Hospital TotalCor

Introdução: A formação do biofilme dental por bactérias cariogênicas, principalmente do gênero Streptococcus, é crucial para o estabelecimento de lesões cariosas. Entretanto, a composição deste biofilme e os níveis quantitativos destas bactérias pode variar e depende de fatores do hospedeiro não totalmente elucidados. Objetivo: Avaliar a variabilidade da colonização do biofilme dentário por bactérias do gênero Streptococcus em pacientes odontológicos residentes em zona rural e relacionar com o uso de drogas, frequência diária de escovação, consumo de plantas medicinais nos últimos seis meses e uso de antimicrobianos nos últimos três meses. Métodos: Bactérias oriundas de biofilme dentário de pacientes odontológicos foram obtidas friccionando-se swab estéril sobre dentes contendo cárie dentária ou não, transferido para o meio de transporte Stuart e levado ao laboratório. As amostras foram submetidas a diluições seriadas na base dois em solução salina estéril e 100 microlitros, das amostras diluídas foram semeadas em placas contendo ágar Mitis-Salivarius. As placas foram incubadas em jarra de microaerofilia com vela e incubadas a 37°C por 24 h. Após crescimento, as colônias foram identificadas quanto à forma e características peculiares das espécies de Streptococcus e contadas. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa envolvendo Seres Humanos da Universidade Estadual de Santa cruz sob número de protocolo CAAE 51682321.7.0000.5526. Resultados: A maioria dos participantes possuía entre 20 a 39 anos, apresentaram hábitos de higiene bucal adequado (>2 vezes ao dia) e fizeram uso de plantas medicinais nos últimos seis meses, sendo Cymbopogon citratus (capim-santo), a planta mais citada. Observou-se uma maior predominância de S. mutans e S. salivarius na composição do biofilme dentário da população estudada e baixa de S. mitis e S. sanguinis. Apenas um paciente informou escovar os dentes uma única vez durante o dia e apresentou níveis elevados de S. mutans. Conclusão: Dos aspectos socioculturais analisados, apenas a frequência de escovação diária interferiu nos níveis quantitativos de S. mutans.

Actualmente, la agricultura moderna emplea agroqumicos para generar mayor rendimiento en su produccin, que conlleva degradacin del suelo, consecuentemente la prdida de diversidad de la biota, especialmente microorganismos beneficiosos para el suelo. El uso de plaguicidas se increment 75% entre 2000 y 2017, y en 2018 se aplicaron unos 109 millones de toneladas de fertilizantes nitrogenados sintticos en todo el mundo, motivando para que desde principios del siglo XXI se incremente la produccin de agroqumicos a 2300 millones de toneladas y se prev que aumentar un 85 % en el 2030. La produccin mundial anual de productos qumicos industriales se ha duplicado desde principios del siglo XXI. La evaluacin de la FAO y el PNUMA pronostic que la contaminacin del suelo y del medio ambiente seguira empeorando a menos que hubiera un cambio en los modelos de produccin, consumo y un mayor compromiso poltico que respalde la gestin sostenible y respete plenamente la naturaleza 1 . La contaminacin del suelo provoca una reaccin en cadena, altera la biodiversidad del suelo, reduciendo la materia orgnica, su capacidad para actuar como filtro, contamina el agua almacenada en el suelo y el agua subterrnea, provocando un desequilibrio de sus nutrientes. Entre los contaminantes del suelo ms comunes se encuentran los metales pesados, los contaminantes orgnicos persistentes y los contaminantes emergentes 1 . Por tal motivo, es prioritario desde el punto de vista econmico y ecolgico, la bsqueda de alternativas como el uso de biofertilizantes, entre ellos los hongos micorrcicos arbusculares (HMA), microorganismos eficientes (EM), bacterias fijadoras de N2 y/o solubilizadores de fsforo, entre otros, que sean amigables con el ambiente, no generen impactos negativos y contribuyan al desarrollo de una agricultura sostenible y competitiva, basada en principios agroecolgicos. Especialmente los HMA, segn diversos estudios han sido muy eficientes como sustitutos del fertilizante mineral por su capacidad de combinacin con la materia orgnica, se le atribuye una mayor eficacia, por tener un efecto sinrgico 2 . As, los HMA contribuyen a mejorar la productividad y calidad de los cultivos, para ello se debe tener en cuenta la introduccin de stos en la rizosfera de la planta, de especies altamente eficientes y realizar prcticas de manejo para optimizar el beneficio de las especies nativas

RESUMO Objetivo: Relatar um caso de gravidez ectopica rota apos Laqueadura Tubaria. Relato de Caso: Paciente de 39 anos atendida em um hospital publico ao sul do Tocantins, com quadro de dor abdominopelvica e sangramento transvaginal. Tomografia de abdome total e β-HCG confirmaram diagnostico de prenhez tubaria rota. Foi submetida a laparotomia exploratoria. Consideracoes Finais: E importante considerar que qualquer mulher em idade reprodutiva, com presenca de dor abdominal inferior e sangramento vaginal, possa ser um caso de gravidez ectopica. Palavras-chave: Gravidez ectopica. Laqueadura.

ObjectiveTo characterize the transport of severely ill patients with extracorporealrespiratory or cardiovascular support.MethodsA series of 18 patients in the state of São Paulo, Brazil isdescribed. All patients were consecutively evaluated by a multidisciplinaryteam at the hospital of origin. The patients were rescued, andextracorporeal membrane oxygenation support was provided on site. Thepatients were then transported to referral hospitals for extracorporealmembrane oxygenation support. Data were retrieved from a prospectivelycollected database.ResultsFrom 2011 to 2017, 18 patients aged 29 (25 - 31) years with a SAPS 3 of 84(68 - 92) and main primary diagnosis of leptospirosis and influenza A (H1N1)virus were transported to three referral hospitals in São Paulo. Amedian distance of 39 (15 - 82) km was traveled on each rescue missionduring a period of 360 (308 - 431) min. A median of one (0 - 2) nurse, three(2 - 3) physicians, and one (0 - 1) physical therapist was present perrescue. Seventeen rescues were made by ambulance, and one rescue was made byhelicopter. The observed complications were interruption in the energysupply to the pump in two cases (11%) and oxygen saturation < 70% in twocases. Thirteen patients (72%) survived and were discharged from thehospital. Among the nonsurvivors, there were two cases of brain death, twocases of multiple organ dysfunction syndrome, and one case of irreversiblepulmonary fibrosis.ConclusionsTransportation with extracorporeal support occurred without seriouscomplications, and the hospital survival rate was high.

When considering the historical problem of flood episodes in the city of So Paulo it's noticiable that there are insufficient proposals that make use of climatology and geomorphology methodologies as equally necessary geographical knowledge fields for an integrated approach to the problem of associated sociospatial impacts. This means that those proposals so far are insufficient because they treat those two fields isolatedly. Viewing this demand, this research is based on simultaneous analyzes of physical and social systems that characterize natural events. The analysis is directed to a hydrographic basin where the recurrence of these events is registered with the presence of vulnerable groups in locations of high susceptibility. It's cosidered the long history of anthropogenic interventions in the original hydrogeomorphological systems, such as urban drainage implementation, construction of stormwater reservoirs, the growing and extensive creation of impervious surfaces, etc. A retrospective analysis covered two representative periods of urban occupation, one of the fastest occupation (1970) and another more recent (2000). In this study it is assumed the component of surface runoff as the fundamental element of river systems and slope dynamics originated from rainfall. For this reason this element was especially considered in the comparative analyzes between tendencies of processes in different morphological scenarios: more preserved (or original) and two anthropized basin conditions. Morphological information from these scenarios were assessed related to interpolated rainfall data, detailed on a rhythmic scale of days with floods confirmed by historical sources in selected rain seasons. Data were also correlated with fluviometric readings taken at different points in the basin's main river. At the same time, a sociospatial vulnerability mapping for the study area was elaborated, resulting in an index that associates factors of physical compartments susceptibility to floodings and the population's socioeconomic vulnerability. This allowed a glimpse at the process of exposure to the currently observed risks. Among the most significant results there is the identification of sites in the basin where the worst conditions of social vulnerability and the presence of flood plains (high susceptibility) overlaps. It is also identified that there is a low correlation between days with events with high volumes of precipitation and the reported flood episodes. The spatial modeling of surface runoff made it possible to observe changes caused by anthropic forms in the systems in both decades. When associated to secondary information about the conditions of the urban drainage and engineering structures present in the canal, the modelling results allowed the effective reconstitution of variables involved on each episode. It is concluded that the proposal of a retrospective analysis made viable bases for the evaluation of different factors of climatic and hydrogeomorphological origin to trigger an flooding impact in a highly modified environment, occupied through the spatial reproduction logic defined by the Controlling social agents.

El presente estudio descriptivo transversal de tipo cuantitativo, estableció mediante una muestra de 157 familias con preescolares en un colegio de Bogotá, el nivel de efectividad del funcionamiento familiar a través de la aplicación del instrumento Escala de efecti - vidad de la funcionalidad familiar , basado en Teoría de organización sistémica de Marie Luise Friedemann. El trabajo determinó los niveles de efectividad alcanzado por estas familias mediante la valoración de las metas de crecimiento, espiritualidad, control y estabilidad, obser - vándose en las dos primeras, niveles intermedios y en las dos restantes, niveles altos de efectividad familiar. Así mismo fue posible la estimación de las dimensiones de mantenimiento, cambio, coherencia e individuación que hacen parte del modelo, mostrando en las tres primeras un grado de efectividad de nivel intermedio, mientras que el último criterio de mantenimiento del sistema fami - liar, tuvo clasificación de alto con el 73%. Con todo lo anterior se pudo concluir que las familias participantes en el estudio mantienen en mayor porcentaje (66%) un nivel total de efectividad alto, como se puede apreciar en los resultados del trabajo.

Asymptomatic nocturnal long ventricular pauses are usually detected accidentally and it has been suggested that they may lead to sudden death. Identification of predisposing factors could prevent cardiovascular events. We report the case of a patient with frequent asymptomatic nocturnal ventricular pauses of 3-11 s, characteristic of a vagally mediated atrioventricular (AV) block. Echocardiography, treadmill test, thyroid function test levels, and polysomnogram were normal. In an attempt to reduce the risk, it was decided that an atrial vagal denervation induced by radiofrequency (RF) ablation (cardioneuroablation) could be useful. Spectral mapping was used to localize endocardial vagal innervation in the right and left aspects of the inter-atrial septum, responsible for the sinus node and AV node modulation, and RF pulses were applied in those sites only. After finishing the procedure, significant changes were observed in the heart rate (66-90 b.p.m.), atrial-His interval (115-74 ms), Wenckebach cycle length (820-570 ms), and sinus node recovery time (1100-760 ms). Follow-up Holter recording demonstrated that the number of ventricular pauses had reduced from 438 to 0. Heart rate and time domain characteristics were compatible with vagal denervation. Ablation of the endocardial vagal innervation sites seems to be safe and efficient in reducing the frequency and the length of the ventricular pauses. It was possible by identifying certain spectral components of the atrial electrogram, resulting in a conservative approach.

This work had as aim to evaluate the predominance of Metabolic Syndrome (SM) and the influence of the familiar historical at adolescents of public and private schools. There were studied 337 pupils of public and private schools in the city ofMarília- SP. The following data were evaluated: IMC, waist circumference, blood pressure and biochemical profile (glycemia, total cholesterol, HDL-c, LDL-c and triglycerides and 18,4% of the pupils already presented the SM. Of the bearers of SM in the private schools, 92,8% presented familiar historical and 85,3% in the public ones; 15,4% of the adolescent were classified as obese and a 54,0% as sedentary people. The presence of SM in the adolescents indicates the possibility to present cardiac complications in the adult phase. It is necessary that government starts an interventionist work boarded by multidiscipline team to assist this group so that they become healthier adult individuals.