665 resultados para 130209 Medicine, Nursing and Health Curriculum and Pedagogy
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Enfermagem (mestrado profissional) - FMB
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BACKGROUND AND OBJECTIVES: Gross motor (GM) deficits are often reported in children with prenatal alcohol exposure (PAE), but their prevalence and the domains affected are not clear. The objective of this review was to characterize GM impairment in children with a diagnosis of fetal alcohol spectrum disorder (FASD) or moderate to heavy maternal alcohol intake.METHODS: A systematic review with meta-analysis was conducted. Medline, Embase, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PEDro, and Google Scholar databases were searched. Published observational studies including children aged 0 to <= 18 years with (1) an FASD diagnosis or moderate to heavy PAE, or a mother with confirmed alcohol dependency or binge drinking during pregnancy, and (2) GM outcomes obtained by using a standardized assessment tool. Data were extracted regarding participants, exposure, diagnosis, and outcomes by using a standardized protocol. Methodological quality was evaluated by using Strengthening the Reporting of Observational Studies in Epidemiology guidelines.RESULTS: The search recovered 2881 articles of which 14 met the systematic review inclusion criteria. The subjects' mean age ranged from 3 days to 13 years. Study limitations included failure to report cutoffs for impairment, nonstandardized reporting of PAE, and small sample sizes. The meta-analysis pooled results (n = 10) revealed a significant association between a diagnosis of FASD or moderate to heavy PAE and GM impairment (odds ratio: 2.9; 95% confidence interval: 2.1-4.0). GM deficits were found in balance, coordination, and ball skills. There was insufficient data to determine prevalence.CONCLUSIONS: The significant results suggest evaluation of GM proficiency should be a standard component of multidisciplinary FASD diagnostic services.
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Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.
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Pós-graduação em Educação - FFC
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The world’s population is having more and more difficulties in performing their daily activities and leisure, becoming, this way, more sedentary. Sedentary lifestyle can be considered as a reduction or as a lack of physical activity, less than the minimum volume suggested by the World Health Organization (WHO). Physical activity changes the behavior and some environmental acts. This study aimed to identify the NAF of students in the area of Physical Education and Healt Nursing and compare it with identified students’ levels non-health areas, being Production Engineer and Pedagogy. Aimed to correlate the found volume of 15 participants, with the state of cardio respiratory fitness (VO2max). The study included 125 students of both sexes from a university located in São Paulo state country. We conducted a cross-sectional study from August to October of 2012. For the initial test of the volume of physical activity we used the International Physical Activity Questionnaire (IPAQ) long version. In order of assessing cardio respiratory fitness, the Katch and McArdle seat test (1981) was used. Data were analyzed according to Physical Activity Level (PAL) presented by the university students in sessions 1, 2, 3, 4 of the IPAQ, and 15 students’ results were correlated with VO2max test. From these results we can say that: IPAQ session 1 showed that students in the health area are statistically superior to the non-health students area to the high-active classification. In session 2 the results were significant and superior to the health area and very active in sedentary classification. The session 3 results were very similar to session 1, showing that the health area as high-active with statistics differences. In session 4 we can see very significant results for health area in high-active areas and irregular actives. A total of 4 sessions found significant results for very active and sedentary. When was the attempt of association between levels 15 participants found the IPAQ long version and test bank VO2max, the results showed no significant association. The results of this study show a need for policies to encourage physical activity in the University environment, emphasizing a greater need for students who do not work in healthcare.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Objective—To identify major environmental and farm management factors associated with the occurrence of tuberculosis (TB) on cattle farms in northeastern Michigan. Design—Case-control study. Sample Population—17 cattle farms with infected cattle and 51 control farms. Procedure—Each case farm (laboratory confirmed diagnosis of Mycobacterium bovis infection) was matched with 2 to 4 control farms (negative whole-herd test results within previous 12 months) on the basis of type of farm (dairy or beef) and location. Cattle farm data were collected from in-person interviews and mailed questionnaires. Wildlife TB data were gathered through state wildlife surveillance. Environmental data were gathered from a satellite image-based geographic information system. Multivariable conditional logistic regression for matched analysis was performed. Results—Major factors associated with increased farm risk of TB were higher TB prevalence among wild deer and cattle farms in the area, herd size, and ponds or creeks in cattle housing areas. Factors associated with reduced farm risk of TB were greater amounts of natural open lands in the surrounding area and reducing deer access to cattle housing areas by housing cattle in barns, barnyards, or feedlots and use of electrified wire or barbed wire for livestock fencing. Conclusions and Clinical Relevance—Results suggest that certain environmental and management factors may be associated with risk of TB on cattle farms.
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In 1975, a wild white-tailed deer infected with bovine tuberculosis was shot in the northeastern Lower Peninsula, Michigan. The shooting of a second infected deer in the same area in 1994 triggered ongoing disease surveillance in the region. By 2002, bovine tuberculosis had been confirmed in 12 Michigan counties: from 449 deer; two elk; 41 non-cervid wildlife; one captive cervid facility and 28 cattle herds. We analyzed geographic spread of disease since the surveillance began and investigated factors influencing the prevalence of disease within the infected area. These analyses reveal that 78 percent of tuberculous deer came from within a 1560 km2 'core' area, within which the prevalence of apparent disease averaged 2.5 percent. Prevalence declined dramatically outside of the core and was an order of magnitude lower 30 km from its boundary. This prevalence gradient was highly significant (P<0.0001) and did not alter over the 6 year surveillance period (P= 0.98). Within the core, deer density and supplemental feeding by hunters were positively and independently correlated with tuberculosis prevalence in deer. Together, these two factors explained 55 percent of the variation in prevalence. We conclude that bovine tuberculosis was already well established in the deer population in 1994, that the infected area has not expanded significantly since that time, and that deer over-abundance and food supplementation have both contributed to ongoing transmission of disease. Managers are currently enforcing prohibitions on deer feeding in the core and are working to lower deer numbers there through increased hunting pressure.
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Clinical guidelines advise that dentists take radiographs in children to detect caries lesions missed by visual inspection; however, due to the current low caries prevalence in most countries, we hypothesized that the adjunct methods of caries detection would not significantly improve the detection of primary molar lesions in comparison to visual inspection alone. We evaluated the performance of visual inspection, alone or in combination with radiographic and laser fluorescence pen (LFpen) methods, in detecting occlusal and approximal caries lesions in primary molars. Two examiners evaluated children who had sought dental treatment with these diagnostic strategies. The reference standard involved the temporary separation of approximal and operative interventions for occlusal surfaces. The sensitivity, specificity, accuracy and utility of diagnostic strategies were calculated. Simultaneous combined strategies increased sensitivities but decreased specificities. Furthermore, no differences were observed in accuracy and utility, parameters more influenced by caries prevalence. In conclusion, adjunct radiographic and laser fluorescence methods offer no benefits to the detection of caries in primary teeth in comparison to visual inspection alone; hence, present clinical guidelines should be re-evaluated. Copyright (C) 2012 S. Karger AG, Basel
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There is growing evidence that the course of Bipolar Affective Disorder (BAD) can be altered by psychotherapeutic approaches, such as Psychoeducation. Therefore, this study was performed with the objective of identifying the implications of a Psychoeducation group on the everyday lives of individuals with BAD. To do this, the authors chose to perform a qualitative case study. Participants included twelve individuals with BAD who had attended at least six meetings of the Psychoeducation Group held at the Sao Jose do Rio Preto Faculty of Medicine (FAMERP). Semi-structured interviews were performed, which were recorded and then transcribed and subjected to Thematic Analysis. The present study showed that the referred group experience promoted the individuals' knowledge acquisition; their awareness regarding the disease and adherence to treatment; their making positive changes in life; the possibility of helping other patients to benefit from the knowledge learned in the group; and their awareness regarding other realities and coping strategies, obtained by exchanging experiences with other participants.
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Objectives To analyse the profile of tuberculosis (TB) among Bolivian immigrants, investigate the impact that this population has on the trends of TB and assess equity in access to TB treatment, in the city of Sao Paulo, Brazil. Methods Descriptive study of the epidemiological profile of TB in four city districts with large Bolivian populations, comparing cases among Brazilians and Bolivians, during the 19982008 period was carried out. We used logistic regression to adjust the treatment outcome for potential confounders. Results We identified 2056 new TB cases: 65.7% in Brazilians, 32.1% in Bolivians and 2.2% among other nationalities. Although TB incidence remained stable (high) over the study period, the annual proportion of cases among Bolivians increased from 15.0% to 53.0%. In comparison with the Brazilians, the Bolivians were younger (median age, 24 vs. 40 years; P < 0.0001) and presented a lower unemployment rate (3.1%vs. 11.6%; P < 0.0001), a lower rate of HIV co-infection (1.5%vs. 28.5%; P < 0.001), a higher proportion of individuals receiving supervised treatment (81.5%vs. 62.0%; P < 0.0001) and a higher proportion of cures (71.6%vs. 63.2%; P < 0.0001). After having been adjusted for potential confounder, cure after treatment was not associated with nationality. Conclusions Bolivian immigrants influenced the incidence but not the trends of TB among Brazilians in the study area. We found no significant differences between Bolivians and Brazilians regarding healthcare access or treatment outcome. Guaranteed universal health care access for all, including undocumented individuals, contributes to health equity. Specific intervention strategies are warranted for immigrants with tuberculosis.
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Objective: To compare the polymerization status of mouse oocyte spindles exposed to various temperatures at various stages of meiosis. Design: Experimental animal study. Setting: University animal laboratory. Animal(s): CF1 mice. Intervention(s): Immature oocytes matured to metaphase I (MI), telophase I (TI), and metaphase II (MII) were incubated at 37 degrees C (control), room temperature (RT), or 4 degrees C for 0, 10, 30, and 60 minutes. Spindle analysis subsequently was performed using polarized field microscopy and immunocytochemistry. Spindles of TI and MII oocytes that underwent vitrification and warming were analyzed also by immunocytochemistry. Main Outcome Measure(s): Detection of polymerized meiotic spindles. Result(s): At RT, and after 60 minutes at 4 degrees C, a significant time-dependent decrease in the percentage of polymerized meiotic spindles was observed in MI and MII oocytes, but not in TI oocytes. The polymerization of TI spindles at 4 degrees C was similar to that of TI spindles at 4 degrees C that underwent vitrification and warming. Conclusion(s): Significant differences in the microtubule dynamics of MI, TI, and MII oocytes incubated at different temperatures were observed. In particular, meiotic spindles in TI oocytes exhibited less depolymerization than did metaphase spindles. (Fertil Steril (R) 2012; 97: 714-9. (C) 2012 by American Society for Reproductive Medicine.)