Dermatology relevance to graduates from the Universidade Estadual de Campinas Medical School

BACKGROUND

Some research indicates that physicians do not dominate the expected dermatological content for the proper exercise of the profession. This fact compromises their diagnostic and therapeutic performance, generating unnecessary costs.

OBJECTIVE

The aim of this study was to evaluate the relevance of Dermatology and the knowledge acquired in the specialty during the undergraduate course in clinical practice of graduates at the State University of Campinas Medical School (FCM/UNICAMP).

METHOD

A questionnaire with 22 closed questions and two open ones was electronically sent to physicians who had graduated more than 10 years ago and others for less than 10 years. In the first group, physicians were trained by the same curriculum and in the second group there were subjects trained by the old and the new curriculum.

RESULTS

Of the 126 respondents, 83% had completed a specialization course. Among all, 82% did not study dermatology after graduation. The majority considered that Dermatology has high relevance in clinical practice, regardless of the group. There was a statistically significant difference between non-dermatologist doctors graduated for more than 10 years and those graduated for less than 10 years regarding confidence about lesion diagnosis, diagnostic investigation and treatment of skin diseases. Physicians who have graduated for a longer time feel more insecure in relation to patients with dermatoses. Concerning contributions offered by graduation program completion they prioritized outpatient care, ability to diagnose, knowledge of pathology, research and knowledge of lesions.

CONCLUSION

This study has shown that Dermatology is relevant in medical practice and more recent graduates from the FCM/UNICAMP feel less insecure when treating a patient with dermatoses.     

Clinical, radiographic, biochemical and histological findings of florid cemento-osseous dysplasia and report of a case

Florid cemento-osseous dysplasia has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually manifests as multiple radiopaque cementum-like masses distributed throughout the jaws. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. The authors present a case of an uncomplicated florid cemento-osseous dysplasia in a 48-year-old black woman. Multiple sclerotic masses with radiolucent border in the mandible were identified radiographically. Histopathologic findings revealed formation of calcified dense sclerotic masses similar to cementum. All clinical, radiographic, biochemical and histological features were suggestive of the diagnosis of florid cemento-osseous dysplasia.     

青年人生理性十二指肠胃反流的相关因素

目的:探讨生理性十二指肠胃反流的反流特点,反流与胃黏膜组织学改变的关系.方法:选取20名青年健康志愿者,分别接受常规胃镜检查,24 h动态胃内pH和胆汁反流监测,HE染色行常规组织病理学检查以及改良Giemsa染色行幽门螺杆菌检查.结果:胃镜与胃黏膜组织检查多为正常黏膜或轻度浅表性炎症,仅2名胃镜下有胆汁反流,6名H pylori阳性.未见溃疡、糜烂、萎缩及肠化生.胆红素监测均有不同程度的十二指肠胃反流,abs>0.14的时间百分比为12.5%±8.8%,短时间反流频率62.8±36.0次、长时间反流频率5.9±3.8次、最长反流时间53.5.0±50.3min,其中立位反流时间显著性长于卧位(P=0.017).胃内pH>4的时间百分比为13.91%±10.1%,与胃内abs>0.14的时间百分比比较无相关性.结论:正常生理条件下均存在生理性十二指肠胃反流,不同个体、不同体位其反流程度不一,但这种反流不引起胃黏膜的病理性改变,也不引起胃内pH的变化.     

改良Black术式修复完全性双侧唇裂畸形

目的 探讨采用改良Black术式修复先天完全性双侧唇裂畸形效果.方法 应用改良的Black术式修复先天完全性双侧唇裂畸形36例,其中前唇组织特别短小者19例,皮肤、唇珠组织不足,均采用裂隙侧唇组织修复.结果 术后随访全部受术者3个月至3年,前唇部唇高正常,两侧唇高对称,唇珠丰满,唇弓静态及动态自然,上唇无明显过长、过紧,唇珠与红唇颜色无差异,切口瘢痕不明显,效果满意.结论 改良术式弥补了Black术式修复双侧完全性唇裂前唇组织特别短小的患者时,出现中央唇高不足、唇珠不够丰满的缺陷,使修复的上唇功能及美容效果更佳,值得临床推广.     

老年失智症家庭照顾者管理策略现状及影响因素分析

目的 了解老年失智症家庭照顾者管理策略现状并探讨其影响因素,为针对性地开展老年失智症家庭照顾者管理策略指导提供参考.方法 以便利抽样法选取老年失智症家庭照顾者202人,采用一般资料调查表、失智症管理策略量表、照顾者积极感受量表、照顾者哀伤量表和社会支持评定量表进行问卷调查.结果 家庭照顾者的失智症管理策略各维度得分分别为积极管理(43.34±8.98)分,鼓励/支持(33.98±10.00)分,批评(28.03±12.64)分.家庭照顾者文化程度、疾病知识了解程度、哀伤和积极感受是批评维度的影响因素;家庭照顾者文化程度、与患者关系和积极感受是鼓励/支持维度的影响因素;失智症照顾经验、哀伤、积极感受和社会支持是积极管理维度的影响因素(P＜0.05,P＜0.01).结论 老年失智症家庭照顾者管理策略以积极管理和鼓励/支持为主,较少采用批评.医护人员需重视老年失智症家庭照顾者管理策略现状,充分利用家庭-社会支持系统,为家庭照顾者提供家庭管理培训,以形成健康的家庭管理策略.     

Study of subretinal intercellular space

The study of the subretinal space has been possible through a technique which allows a biochemical examination of the intercellular fluid of this space. This subretinal intercellular fluid had been collected in two fractions by saline washes of the interphotoreceptor spaces ($\text{R}\text{F}$) of the detached retina and the apical surface of the exposed retinal pigment epithelium ($\text{RPE}\text{F}$). This technique produced negligible contamination from the blood, surrounding tissues or intraocular fluids. Generally, the $\text{R}\text{F}$ contained twice the quantity of collectable proteins as the $\text{RPE}\text{F}$. Major differences between the two fractions of saline washes were in the proportional concentration of several specific proteins in these washes. Noticeable species specific differences between the electrophoretic patterns of rabbit and rat subretinal proteins were evident. This technique has been shown to be very reliable and has yielded consistant results.     

微创美容技术修复急诊面部皮肤软组织外伤的临床观察

目的探讨应用微创美容技术修复急诊面部外伤的方法。方法对伤口进行彻底清创止血后,应用整形美容外科微创原则修剪伤口,一般的伤口用细针细线分层缝合,有皮肤缺损的伤口应用局部皮瓣或植皮修复。结果本组共治疗82例患者,79例伤口甲级愈合,随访6~18个月,无疤痕增生、挛缩,不需Ⅱ期整形。结论应用微创美容技术对面部外伤修复,美容效果好,患者满意率高,值得临床推广应用。