Risk of osteoporotic fracture in women using the FRAX tool with and without bone mineral density score in patients followed at a tertiary outpatient clinic ‒ An observational study.

Objectives: Fragility fractures increase morbidity and mortality. Adding assessment of clinical risk factors independently or as a previous step to Bone Densitometry (BD) should provide better accuracy in fracture risk prediction. FRAX tool might be used to stratify patients in order to rationalize the need for BD and risk classification.

Perception of usefulness of laboratory tests ordering by internal medicine residents in ambulatory setting: A single-center prospective cohort study.

The demand for high value health care uncovered a steady trend in laboratory tests ordering and inappropriate testing practices. Residents' training in laboratory ordering practice provides an opportunity for quality improvement. We collected information on demographics, the main reason for the appointment, preexisting medical conditions and presence of co-morbidities from first-visit patients to the internal medicine outpatient service of our university general hospital.

Improving serum calcium test ordering according to a decision algorithm.

Aim: To detect differences in the pattern of serum calcium tests ordering before and after the implementation of a decision algorithm.

Methods: We studied patients admitted to an internal medicine ward of a university hospital on April 2013 and April 2016. Patients were classified as critical or non-critical on the day when each test was performed.

Laboratory Tests Ordering Pattern by Medical Residents From a Brazilian University Hospital.

Objectives: The adequacy of laboratory test orders by medical residents is a longstanding issue. The aim of this study is to analyze the number, types, and pattern of repetition of tests ordered by medical residents.

Methods: We studied all tests ordered over a 1-year period for inpatients of an internal medicine ward in a university hospital.

Rational use of blood calcium determinations.

Context And Objective: This study was motivated by the recent excessive increase in requests for blood calcium determinations and laboratory tests in general, in the Hospital das Clínicas complex of Faculdade de Medicina, Universidade de São Paulo (HCFMUSP). Its aim was to suggest rules for the determination of total and ionized calcium in our intensive care units, emergency department, wards and outpatient services, thus contributing towards improving the quality of medical care and achieving more appropriate use of human and financial resources.

Design And Setting: Critical analysis on clinical and laboratory data and the pertinent scientific literature, conducted by the study group for rational clinical laboratory use, which is part of the Central Laboratory Division, HCFMUSP.

Vitamin D: non-skeletal actions and rational use.

Recent years have witnessed a substantial increase in the number of seric determinations of vitamin D, in a worldwide basis. At Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo that increase reached 700% over the last four years. Nevertheless there are many controversies on the literature about the role of vitamin D in conditions unrelated to the musculoskeletal system.

C-reactive protein: clinical applications and proposals for a rational use.

C-reactive protein (CRP) is an acute-phase protein whose requests have been growing exponentially in several countries, including Brazil. In this study, the use of CRP in several clinical situations was reviewed by a group of physicians comprised by specialists in internal medicine, medical emergencies, intensive care, screening, and laboratory medicine, aiming to analyze the applicable literature and to propose guidelines for a more rational use of this laboratory test. The result was the creation of flowcharts guiding CRP request, adjusted to four different healthcare environments, namely, intensive care units, emergency room, wards, and outpatient clinics.

Risk factors for computer visual syndrome (CVS) among operators of two call centers in São Paulo, Brazil.

The aims of this study were to investigate work conditions, to estimate the prevalence and to describe risk factors associated with Computer Vision Syndrome among two call centers' operators in São Paulo (n = 476). The methods include a quantitative cross-sectional observational study and an ergonomic work analysis, using work observation, interviews and questionnaires. The case definition was the presence of one or more specific ocular symptoms answered as always, often or sometimes.

[Speech tests: application in individuals with noise induced hearing loss].

Background: Speech intelligibility.

Aim: To evaluate speech recognition in individuals with noise induced hearing loss (NIHL).

Method: 79 adults were divided in two groups: a control group with 39 individuals with hearing limits up to 25 dB, and a research group with 40 individuals with audiometric configuration and occupational history suggesting NIHL.