A comunidade da suspensão de cirurgias pediátricas: motivos e sentimentos envolvidos no processo

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Treinamento esfincteriano anal: estudo transversal em crianças de 3 a 6 anos de idade

Pós-graduação em Pediatria - FMB

Compreendendo a experiência de crianças e adolescentes submetidos à punção de medula óssea e lombar em centro cirúrgico de um hospital oncológico

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Incidência de parada cardíaca e mortalidade pediátrica durante a anestesia em hospital universitário de atendimento terciário no período de 2005 a 2010

Pós-graduação em Cirurgia Veterinária - FCAV

Comparação da umidade e temperatura dos gases inalados com alto ou baixo fluxo de gases frescos e com ou sem permutador de calor e umidade em anestesia pediátrica

Pós-graduação em Anestesiologia - FMB

Promoção da segurança no cuidado de enferamgem pediátrica: contribuições para o ensino técnio

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Caracterização da demanda do pronto socorro do Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP

The demand for health services can be understood as an application needs the user has. The inability to use the outpatient services and limited supply of these make it possible for users to browse sites that focus attention on a greater possibility of entry doors, in which first-aid centers and hospital emergency match this profile, distorting the flow of patients in the network through an inverse demand of the movement hierarchy. Added to this, the burden of care in these services results in overcrowding and poor quality of care. Evaluate the demand of the visits occurred in the Emergency Room of the Hospital of the Medical School of Botucatu / UNESP (PS - HC - FMB / UNESP) during June-July 2010. A transversal, descriptive and retrospective. For data collection sheet was used in the proposed Service unit and the data it was filled out the form with the necessary items for the search. Made an exploratory analysis and frequency distributions for categorical variables of the form. Females predominated (56%) and aged 61 years or older with 30%. 96.5% were owned by DRS VI, and 62.5% of Botucatu. The attendance by the physician on duty and corresponded to 57.7% among the 23 medical specialties, Gastric (7.0%), Cardiology (4.5%), Medical (4.4%), urology (4.2%) and Pulmonology (4.1%) were the ones that stood out. The medical procedures performed that stood out were X-ray (46.4%) and electrocardiogram (ECG) (42.3%) and in most specialty care occurred, only the daily consultation with the patient. It was possible to characterize, so the demand for PS - HC - FMB / UNESP for the period June- July 2010, The predominance of the elderly shows that come along with aging diseases and addictions, causing a greater need for health services. Moreover, this study showed that the high number of visits is related to both the daily demands that the tertiary hospital has the same transformation... (Complete abstract click electronic access below)

Opinião de familiares sobre a internação de crianças em uma Unidade de Terapia Intensiva Pediátrica

A Pediatric Intensive care Unit (PICU) is an environment where care is provided to seriously ill children. Hospitalization is regarded as an unpleasant experience that requires adaptation and routine change. To assess the opinion of relatives of children hospitalized at a PICU concerning tie breakage and/or separation between children and their families. It is a descriptive, cross-sectional, quantitative study. A structured interview was conducted with the families of hospitalized children from July to September, 2010. The data were statistically analyzed. RESULTS: Twenty relatives were interviewed, 80% of whom believed that children’s behavior changes when they are present in the unit, and 85% considered the visitation time established to be sufficient. All the respondents reported to be satisfied about the care provided. The feelings prevailing in 50% of the relatives were fear and hope. Change in the family’s union after hospitalization occurred in 85% of the families. The most fearful aspect concerning the ICU is the equipment (25%), and the most worrisome, as regards personal life, is the separation from other children (65%). Health care professionals must pay more attention to relatives by including them in their health care plan so that the health care team and the family, who are essential in children’s recovery, can interact in a congenial fashion. It is also necessary to improve the knowledge related to that subject so that the health care team and families can work together towards children’s recovery

Abordagem dos maus tratos na infância por unidades de saúde da família

The goal of this study was to apprehend conceptualizations and professional experiences concerning child maltreatment as reported by physicians and nurses working for the Family Health Strategy implemented in a medium-sized city in São Paulo state. It is a descriptive qualitative study in which 20 professionals were included and semi-structured taped interviews were used. The data obtained were analyzed according to the Collective Subject Discourse and systematized into five themes: Conceptualizations of child maltreatment; Professional training to work in this field; Professional experiences related to such aggravations; Difficult and easy aspects faced during care provision to child maltreatment in the Family Health Strategy; Proposals to promote child safety. It was concluded that care provision to such aggravation types by family health units is configured as an important strategy to promote child safety and support families in relation to this issue. However, it was observed that, in order to qualify professionals for such care provision, it is necessary to invest in continuing education for the multiprofessional team. Also, municipal policies concerning care provision to child abuse, particularly in the organization of integrated work of the health care, education, social welfare and justice sectors must be urgently established by actively including the general society in such process

Percepção da criança sobre a hospitalização

Regardless of their age, hospitalized children suffer from being separated from their mothers or their attachment figures. Hospitalization is a process that is difficult for children to cope with due to their separation from families, everyday environments and embedded disease scenarios. According to age, the intensity of such suffering is related to the development phase in which a child is found. The health care professionals that are close to children, not only as concerns care provision, but also emotionally, should be knowledgeable about the mother-child attachment. emotionally, should be knowledgeable about the mother-child attachment. To evaluate children’s perception of hospitalization. The study was conducted at the pediatric hospitalization unit of the Botucatu School of Medicine University Hospital – UNESP by means of interviews with hospitalized children aged 7 – 12 years and by using content analysis according to Bardin. Most of the interviewed children did not like the hospital environment and reported to miss their homes. From their statements, they showed their dissatisfaction in relation to pain and their submission to invasive procedures, which were the main complaints during the interviews. Our results agree with those found in the literature in relation to the hospital environment when the children reported the fact that they missed their homes as a difficulty to adapt. The analysis of results in this study and in previous ones led to the reflection on the importance of the presence of a relative during children’s hospitalization and the adaptation process. Despite their dissatisfaction in relation to invasive procedures, none of the children tried to stop the performance of tests and understood their importance. This is a characteristic of the operational phase, which comprises the development of perception of a whole situation and is when... (Complete abstract click electronic access below)

Morte e morrer: opinião dos profissionais de saúde de uma unidade de terapia intensiva pediátrica

Presently, the dying process and death most often occur in hospitals and, particularly, in Intensive Care Units (ICU), where patients’ lives are prolonged thanks to advanced technological devices and highly efficient medicines. To learn about the opinion of health care professionals working at a Pediatric Intensive Care Unit in relation to the dying process and dying. This is a descriptive quantitative study. A questionnaire was applied to the unit’s staff members from June to August, 2011. Data were statistically analyzed. Twenty-five professionals answered the questionnaire, and 72% faced death as a natural life process. 60% felt compassion, but that feeling did not interfere with how they cared for patients. Concerning their professional training, 52% reported not to have received any concerning patients’ caregivers in the dying process or death; therefore, they experienced such situation when they were already working, and 76% reported to be interested in updating courses on that theme. Further discussion about this topic during academic education is necessary. It is also necessary to provide health care professionals with specialization courses, debates and experience exchange so that they can better understand and deal with their feelings and limitations in face of death and thus give better care to patients and relate to patients’ families during the dying process of a loved one

Expansão ex vivo de células uroteliais em scaffolds 3D

Malformations and possible damages to the urogenital system can be originated in the embryonic period. Moreover, fire guns, knives and accidents, where there is the disruption of the urethra, also cause these lesions. The objective was to analyze the contribution of tissue engineering in the construction of neo-urethra, developed by bioengineering. We performed an urothelial ex vivo expansion of cells in 3D scaffolds (platelet gel matrix and acellular porcine aorta) to assess the contribution of this technique in the construction of a neo-urethra. Mechanical dissociation was made of the inner wall of 10 North Folk rabbit’s bladder, weighing 2.5 to 3.0 kg. After dissociation the cell content was centrifuged and obtained a pellet of urothelial cells. The pellet was ressuspended in culture medium DMEM F12 and cells were maintained in culture for 15 days. Immunohistochemical analysis characterized the urothelial culture. The cells were then implanted in the scaffold - platelet gel. In a second experiment using aortic porcine acellular matrix were implanted urothelial cells alone and urothelial cells on platelet gel, on the inner wall of the scaffold - aorta, with space for setting bordered by a urethral probe. The complex probe - cells - aorta and probe - cells in platelet gel - aorta, were sealed with suture material and culture were maintained in a humidified 37ºC incubator with 5% CO2 in air for 12 days to subsequent histological analysis of urothelium cell adhesion to the scaffolds. By observation under an optical microscope, we could see the growth of cells in the scaffold platelet gel, from a monolayer in to a three-dimensional structure. In the acellular porcine aortic matrix containing the platelet gel, we could observe a few quantity of urothelial cells adhered. However with the acellular porcine aortic matrix in which was implanted only the urothelial cells, we have obtained adhesion to the wall

Qualidade de vida de crianças e adolescentes com epilepsia no município de Maringá

Pós-graduação em Saúde Coletiva - FMB

Robotic-assisted laparoscopic partial nephrectomy: initial experience in Brazil and a review of the literature

CONTEXT AND PURPOSE: Partial nephrectomy has become the standard of care for renal tumors less than 4 cm in diameter. Controversy still exists, however, regarding the best surgical approach, especially when minimally invasive techniques are taken into account. Robotic-assisted laparoscopic partial nephrectomy (RALPN) has emerged as a promising technique that helps surgeons achieve the standards of open partial nephrectomy care while offering a minimally invasive approach. The objective of the present study was to describe our initial experience with robotic-assisted laparoscopic partial nephrectomy and extensively review the pertinent literature. MATERIALS AND METHODS: Between August 2009 and February 2010, eight consecutive selected patients with contrast enhancing renal masses observed by CT were submitted to RALPN in a private institution. In addition, we collected information on the patients' demographics, preoperative tumor characteristics and detailed operative, postoperative and pathological data. In addition, a PubMed search was performed to provide an extensive review of the robotic-assisted laparoscopic partial nephrectomy literature. RESULTS: Seven patients had RALPN on the left or right sides with no intraoperative complications. One patient was electively converted to a robotic-assisted radical nephrectomy. The operative time ranged from 120 to 300 min, estimated blood loss (EBL) ranged from 75 to 400 mL and, in five cases, the warm ischemia time (WIT) ranged from 18 to 32 min. Two patients did not require any clamping. Overall, no transfusions were necessary, and there were no intraoperative complications or adverse postoperative clinical events. All margins were negative, and all patients were disease-free at the 6-month follow-up. CONCLUSIONS: Robotic-assisted laparoscopic partial nephrectomy is a feasible and safe approach to small renal cortical masses.Further prospective studies are needed to compare open partial nephrectomy with its minimally invasive counterparts.

Underexpression of MMP-2 and its regulators, TIMP2, MT1-MMP and IL-8, is associated with prostate cancer

OBJECTIVE: Extracellular matrix homeostasis is strictly maintained by a coordinated balance between the expression of metalloproteinases (MMPs) and their regulators. The purpose of this study was to investigate whether MMP-2 and its specific regulators, TIMP-2, MT1-MMP and IL-8, are expressed in a reproducible, specific pattern and if the profiles are related to prognosis and clinical outcome of prostate cancer (PCa). MATERIALS AND METHODS: MMP-2, TIMP-2, MT1-MMP and IL-8 expression levels were analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) in freshly frozen malignant and benign tissue specimens collected from 79 patients with clinically localized PCa who underwent radical prostatectomies. The control group consisted of 11 patients with benign prostate hyperplasia (BPH). The expression profile of the MMP-2 and its regulators were compared using Gleason scores, pathological stage, pre-operative PSA levels and the final outcome of the PCa. RESULTS: The analysis of 79 specimens of PCa revealed that MMP-2, TIMP-2, MT1-MMP and IL-8 were underexpressed at 60.0%, 72.2%, 62.0% and 65.8%, respectively, in malignant prostatic tissue in relation to BPH samples. Considering the prognostic parameters, we demonstrated that high Gleason score tumors (> 7) overexpressed MMP-2 (p = 0.048) and TIMP-2 (p = 0.021), compared to low Gleason score tumors (< 7). CONCLUSION: We have demonstrated that MMP-2 and its regulators are underexpressed in PCa. Alternatively, overexpression of MMP-2 and TIMP-2 was related to higher Gleason score tumors. We postulate that alterations in metalloproteinase expression may be important in the control of tissue homeostasis related to prostate carcinogenesis and tumor behavior.