José Simão de Paula Pinto

Protocolo eletrônico multiprofissional em cirurgia bariátrica

BACKGROUND: Obesity is a multi factorial disease. Data collection plays a fundamental role for conducting papers with high level of quality and obesity surgery lacks the means to carry out prospective studies with high reliability. Data from electronic protocols are more complete, have fewer errors, are more consistent and have a low percentage of violations in relation to paper charts. AIM: 1) To create a theoretical basis of clinical data regarding the multiprofessionalism on metabolic and bariatric surgery; 2) to computerize this basis by transforming it into electronic multi professional protocol; 3) to incorporate it into the SINPE©; 4) to provide the protocol address and their collections for viewing via the Internet using SINPE WEB©. METHOD: The creation of the theoretical background was done in Word© - later transformed into digital form to be used as electronic protocol - based on literature review of nine textbooks in morbid obesity, bariatric surgery and metabolic multi professionalism books, special books in psychology and nutrition applied to the subject. Was added systematic review of the literature based on scientific articles published over the last five years in Medline/Pubmed, Lilacs and Scielo and in theses and dissertations done with electronic protocols. Thus, 10,306 items were computerized in a hierarchical and branched containing data related to medicine, physiotherapy, psychology and nutrition applied to the subject. RESULTS: The complete protocol can be accessed to view in site www.sinpe.com.br CONCLUSIONS: 1) It was possible to create electronic database regarding the clinical multi professionalism on bariatric and metabolic surgery to collect standardized information; 2) it was possible to computerized the database; 3) it is incorporated into the SINPE©; 4) the electronic protocol and its collections were made available for viewing via the Internet using SINPE WEB©.

Criação de protocolo eletrônico para terapia nutricional enteral domiciliar

BACKGROUND Informatics can help the development of home enteral nutrition therapy (HENT). By using an electronic protocol with an electronic database it is possible to organize, structure and manage, information. AIM To develop an electronic protocol for data collection on treatment of patients with home enteral nutrition. METHOD After a review in theoretical material about home enteral nutrition therapy, 1793 data collection items were selected and grouped into nine categories: patient identification, nutritional assessment, dietetics prescription, indications for enteral nutrition, access to enteral nutrition options, composition of enteral nutrition, administration system, complications, and readmission. Was used the Electronic Integrated Computerized Procotols System (SINPE©) to organize that knowledge and the database that attends this research was named Informatized Master Protocol of HENT. The last step was the creation of a specific protocol to collect data by using informations from this database. RESULTS After installing the program, the system recognizes the user by identifying a pre-defined security authorization and also provides a screen to select a master protocol which the user can access. Items that arrange the specific protocol are contained in the Master Protocol and the information for this protocol are displayed. CONCLUSION It was possible to create an electronic protocol for HENT patients care with safety data based on research in enteral nutrition support.

Protocolo eletrônico para coleta estruturada de dados clínicos para pacientes pediátricos em terapia nutricional utilizando o SINPE© (Sistema Integrado de Protocolos Eletrônicos)

OBJECTIVES: To develop a clinical database for pediatric patients in nutrition therapy, to computerize the database turning it into an electronic protocol, to make the multicentric use of the database possible. METHOD: The database was developed based on medical literature search, using textbooks and scientific studies about pediatric nutrition therapy. It was initially organized in one master protocol and after that divided into two specific protocols, one for patients admission and other one for evolution. The database computerization was performed using a software developed in the C# (C sharp) language, by the electronic laboratory for clinical research at the Hospital of Clinics from Federal University of Parana. RESULTS: The electronic protocol allows data collection of clinical, laboratorial and radiological parameters. The final version includes 6694 parameters, 392 distributed in Admission and 6302 in Evolution. CONCLUSION: the creation of a database for pediatric patients in nutrition therapy was possible, the computerization of this database was reliable, there is the possibility of integration between different medical centers for development of multicentric studies, the application of the electronic protocol in the mentioned group of patients was reliable.

Electronic data collection for the analysis of surgical maneuvers on patients submitted to rhinoplasty

Summary Introduction: In the health field, computerization has become increasingly necessary in professional practice, since it facilitates data recovery and assists in the development of research with greater scientific rigor. Objective: the present work aimed to develop, apply, and validate specific electronic protocols for patients referred for rhinoplasty. Methods: The prospective research had 3 stages: (1) preparation of theoretical data bases; (2) creation of a master protocol using Integrated System of Electronic Protocol (SINPE©); and (3) elaboration, application, and validation of a specific protocol for the nose and sinuses regarding rhinoplasty. Results: After the preparation of the master protocol, which dealt with the entire field of otorhinolaryngology, we idealized a specific protocol containing all matters related to the patient. In particular, the aesthetic and functional nasal complaints referred for surgical treatment (i.e., rhinoplasty) were organized into 6 main hierarchical categories: anamnesis, physical examination, complementary exams, diagnosis, treatment, and outcome. This protocol utilized these categories and their sub-items: finality; access; surgical maneuvers on the nasal dorsum, tip, and base; clinical evolution after 3, 6, and 12 months; revisional surgery; and quantitative and qualitative evaluations. Conclusion: The developed electronic-specific protocol is feasible and important for information registration from patients referred to rhinoplasty.

Análise informatizada dos resultados obtidos pela aplicação de protocolo eletrônico na microcirurgia endoscópica transanal (TEM)

RACIONAL: A informacao obtida pelos registros feitos em prontuario de papel, de maneira geral, nao e de boa qualidade, pois os dados sao perdidos ou coletados precariamente. A informatica possibilita a coleta dos dados na forma prospectiva melhorando a assistencia ao paciente e o acesso a informacao, servindo, tambem, como base para elaboracao de pesquisas cientificas. OBJETIVOS: 1) Apresentar estudos de mineracao de dados (verificacao de padroes e tendencias nao visiveis pela coleta de dados); 2) apresentar estudos analiticos dos resultados comparados entre grupos de pacientes do protocolo da TEM. METODO: Apos a coleta de dados no protocolo eletronico do TEM no SINPE©, efetuou-se estudo descritivo com interpretacao das informacoes pelo modulo SINPE© Analisador. Primeiro, executou-se estudos de mineracao de dados com verificacao de padroes e tendencias nao visiveis pela coleta de dados. Segundo, analise comparativa, comprovadas estatisticamente, dos resultados entre grupos de pacientes submetidos a TEM obtidos pelo protocolo eletronico em relacao a incidencia do carcinoma incidental, complicacoes pos-operatorias e estadiamento pre-operatorio e pos-operatorio. RESULTADOS: A mineracao de dados demonstrou as seguintes tendencias: 1) Adenomas maiores que 4 cm de aspecto sessil como fatores de risco de carcinoma incidental; 2) Tumores maiores que 5 cm, invasao angiolinfatica, tipo histologico viloso e margens cirurgicas comprometidas como fatores de risco para recidiva da neoplasia. Os estudos analiticos comparados concluiram que nao houve diferencas estatisticas significativas em relacao a incidencia do carcinoma incidental, em adenomas menores e maiores que 4 cm e, tambem, em relacao a presenca de complicacoes pos-operatorias entre portadores de adenoma e adenocarcinoma. Comprovou-se, ainda, que a margem de erro em tumores com estadiamento ultrassonografico de uT1, uT2 e uT3, em relacao ao estadiamento patologico, e muito maior que em tumores uT0. CONCLUSOES: Foi possivel realizar estudos de mineracao doa dados coletados pelo uso do SINPE©. Foi possivel realizar estudos analiticos dos resultados comparados entre grupos de pacientes do protocolo da TEM, sendo realizadas analises em relacao ao carcinoma incidental, estadiamento pre e pos-operatorio e complicacoes pos-operatorias.

Protocolo eletrônico de coleta de dados clínicos da microcirurgia endoscópica transanal (TEM): desenvolvimento e aplicação

INTRODUCAO: A coleta de dados na forma prospectiva melhora a assistencia ao paciente e o acesso a informacao. Os registros feitos em prontuarios de papel geralmente nao trazem informacao satisfatoria, pois os dados acabam sendo perdidos ou nao coletados adequadamente. A informatica na saude possibilita o melhor uso da informacao, servindo, inclusive, como suporte para pesquisas cientificas. OBJETIVOS: 1 - Criar, informatizar e armazenar uma base de dados clinicos da Microcirurgia Endoscopica Transanal (TEM), incorporando-a ao SINPE© e realizando coleta de dados; 2 - apresentar estudo descritivo dos resultados da coleta de dados realizada em 59 pacientes submetidos a TEM. METODOS: Primeiro foi realizada a criacao da base teorica de dados da TEM, que foi a seguir informatizada e incorporando-a ao SINPE© e realizou-se a coleta de dados. Segundo, efetuou-se estudo descritivo com interpretacao das informacoes obtidas atraves de estatisticas e graficos pelo modulo SINPE©Analisador. RESULTADOS: A utilizacao do software possibilitou a criacao do protocolo da TEM. Os dados armazenados pela coleta de 59 pacientes submetidos ao procedimento cirurgico foram resgatados e analisados pelo modulo SINPE Analisador©, gerando graficos e estudos descritivos automaticamente. Verificou-se que 74,55% (41) dos pacientes apresentavam, antes do procedimento operatorio, o diagnostico de adenoma. No estadiamento pre-operatorio realizado por ultrassonografia transrretal, notou-se que a maioria dos tumores apresentaram estadiamento pre-operatorio de adenoma (uT0). Em relacao ao acometimento linfonodal dois foram avaliados no ultrassom como comprometidos. Quanto a profundidade de resseccao da parede retal verificou-se que mais de 60% dos pacientes submetidos a TEM realizaram resseccao em bloco de toda a parede retal, ou seja, ate a gordura perirretal. Verificou-se, que o numero total de pacientes portadores de adenocarcinoma foi maior no estudo histopatologico da peca cirurgica que na biopsia pre-operatoria. Os resultados do estadiamento histopatologico da peca cirurgica apresentou diferencas entre o estadiamento pre-operatorio e pos-operatorio. A presenca de carcinoma incidental em pacientes que possuiam diagnostico pre-operatorio de adenoma, foi de 13 (31,7%). Realizou-se avaliacao dos pacientes portadores de adenocarcinoma que foram submetidos a resseccao em bloco da parede retal, ou seja, ate a gordura perirretal. Foram diagnosticados, no exame histologico pos-operatorio, 22 pacientes (37,28% dos pacientes submetidos a TEM) portadores de adenocarcinoma. Destes 19 foram submetidos a resseccao ate a gordura perirretal (86,36% dos pacientes portadores de adenocarcinoma). O estadiamento realizado pela ultrassonografia transrretal demonstrou 24 tumores uT0. No exame histopatologico das pecas cirurgicas, observou-se que 11 apresentavam adenoma, nove carcinoma in situ, ou seja, dos 24 tumores estadiados em uT0, 20 apresentaram estadiamento pos-operatorio compativel o exame pre-operatorio (83,33%). CONCLUSOES: O software SINPE© representou ferramenta adequada a pesquisa clinica e contribuiu com o levantamento preciso e facil dos dados coletados em pesquisa prospectiva.

Protocolo eletrônico de fisioterapia respiratória em pacientes com escoliose idiopática do adolescente

OBJECTIVE To create a clinical database of respiratory function in patients with adolescent idiopathic scoliosis; computerize and store this clinical data through the use of a software; incorporate this electronic protocol to the SINPE© (Integrated Electronic Protocols System) and analyze a pilot project with interpretation of results. METHODS From the literature review a computerized data bank of clinical data of postural deviations was set up (master protocol). Upon completion of the master protocol a specific protocol of respiratory function in patients with adolescent idiopathic scoliosis was designed and a pilot project was conducted to collect and analyze data from ten patients. RESULTS It was possible to create the master protocol of postural deviations and the specific protocol of respiratory function in patients with adolescent idiopathic scoliosis. The data collected in the pilot project was processed by the SINPE ANALYZER©, generating charts and statistics. CONCLUSION The establishment of the clinical database of adolescent idiopathic scoliosis was possible. Computerization and storage of clinical data using the software were viable. The electronic protocol of adolescent idiopathic scoliosis could be incorporated into the SINPE© and its use in the pilot project was successful.

Utilization of the Apriori Data Mining method in a research software with electronic protocol in Enteral Nutrition

The aims this paper is to display the apriori data mining method results implanted in SINPE© (Electronic Protocols Integrated System) in an Enteral Nutrition research. We developed the data mining in the SINPE and later the items body mass index (BMI or IMC) and Enteral diet were selected from the database of the Homecare Enteral Nutrition Research. The parameters used were 10% support and 50% confidence. The Apriori generated a rule showing that patients with BMI ¿ 22 kg/m2 implied the intake of a homemade diet. The application of the apriori data mining method shows itself more dynamic, allowing the data intersection, and helping on decisions and on the elaboration of diagnostics as well as on diet prescriptions, checking the possible relationships between the analyzed items.

Proposed computerized protocol for epidemiological study of patients undergoing microsurgery of the larynx

Summary Introduction: The merging of medicine with information technology facilitates the retrieval of stored data, aiding the conduct of research with greater scientific rigor. Studies in the field of otorhinolaryngology, specifically in the area of laryngology and voice, are of fundamental importance, since 70% of the economically active need their voice to work. Objective: To create a computerized protocol of the diseases of the larynx, apply and validate it, and use it to evaluate patients undergoing laryngoscopic microsurgery of the larynx. Method: We created a database of ENT diseases through a literature review of textbooks and scientific articles. Next, we computerized the data and incorporated it into the SINPE©, creating a master protocol (ENT diseases) and a specific protocol (laryngeal diseases). Data were collected prospectively from patients undergoing laryngeal microsurgery in the ENT Hospital of Paraná. The collected data were analyzed with graphs through the SINPE© Analyzer module. Results: We evaluated 245 patients aged 9–79 years, and determined that 36.61% (93 patients) underwent surgery for the presence of polyps on the vocal folds, 12.6% (32) underwent surgery for papillomatosis, and 11.83% (29) underwent surgery for intracordal cysts. Conclusions: The creation of an electronic database of clinical ENT diseases was feasible. We were also able to implement and validate the protocol. The database may be released to physicians involved in clinical data collection and retrieval of information to conduct scientific research in an organized manner. The most common laryngeal disorders identified were polyps, papilloma, and intracordal cysts.

Modelizando práticas para a socialização de informações: a construção de saberes no ensino superior

This paper proposes a methodology to create an integrated environment monitoring for the management and publishing of the Referential Data Base of Articles from Information Science Periodicals (Brapci). Defines and examines variables guiding the research and, through an exploratory study and mapping of users demands, makes the accomplishment of a prototype for implementing the proposal. It describes the planning, construction, development and validation of the functional system using the Internet as a network application platform.