to cope with due to their separation from families, everyday environments and embedded disease scenarios. According to age, the intensity of such suffering is related to the development phase in which a child is found. The health care professionals that are close to children, not only as concerns care provision, but also emotionally, should be knowledgeable about the mother-child attachment. emotionally, should be knowledgeable about the mother-child attachment. To evaluate children’s perception of hospitalization. The study was conducted at the pediatric hospitalization unit of the Botucatu School of Medicine University Hospital – UNESP by means of interviews with hospitalized children aged 7 – 12 years and by using content analysis according to Bardin. Most of the interviewed children did not like the hospital environment and reported to miss their homes. From their statements, they showed their dissatisfaction in relation to pain and their submission to invasive procedures, which were the main complaints during the interviews. Our results agree with those found in the literature in relation to the hospital environment when the children reported the fact that they missed their homes as a difficulty to adapt. The analysis of results in this study and in previous ones led to the reflection on the importance of the presence of a relative during children’s hospitalization and the adaptation process. Despite their dissatisfaction in relation to invasive procedures, none of the children tried to stop the performance of tests and understood their importance. This is a characteristic of the operational phase, which comprises the development of perception of a whole situation and is when... (Complete abstract click electronic access below)

Classificação e quantificação de tecidos Biológicos para construção de fantomas pediátricos

Paediatric diagnostic radiology can be considered as a separate specialty and with distinct characteristics of the radiology applied in adult patients. This in reason of the variability in the anatomical structures size and bigger sensitivity of tissues. The literature present in its majority methodologies for segmentation and tissue classification in adult patients, and works on tissue quantification are rare. This work had for objective the development of a biological tissue classifier and quantifier algorithm, from histograms, and that converts the quantified average thickness of these tissues for its respective simulator materials. The results will be used in the optimization process of paediatrics images, in future works, since these patients are frequently over exposed to the radiation in the repeated attempts of if getting considered good quality radiographic images. The developed algorithm was capable to read and store the name of all the archives, in the operational system, to filter artifacs, to count and quantify each biological tissues from the histogram of the examination, to obtain the biological tissues average thicknesses and to convert this value into its respective simulator material. The results show that it is possible to distinguish bone, soft, fat and pulmonary tissues from histograms of tomographic examinations of thorax. The quantification of the constituent materials of anthropomorphic phantom made by the algorithm, compared with the data of literature shows that the biggest difference was of 21,6% for bone. However, the literature shows that variations of up to 30% in bone thickness do not influence of significant form in the radiographic image quality. The average thicknesses of biological tissues, quantified for paediatrics patients, show that one phantom can simulate patients with distinct DAP ranges, since variations... (Complete abstract click electronic access below)

Innovation in pediatric surgery: the use of ultrasonic CVD tips: case report

The non-eruption of teeth due to highly keratinized gingival mucosa is a frequent event in the pediatric dentistry, which harms the oral aesthetics and function. A surgical excision of the involved area is indicated, exposing the non-erupted tooth. This procedure involves anesthesia and cutting instruments that may increase the fear and anxiety in young patients. The use of new technologies has avoided these instruments and has promoted more comfort to the patients. This study presents clinical cases in which gingivectomy was performed using the innovative method with an ultrasound-activated CVD tip. It was concluded that this method presented effectiveness, promoted more comfort, and less fear to the patients, making its use a viable alternative to pediatric surgery.

Elaboração e validação de um instrumento de avaliação da disfagia orofaríngea na paralisia cerebral

Pós-graduação em Fonoaudiologia - FFC

Fatores de risco para complicações respiratórias após adenotonsilectomia em crianças com apneia obstrutiva do sono

Identificar fatores de risco para complicações respiratórias após adenotonsilectomia em crianças ≤ 12 anos com apneia obstrutiva do sono encaminhadas à UTI pediátrica (UTIP). Estudo de coorte histórica com corte transversal que analisou 53 crianças após adenotonsilectomia que preencheram os critérios pré-estabelecidos para encaminhamento à UTIP em um hospital escola de nível terciário. Foram utilizados o teste t de Student, o teste de Mann-Whitney e o teste do qui-quadrado para identificar os fatores de risco. Das 805 crianças submetidas à adenotonsilectomia entre janeiro de 2006 e dezembro de 2012 no hospital escola, 53 foram encaminhadas à UTIP. Vinte e uma crianças (2,6% do total de submetidas à adenotonsilectomia e 39,6% das que foram encaminhadas à UTIP) apresentaram complicações respiratórias, sendo 12 do gênero masculino e a idade média de 5,3 ± 2,6 anos. Maior índice de apneia-hipopneia (IAH; p = 0,0269), maior índice de dessaturação de oxigênio (IDO; p = 0,0082), baixo nadir da SpO2 (p = 0,0055), maior tempo de intubação orotraqueal (p = 0,0011) e rinopatia (p = 0,0426) foram preditores independentes de complicações respiratórias. Foram observadas complicações respiratórias menores (SpO2 entre 90-80%) e maiores (SpO2 ≤ 80%, laringoespasmos, broncoespasmos, edema agudo de pulmão, pneumonia e apneia). Em crianças de até 12 anos e com apneia obstrutiva do sono, aquelas que têm maior IAH, maior IDO, menor nadir da SpO2 e/ou rinopatia são mais predispostas a desenvolver complicações respiratórias após adenotonsilectomia do que aquelas sem essas características.

Perception of the informed consent form by participants in clinical trials

To understand the perception of the participants in controlled clinical trials (CCTs) about the informed consent and describe the meaning of their participation in the research. Qualitative study using the focus group technique. The sample was composed of 19 patients who participated in clinical trials about hypertension and coronary disease in a specialized cardiologic hospital located in the city of Sao Paulo. The methodological framework used was the content analysis. Some of the participants were aware of the real objective of these studies while others had misperceptions. The reading of the informed consent is not always done and, when it is done, the patient does not understand it. The lack of understanding about the term ''placebo'' was mentioned by some participants. The motivation to participate was the personal benefit. This study shows that obtaining the informed consent in CCTs is complex and that there is the need to adapt the structure and application of this document, in order to protect the participants and improve the quality of clinical trials performed in the country.

Repercussões cardiovasculares em crianças com distúrbios respiratórios obstrutivos do sono: revisão de literatura

Objective: To review the cardiovascular consequences of obstructive sleep-disordered breathing in children Data source: Medline and Ovid data base. Study selection: pediatric articles (original articles and case report) that investigated the obstructive sleep-disordered breathing in children Data synthesis: The obstructive sleep-disordered breathing can lead to serious cardiovascular consequences such as pulmonary hypertension, pulmonary edema and anatomic and functional abnormalities Conclusions: The knowledge of cardiovascular repercussions allows in better management of pediatric patients and may result in positive consequences for treatment and follow up of these patients.

Diagnóstico e tratamento de mucocele em odontopediatria: relato de caso

Mucocele is a retention phenomenon from minor salivary gland caused by the excretory ducts rupture. This phenomenon may be caused by local trauma and its location is usually more frequent in the lower lip. Clinically, they appear as nodular lesions and may be exophytic and pedunculated. Histologically, this lesion can be classified as mucus extravasation phenomenon and mucus retention cyst. The treatments described in the literature are total lesion excision, marsupialization, cryosurgery, laser or micromarsupialização. To report a case of mucocele by mucus extravasation developed after a local trauma. A 7 years old Male was attended in the Pediatric Dentistry Clinic, Araçatuba School of Dentistry, complaining about the appearance of lesion in the lower lip since 40 days approximately. During clinical oral examination, it was observed that the lesion was pedunculated, nodular, fibrous to palpation, around 2 cm in diameter, similar in color to the surrounding mucosa, smoothly in surface, non-ulcerated and asymptomatic. As treatment, it was chosen the total lesion excision. Histopathology test confirmed the clinical diagnosis of: mucocele. Since mucocele is a frequent lesions in the oral cavity, it is extremely important that the professionals can to recognize this lesion (its pathogenesis and clinical features), to achieve a definitive diagnosis and perform an appropriate treatment.