Guidelines for the management and treatment of periodic fever syndromes Familial Mediterranean Fever

To establish guidelines based on scientific evidence for the management of familial Mediterranean fever. The Guideline was prepared from 5 clinical questions that were structured through PICO (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. 10,341 articles were retrieved and evaluated by title and abstract; from these, 46 articles were selected to support the recommendations. 1. The diagnosis of FMF is based on clinical manifestations, characterized by recurrent febrile episodes associated with abdominal pain, chest or arthritis of large joints; 2. FMF is a genetic disease presenting an autosomal recessive trait, caused by mutation in the MEFV gene; 3. Laboratory tests are not specific, demonstrating high serum levels of inflammatory proteins in the acute phase of the disease, but also often showing high levels even between attacks. SAA serum levels may be especially useful in monitoring the effectiveness of treatment; 4. The therapy of choice is colchicine; this drug has proven effectiveness in preventing acute inflammatory episodes and progression towards amyloidosis in adults; 5. Based on the available information, the use of biological drugs appears to be an alternative for patients with FMF who do not respond or are intolerant to therapy with colchicine.

Diretrizes para o uso da gestão de design a partir de um diagnóstico setorial das microrregiões de Araçatuba e Birigui do Estado de São Paulo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Speech-language therapy for treatment of dysphagia and dysphonia in systemic granulomatous diseases: granulomatous diseases: dysphagia and dysphonia treatments

The granulomatous lesions are frequently founded in infectious diseases and can involve the larynx and pharynx and can cause varying degrees of dysphonia and dysphagia. There is still no systematic review that analyzes effectiveness of speech therapy in systemic granulomatous diseases. Research strategy: A systematic review was performed according to Cochrane guideline considering the inclusion of RCTs and quasi-RCTs about the effectiveness of speech-language therapy to treat dysphagia and dysphonia symptoms in systemic granulomatous diseases of the larynx and pharynx. Selection criteria: The outcome planned to be measured in this review were: swallowing impairment, frequency of chest infections and voice and swallowing symptoms. Data analysis: We identified 1,140 citations from all electronic databases. After an initial shift we only selected 9 titles to be retrieved in full-text. After full reading, there was no RCT found in this review and therefore, we only described the existing 2 case series studies. Results: There were no randomized controlled trials found in the literature. Therefore, two studies were selected to be included only for narratively analysis as they were case series. Conclusion: There is no evidence from high quality studies about the effectiveness of speech-language therapy in patients with granulomatous diseases of the larynx and pharynx. The investigators could rely in the outcomes suggested in this review to design their own clinical trials.

Utilizando estudo de caso(s) como estratégia de pesquisa qualitativa: boas práticas e sugestões

Conselho Nacional de Desenvolvimento Cientifico e Tecnológico (CNPq)

Avaliação dos protocolos de diagnóstico e de controle da hiperglicemia materna: impacto na prevalência de Diabetes Melito Gestacional (DMG) e de Hiperglicemia Gestacional Leve (HGL) e nos resultados perinatais

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Análise de junta aparafusada de biela automotiva

Pós-graduação em Engenharia Mecânica - FEG

A comunicação não verbal da equipe de enfermagem contribuindo para o cuidado do idoso em internação hospitalar

Pós-graduação em Enfermagem (mestrado profissional) - FMB

A prática como componente curricular via Projeto Integrado de Prática Educativa (PIPE) no ensino de estatística na Universidade: implementação e implicações na Formação Inicial do Professor de Matemática

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Utilização das tecnologias digitais por professores de matemática: um olhar para a região de São José do Rio Preto

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

As contribuições da Pedagogia Waldorf no atendimento a diversidade e na valorização das diferenças

The ideal of Waldorf Education, since the opening of the first school in 1919, was based on innovative principles for a humanized society. Among those principles, there was the attendance of all children without distinction, which is exactly the main idea of the inclusive school. Waldorf pedagogy defends that under the right pedagogical action and care with the individual development, anyone can develop, regardless of their disability. This statem ent highlights the main objective of this methodology, that is the human development, aligned to another fundamental guideline of inclusive education. Accordingly, the hypothesis of this work is that Waldorf education promotes inclusive schooling contexts, attending diversity and valuing differences. The general objective of this study is: analyze Waldorf Education to verify if it promotes inclusive contexts. And the specific objetives were: identify elements in this practice that favors diversity attend; analyze the practice of a Waldorf school, considering documentation, structure, and conception of managers, teachers and parents. The study was based on quantitative and qualitative research approach, and the data was collected trough observation of teaching practices in a classroom where a disabled student was present, as well as through documentation and observation of the school environment. Furthermore, in order to verify the understanding of parents (71 individuals) and teachers (18 individuals) on inclusion, a specific questionnaire was developed for each of these two groups. For the records, a diary and an observation script were used. It was concluded that Waldorf methodology provides all the necessary conditions to inclusion, mainly due to it's enhancement of individuality, didactic organization and it's roots in social relations

Review of the Evidence Used In The Description Of Currently Recognized Cetacean Subspecies

We reviewed the subspecies listed by Rice (1998) and those described since (a total of 49, in 19 species), assessing them against the criteria recommended by the recent Workshop on Shortcomings of Cetacean Taxonomy in Relation to Needs of Conservation and Management (Reeves et al., 2004). The workshop suggested that the subspecies concept can be construed to cover two types of entities: a) lineages diverging but not quite far along the continuum of divergence (still having significant gene flow with another lineage or lineages) to be judged as species, and b) lineages that may well be species but for which not enough evidence is yet available to justify their designation as such. As a criterion for support of a subspecies, the workshop suggested as a guideline that there be at least one good line of either morphological or appropriate genetic evidence. "Appropriate" was not defined; the recommendation was that that be left up to the taxonomist authors of subspecies and to their professional peers. A further recommendation was that evidence on distribution, behavior and ecology should be considered not as primary but as supporting evidence, as there was not agreement at the workshop that such characters are necessarily stable (in the case of distribution) or inherent (behavior and ecology).

As contribuições da Pedagogia Waldorf no atendimento a diversidade e na valorização das diferenças

The ideal of Waldorf Education, since the opening of the first school in 1919, was based on innovative principles for a humanized society. Among those principles, there was the attendance of all children without distinction, which is exactly the main idea of the inclusive school. Waldorf pedagogy defends that under the right pedagogical action and care with the individual development, anyone can develop, regardless of their disability. This statem ent highlights the main objective of this methodology, that is the human development, aligned to another fundamental guideline of inclusive education. Accordingly, the hypothesis of this work is that Waldorf education promotes inclusive schooling contexts, attending diversity and valuing differences. The general objective of this study is: analyze Waldorf Education to verify if it promotes inclusive contexts. And the specific objetives were: identify elements in this practice that favors diversity attend; analyze the practice of a Waldorf school, considering documentation, structure, and conception of managers, teachers and parents. The study was based on quantitative and qualitative research approach, and the data was collected trough observation of teaching practices in a classroom where a disabled student was present, as well as through documentation and observation of the school environment. Furthermore, in order to verify the understanding of parents (71 individuals) and teachers (18 individuals) on inclusion, a specific questionnaire was developed for each of these two groups. For the records, a diary and an observation script were used. It was concluded that Waldorf methodology provides all the necessary conditions to inclusion, mainly due to it's enhancement of individuality, didactic organization and it's roots in social relations

International Consensus Guidelines for Nutrition Therapy in Pancreatitis

Guidelines for nutrition support in pancreatitis have been inconsistently adapted to clinical practice. The International Consensus Guideline Committee (ICGC) established a pancreatitis task force to review published guidelines for pancreatitis in nutrition support. A PubMed search using the terms pancreatitis, acute pancreatitis, chronic pancreatitis, nutrition support, parenteral nutrition, enteral nutrition, and guidelines was conducted for the period from January 1999 to May 2011. Eleven guidelines were identified for review. The ICGC used the following process to develop unified guideline statements: summarize the strength of evidence (grading) of the guidelines; establish level of evidence for ICGC statements as high, intermediate, and low; assign published guideline levels of evidence; and define an ICGC grading system. International Pancreatitis Guideline Grades were established as follows: platinum-high level of evidence and consistent agreement among the guidelines; gold-acceptable level of evidence and no conflicting statements in guidelines; and silver-single existing guideline statement with no conflict in other guidelines. Eighteen ICGC statements were derived from the 11 published pancreatitis guidelines. Uniform agreement from widely disparate groups (United States, Europe, Japan, and China) resulted in 4 platinum-level guideline statements for nutrition in pancreatitis: nutrition support therapy (NST) is generally not needed for mild to moderate disease, NST is needed for severe disease, enteral nutrition (EN) is preferred over parenteral nutrition (PN), and use PN when EN is contraindicated or not feasible. This methodology provides a template for future ICGC nutrition guideline development. (JPEN J Parenter Enteral Nutr. 2012;36:284-291)

Massage application for occupational low back pain in nursing staff

This is a clinical trial which aims to evaluate the efficiency of massage in the reduction of occupational low back pain, and its influence on the performance of work and life activities for the nursing team. The sample consisted of 18 employees who received seven to eight sessions after their work period. From the Numerical Pain Rating Scale, significant improvements were found between the 3rd and 1st evaluations (p=0.000) and between the 3rd and 2nd (p=0.004), using the Wilcoxon test. Regarding the Oswestry Disability Index, the paired t test showed a statistical difference (p=0.02) between the baseline, with a mean of 21.33% and the second evaluation (18.78%), which was also seen between the second and third evaluation (16.67%). The score for the Handling and Transfer Risk Evaluation Scale was 18 points (medium risk). It is concluded that massage was effective in reducing occupational low back pain, and provided improvement in activities of work and life. Clinical Trials Identifier: NCT01315197.

Applying validated quality indicators to surgical antibiotic prophylaxis in a Brazilian hospital: Learning what should be learned

Background: Compliance with the best surgical antibiotic prophylaxis practice is usually low despite many published guidelines. Objective: This study investigated compliance with the Hospital Infection Control Committee guideline for antibiotic prophylaxis in a Brazilian hospital using quality indicators. Methods: A retrospective study was carried out from November 2009 to March 2010. Medical records from adult inpatients undergoing cardiac, neurologic, and orthopedic clean surgeries were included. The full compliance index was considered 100% when the antibiotic prophylaxis showed adequacy in all evaluated attributes. Analyses were conducted with 5% significance. Results: Medical records from 101 cardiac, 128 neurologic, and 519 orthopedic surgical patients were evaluated. The compliance index was 4.9%, and the compliance index according to specialty was 5.8%, 3.1%, and 3.0%, respectively, for orthopedic, neurologic, and cardiac surgeries. The attribute route of administration produced the best outcomes, whereas the attribute duration of antibiotic prophylaxis produced the worst. No association was identified between compliance to the attributes and patient characteristics. Conclusion: This study showed a low level of adherence to Hospital Infection Control Committee guidelines for antibiotic prophylaxis. This suggests that different strategies should be implemented to promote the best possible practice in the field of antibiotic prophylaxis with greater surgeon engagement. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.