Densidade mineral óssea de adolescentes sobrepesos, obesos e superobesos: o impacto do excesso de gordura corporal sobre a massa óssea

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Avaliação de qualidade de vida de pacientes submetidos à angioplastia coronariana e elaboração de material educativo

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Staphylococcus aureus: resistência de virulência e tipagem de MRSA pelas técnicas de MLST e spa typing

Pós-graduação em Doenças Tropicais - FMB

Efeitos da higienização brônquica nas variáveis cardiorrespiratórias de pacientes em ventilação mecânica

INTRODUCTION: During mechanical ventilation (MV), the airways may accumulate secretions. Patients are submitted to Respiratory Therapy (RT) and tracheal aspiration when in MV, alone or associated, to eliminate these secretions. OBJECTIVE: The objective was to compare the effects of different protocols of bronchial hygiene in blood pressure, heart rate, oxygen saturation and respiratory rate of patients undergoing MV. MATERIALS AND METHODS: We conducted a prospective, randomized, controlled crossover, with intentional non-probabilistic sample in the Medical School Hospital of Marília. We included patients in invasive MV who were submitted to three different bronchial hygiene protocols: PP - physiotherapy protocol (manual chest compression and manual hyperinflation); AP - aspiration protocol; and PP + AP. Respiratory rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation and heart rate were evaluated in three moments: before (M1), immediately after (M2) and 30 minutes after (M3) for each protocol. The differences among protocols and times were assessed using ANOVA and post hoc Student Newman-Keus (p < 0.05). RESULTS: We studied eighteen 71.2 ± 13.9 year-old patients with 15.1 ± 17.7 days of MV. There were no differences among protocols. There was a significant decreasing in SBP (p = 0.0261) and DBP (p = 0.0119) from M2 to M3 in the aspiration protocol. CONCLUSION: There was a decrease of blood pressure on MV patients after 30 minutes of aspiration and no change in the other variables, and there was no difference among protocols.

Frequency of various types of neoplasia in a group of acromegalic patients

OBJECTIVE: To determine the frequency of colon cancer, primary hyperparathyroidism, thyroid tumor, and skin cancer in all acromegalic patients in follow-up at the Clinics Hospital - Botucatu Medical School, from 2005 to 2011. SUBJECTS AND METHODS: These patients were evaluated retrospectively for colon cancer, primary hyperparathyroidism, dermatological, and thyroid tumors. RESULTS: Of 29 patients included at the beginning of the study, two were excluded. Among 19 patients submitted to colonoscopy, one presented colon adenocarcinoma (5%). Thyroid nodules were present in 63% of patients, and papilliferous carcinoma was confirmed in two patients (7,7%). Four patients were confirmed as having primary hyperparathyroidism (15%). The most common dermatologic lesions were thickened skin (100%), acrochordons (64%), epidermal cysts (50%), and pseudo-acanthosis nigricans (50%). Only one patient presented basal cell carcinoma. CONCLUSION: Although a small number of acromegalic patients was studied, our findings confirm the high frequency of thyroid neoplasias and primary hyperparathyroidism in this group of patients.

Translation, cultural adaptation to Brazil and validation of the venous leg ulcer quality of life questionnaire (VLU-QoL-Br)

Objetivo:traduzir o instrumento Venous legulcer quality of life questionnaire (VLU-QoL), adaptá-lo culturalmente para o português do Brasil e validá-lo com pacientes do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMB) da Universidade Estadual Paulista (Unesp). Métodos:o questionário foi traduzido por um tradutor profissional e por dois dermatologistas especialistas na área de úlceras venosas (UV), sendo reformulado em reunião com os três tradutores. O constructo (VLU-QoL-Br) foi submetido a pré-entrevista com 10 portadores de UV para a adaptação da linguagem. Posteriormente, foi aplicado em pacientes do HC-Unesp, e como teste-reteste para verificação de sua reprodutibilidade. Resultados:foram avaliados 82 pacientes, sendo 56 (68%) do sexo feminino. A idade média foi de 67,3 anos. O questionário foi traduzido, adaptado e aplicado aos pacientes. O constructo apresentou alta consistência interna (alfa= 0,94) e adequada correlação item-total. Quando avaliados os 32 retestes, observou-se correlação intraclasse para concordância de 0,78 (p < 0,01), indicando boa reprodutibilidade do constructo. A análise fatorial confirmatória corroborou as dimensões do questionário original: atividades, psicológico e sintomas. Escores do VLU-QoL-Br se associaram, independentemente, à área total das úlceras e a menor escolaridade dos sujeitos (p < 0,01). Conclusão:a tradução, a adaptação e a validação do questionário VLU-Qol-Br demonstrou boa performance psicométrica, permitindo seu uso clínico no Brasil. É importante avaliar seu desempenho em outras regiões e em diferentes amostras de indivíduos.

Testing search strategies for systematic reviews in the Medline literature database through PubMed

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

Intra-abdominal pressure as a predictor of acute kidney injury in postoperative abdominal surgery

Objectives: The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. Patients and methods: A prospective observational study was conducted in the period from January 2010 to March 2011 in the Intensive Care Units (ICUs) of the University Hospital of Botucatu Medical School, UNESP. Consecutive patients undergoing abdominal surgery were included in the study. Initial evaluation, at admission in ICU, was performed in order to obtain demographic, clinical surgical and therapeutic data. Evaluation of IAP was obtained by the intravesical method, four times per day, and renal function was evaluated during the patient's stay in the ICU until discharge, death or occurrence of AKI. Results: A total of 60 patients were evaluated, 16 patients developed intra-abdominal hypertension (IAH), 45 developed an abnormal IAP (>7 mmHg) and 26 developed AKI. The first IAP at the time of admission to the ICU was able to predict the occurrence of AKI (area under the receiver-operating characteristic curve was 0.669; p=0.029) with the best cutoff point (by Youden index method) >= 7.68 mmHg, sensitivity of 87%, specificity of 46% at this point. The serial assessment of this parameter did not added prognostic value to initial evaluation. Conclusion: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.

Serum thiamine concentration and oxidative stress as predictors of mortality in patients with septic shock

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência do estado nutricional e da composição corporal na evolução clínica dos pacientes com doença inflamatória intestinal

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Função cognitiva e qualidade de vida de pacientes com doença renal crônica nos estadios III e IV

Pós-graduação em Saúde Coletiva - FMB

Clinicopathologic features and outcome of mycophenolate-induced colitis in renal transplant recipients

Reports on the clinical course of mycophenolic acid (MPA)-related colitis in kidney transplant recipients are scarce. This study aimed at assessing MPA-related colitis incidence, risk factors, and progression after kidney transplantation. All kidney transplant patients taking MPA who had colonic biopsies for persistent chronic diarrhea, between 2000 and 2012, at the Kidney Transplantation Unit of Botucatu Medical School Hospital, Brazil, were included. Cytomegalovirus (CMV) immunohistochemistry was performed in all biopsy specimens. Data on presenting symptoms, medications, immunosuppressive drugs, colonoscopic findings, and follow-up were obtained. Of 580 kidney transplant patients on MPA, 34 underwent colonoscopy. Colonoscopic findings were associated with MPA usage in 16 patients. The most frequent histologic patterns were non-specific colitis (31.3%), inflammatory bowel disease (IBD)-like colitis (25%), normal/near normal (18.8%), graft-versus-host disease-like (18.8%), and ischemia-like colitis (12.5%). All patients had persistent acute diarrhea and weight loss. Six of the 16 MPA-related diarrhea patients (37.5%) showed acute dehydration requiring hospitalization. Diarrhea resolved when MPA was switched to sirolimus (50%), discontinued (18.75%), switched to azathioprine (12.5%), or reduced by 50% (18.75%). No graft loss occurred. Four patients died during the study period. Late-onset MPA was more frequent, and no correlation with MPA dose or formulation was found.

Hyaluronic Acid Behavior in the Lamina Propria of the Larynx with Advancing Age

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

Characterization of the clonal profile of MRSA isolated in neonatal and pediatric intensive care units of a University Hospital

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

Proliferating cell nuclear antigen immunoreaction in adrenal-tumors

Aims mid background: We studied, retrospectively, 33 cases of adrenal tumors of children at the Pediatric Endocrinology Unit, Children's Institute, Sao Paulo State University Medical School, from 1975 to 1993. Ail patients had at least 2 years of follow-up with a few exceptions. Methods: Clinical follow-up data were correlated with histopathologic review, laboratory data and cell kinetic evaluation (based on detection of proliferating cell nuclear antigens). Results: With one exception, all the patients had presented signs of androgen production and had high levels of dehydro-epiandrosterone-sulfate. Tumor weight evaluation represented a good parameter of neoplasm evolution: of 19 cases weighing less than 250 g, 17 had no evidence of disease after surgery, and 2 had an unfavorable prognosis. Of 14 cases weighing more than 250 g, only 1 had no evidence of disease and 13 had an unfavorable evolution. Conclusions: Proliferating cell nuclear antigen (PCNA) was not helpful to evaluate adrenal neoplasm evolution: our study did not show any correlation between PCNA score and prognosis.