Satisfação dos Usuários do Ambulatório Geral do Hospital das Clínicas de Botucatu

The searches for a health service it’s a part of a process, searches for a qualified evaluation can arise the perception, in form of irritating factors taking for an alert state. The personal expectation, it makes influence in its perceptions, too. The objective was to evaluate the satisfaction degree of the users of “Seção Técnica de Ambulatório Geral do Hospital das Clínicas de Botucatu”. The work is about a quantitative and transversal study, with calculated sample of 366 users, chosen randomly and invited to participate through a questionnaire. The population was compounded by a majority of women (64,5%), between 50 to 59 years old and average degree of education (38,3%). 25 specialties were cited. The evaluate about comfort, cleaning, reception, waiting time, medical attention and nursing vary between “very good” and “good”. Obtained significant “regular” assessment, the comfort in the waiting rooms (24%), silence (25%) and cleaning bathroom (63%). Others negative evaluation was the reception about the waiting time (26%), waiting time between arrival and the consultation (34%), waiting time between the request and consultation (27%). 30,6% report to know the place for complaints and 79,4% of these pointed to the ombudsman. 62% consider their problems solved, 84,4% would indicate the hospital, 57,4% would consider the hospital better than imagined. 42,62% used the opened area for thanking, critical for staff, suggestion infrastructure improvements, cleaning and waiting time. The biggest complaint was the staff turnover in the treatment. There was disharmony between the objective and subjective questions, but, all of them must be considered to propose improvements. The satisfaction evaluation makes the service more effective, bringing credibility to the health service and the patients adhere better to the treatment

Acidentes na infância atendidos no pronto socorro de pediatria do Hospital das Clínicas de Botucatu que motivaram internação

Accidents represent a major public health problem as they are frequent, preventable, and account for high morbidity and mortality rates. Children are the most vulnerable to accidents due to their inherent characteristics, and as a result of their physical, sensorial, psychomotor and cognitive limitations, which will only develop with time. Watchfulness and careful attention are of paramount importance, especially as children develop locomotor skills that are accompanied by curiosity about their surroundings. Child accidents, particularly those that could have been avoided, are the accidents most commonly seen in emergency and urgency departments. Urgency and emergency departments are the greatest allies in the attention to pediatric accidents as they offer adequate, immediate and specific high complexity care to patients at risk, viewing their vital stabilization. Investigating the causes and consequences of this insult is essential to establish a diagnosis and to contribute for the adoption of measures of prevention, control, and assistance. To identify the epidemiologic characteristics of the accidents involving children that received care at the pediatric emergency department of Botucatu Medical School Hospital and required hospitalization. This quantitative, retrospective, descriptiveanalytic epidemiologic study included all children aged 0-14 years who had had an accident and were seen at the Pediatric Emergency Department of Botucatu Medical School Hospital of São Paulo State University/UNESP between January 1/2008 and December 31/2009. A total of 227 medical charts were reviewed and 178 (78.4%) patients were included in this study. Of these, 116 (65.1%) were males and 62 (34.8%) were females. Children aged 5 - 9 years (38.9%) were the most affected, followed by those aged 10 - 14 years (37.5%). Fractures occurred in 138 (77.5%) of the cases, followed by foreign bodies... (Complete abstract click electronic access below)

Diversidade genética em Staphylococcus aureus resistentes à oxacilina em isolados de pacientes pediátricos do Hospital das Clínicas de Botucatu

Staphylococcus aureus é um patógeno ubíquo capaz de causar uma variedade de infecções em humanos. A resistência desse microrganismo a antibióticos como oxacilina e meticilina é um problema sério, de crescimento significativo para a terapêutica antimicrobiana clínica em pacientes acometidos por infecções estafilocócicas. A resistência à meticilina em S. aureus é decorrente da alteração do sítio de ação dos antibióticos β-lactâmicos, os quais agem através da inibição de enzimas que catalisam a síntese da parede celular. Essas enzimas são o sítio de ação das penicilinas, e por isso, passaram a ser chamadas de proteínas ligadoras de penicilinas (PBPs). O gene mecA codifica a PBP2a, que substitui a função das outras PBPs neste patógeno e confere resistência a β-lactâmicos. A PBP2a exibe uma afinidade reduzida pelo anel β-lactâmico e permite que a bactéria continue a sintetizar a parede bacteriana. Este gene faz parte de um elemento genético móvel encontrado em isolados de MRSA, designado cassete cromossômico estafilocócico mec (SCCmec), integrado ao cromossomo de S. aureus. O objetivo do estudo foi a caracterização molecular de 139 isolados de S.aureus provenientes de pacientes pediátricos com bacteremia durante o período de 1991 a 2010. Métodos moleculares foram utilizados para a determinação do perfil genético das amostras, incluindo, identificação do tipo de SCCmec, detecção do gene codificador de leucocidina de panton valentine (PVL) e similaridade clonal em gel de eletroforese em campo pulsado (PFGE). O gene mecA foi detectado em 32 (23%) amostras e houve predomínio do SCCmec IV (68,8%) em relação ao SCCmec III (31,2%). A presença de PVL foi encontrada em 18 amostras (12,9%), todas sensíveis à oxacilina. O clone epidêmico brasileiro, relacionado ao SCCmec tipo III, esteve presente na unidade neonatal do hospital... (Resumo completo, clicar acesso eletrônico abaixo)

Alterações clínicas e laboratoriais de equinos submetidos à biópsia hepática com agulha Tru-cut guiada por ultrassom

Pós-graduação em Medicina Veterinária - FCAV

Dinâmica linear e não linear da variabilidade da frequência cardíaca: sensibilidade, especificidade, valor preditivo e correlação de características físicas e clínicas no Diabetes Mellitus tipo 1

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

Extração seriada: considerações clínicas

The early malocclusion treatment has increased interest of orthodontic community. Among these is the serial extraction that harmonizes the differences between the amount of dental material and permanent deficiency of supporting bone. The technique is applied in mixed dentition through a predetermined sequence of extractions between deciduous and permanent teeth, in order to reach spontaneous immediately alignment of remaining permanent teeth with a minimum orthodontic mechanics. It will be reported a case where the serial extraction was performed in a growing patient with biprotrusion, Class I malocclusion and severe crowding. All functional and aesthetics goals were reached.

Características clínicas da associação entre o bruxismo do sono e o refluxo gastroesofágico merecem atenção profissional

Introduction: Bruxism has been defined as an oral parafunctional activity that includes clenching and/or grinding the teeth while asleep or awake. In addition to sleep bruxism (SB), various other orofacial movements sporadically occur during sleep. Occasional regurgitation and heartburn due to gastroesophageal reflux (GER) are frequent in the general population. GER refers to the presence of symptoms that are secondary to the reflux of gastric content through the esophagus with or without signs of esophageal mucosal lesions. Dentists are often the first health care professionals to diagnose GER through observation of its oral manifestation. Objective: The aim of the present case reports was to discuss the diagnosis and clinical procedures followed in two patients with SB and GER, thereby contributing to the dissemination of knowledge about these two entities. We therefore recommend dentists to be alert to identifying the first signs of GER that appear in the oral cavity. Conclusion: At this point, we highlight the importance of treating the patient as a whole, in an endeavor to identify other sources of the problems that could contribute as factors aggravating these conditions.

Próteses parciais removíveis associadas a encaixes: implicações clínicas e laboratoriais

Nowadays, the fixed partial dentures and/or dental implants is the most requested treatmentby the majority of partially edentulous patients. However, depending on the periodontal condition of the remaining teeth, as well as the bone condition of the prosthetic space, the oral rehabilitation with these treatments may be limited or even contraindicated. In such cases, the use of removable partial dentures associated to attachments becomes an important alternative for aesthetic and functional rehabilitation. Attachments are mechanical devices consisted of two parts (patrix-matrix), one placed inside another, which act as direct retainer, providing retention, support and stability to the dentures. These devices can be classified as intra or extracoronal attachments, considering their position in relation to the abutment tooth. However, regardless the type of attachment, the association between fixed and removable partial dentures should be performed respecting the biomechanical principles of both. Therefore, the purpose of this study was to review and discuss the literature about the clinical and laboratory implications of the association between fixed and removable partial dentures by means of attachments.

Sistemas cerámicos puros parte 2: materiales, propiedades ópticas y consideraciones clínicas

While dentistry continues to advance, the aesthetic techniques have evolved in proceedings more effective, functional and biocompatible. Meanwhile, cosmetic dentistry has become a bit more complex and technically difficult. With improvement of the properties (physical and optical) of the ceramics and the establishment of a working protocol, ceramic restorations have become increasingly popular. Currently there are several ceramic systems have excellent optical properties such as opalescence, fluorescence, translucency, chromaticity, which allow the restoration to mimic the tooth structure. From the physical point of view has restored biomechanical integrity and strengthening the remaining tooth structure. All this has led the profession to experience the use of new ceramic systems ranging from conventional feldspathic ceramics to modem ceramic reinforced, injected or computer-aid made. The material selection should be based on clinical need, aesthetic and functional requirements, restoration site, prosthetic design and laboratory techniques. In this article we will deal with the characteristics of the materials, their optical properties and clinical considerations for proper selection.

Tradução e relações intertextuais em Historias ocultas en la Recoleta, de María Rosa Lojo

The aim is to analyze some aspects of the strategy of intertextual Maria Rosa Lojo and her importance to the translation of two tales Historias Ocultas en la Recoleta. Then, the theory by Umberto Eco about the intertextual irony and its implications in the act of tranlation were used to the understanding. The theories and considerations by Linda Hutcheon on intertextuality, parody and discourses of history also contributed.

Estudo comparativo entre cinco diferentes tratamentos sobre as alterações clínicas e laboratoriais do rato diabético induzido pela aloxana

The long-term effects of five different treatments of diabetes were evaluated in alloxan-induced diabetic rats. Seven experimental groups, with 50 rats each (GN--normal control; GD--untreated diabetic control; GI, GA, GIA--treated groups with insulin, acarbose, and insulin plus acarbose, respectively; GTIL, GTPD--treated groups with islet of Langerhans and pancreas transplantation) were studied. Clinical (body weight, water intake, food intake and urine output) and laboratory (blood and urinary glucose, and plasma insulin) parameters were analyzed at the beginning of the study, and after 1, 3, 6, 9 and 12 months of follow-up. Mortality was observed in all groups, except GN, during 12 months (GD = 50%; GI = 20%; GA = 26%; GIA = 18%; GTIL = 4%; GTPD = 20%). Rats from the GD, GI, and GIA groups died due to metabolic or hydrossaline disbalance, and/or pneumonia, diarrhoea, and cachexy. All deaths observed in GTIL and GTPD groups were in decorrence of technical failure at the immediate postoperative, until 72h. Animals from the GI, GA and GIA had significative improving of the clinical and laboratory parameters (p < 0,05) observed in diabetic rats, being the efficacy of theses treatments equal. However, rats from the GTIL and GTPD groups had better control of these parameters than GI, GA, and GIA groups. Transplanted rats had complete restoration, at the normal levels, of all analyzed variables (p < 0.01). Conventional treatments with insulin, acarbose, and insulin plus acarbose improved the severe diabetic state of the alloxan-diabetic rats, but pancreas and islet transplantation have a better performance for treatment of diabetes.

Características clínicas e laboratoriais de gestantes com pré-eclâmpsia versus hipertensão gestacional

Purpose: To compare clinical and laboratory characteristics, obstetric and perinatal outcomes of patients with pre-eclampsia versus gestational hypertension. Methods: A retrospective study was carried out to analyze medical records of patients diagnosed with pre-eclampsia and gestational hypertension whose pregnancies were resolved within a period of 5 years, for a total of 419 cases. We collected clinical and laboratory data, obstetric and perinatal outcomes. Comparisons between groups were performed using the test suitable for the variable analyzed: unpaired t test, Mann-Whitney U test or χ2test, with the level of significance set at p<0.05. Results: Were evaluated 199 patients in the gestational hypertension group (GH) and 220 patients in the pre-eclampsia group (PE). Mean body mass index was 34.6 kg/m2 in the GH group and 32.7 kg/m2 in the PE group, with a significant difference between groups. The PE group showed higher systolic and diastolic blood pressure and higher rates of abnormal values in the laboratory tests, although the mean values were within the normal range. Cesarean section was performed in 59.1% of cases of PE and in 47.5% of the GH group; and perinatal outcomes in terms of gestational age and birth weight were significantly lower in the PE group. Conclusion: Women with gestational hypertension exhibit epidemiological characteristics of patients at risk for chronic diseases. Patients with pre-eclampsia present clinical and laboratory parameters of greater severity, higher rates of cesarean delivery and worse maternal and perinatal outcomes.

Associação entre Síndrome de burnout, uso prejudicial de álcool e tabagismo em profissionais de enfermagem nas unidades de teripa intensiva do Hospital das Clínicas de Botucatu-UNESP

Pós-graduação em Saúde Coletiva - FMB

Linfoma de Hodgkin: características anátomo-clínicas e análise de novo biomarcador (IMP3)

Pós-graduação em Patologia - FMB

Superdotados acompanhados em serviço especializado: características clínicas, sociodemográficas e qualidade de vida

Pós-graduação em Saúde Coletiva - FMB