Referral letters in oral medicine: an approach for the general dental practitioner

The aim of this study was to analyze the contents of referral letters related to clinical history and reason for consultation. A total of 236 consecutive referral letters were evaluated. Analysis of the referral letters was based on key items concerning patient identification. chief complaint, previous consultation. laboratory investigation and use of drugs for the chief complaint. A database was organized (Epinfo 6.04) and the chi (2) test (a = 0.05) was applied to the results. of the 800 files examined. only 30%, (236) had a referral letter. of the 236 referral letters. 67% were from dentists, 22% from physicians and 11% from unidentified professionals. Patient age did not appear in 70%, of the letters and the chief complaint was mentioned only in 55%. The letters had no details such as description of the oral lesion (80%), anatomical site (34%), size (99%), symptoms (83%), or period of evolution (92%). Clinical diagnosis was not included in 84% of the letters. Less than 5% of the referral letters contained information about previous consultation and laboratory investigation. The chi (2) test showed significant differences for ail items of the referral letter. Referral letters did not satisfy minimal requirements about clinical history or reason for consultation. leading to failed communication among professionals. Based on this study, we suggest that standard letters are important to improve the quality of the letters, reducing the rate of omission of relevant items.

Referral letters in oral medicine: standard versus non-standard letters

Usually referral letters are the only means of communication between general practitioners and specialists in the health area. However, they are inadequate if important basic data are omitted. The aim of this study was to compare the content of standard and non-standard letters. A total of 1956 files from the Oral Medicine Service were consecutively evaluated (March 1996 to September 2000). Key items were considered for analysis and the results were stored in a database using the Epinfo 6.04 program. The X-2 test (a=0.05) was applied to the results. of the 1956 files examined, 34% (662) had a referral letter, 31% of them being standard letters and 69% non-standard letters. Most standard letters (87%) were from professionals of public health institutions. Most percent discrepancies between standard and non-standard letters were observed for patient address (14.90 vs 1.32%), patient age (54.81 vs 9.47%), chief complaint (32.21 vs 8.37%), fundamental lesion (29.33 vs 13.66%), and symptoms (27.81 vs 15.42%,,). Statistically significant differences were observed for patient age, professional referring the patient, chief complaint, and site of the lesion. The quality and quantity of the information differed significantly between the two types of letters. The standard letters were more complete and contained information commonly absent in the non-standard letters. We suggest the use of standard letters for improving the quality of communication among professionals.

Surveillance on the light-front gauge-fixing Lagrangians

In this work we propose two Lagrange multipliers with distinct coefficients for the light-front gauge that leads to the complete (non-reduced) propagator. This is accomplished via (n · A)2 + (∂ · A) 2 terms in the Lagrangian density. These lead to a well-defined and exact though Lorentz non invariant light-front propagator.

Quantum gauge boson propagators in the light front

Gauge fields in the light front are traditionally addressed via, the employment of an algebraic condition n·A = 0 in the Lagrangian density, where Aμ is the gauge field (Abelian or non-Abelian) and nμ is the external, light-like, constant vector which defines the gauge proper. However, this condition though necessary is not sufficient to fix the gauge completely; there still remains a residual gauge freedom that must be addressed appropriately. To do this, we need to define the condition (n·A) (∂·A) = 0 with n·A = 0 = ∂·A. The implementation of this condition in the theory gives rise to a gauge boson propagator (in momentum space) leading to conspicuous nonlocal singularities of the type (k·n)-α where α = 1, 2. These singularities must be conveniently treated, and by convenient we mean not only mathemathically well-defined but physically sound and meaningful as well. In calculating such a propagator for one and two noncovariant gauge bosons those singularities demand from the outset the use of a prescription such as the Mandelstam-Leibbrandt (ML) one. We show that the implementation of the ML prescription does not remove certain pathologies associated with zero modes. However we present a causal, singularity-softening prescription and show how to keep causality from being broken without the zero mode nuisance and letting only the propagation of physical degrees of freedom.

Erudição e ciência: as procelas de Júlio Ribeiro no Brasil oitocentista

Pós-graduação em História - FCLAS

Práticas de informação e leitura: mediação e apropriação da informação nas cartas de leitores de um jornal popular do interior de São Paulo

Pós-graduação em Ciência da Informação - FFC