Objetivo: Analisar indicações de partos cesáreos em pacientes de baixo e de alto risco provenientes, respectivamente, do Hospital Santa Lucinda (HSL) e do Conjunto Hospitalar de Sorocaba (CHS), do Sistema Único de Saúde (SUS), em Sorocaba, São Paulo. Métodos: Estudo retrospectivo dos prontuários das pacientes internadas nesses hospitais, submetidas a cesáreas no período de 01 de março de 2014 a 01 de março de 2015. A pesquisa avaliou parâmetros maternos socioepidemiológicos, reprodutivos, clínicos, indicações das cesáreas e dados neonatais dos recém-nascidos. Resultados: No total de partos ocorridos, indicaram-se cesáreas em 56,3% (CHS) e 32,4% (HSL), havendo significância estatística (p<0,001). Pacientes com cesárea anterior prevaleceram no HSL (77,0%) em comparação com o CHS (56,4%), com proporções estatísticas significativas (p=0,0009). As indicações prevalentes de cesáreas no HSL foram: sofrimento fetal (24,0%), falha na indução ao parto (22,0%) e desproporção céfalo-pélvica (18,7%). No CHS, as maiores proporções foram: sofrimento fetal (35,3%) e iteratividade (25,3%), revelando significância estatística (p<0,0001). Conclusões: O estudo revelou que as proporções de partos cesáreos em ambas as maternidades são superiores àquelas preconizadas pela Organização Mundial de Saúde (OMS). A provável redução de proporções de partos cesáreos na maternidade de baixo risco poderia vir com indicações precisas de indução à parturição, utilização de analgesia ao parto e, ainda, com a devida prática da extração baixa transvaginal do feto pelo fórcipe de alívio às parturientes. Em relação às pacientes de alto risco, tal queda de cesáreas estará subordinada às melhores atenções das políticas públicas de atenção à saúde da mulher brasileira.
Perfil clínico e laboratorial de pacientes pediátricos com diabetes mellitus tipo 1, atendidos em um hospital público terciário de Sorocaba, São Paulo, e sua relação com a adesão ao tratamento Clinical and laboratory profile of pediatric outpatients with type 1 diabetes mellitus, attended in the tertiary public hospital of Sorocaba,
Objective:The objective of this study was to evaluate the impact of probiotic supplementation therapy on anthropometric values and body composition of children and adolescent with obesity. Subjects and methods: This is a nonrandomized controlled, prospective, double-blind interventional clinical trial with primary data analysis. The sample comprised 44 pubertal children and adolescent (8-17 years old) with obesity. The patients were allocated to probiotic (Lactobacillus rhamnosus) or placebo group, with matching of gender and chronological age. Both groups received nutritional guidance, and were followed for six months. In all patients the anthropometric assessment was carried out by a nutritionist and data on weight, height and waist circumference (WC) were collected. Body composition was assessed using dual emission X-ray absorptiometry (DXA). Results: After six months, both groups had increased weight, height but reduced body index mass (BMI) standard deviation score, with no differences between groups. After the intervention, both groups showed a reduction in the percentage of total body fat and an increase in lean mass, but only the placebo group showed a reduction in the percentage of trunk fat. However, the variation in these parameters did not differ between groups. Conclusions: The probiotic group does not seem to have benefited from supplementation. However, we suggest that this reduction in BMI SDS in both groups may have occurred due to improvements in diet because of the nutritional advice given throughout the therapy. We concluded that supplementation with this strain of probiotic was not effective in promoting weight loss or improving the body composition of this population.
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