Diagnóstico diferencial entre Doença de Crohn e Hidradenite Supurativa: relato de caso

Crohn’s disease is a chronic infl ammatory bowel disease with segmental transmural infl ammation, which complicate with formation of fi stulas and abscesses. The hidradenitis suppurativa (HS) is characterized by recurrent abscesses, with a predilection for areas rich in apocrine glands such as the axillary, inguinal and perineal. The differential diagnosis between these diseases is diffi cult and may compromise treatment. Report case: C.R.M.A., 40 year-old, female, white, ileal and colonic Crohn’s disease complicated with perianal and rectovaginal fi stula for 12 years, treated with biological therapy since May 2010. In Sep/2010 presented with an abscess in the buttock D with purulent discharge refractory to the use of ciprofl oxacin and metronidazole. USG: collection of 30 cm3 in buttock D. The diagnosis was HS and the patient underwent extensive surgical removal of the affected areas (10 x 2 cm) with healing by secondary intention. Skin graft performed unsuccessfully in Dec/2010. The patient returned in jan/2011 with a new fi stula at the site of resection, consistent with Crohn’s disease. In fev/2011 underwent drainage of abscesses and placement of setons in perianal fi stulas. Currently in therapy with good biological evolution of fi stulas. The prevalence of HS varies from 0.3 to 4% of the population in general. The axilla is the region most affected and perianal lesions are associated with greater weakness. There are published reports of association between HS and Crohn’s disease sporadically and further studies are needed to assess a common pathogenesis. The differential diagnosis should be performed in all cases planning immediate treatment, avoiding complications and worsening of the patient’s quality of life.

Uso de plasma rico em plaquetas em úlceras de córnea em cães

This study aims to clinically and macroscopically evaluate the adjuvant therapy with platelet-rich plasma in the form of eyedrops or clot, for corneal ulcers in dogs treated at the Veterinary Ophthalmology Service. We analyzed 20 eyes diagnosed with ulcerative keratitis, divided into two experimental groups. The eyedrop group (GC) was composed of eyes treated topically with eyedrops of autologous plateletrich plasma (PRP), and the clot group (GT) was composed of eyes treated with a platelet-rich clot and covered with a third eyelid for retention of the clot. The groups were evaluated by clinical and macroscopic analysis and by the analysis of epithelial defect reduction, at different times, at three, five, ten, 15 and 30 days, except for the third day in GT. The coverage of the third eyelid was removed on the fifth day. In both groups the inflammation signs reduced, there was an improvement in ocular sensibility and proper repair of epithelial defect. All GT eyes and 70% GC eyes showed complete healing on the fifth day, the remainder of GC completed healing on the tenth day. PRP in the form of eyedrops and clot is an excellent adjuvant therapy to be instituted in the clinical treatment for corneal ulcer in dogs, because it decreases the inflammatory signs and the ocular pain and it potentially assists in healing epithelial defects.

Características do processo de diagnóstico de hanseníase no atendimento primário e secundário

Contexto e objetivo: A hanseníase caracteriza-se por ter diagnóstico eminentemente clínico, principalmente através da constatação de hipo ou anestesia das lesões, ou seja, sem necessariamente o uso de exames adicionais, como baciloscopia e biópsia, utilizados para classificação clínica da doença. Buscou-se definir se há tendência à desvalorização da avaliação clínica em favor do excesso de exames complementares, investigar a adequação do registro nos atendimentos da atenção básica e compará-los com o obtido em serviço de média complexidade. Desenho e local: Estudo transversal, de base populacional, utilizando registros de prontuários, realizado em dois âmbitos de atendimentos de saúde da cidade de Campinas (SP): os Centros de Saúde e a assistência dermatológica especializada de hospital de ensino. Métodos: Os registros foram investigados por meio da aplicação de checklist, contendo itens indispensáveis ao atendimento a hansenianos. Associações foram testadas pela prova de Goodman e ao nível de 5% de significância. Resultados: Foram avaliados 33 prontuários oriundos dos centros de saúde e 36 do hospital, observou-se polarização entre registros adequados e ausentes, evidenciando a presença de efeito tudo ou nada nos atendimentos; de 26 variáveis, apenas em 5 (19,23%) obteve-se predomínio da avaliação do hospital sobre os centros de saúde; evidenciou-se dependência de exames complementares, solicitados em 67 dos 69 atendimentos (97,10%), para diagnóstico da doença. Conclusão: Confirmou-se, neste estudo, déficit da avaliação médica e indicação inadequada de exames adicionais. Por associar-se com excesso de solicitação de exames, a observação clínica mostrou-se incompleta, comprometendo a capacidade diagnóstica dos atendimentos a hansenianos.

Utilização de imagem de satélite Landsat no mapeamento da ocupação da terra e seus conflitos de uso em APPs na bacia hidrográfica do ribeirão Paraíso - São Manuel (SP)

The objectives of this study were to evaluate land use and occupation of Permanent Preservation Areas (PPA) as well as its use conflicts by TM (Thematic Mapper) image of the 2010 Landsat-5 satellite, according to the Forest Code. For that purpose, Geographic Information Systems in the Ribeirão Paraíso watershed, São Manuel, SP were used. The combination of Remote Sensing and Geographic Information System technologies allowed representation of spatial distribution of the landscape and data integration in the diagnosis of geographic interest. The 2010 mapping showed 12 use categories, and the sugar cane crop had the largest land occupation, 48.25% of the area. The areas of permanent preservation amounted to 925.74 ha, which is an ideal value based on the Brazilian legislation. Mapping of land use conflicts showed intensive anthropic actions going 80.13% forward on PPAs, with only 19.87% remaining forests, which highlights their negative impact and illegal situations in these areas.

Diagnóstico de conflitos em áreas de preservação permanente na bacia do Rio Capivara - Botucatu (SP)

The permanent preservation areas (PPA) established by Brazilian law are there to protect the natural environment. With the expansion of space occupied by man and development of economic activities in these areas were engaged in conflicts characterized PPA, where the use is other than the natural vegetation. According to these paradigms work aims to raise these conflict areas in the River Basin Capivara, Botucatu (SP) with the help of GIS Ilwis 3.4, topographic maps of IBGE and satellite images CBERS 2B. The map was generated from PPA in the GIS by distance calculation in relation to drainage, springs and break line on Cuesta de Botucatu. The classes of land use and natural vegetation were determined by interpretation of satellite images and field visits to check their veracity. With the cutting of the map of land use and natural vegetation in relation to PPA unit it was determined that the total 44,63% PPA is in conflict occupied by pasture, forest plantation, orange, annual crops, farms and irrigated rice project in lowland. This diagnostic characterizes the degradation of the environment and highlights the need to harmonize the economic and urban development with the preservation of the environment to ensure sustainability of the region.

Diagnóstico de potenciliade das unidades ambientais na bacia do Rio Capivara, Botucatu - SP

This work has the objective to elaborate the potentialities of the farming expand diagnosis of the Capivara River Hydrographic basin, in the Botucatu – SP municipal district, to obtain an interpretation of the system actual situation through the historical trajectory and possible evolution with the assistance of the SIG Ilwis 3.4 and orbital images CBERS 2B, in the pancromatics bands, obtained in 12/07/2008. The potentialities of the farming expand diagnosis was obtained through the physical mean modeling, of the farming expand presents in the studied environment and shows possible line actions to minimize the impacts e reach a sustainable development to the region. The Capivara river basin presents more than 70% of your areas occupied by the anthropic expanding, with the extensive farming predominance, forestall planting, orange and sugar cane. In the potentiality diagnostic analyses notes the good quality of the basin to the farming expand, except the region comprehended by the Botucatu Cuesta and the meadows area. The basin until has a good environmental quality and this diagnosis must serve for a start point to the realization of the territorial ordination as quick as possible to the environment conditions finds remains the same, granting the recovery capability.

Técnicas estatísticas utilizadas em climatologia geográfica: diagnóstico e propostas

Pós-graduação em Geografia - FCT

Avaliação do uso de medicamentos psicotrópicos pelos pacientes de uma Unidade Básica de Saúde de um município de pequeno porte do Estado de São Paulo

Pós-graduação em Saúde Coletiva - FMB

Diagnóstico dos agentes e processos atuantes na fragmentação da paisagem na bacia hidrográfica do rio Pericumã, ambiente de Amazônia Maranhense

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

Diagnóstico e proposição de medidas para o controle das perdas de água no sistema de abastecimento de Guaratinguetá

Over the past two years, Brazil has been facing a major water crisis in its history and the state of Sao Paulo is the one that has been going through worst difficulties. In this scenario, all water users should do everything possible so that the consumption of water resources is carried out in a sustainable manner. In this context, the companies responsible for the public water supply must increase the efficiency of water resource management. It is indispensable combating losses in the public supply system. When there is a non-visible leak in a pipe, the wastewater volume can be high, but in this case, the water returns to nature and continues to participate in the hydrological cycle. The economic loss corresponds to the value added to the product water, which includes the intrinsic costs of exploration, processing and distribution. This damage results in a reduced availability of financial resources of sanitation companies to invest in environmentally friendly solutions. This study aimed to diagnose the water distribution system in the city of Guaratinguetá (SP), held by the Companhia de Serviços de Água, Esgoto e Resíduos de Guaratinguetá (SAEG), to propose measures to combat water loss. Among the proposed measures, there is the monitoring of losses, planning for replacement of old pipes and company awareness as a whole in relation to combat water losses

Avaliação de cardiotoxicidade subclínica tardia em pacientes com diagnóstico prévio de linfoma não Hodgkin tratados com antraciclinas

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

O uso da endoscopia para o rastreamento do câncer do trato aerodigestório alto em população de alto risco

Pós-graduação em Bases Gerais da Cirurgia - FMB

Diagnóstico e proposição de medidas para o controle das perdas de água no sistema de abastecimento de Guaratinguetá

Over the past two years, Brazil has been facing a major water crisis in its history and the state of Sao Paulo is the one that has been going through worst difficulties. In this scenario, all water users should do everything possible so that the consumption of water resources is carried out in a sustainable manner. In this context, the companies responsible for the public water supply must increase the efficiency of water resource management. It is indispensable combating losses in the public supply system. When there is a non-visible leak in a pipe, the wastewater volume can be high, but in this case, the water returns to nature and continues to participate in the hydrological cycle. The economic loss corresponds to the value added to the product water, which includes the intrinsic costs of exploration, processing and distribution. This damage results in a reduced availability of financial resources of sanitation companies to invest in environmentally friendly solutions. This study aimed to diagnose the water distribution system in the city of Guaratinguetá (SP), held by the Companhia de Serviços de Água, Esgoto e Resíduos de Guaratinguetá (SAEG), to propose measures to combat water loss. Among the proposed measures, there is the monitoring of losses, planning for replacement of old pipes and company awareness as a whole in relation to combat water losses

Avaliação de cardiotoxicidade subclínica tardia em pacientes com diagnóstico prévio de linfoma não Hodgkin tratados com antraciclinas

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

O uso da endoscopia para o rastreamento do câncer do trato aerodigestório alto em população de alto risco

Pós-graduação em Bases Gerais da Cirurgia - FMB