Identificação de Enterococcus spp. e avaliação da ocorrência de genes de resistência á vancomicina em amostras de pacientes de hospitais de manaus, AM

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Estudo da apneia do sono em pacientes obesos em programação de cirurgia bariátrica

Pós-graduação em Bases Gerais da Cirurgia - FMB

Análise de fatores de dor intra-operatória na cirurgia ambulatorial no câncer de mama

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

O atendimento por instituição pública de saúde: percepção de famílias de doentes com câncer

This study aimed to analyze how the families of cancer patients perceived the treatment provided at a specialist public outpatient clinic, using Bardin's method of Content Analysis. Seven families consisting of fourteen family members were interviewed. They underlined doctor-patient relationship, judging it to be impersonal and superficial, resulting in a lack of security and trust. Families try to to participate but feel undervalued and excluded from the care. Necessary information that they are not given is sought in the media, while comfort is achieved through religious or spiritual practices. Health care training must encourage professionals to view the family as a unit of care, aligning training to different modes of health care.

Humanização na atenção básica de saúde na percepção de idosos

O objetivo deste estudo foi analisar a percepção do idoso quanto ao cuidado humanizado na atenção básica de saúde, com enfoque sobre os aspectos do atendimento ambulatorial que interferem na qualidade do atendimento. Para isso, realizou-se um estudo do tipo transversal, abrangendo todas as unidades básicas de saúde de um município do interior do Estado de São Paulo, por meio de entrevistas dirigidas aos idosos que frequentavam essas unidades. O instrumento utilizado foi desenvolvido pela Organização Mundial da Saúde (OMS), que, em busca de maior objetividade para a avaliação da qualidade do cuidado à saúde, propôs o conceito de responsividade, para referir-se aos elementos não diretamente ligados ao estado de saúde, e sim aos envolvidos no atendimento acolhedor e resolutivo com responsabilidade e vínculo. Dessa forma, os domínios de responsividade avaliados foram: pronta atenção, dignidade, comunicação, autonomia, escolha dos profissionais, confidencialidade e estrutura física e conforto. Os resultados foram analisados através do software Epi Info 3.5.2. Verificou-se que alguns domínios da atenção em saúde, altamente valorizados pelos idosos, tiveram desempenho bem inferior, como: Autonomia, em que apenas 54,4% tiveram liberdade para tomar decisões sobre sua saúde ou tratamento; e Comunicação, em que 67,6% não obtiveram informações sobre outros tipos de tratamentos ou exames e 79,2% não tiveram oportunidade para esclarecimentos quanto às dúvidas sobre o tratamento. Sugere-se, portanto, mudanças nos serviços de atenção básica à saúde prestados, principalmente quando se trata de idosos, uma população especial que necessita receber uma assistência diferenciada.

Association between phase angle, anthropometric measurements, and lipid profile in HCV-infected patients

OBJECTIVE: The objective of this study was to investigate the associations between phase angle, anthropometric measurements, and lipid profile in patients chronically infected with the hepatitis C virus. METHODS: A total of 160 consecutive patients chronically infected with the hepatitis C virus and who received treatment at the hepatitis C outpatient unit of our hospital from April 2010 to May 2011 were prospectively evaluated. Bioelectrical impedance analysis, anthropometric measurements, and serum lipid profile analysis were performed. RESULTS: Twenty-five patients were excluded. A total of 135 patients with a mean age of 49.8±11.4 years were studied. Among these patients, 60% were male. The phase angle and BMI means were 6.5±0.8° and 26.5±4.8 kg/m2, respectively. Regarding anthropometric variables, mid-arm circumference, mid-arm muscle circumference, and arm muscle area had a positive correlation with phase angle. In contrast, when analyzing the lipid profile, only HDL was inversely correlated with phase angle. However, in multiple regression models adjusted for age and gender, only mid-arm circumference (p = 0.005), mid-arm muscle circumference (p = 0.003), and arm muscle circumference (p = 0.001) were associated with phase angle in hepatitis C virus-infected patients. CONCLUSIONS: In conclusion, phase angle is positively correlated with anthropometric measures in our study. However, there is no association between phase angle and lipid profile in these patients. Our results suggest that phase angle is related to lean body mass in patients chronically infected with hepatitis C virus.

Tratamento ambulatorial e hospitalar na monitorização glicêmica de gestantes diabéticas em uso de insulina

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Clinical and Microbiologic Evaluation of Chronic Leg Ulcers: A Cross-sectional Study

OBJECTIVE: This study aimed at evaluating the flora and bacterial load of chronic leg ulcers (CLUs) according to the clinical judgment of colonization or infection.DESIGN: This was an analytical and cross-sectional study.SETTING: This study was conducted in an outpatient wound care unit in the Dermatology Department of the Botucatu School of Medicine-UNESP, Brazil.PARTICIPANTS: The participants were patients with CLUs who did not use systemic antibiotics.METHODS: The ulcers were clinically divided into 3 groups: ulcers with good granulation tissue (GGT), critical colonization (CC), and infection. Secretion was collected from a 1-cm(2) area using a swab and seeded by the semiquantitative method.OUTCOME MEASURES: The main outcome measures were genus and species of the bacteria found in the cultures and result of the semiquantitative culture correlating with the clinical diagnosis of GGT, CC, and infection.MAIN RESULTS: Seventy-seven ulcers were evaluated: 27 with GGT, 29 with CC, and 21 with infection. Gram-negative bacteria were most often found in all groups (81%): Pseudomonas aeruginosa, in granulation and colonized ulcers, and Proteus mirabilis, in infected ulcers. Ulcers from the infected group showed higher bacterial load.CONCLUSIONS: The flora of CLUs was predominantly constituted by gram-negative bacteria, and P aeruginosa was the most prevalent. The bacterial load of infected ulcers was higher as compared with the others, although some ulcers with GGT also presented a high load. The interpretation of microbiologic tests based on the swab techniques and even on semiquantitative analysis requires close clinical correlation.

Cervicovaginal Levels of Proinflammatory Cytokines Are Increased During Chlamydial Infection in Bacterial Vaginosis But Not in Lactobacilli-Dominated Flora

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

Influência do estado nutricional e da composição corporal na evolução clínica dos pacientes com doença inflamatória intestinal

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Self-reported moderate-to-vigorous leisure time physical activity predicts less pain and disability over 12 months in chronic and persistent low back pain

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Acute respiratory infection and influenza-like illness viral etiologies in Brazilian adults

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

The effects of elastic tubing-based resistance training compared with conventional resistance training in patients with moderate chronic obstructive pulmonary disease: a randomized clinical trial

Objective: To investigate the effects of elastic tubing training compared with conventional resistance training on the improvement of functional exercise capacity, muscle strength, fat-free mass, and systemic inflammation in patients with chronic obstructive pulmonary disease.Design: A prospective, randomized, eight-week clinical trial.Setting: The study was conducted in a university-based, outpatient, physical therapy clinic.Subjects: A total of 49 patients with moderate chronic obstructive pulmonary disease.Interventions: Participants were randomly assigned to perform elastic tubing training or conventional resistance training three times per week for eight weeks.Main measures: The primary outcome measure was functional exercise capacity. The secondary outcome measures were peripheral muscle strength, health-related quality of life assessed by the Chronic Respiratory Disease Questionnaire (CRDQ), fat-free mass, and cytokine profile.Results: After eight weeks, the mean distance covered during six minutes increased by 73 meters (69) in the elastic tubing group and by 42 meters (+/- 59) in the conventional group (p < 0.05). The muscle strength and quality of life improved in both groups (P < 0.05), with no significant differences between the groups. There was a trend toward an improved fat-free mass in both groups (P = 0.05). After the first and last sessions, there was an increase in interleukin 1 (IL-1) and interleukin 10 (IL-10) in both groups, while tumour necrosis factor alpha (TNF-) was stimulated only in the conventional training group.Conclusion: Elastic tubing training had a greater effect on functional exercise capacity than conventional resistance training. Both interventions were equally effective in improving muscle strength and quality of life.

Non-alcoholic fatty liver disease and its associated risk factors in Brazilian postmenopausal women

Objective To evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women.Methods A cross-sectional study was carried involving 188 women (age >= 45 years and amenorrhea >= 12 months) attending the outpatient unit in south-eastern Brazil. Exclusion criteria were liver disease (hepatitis B and C, cholestatic disease, liver insufficiency), use of drugs that affect liver metabolism; alcoholics; AIDS or cancer history; and morbid obesity. NAFLD was diagnosed by abdominal ultrasound. Clinical, anthropometric (body mass index, waist circumference) and biochemical variables were measured.Results Of the 188 women, 73 (38.8%) had NAFLD. Blood pressure, waist circumference, body mass index, LDL cholesterol, triglycerides and glucose were significantly higher in NAFLD patients when compared with women without NAFLD (control group) (p < 0.05). HOMA-IR values indicated insulin resistance only in the NAFLD group (6.1 +/- 4.6 vs. 2.4 +/- 1.4 in control group, p < 0.05). Metabolic syndrome was detected in 93.1% of the women affected by NAFLD, and 46.1% of the control group (p < 0.05). In multivariate analysis, adjusted for age and weight, the variables considered at risk for the development of NAFLD, were: high waist circumference (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01-1.13), insulin resistance (OR 3.81, 95% CI 2.01-7.13), and presence of metabolic syndrome (OR 8.68, 95% CI 3.3-24.1).Conclusion NAFLD showed a high prevalence among postmenopausal women. The presence of metabolic syndrome, abdominal obesity and IR were indicators of risk for the development of NAFLD.

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

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)