ABSTRACT
Objective: Our study evaluated the effectiveness of the Botucatu Abbreviated Protocol in breast magnetic resonance imaging (MRI) within Brazil's public healthcare system, focusing on its impact on patient access to MRI exams. Methods: This retrospective study involved 197 breast MRI exams of female patients over 18 years with histological breast carcinoma diagnosis, conducted at Hospital das Clínicas de Botucatu - UNESP between 2014 and 2018. Two experienced examiners prospectively and blindly analyzed the exams using an Integrated Picture Archiving and Communication System (PACS). They first evaluated the Botucatu Abbreviated Protocol, created from sequences of the complete protocol (PC), and after an average interval of 30 days, they reassessed the same 197 exams with the complete protocol. Dynamic and morphological characteristics of lesions were assessed according to BI-RADS 5th edition criteria. The study also analyzed the average number of monthly exams before and after the implementation of Botucatu Abbreviated Protocol. Results: The Botucatu Abbreviated Protocol showed high sensitivity (99% and 96%) and specificity (90.9% and 96%). There was a significant increase in the average monthly MRI exams from 6.62 to 23.8 post-implementation. Conclusion: The Botucatu Abbreviated Protocol proved effective in maintaining diagnostic accuracy and improving accessibility to breast MRI exams, particularly in the public healthcare setting.
Subject(s)
Breast Neoplasms , Magnetic Resonance Imaging , Humans , Female , Retrospective Studies , Breast Neoplasms/diagnostic imaging , Middle Aged , Adult , Aged , Brazil , Health Services Accessibility , Sensitivity and Specificity , Clinical ProtocolsABSTRACT
Abstract Objective Our study evaluated the effectiveness of the Botucatu Abbreviated Protocol in breast magnetic resonance imaging (MRI) within Brazil's public healthcare system, focusing on its impact on patient access to MRI exams. Methods This retrospective study involved 197 breast MRI exams of female patients over 18 years with histological breast carcinoma diagnosis, conducted at Hospital das Clínicas de Botucatu - UNESP between 2014 and 2018. Two experienced examiners prospectively and blindly analyzed the exams using an Integrated Picture Archiving and Communication System (PACS). They first evaluated the Botucatu Abbreviated Protocol, created from sequences of the complete protocol (PC), and after an average interval of 30 days, they reassessed the same 197 exams with the complete protocol. Dynamic and morphological characteristics of lesions were assessed according to BI-RADS 5th edition criteria. The study also analyzed the average number of monthly exams before and after the implementation of Botucatu Abbreviated Protocol. Results The Botucatu Abbreviated Protocol showed high sensitivity (99% and 96%) and specificity (90.9% and 96%). There was a significant increase in the average monthly MRI exams from 6.62 to 23.8 post-implementation. Conclusion The Botucatu Abbreviated Protocol proved effective in maintaining diagnostic accuracy and improving accessibility to breast MRI exams, particularly in the public healthcare setting.
ABSTRACT
The new ichnospecies Paleohelcura araraquarensis isp. nov. is described from the Upper Jurassic-Lower Cretaceous Botucatu Formation of Brazil. This formation records a gigantic eolian sand sea (erg), formed under an arid climate in the south-central part of Gondwana. This trackway is composed of two track rows, whose internal width is less than one-quarter of the external width, with alternating to staggered series, consisting of three elliptical tracks that can vary from slightly elongated to tapered or circular. The trackways were found in yellowish/reddish sandstone in a quarry in the Araraquara municipality, São Paulo State. Comparisons with neoichnological studies and morphological inferences indicate that the producer of Paleohelcura araraquarensis isp. nov. was most likely a pterygote insect, and so could have fulfilled one of the ecological roles that different species of this group are capable of performing in dune deserts. The producer could have had a herbivorous or carnivorous diet or been part of the fauna of omnivores, being able to adopt herbivorous, carnivorous, and saprophagous diets when necessary. In modern dune deserts, some species of pterygote insects are detritivores (like Tenebrionidae), relying on organic matter that accumulated among the sand grains of the dunes during dry periods with no plant growth. The presence of additional burrows suggests that the Botucatu paleodesert would have had a detritivorous fauna like this. Based on the interpretation of the ichnofossil producers, it was possible to reconstruct the food web of this paleodesert. All the omnivorous and herbivorous invertebrates and the herbivorous ornithopod dinosaurs made up the primary consumers. These animals were, in turn, the food source for bigger carnivorous or omnivorous animals unable to feed on detritus, like arachnids, possible predatory insects, mammaliaforms, and theropod dinosaurs. The highest trophic level was occupied by larger theropod dinosaurs and mammaliaforms, which, because of their size, could prey upon a wide range of animals. The producer of Paleohelcura araraquarensis isp. nov. could have been a primary consumer if it were an omnivorous detritivore or a herbivore, or a secondary consumer if it were produced by a predatory insect or an omnivore relying on animal biomass. The description of this new trackway expands the knowledge on the faunal composition of the Botucatu paleodesert and provides insights into the ecological relationships in ancient deserts. The presence of these arthropod trackways in Mesozoic eolian deposits helps to trace a continuity between Paleozoic and post-Paleozoic desert ichnofaunas, further reinforcing a single Octopodichnus-Entradichnus Ichnofacies for eolian deposits.
ABSTRACT
A Leishmaniose Visceral Americana (LVA) é uma enfermidade de caráter zoonótico, exposta a cerca de 200 milhões de pessoas entre cinco continentes do mundo e apresenta grande impacto na saúde pública, devido à alta letalidade em humanos. No Brasil, o cão doméstico (Canis familiaris) é o principal reservatório para LVA, sendo este animal a principal fonte de infecção para o homem. Esta pesquisa teve como objetivo avaliar de forma pareada no intervalo de um ano, a situação soro-epidemiológica prospectiva da LVA da população canina da área urbana de 100km2 do município de Botucatu, SP, que é classificado epidemiologicamente como silencioso não receptivo e vulnerável. Para o presente estudo, foram utilizados 360 cães, selecionados aleatoriamente com representatividade da área urbana, os quais tiveram amostras de sangue colhidas no primeiro momento na 41ª campanha de vacinação anual contra Raiva. Para a determinação do tamanho amostral foi utilizado o nível de 95% de confiança juntamente a um erro de estimação da ordem de 10%, associados à participação casual do animal. Após o período de um ano, foram realizadas as repetições das colheitas de sangue nos mesmos cães nos respectivos domicílios. O método sorológico de diagnóstico utilizado, em ambos os momentos, foi a reação de imunofluorescência indireta (RIFI). Os resultados sorológicos nos cães revelaram-se não reagentes. Desta forma, considerando que o presente estudo encontrou apenas resultados sorológicos pareados não reagentes na identificação da LVA canina no Município e que o tamanho amostrado foi significativo para as condições da pesquisa, pode-se afirmar que a população canina da área urbana estudada encontrava-se, na ocasião, sem indicativos da ocorrência da enfermidade.
The American Visceral Leishmaniasis (AVL) is a zoonotic disease, exposed to about 200 million people across five continents of the world and has a great impact on public health, due to high mortality in humans. In Brazil, the domestic dog (Canis familiaris) is the main reservoir for AVL, and this animal is the main source of infection for man. This research aimed to evaluate in the paired form within one year, the situation seroepidemiological prospective AVL in dog population of the urban area of 100km² of Botucatu, SP, which is classified as epidemiologically silent, unreceptive and vulnerable. To the present study, we used 360 dogs randomly selected that were representative of the urban area, which had blood samples taken for the first time at the 41st annual vaccination campaign against rabies. To determine the sample size it was used at the 95% confidence, coupled to an estimation error of about 10%, associated to the casual participation of the animal. After one year, repetitions of blood samples were made on the same dogs, in their homes. The serological diagnostic method used, both times, was the indirect immunofluorescence assay (IFA). The serological results in dogs proved nonreactive. Thus, considering that this study found only paired serological results were also negative in the identification of canine LVA in the city and that the size sampled was significant for the conditions of the research, it can be said that the dog population of the urban area studied was at the time, without any indication of the occurrence of the disease.
La leishmaniasis visceral Americana (LVA) es una enfermedad zoonótica, expuesta a unas 200 millones de personas en los cinco continentes del mundo y tiene un gran impacto en la salud pública, debido a la alta mortalidad en seres humanos. En Brasil, el perro doméstico (Canis familiaris) es el principal reservorio de la LVA, y este animal es la principal fuente de infección para el hombre. Este estudio tuvo como objetivo evaluar utilizando muestras sucesivas del mismo animal, en el intervalo de un año, la situación seroepidemiológica prospectiva de la LVA en la población canina de la zona urbana de 100km² de Botucatu, SP, que es clasificado epidemiológicamente silencioso, no receptivo y vulnerable. Para el presente estudio, se utilizaron 360 perros seleccionados al azar representativos de la zona urbana, que tuvieron muestras de sangre colectadas por primera vez en la 41ª campaña de vacunación anual contra la Rabia. Para determinar el tamaño de la muestra se utilizó el nivel de confianza del 95% acoplado a un error de estimación de alrededor de 10%, asociado a la participación ocasional del animal. Después de un año, se realizaron repeticiones de colecta de muestras de sangre en los mismos perros en sus domicilios. El método de diagnóstico serológico utilizado, en ambas ocasiones, fue la prueba de reacción de inmunofluorescencia indirecta (RIFI). Los resultados serológicos en perros se demostraron no reactivos. De esta manera, se considera que el presente estudio encontró solamente resultados serológicos pareados no reactivos en la identificación de LVA canina en Botucatu y que el tamaño de muestra fue significativo para las condiciones del estudio, se puede afirmar que la población canina del área urbana estudiada se encuentra, en ocasión, sin indicativos de ocurrencia de la enfermedad.
Subject(s)
Animals , Dogs , Seroepidemiologic Studies , Leishmania infantum/isolation & purification , Leishmaniasis, Visceral/veterinary , Brazil , Enzyme-Linked Immunosorbent Assay/veterinary , Matched-Pair AnalysisABSTRACT
A presença do cão e do gato na convivência com os seres humanos é intensa, embora a população geralmente desconheça ou conheça parcialmente os riscos que estes animais podem oferecer como potenciais transmissores de zoonoses. O objetivo do presente estudo foi avaliar o grau de conhecimento da população de Botucatu-SP sobre raiva, leptospirose, leishmaniose, toxoplasmose e verminoses. Foram aplicados questionários em 99 domicílios sorteados, segundo planejamento amostral estatístico, em 55 bairros do município. Os questionários foram compostos de 30 questões, no total, envolvendo epidemiologia da leptospirose, raiva, toxoplasmose, verminoses e leishmaniose. Verificou-se que a população botucatuense reconhece a importância das zoonoses, mas não tem conhecimento (ou apresenta conhecimento parcial) da cadeia epidemiológica destas enfermidades. 57,6%; 41,4%; 38,5%; 15,2%; e 8,1% dos entrevistados apresentavam algum tipo de informação correta sobre verminoses, leptospirose, raiva, leishmaniose e toxoplasmose, respectivamente. Com base nos resultados apresentados, conclui-se que um intenso trabalho educacional deva ser desenvolvido na comunidade botucatuense, com referência às principais zoonoses transmitidas por cães e/ou gatos, especialmente no tocante à leishmaniose e toxoplasmose.
Dogs and cats are intensively present in the human environment, but the population normally does not know - or partially know - about the risks that these animals can offer, as potential zoonosis' transmitters. The aim of present study was to evaluate the knowledge level of Botucatu-SP population about rabies, leptospirosis, leishmaniasis, toxoplasmosis and worms. It where applied 99 queries in sorted houses, according to statistical sampling plan, in 55 districts. The queries were composed by a total of 30 questions regarding the epidemiology of leptospirosis, rabies, toxoplasmosis, worms and leishmaniasis. It was verified that Botucatu's population Inows about the zoonosis importance but has not knowledge (or presents partial knowledgement) of epidemiological cycle of these diseases. 57.6%, 41.4%, 38.5%, 15.2%, and 8.1% of individuals that answered the queries presented some kind of correct information about worm's infestation, leptospirosis, rabies, leishmaniasis and toxoplasmosis, respectivelly. Considering the presented results, it is possible to conclude that an intensive educational work must be developed in Botucatu's community, regarding the major zoonosis transmitted by cats and/or dogs, with special attention for leishmaniasis and toxoplasmosis.
La presencia del perro y del gato en el convivio con los seres humanos intensa, a despecho de la población generalmente desconozca o parcialmente conozca los riesgos que estos animales pueden ofrecer como potenciales transmisores de zoonosis. El objetivo del presente estudio fue evaluar el grado de conocimiento de la población de Botucatu-SP sobre Rabia, leptospirosis, leishmaniosis, toxoplasmosis y helmintiasis. Fueron aplicados cuestionarios en 99 residencias sorteadas, según planeamiento de muestra estadístico, en 55 barrios del municipio. Los cuestionarios eran compuestos de 30 cuestiones, en total, envolviendo epidemiologia de leptospirosis, Rabia, toxoplasmosis, las helmintiasis y leishmaniosis. Se verificó que la población de la ciudad de Botucatu/SP reconoce la importancia de las zoonosis, pero no tiene conocimiento (o presenta conocimiento parcial) de la cadena epidemiológica de estas enfermedades. 57,6%; 41,4%; 38,5%; 15,2%; y 8,1% de los entrevistados presentaban alguno tipo de información correcta sobre helmintiasis, leptospirosis, Rabia, leishmaniosis y toxoplasmosis, respectivamente. Con base en los resultados presentados, se concluye que un intenso trabajo educacional deba ser desarrollado en la comunidad de la ciudad, con referencia a las principales zoonosis transmitidas por perros y/o gatos, especialmente en el tocante a la Leishmaniosis y Toxoplasmosis.
Subject(s)
Humans , Animals , Cats , Dogs , Zoonoses/prevention & control , Health Knowledge, Attitudes, Practice , Zoonosis Surveillance , Health Services Research/statistics & numerical data , BrazilABSTRACT
A presença do cão e do gato na convivência com os seres humanos é intensa, embora a população geralmente desconheça ou conheça parcialmente os riscos que estes animais podem oferecer como potenciais transmissores de zoonoses. O objetivo do presente estudo foi avaliar o grau de conhecimento da população de Botucatu-SP sobre raiva, leptospirose, leishmaniose, toxoplasmose e verminoses. Foram aplicados questionários em 99 domicílios sorteados, segundo planejamento amostral estatístico, em 55 bairros do município. Os questionários foram compostos de 30 questões, no total, envolvendo epidemiologia de leptospirose, raiva, toxoplasmose, verminoses e leishmaniose. Verificou-se que a população botucatuense reconhece a importância das zoonoses, mas não tem conhecimento (ou apresenta conhecimento parcial) da cadeia epidemiológica destas enfermidades. 57,6%; 41,4%; 38,5%; 15,2%; e 8,1% dos entrevistados apresentavam algum tipo de informação correta sobre verminoses, leptospirose, raiva, leishmaniose e toxoplasmose, respectivamente. Com base nos resultados apresentados, conclui-se que um intenso trabalho educacional deva ser desenvolvido na comunidade botucatuense, com referência às principais zoonoses transmitidas por cães e/ou gatos, especialmente no tocante à leishmaniose e toxoplasmose.
ABSTRACT
In the last eight decades, São Paulo state has been a center of anurans research. However, at central-west of São Paulo state, studies in Peripheral Depression (PD) communities are scarce. In order to bring new information, our objectives were surveying frogs in PD area, linking our results with other data and comparing with known results from crest of the Botucatu cuesta. The inventory was conducted during 13 months (December 2008 to December 2009), and data has obtained in 24 days sampling. The frogs were investigated in sites that anurans currently using for reproduction, by traditional field methods, based on visual-encounter survey and auditory. We recorded 29 species into 12 genera and six families. The high frog diversity was considered because this area has suffered human action. Although the most of the species has been identified in open areas, we associated this high number due to forest remnants in interfluves. Therefore, the differences between our study and others at the same region were due low number of related species on the forest environment. The absence of similar topography at PD probably was a determinant factor for the low number of species in forest habitat. The amphibian activity was higher during hot and humid period and a decrease in the cold and dry period. The most part of anurans had a restricted activity during rainy season; however, each species has its own period and peak of calling activity. The similarity results indicate the most part of higher clusters was observed between species that different requirements for habitat and microhabitat. We believe that, differences in temporal pattern distribution of organisms in the community are of great importance in sharing resources and adjusting the species in the community, which contributed to the high number of amphibians and observed the coexistence of taxa in the study area.
A anurofauna do estado de São Paulo, nas últimas oito décadas, tem sido foco do estudo de importantes grupos de pesquisa em anfíbios anuros. Porém, pesquisas realizadas com comunidades na área da Depressão Periférica do centro-oeste paulista ainda são escassas. A fim de trazer novas informações sobre essa região, nosso objetivo foi inventariar a anurofauna de uma área na Depressão Periférica, associando os resultados com dados da literatura e confrontando os mesmos com aqueles conhecidos para a anurofauna no altiplano da Cuesta de Botucatu. O inventário foi realizado a partir dos dados obtidos em 24 dias de amostragem, decorridos 13 meses de coleta (dezembro de 2008 a dezembro de 2009). Os anuros foram amostrados em potenciais sítios reprodutivos, pelos métodos de encontro visual e busca auditiva. Foram registradas 29 espécies distribuídas em 12 gêneros e seis famílias. Apesar da maioria das espécies serem predominantemente de áreas abertas, consideramos a riqueza elevada, e associamos essa riqueza à existência dos remanescentes de mata nos interflúvios. Entretanto, apesar da presença desses remanescentes, a ocorrência de espécies associadas exclusivamente a essas áreas foi pequena, se comparada aos fragmentos no altiplano, fato que aparentemente está associado às diferenças existentes entre os fragmentos contidos nos interflúvios e os fragmentos do altiplano. A atividade dos anfíbios foi concentrada no período quente e úmido, diminuindo à medida que se aproxima o ápice da estação fria e seca. Com base na análise de similaridade, observou-se a formação de agrupamentos com alta sobreposição. Entre esses agrupamentos, destacaram-se aqueles formados por espécies com atividade de vocalização prolongada, mas que diferiram quanto ao período de maior atividade (início e final da estação chuvosa) bem como, aqueles constituídos por espécies com período de vocalização mais curto, restrito a poucos dias, e que também diferiram no mês de pico de atividade (início e final da estação chuvosa). Com isso acreditamos que as diferenças quanto à distribuição temporal dos organismos da comunidade sejam importantes na partilha de recursos e no ajuste das espécies, fato que contribuiu para o elevado número de anfíbios observados e na coexistência dos táxons na área de estudo.
ABSTRACT
The bat fauna of the region of Botucatu, state of São Paulo, is composed of 36 species, belonging tofour families (Phyllostomidae, Molossidae, Vespertilionidae and Noctilionidae). The former is the most rich with18 known species. In the urban area, the most common species were Molossus molossus, Artibeus lituratus and Platyrrhinus lineatus, while in the rural area it was Desmodus rotundus. The rabies exam of bats from Botucatu region was positive just for bats of D. rotundus, M. molossus, A. lituratus and C. perspicillata.
ABSTRACT
The bat fauna of the region of Botucatu, state of São Paulo, is composed of 36 species, belonging tofour families (Phyllostomidae, Molossidae, Vespertilionidae and Noctilionidae). The former is the most rich with18 known species. In the urban area, the most common species were Molossus molossus, Artibeus lituratus and Platyrrhinus lineatus, while in the rural area it was Desmodus rotundus. The rabies exam of bats from Botucatu region was positive just for bats of D. rotundus, M. molossus, A. lituratus and C. perspicillata.
ABSTRACT
O objetivo deste estudo foi estimar prevalência dos transtornos mentais comuns (TMC) e bebedores problemas (BP) e também a utilização de serviços, a partir de estudo seccional, populacional com amostragem aleatória. Incluiu-se sujeitos com 16 anos e mais, avaliando-se aspectos sócio-demográficos, uso de álcool, saúde mental e utilização de serviços. A prevalência de TMC foi 21,7%, de BP foi 4,4%. Na ultima quinzena 14,6% procuraram serviço de saúde. As prevalências observadas confirmam achados da literatura: TMC e BP são importantes problemas de saúde pública, com implicações para a organização de serviços e formação de recursos humanos.
The aim of this cross-sectional study was to estimate the prevalence of common mental disorders (CMD) and problem drinking (PD), as well as health services use in an unselected populational sample. Subjects over 16 years were included and aspects related to socio-demographic characteristics, alcohol use, mental health and services use were studied. The prevalence of CMD was 21.7%, of PD 4.4%. In the two weeks preceeding the interview, 14.6% had used a health service. The results are in accordance with the literature: CMD and PD are important health problems, with implications for health services organization and formation of health professionals.