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Discrepancies between clinical diagnoses and autopsy findings
Coradazzi, A.L.;Morganti, A.L.C.;Montenegro, M.R.G.;
Brazilian Journal of Medical and Biological Research , 2003, DOI: 10.1590/S0100-879X2003000300014
Abstract: autopsy examination is considered to be an essential element for medical auditing and teaching. despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. in the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the university teaching hospital of the faculdade de medicina de botucatu, botucatu, sp, brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. the clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. the percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. the discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses.
Discrepancies between clinical diagnoses and autopsy findings  [cached]
Coradazzi A.L.,Morganti A.L.C.,Montenegro M.R.G.
Brazilian Journal of Medical and Biological Research , 2003,
Abstract: Autopsy examination is considered to be an essential element for medical auditing and teaching. Despite the significant progress in diagnostic procedures, autopsy has not always confirmed the clinical diagnosis. In the present study, we compared the diagnosis recorded on medical charts with reports of 96 autopsies performed at the University Teaching Hospital of the Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil, between 1975 and 1982, and of 156 autopsies performed at the same institution between 1992 and 1996. The clinical diagnosis of the basic cause of death was confirmed at autopsy in 77% of cases. The percent confirmation fell to 60% when the immediate terminal cause of death was considered, and in 25% of cases, the terminal cause was only diagnosed at autopsy. The discrepancies between clinical and autopsy diagnosis were even larger for secondary diagnoses: 50% of them were not suspected upon clinical diagnosis. Among them, we emphasize the diagnosis of venous thromboses (83%), pulmonary embolisms (80%), bronchopneumonias (46%) and neoplasias (38%). Iatrogenic injuries were very frequent, and approximately 90% of them were not described in clinical reports. Our results suggest that highly sensitive and specific diagnostic tests are necessary but cannot substitute the clinical practice for the elaboration of correct diagnoses.
Canaliculites: apresenta??o de série de casos atendidos na Faculdade de Medicina de Botucatu-UNESP - com ênfase no tratamento realizado
Schellini, Silvana Artioli;Sales, Fabrício Rendeiro;Carvalho, Geraldo Miranda de;Padovani, Carlos Roberto;
Revista Brasileira de Oftalmologia , 2011, DOI: 10.1590/S0034-72802011000600012
Abstract: canaliculitis is a rare disorder of the lacrimal system. the authors present five cases treated at the faculdade de medicina de botucatu-unesp. the findings according to the literature review are comment with considerations on the treatment performed and emphasizing that the canaliculotomy may have good results even without canaliculus sutures or stents.
Perfil dos portadores de cavidade anoftálmica: estudo na Faculdade de Medicina de Botucatu - UNESP
Narikawa, Silvia;Natsuaki, Kryscia Leiko;Fruet, Juliana;Padovani, Carlos Roberto;Schellini, Silvana Artioli;
Arquivos Brasileiros de Oftalmologia , 2011, DOI: 10.1590/S0004-27492011000500010
Abstract: purpose: to evaluate the profile of anophthalmic cavity carriers and patients' evolution with the employed treatments. methods: retrospective study carried out at faculdade de medicina de botucatu, to evaluate the profile and the evolution of patients with anophthalmic cavity treated in our service. data were evaluated according to the frequency of occurrence and analysis of association. results: anophthalmic cavity was more frequently observed in young males, workers in activities carried on with their hands. trauma and phthisis bulbi were the most frequent causes, with differences according to age and gender. the complications were high (57.1% of cases), the majority occurred belatedly. conclusions: trauma is still an important cause of loss of the eye. the complications during the follow-up of the patient are frequent, occurring in general, very late, which reinforces the need for periodic and prolonged monitoring of patients with anophthalmic cavity.
Perspectivas da Medicina Tradicional e das práticas contemplativas na faculdade de medicina de Botucatu, UNESP
Thaís Bassi Cardoso,Renata Tamie Akazawa,Giovana Pieteri Alcantara,Gabriel Braga Almeida
Revista Brasileira de Medicina de Família e Comunidade , 2012, DOI: 10.5712/rbmfc7(1)617
Abstract: Introdu o: A designa o de saúde como “ausência de doen a” sofreu uma altera o desde a cria o da OMS, definindo-a como “o estado do mais completo bem-estar físico, mental e social e n o apenas a ausência de enfermidade”. A partir da década de 70, houve a hipervaloriza o do atendimento terciário em saúde e do tecnocentrismo, evidente com o processo de hospitaliza o e da tecnologia de ponta. Apesar de todo o avan o alcan ado, tem-se observado um movimento considerável em várias partes do mundo em rela o ao ensino e utiliza o de terapêuticas relacionadas à Medicina Tradicional (MT) e às Práticas Contemplativas (PC). Objetivo:Descrever as perspectivas da MT e das PC na Faculdade de Medicina de Botucatu (FMB), a partir da análise das a es que iniciaram a discuss o sobre o tema. Metodologia: Análise descritiva e reflexiva dos fatos acadêmicos relacionados à MT e às PC que ocorreram na FMB. Resultados: Apesar do Hospital das Clínicas de Botucatu oferecer gratuitamente, desde 2000, atendimento homeopático e acupuntura, tendo atendido mais de 7000 pacientes, os graduandos n o tinham a oportunidade de acompanhar o servi o. As práticas existentes eram restritas aos ambulatórios e n o havia disciplinas optativas ou matérias curriculares oferecidas aos estudantes.A partir da demanda foram formados grupos de estudo sobre Homeopatia, Medicina Antroposófica e Espiritualidade. A fim de prover uma acessibilidade maior ao tema, em 2011 foi criada a Liga da Medicina Integrativa e Complementar. No mesmo ano ocorreram ainda o “I Congresso Médico Acadêmico de Acupuntura e Homeopatia”, além de uma noite dedicada ao tema da Medicina Integrativa no 20° Congresso Médico Acadêmico de Botucatu. Conclus es:Incentivar o acesso ao conhecimento das abordagens que comp em a MT e as PC, n o é apenas seguir uma tendência mundial, mas sim disponibilizar aos estudantes a possibilidade de um aprendizado que pode contribuir com a promo o do bem estar e da saúde integral do ser humano.
Perfil dos alunos usuários de lentes de contato do curso de Medicina da Universidade Estadual Paulista - UNESP - Botucatu
Vidotti, Vanessa Gon?alves;Kamegasawa, Amélia;
Arquivos Brasileiros de Oftalmologia , 2006, DOI: 10.1590/S0004-27492006000200012
Abstract: purpose: to analyze the ametropy, way of acquisition, the care and complications related to contact lens wear among medical students from faculdade de medicina de botucatu da universidade estadual paulista - unesp - botucatu (sp). methods: questionnaire applied to students from the 1st to the 6th year of the medical school of the faculdade de medicina de botucatu da universidade estadual paulista - unesp - botucatu (sp), forming an analytical cross-sectional survey. results: 27.4% of the students use contact lenses, and among them 94.8% use soft contact lenses and 98% have negative degree. 46.9% discard their contact lens monthly. 63.9% have an average daily use of 14 hours, 14.1% acquire the contact lenses from optician stores or at pharmacies and 46.5% of the students clean their contact lenses when they put them on and take them off. regarding complications, 51.0% reported ocular redness; 44.5%, blurred vision; and 42.6%, foreign body sensation, whereas only 4 students reported "keratitis". conclusion: we concluded that the inadequate adaptation that occurs even in users knowledgeable about this issue such as medical students, has increased the risk of complications. this fact indicates that more attention must be paid to contact lens care in order to prevent permanent visual deficit.
PROFILE OF PATIENTS ATTENDING THE OXYGEN THERAPY SERVICE AT THE MEDICAL SCHOOL IN BOTUCATU - UNESP Levantamento das características dos pacientes atendidos no servi o de oxigenoterapia da Faculdade de Medicina de Botucatu-UNESP  [cached]
Maria Virgínia Martins Faria Faddul Alves,Irma de Godoy,Cláudia Helena Bronzato Luppi
Revista Ciência em Extens?o , 2010,
Abstract: This work was held from January 1997 to January 1999 with 66 patients registered in the Oxygen Therapy Service at the Medical School in Botucatu (FMB) – UNESP. The aim of this study was to evaluate the patients’ health and overall characteristics as well as the oxygen delivery and use conditions. The average age was 61.2 ± 10.1 years, 61% men, with poor education level, low income and social conditions. Chronic obstructive pulmonary disease (COPD) was the major pathology found, corresponding to 78.2% diagnoses. According to the arterial blood gasometry results (PaO2 = 46.14 ± 9.07 mmHg, PaCO2 = 45.80 ± 7.99 mmHg and SaO2 = 79.25 ± 11.44%), all patients have met the indication and utilization criteria for long-term oxygen therapy (LTOT) in agreement with the national and international consensus committee. Patients were delivered oxygen by means of a gas cylinder and by nasal cannula . The municipal public services were in charge of the oxygen delivery for 80.5% patients. The oxygen flow was used following recommendations, although the number of hours was less than the prescribed one; only 8.4% patients used LTOT more than 12 hours a day. Based on this study some arrangements regarding these patients’ care have been carried out, such as the replacement of the gas cylinder by the oxygen concentrator, leading to an improved care quality. The oxygen therapy service from the Medical School became a reference symbol for the Health Secretary in Botucatu as well as for LTOT prescription and patients’ follow-up. CONCLUSION : The majority of the patients who have undertaken long term oxygen therapy are of the male sex, COPD carriers and have not followed the treatment as they have been prescribed. O presente trabalho foi realizado no período de janeiro de 1997 a janeiro de 1999 com 66 pacientes cadastrados no Servi o de Oxigenoterapia da Faculdade de Medicina de Botucatu (FMB) - UNESP. O objetivo foi conhecer os pacientes, suas características gerais e de saúde, bem como as condi es de fornecimento e uso do oxigênio. A média de idade foi de 61,2 ± 10,1 anos, 61% eram do sexo masculino, apresentavam grau de escolaridade baixo e condi o sócio-econ mica desfavorável. A doen a pulmonar obstrutiva cr nica (DPOC) foi a principal patologia encontrada, correspondendo a 78,2% dos diagnósticos. De acordo com os resultados da gasometria arterial (PaO2 = 46,14 ± 9,07 mmHg, PaCO2 = 45,80 ± 7,99 mmHg e SaO2 = 79,25 ± 11,44%), todos os pacientes preenchiam os critérios de indica o e uso de oxigenoterapia domiciliar prolongada (ODP) de acordo com os consensos nacional e intern
PREVALêNCIA DE ENDOPARASITAS EM AMOSTRAS FECAIS DE AVES SILVESTRES E EXóTICAS EXAMINADAS NO LABORATóRIO DE ORNITOPATOLOGIA E NO LABORATóRIO DE ENFERMIDADES PARASITáRIAS DA FMVZ-UNESP/BOTUCATU-SP PREVALENCE OF ENDOPARASITES IN FECAL SAMPLES OF EXOTIC AND WILD BIRDS EXAMINED IN THE LABORATORY OF ORNITOPATOLOGY AND LABORATORY OF PARASITICS DISEASES OF THE FMVZ – UNESP/BOTUCATU, SP  [cached]
Guilherme Augusto Marietto-Gon?alves,Thiago Fernandes Martins,Edna Tereza de Lima,Raimundo de Souza Lopes
Ciência Animal Brasileira , 2009,
Abstract: Dos vários problemas sanitários que afetam as aves, as enfermidades parasitárias est o entre as mais frequentes. Analisou-se no presente trabalho a prevalência de endoparasitas das 207 amostras fecais de aves silvestres e exóticas atendidas no Laboratório de Ornitopatologia e no Laboratório de Enfermidades Parasitárias do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade Estadual Paulista (FMVZ-UNESP), campus de Botucatu, SP. As amostras foram inicialmente analisadas através do exame direto a fresco e, após a constata o da presen a de ovos, cistos ou oocistos nas fezes, as mesmas amostras foram submetidas à Técnica de Faust e ao Método de Willis. No estudo encontraram-se ovos de três gêneros de nematoídes e cistos de quatro gêneros de protozoários em cinco de doze ordens aviárias, sendo Passeriformes a que apresentou o maior número de indivíduos parasitados. PALAVRAS-CHAVES: Aves, ornitopatologia, parasitologia. Among the various sanitary problems affecting birds, parasitic diseases are some of the most common ones. This study analyses the prevalence of endoparasites in 20 fecal samples of wild and exotic birds attended at the Ornitopathology and Parasitic Diseases Laboratories of the Veterinary Hospital, Faculty of Veterinary Medicine and Zootecnics, S o Paulo State University (FMVZ-UNESP), campus Botucatu. After confirmation of eggs, cysts or oocysts through direct fecal test, Faust technique and Willis Method were performed on feces. Eggs of three genera of nematodes as well as cysts of four genera of protozoaries were found in five of 12 avian orders, with the order Passeriformes representing the most of the parasited individuals. KEY WORDS: Birds, ornitopathology, parasitology.
Tick fever in cattle in the region of Botucatu - SP: a retrospective study of 1986-2007/ Tristeza Parasitária em bovinos na regi o de Botucatu – SP: estudo retrospectivo de 1986 – 2007  [cached]
Roberto Calderon Gon?alves,Andreza Amaral da Silva,Danilo Otávio Laurenti Ferreira,Simone Biagio Chiacchio
Semina : Ciências Agrárias , 2011,
Abstract: A retrospective study of Cattle Tick Fever was made with animals up to one year old, which occurred from 1986-2007 in Botucatu-SP in the influence area of the Veterinary Hospital of the School of Veterinary Medicine and Animal Science – UNESP. There were 232 cases and 57 deaths. The main etiological agent causing the disease on this region is Anaplasma marginale identified as a single agent in 31.5% of the cases. Most of the cases occurred on autumn in mixed-blood animals two to six months old. Predominant clinical signs included apathy, hyporexia or anorexia, dehydration, weight loss and pale mucosa. The high incidence and mortality observed justify prophylactic actions to have the balance between host, agent, vector, and environment, thus avoiding the clinical form of disease and death of livestock herds in the region. Foi realizado um estudo retrospectivo dos casos de tristeza parasitária bovina (TPB) em bovinos com até um ano de idade ocorridos na regi o de Botucatu-SP, área de influência do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia de Botucatu – UNESP, entre os anos de 1986 e 2007. Ocorreram, nesse período, 232 casos da doen a e 57 mortes. O principal agente etiológico causador da doen a nesta regi o foi o Anaplasma marginale, identificado como um único agente em 31,5% dos episódios da doen a. A maioria dos casos ocorreu no Outono, em animais mesti os e com dois a seis meses de idade. Os sinais clínicos predominantes foram: apatia, hiporexia ou anorexia, desidrata o, perda de peso e palidez das mucosas. A elevada incidência e mortalidade observados justificam a es profiláticas visando o equilíbrio entre hospedeiro, agente, vetor, e meio ambiente, evitando, assim, a forma clínica da doen a e morte dos animais em rebanhos da regi o.
Porcentagens de saponinas e taninos em vinte e oito cultivares de alfafa (Medicago sativa L.) em duas épocas de corte - Botucatu - SP  [cached]
Vieira Maria Eunice de Queiroz,Costa Ciniro,Silveira Ant?nio Carlos,Arrigoni Mário De Beni
Revista Brasileira de Zootecnia , 2001,
Abstract: O objetivo do estudo foi determinar os conteúdos de saponinas, taninos e a solubilidade da proteína (SP) de 28 cultivares de alfafa: Crioula, Monarca, BR 4, Alto Great, MH 4, SW 9210 A, 5929, BR 1, EL Grande, 5715, MH 15, Valley Plus, BR 2, Rio, SW 8210, Maricopa, ICI 990, 5888, P 30, Alfa-200, WL 516, SW 8112 A, BR 3, Florida 77, Araucana, Falcon, Semit 921 e Sutter. O material analisado foi obtido do 10o e 14o corte, respectivamente; em 08/12/97 e 16/04/98, de um experimento desenvolvido na Faculdade de Medicina Veterinária e Zootecnia, UNESP, Botucatu. Amostras de cada cultivar foram colhidas, pesadas e secas em estufa a 52oC. As saponinas foram extraídas com solvente hidrofílico e lipofílico e o conteúdo foi calculado pela equa o y=0,8121x-1,4759, R2 = 1,00. A extra o dos taninos totais e condensados foi efetuada por meio de ultra-som (12 min), sendo os taninos totais determinados pela equa o: y=44,978 + 0,5644 com R2=0,9977 e os condensados, multiplicando-se a absorbancia por 78,26 dividido pelo teor de matéria seca. A SP foi determinada pelo método de KOH, de acordo com a seguinte fórmula: SP (%) = proteína solúvel x 100/proteína bruta da amostra. Os teores de saponinas, taninos totais e condensados e a solubilidade da proteína n o diferiram (P>0,05) entre as cultivares. Houve efeito (P<0,05) da época de corte apenas sobre o teor de taninos totais. Os teores médios de saponinas de 1,00% aliados à baixa solubilidade média da proteína bruta (34,11%) n o se constituem em fatores limitantes para uso dos cultivares de alfafa estudadas.
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