Análise das internações por condições sensíveis à Atenção Primária em hospital de referência regional, SP/Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Perfil clínico de crianças com indicação da cirurgia das tonsilas em um hospital terciário universitário

The indications for adenotonsillectomy in pediatric patients have changed considerably during the 90th decade. Local or systemic complications of the adenoid or tonsil hypertrophy itself have now been substituted by signs of obstructive ventilatory disturbances, including obstructive sleep apnea as the major indications for surgery. Objective: This study analyses the clinical profile of children submitted to adenotonsilectomy in their pre and postoperative state, at Botucatu Medical School-State University São Paulo, UNESP. Methods: 332 children of both genders, aged 1 to 12 years, who underwent adenotonsillectomy between 1999 and 2004, were studied, focused on epidemiological profile, pre and postoperative (1 month) symptoms, obtained from medical records. Height and weight were compared to brazilian normal age related values. Results: We found a predominance of the male gender, except in he group aged from 10 to 12 years. Considering wheight and height, we found important failure to thrive, mostly for height deficit. Among clinical aspects, we found a significant reduction in obstructive symptoms like snoring or apneia (p<0001) in the postoperative period. Conclusion: Our results were similar to the literature findings of patients clinical profile. The major indication for adenotonsillectomy in our service was clinical diagnosis of obstructive sleep apnea.

Queixas técnicas e eventos adversos a medicamentos notificados em um hospital sentinela do interior de São Paulo, 2009-2010

Objective: to describe technical complaints and adverse drug events reported in a sentinel hospital in São Paulo state in 2009 and 2010. Methods: This is a descriptive study. Information was obtained from the sentinel hospital Risk Management database. Results: we found 199 reports related to drugs: 70.0% were technical complaints, 21.0% ineffective therapy and 9.0% adverse reaction to medication. The pharmacological groups with highest number of reports were: drugs that act on alimentary tract and metabolism (25.1%), the nervous system (25.1%) and anti-infective drugs for systemic use (22.1%). Conclusion: technical complaints and adverse drug events were frequent, despite recognized underreporting. The characterization of these events could inform the adoption of control measures and permanent educational actions in health services in order to prevent their occurrence.

Estudo com familiares de pacientes com câncer de mama: abordando conhecimento sobre fatores de risco

Breast cancer (BC) is the most common malignancy in women worldwide, with one million new cases confirmed each year. This study aimed at identifying the knowledge of patients? relatives concerning the risk factors (RF) for BC. It is a descriptive quantitative study carried out in the Chemotherapy Technical Division of a University Hospital in São Paulo state, Brazil, from September to October 2006. Only female (30) relatives were included due to the fact that BC is more frequent in females. The major RF cited were family history for BC 33.3% (10), smoking 16.6% (5), alcoholic-drink consumption 10% (3), animal-fat-rich diet 3.3% (1). Other factors such as not breastfeeding, environmental factors, use of oral contraceptives and hormone-replacement therapy were mentioned by 10% (3) of the relatives. It was concluded that the relatives of patients undergoing chemotherapeutic treatment showed to have little knowledge concerning RF for BC. Hence, it is important to rethink the inclusion of the health education process in the family scenario. This issue reaches far beyond thesimple transmission of information. Healthcare professionals and nurses in particular, must focus on these individuals? social context, values, beliefs and needs.

Estudo retrospectivo (2007-2011) da casuística de cães com mastocitomas cutâneos atendidos em um hospital-escola

Neoplasms of mast cell origin are uncommon in most animal species. Although cases of cutaneous mastocitoma (CM) are rare in humans, it is the second most diagnosed cancer in dogs, accounting for approximately 20% of cutaneous tumors in this species. The age group most frequently affected is between eight and nine years, but it may occur in animals up to three weeks old. This study aimed to describe the epidemiological, hematological and histopathological characteristics of 73 dogs with cutaneous mast cell tumors attended between 2007 and 2011 by the Oncology Service of a teaching hospital in the state of São Paulo. Data collected included race, age, sex, weight, skin region affected, blood tests results at the first consultation and histopathological grading of dogs diagnosed with this neoplasia.

Acidentes de trabalho em hospital público de alta complexidade no interior paulista: estudo das concepções de segurança

Pós-graduação em Saúde Coletiva - FMB

Segurança do paciente: análise das notificações de eventos em um hospital privado

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Hydrogeologic Setting and Ground-Water Flow Simulations of the Eastern High Plains Regional Study Area, Nebraska

The transport of anthropogenic and natural contaminants to public-supply wells was evaluated in a part of the High Plains aquifer near York, Nebraska, as part of the U.S. Geological Survey National Water-Quality Assessment Program. The aquifer in the Eastern High Plains regional study area is composed of Quaternary alluvial deposits typical of the High Plains aquifer in eastern Nebraska and Kansas, is an important water source for agricultural irrigation and public water supply, and is susceptible and vulnerable to contamination. A six-layer, steady-state ground-water flow model of the High Plains aquifer near York, Nebraska, was constructed and calibrated to average conditions for the time period from 1997 to 2001. The calibrated model and advective particle-tracking simulations were used to compute areas contributing recharge and travel times from recharge areas to selected public-supply wells. Model results indicate recharge from agricultural irrigation return flow and precipitation (about 89 percent of inflow) provides most of the ground-water inflow, whereas the majority of ground-water discharge is to pumping wells (about 78 percent of outflow). Particle-tracking results indicate areas contributing recharge to public-supply wells extend northwest because of the natural ground-water gradient from the northwest to the southeast across the study area. Particle-tracking simulations indicate most ground-water travel times from areas contributing recharge range from 20 to more than 100 years but that some ground water, especially that in the lower confined unit, originates at the upgradient model boundary instead of at the water table in the study area and has travel times of thousands of years.

Biometric relationships of the spotted lobster, Panulirus echinatus, from Tamandare coastal reefs, Pernambuco State, Brazil

Biometric relationships were recorded for 2431 male and female Panulirus echinatus sampled at Tamandare coastal reefs, Pernambuco, Brazil. The following body measurements were taken: carapace length and width, abdomen length and width, total length, third and fifth pereiopod length, cephalothorax-abdomen and total weight. Twelve relationships were studied to compare the biometric characteristics Of males and females. Eleven of them showed difference between the sexes. Comparing sexes with the same carapace length, males have a heavier cephalothorax and longer third and fifth pereiopods than females, whereas females are longer, wider, and have a heavier abdomen than males. For genders with the same total length, males are heavier and have a longer carapace than females, while females have a larger abdomen. For genders with the same abdomen length, males have a heavier abdomen than females. The relationships TWg/TL and A Wg/AL showed positive allometric growth for the males. All other relationships involving weight, presented negative allometric growth for both sexes.

HEV infection in swine from Eastern Brazilian Amazon: Evidence of co-infection by different subtypes

Hepatitis E virus (HEV) is a fecal-orally transmitted member of the genus Hepevirus that causes acute hepatitis in humans and is widely distributed throughout the world. Pigs have been reported as the main source of genotypes 3 and 4 infection to humans in non-endemic areas. To investigate HEV infection in pigs from different regions of Para state (Eastern Brazilian Amazon), we performed serological and molecular analyses of serum, fecal and liver samples from 151 adult pigs slaughtered between April and October 2010 in slaughterhouses in the metropolitan region of Belem, Para. Among the animals tested, 8.6% (13/151) were positive for anti-HEV IgG but not for anti-HEV IgM. HEV RNA was detected in 4.8% (22/453) of the samples analyzed and 9.9% (15/151) of the animals had at least one positive sample. Phylogenetic analysis showed that all sequences belonged to genotype 3 that were related to human isolates from other non-endemic regions, suggesting that the isolates had zoonotic potential. Subtypes 3c and 3f were simultaneously detected in some pigs, suggesting co-infection by more than one strain and/or the presence of a recombinant virus. These results constitute the first molecular and serologic evidence of swine HEV circulation in the Eastern Brazilian Amazon. (C) 2012 Elsevier Ltd. All rights reserved.

Feeding habits of Guiana dolphins, Sotalia guianensis, from south-eastern Brazil: new items and a knowledge review

This study presents new information on feeding habits of Guiana dolphins, Sotalia guianensis, in south-eastern Brazil, together with new regression equations to evaluate the weight and length of fish from otoliths, showing an overview on the knowledge about this species' diet in this area. Eighteen stomach contents had been analysed and compared to 180 samples collected in another eight feeding studies. The analysed specimens were either incidentally caught in gillnets used in coastal waters by the fleet based in the Cananeia main harbour (25 degrees 00'S 47 degrees 55'W), south of Sao Paulo State, or found dead in inner waters of the Cananeia estuary between 2003 and 2009. Based on the index of relative importance analysis, the most important fish species were the banded croaker, Paralonchurus brasiliensis. Doryteuthis plei was the most representative cephalopod species. Stellifer rastrifer was the most important fish species observed in dolphins in inner estuarine waters and P. brasiliensis in recovered dolphins from coastal waters. Loliguncula brevis is the only cephalopod species reported from dolphins found in inner estuarine waters up to date. Doryteuthis plei was the most important cephalopod species observed in coastal dolphins. When considering other feeding studies, the most representative fish family in the diet of S. guianensis was Sciaenidae, which is mainly represented by demersal fishes. The main preys of S. guianensis are abundant in the studied areas, which may indicate an opportunistic feeding habit. The majority of them are not the most important target species by the commercial fishery in south-eastern Brazil.

Population biology and diet of the puffer fish Lagocephalus laevigatus (Tetraodontiformes: Tetraodontidae) in Caraguatatuba Bay, south-eastern Brazil

This study describes the spatio-temporal distribution, population biology, and diet of the puffer fish Lagocephalus laevigatus in Caraguatatuba Bay, south-eastern Brazil. Monthly samples were taken between August 2003 and October 2004 by trawls in two areas, south and north, at depths of 1 to 4 m. The fish were measured and their sex and reproductive stage determined. The abundance of this species was compared between areas and among months, and the items in the diet were identified and quantified. Lagocephalus laevigatus was rare in Caraguatatuba Bay, where only 199 small individuals (4.8 to 15.4 cm) were obtained in the entire study period, suggesting that this species uses the estuary as a nursery. None of the specimens of L. laevigatus captured in Caraguatatuba Bay were sexually mature. Higher densities of L. laevigatus in the bay were recorded in the south area and between October and December 2003, i.e. in the spring, suggesting that spawning may occur from late winter to spring (August through to November). The diet items consumed by L. laevigatus in Caraguatatuba Bay were, as expected from the current literature, crustaceans, mainly amphipods, and fish. However, the most-consumed item was the sea whip Leptogorgia setacea (Cnidaria). This feeding habit may be related to the presence of toxins (tetrodotoxin and saxitoxin) that are frequently found in the skin and viscera of L. laevigatus, which may be sequestered from the sea whip, which possibility still needs to be specifically evaluated.

Renal Function at Hospital Admission and Mortality Due to Acute Kidney Injury after Myocardial Infarction

Background: The role of an impaired estimated glomerular filtration rate (eGFR) at hospital admission in the outcome of acute kidney injury (AKI) after acute myocardial infarction (AMI) has been underreported. The aim of this study was to assess the influence of an admission eGFR<60 mL/min/1.73 m(2) on the incidence and early and late mortality of AMI-associated AKI. Methods: A prospective study of 828 AMI patients was performed. AKI was defined as a serum creatinine increase of >= 50% from the time of admission (RIFLE criteria) in the first 7 days of hospitalization. Patients were divided into subgroups according to their eGFR upon hospital admission (MDRD formula, mL/min/1.73 m(2)) and the development of AKI: eGFR >= 60 without AKI, eGFR<60 without AKI, eGFR >= 60 with AKI and eGFR<60 with AKI. Results: Overall, 14.6% of the patients in this study developed AKI. The admission eGFR had no impact on the incidence of AKI. However, the admission eGFR was associated with the outcome of AMI-associated AKI. The adjusted hazard ratios (AHR, Cox multivariate analysis) for 30-day mortality were 2.00 (95% CI 1.11-3.61) for eGFR, 60 without AKI, 4.76 (95% CI 2.45-9.26) for eGFR >= 60 with AKI and 6.27 (95% CI 3.20-12.29) for eGFR, 60 with AKI. Only an admission eGFR of <60 with AKI was significantly associated with a 30-day to 1-year mortality hazard (AHR 3.05, 95% CI 1.50-6.19). Conclusions: AKI development was associated with an increased early mortality hazard in AMI patients with either preserved or impaired admission eGFR. Only the association of impaired admission eGFR and AKI was associated with an increased hazard for late mortality among these patients.

COMPARING RAINFALL INTENSITY DURATION RELATIONSHIPS FOR SITES OF THE STATE OF SAO PAULO

Rainfall intensity durations relationships are extremely important in the design of systems for mitigating runoff losses. The objective of this work was to compare rainfall depths generated by the PLUVIO 2.1 software, with depths from the standard intensity duration curves developed by MARTINEZ & MAGNI (1999). It was compared rainfall intensities of 10, 20, 30, 60, 120 and 1440 minute durations for 2, 5, 10, 50 and 100 year return periods for 30 sites in the state of Sao Paulo. The results showed that PLUVIO was effective, except in predicting the 24 hours rainfall from 100 year return period events in four locations in the central and eastern regions of the state.

Magmatism and fenitization in the Cretaceous potassium-alkaline-carbonatitic complex of Ipanema So Paulo State, Brazil

The Ipanema alkaline-carbonatitic complex is part of the Meso-Cenozoic alkaline magmatism located within the southeastern part of the Brazilian Platform. Drill-core and field sampling have indicated the occurrence of glimmerites, with subordinate shonkinites (mela-syenites), clinopyroxene-bearing glimmerites, diorites and syenites. The glimmerites are cross-cut by lamprophyric dykes and calciocarbonatites. Fenitization has deeply affected the country rocks, originating dioritic and syenitic rocks. The Ipanema rocks show a distinct potassic affinity. The initial Sr-Nd- isotopic composition of the Ipanema rocks ((87)Sr/(86)Sr = 0.70661-0.70754 and (143)Nd/(144)Nd = 0.51169-0.51181) is similar to that of tholeiitic and potassium-rich-alkaline rocks of the Eastern Paraguay. Stable isotope data for the Ipanema calciocarbonatite suggest interaction with fluids at temperatures typical of hydrothermal stages, as hypothesized for other carbonatite complexes from southeastern Brazil. The chemical differences between the lamprophyre, glimmerites, carbonatites, apatitites and magnetitites, and the absence of marked REE enrichment in the evolved lithologies, all indicate that fractional crystallization and accumulus of liquidus phases in a magma reservoir, likely coupled with liquid immiscibility processes, may have played an important role in the genesis of the Ipanema rocks.