O Programa Saúde na Escola no Distrito Federal antes e durante a pandemia da Covid-19 / The School Health Program in the Federal District, Brazil, before and during the COVID-19 pandemic

RESUMO Esta pesquisa do tipo exploratória descritiva objetivou analisar a execução do Programa Saúde na Escola (PSE) no Distrito Federal, no período anterior e durante a pandemia da Covid-19. Os dados foram produzidos de fevereiro a abril de 2022 mediante pesquisa documental e aplicação de questionário on-line a profissionais das equipes de Atenção Primária à Saúde (APS), no âmbito do Programa de Qualificação da Atenção Primária do Distrito Federal (QualisAPS). Foram acessados os bancos de dados do Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira, do Sistema de Informação para a Atenção Básica e da Plataforma QualisAPS sobre as ações desenvolvidas de 2018 a 2021, a estruturação do programa e a sua inclusão nos planos de ação das equipes de saúde da família e saúde bucal. Por meio de estatística descritiva e análise de conteúdo, evidenciaram-se ampliação da adesão das escolas ao Programa e predominância de registros referentes à temática saúde bucal e verificação vacinal nos dois períodos, mas com redução quantitativa em decorrência da pandemia. A realidade do Distrito Federal desvela que a inter-relação do PSE com a APS e o apoio do QualisAPS favorecem um processo contínuo de planejamento trazendo perspectivas de fortalecimento das ações.

ABSTRACT This exploratory descriptive research aims to analyze the implementation of the School Health Program in the Federal District, in the period before and during the COVID-19 pandemic. The data were produced from February to April 2022 through documentary research and application of an online questionnaire with professionals from the Primary Health Care (PHC) teams within the scope of the Primary Care Qualification Program of the Federal District-QualisAPS. The databases of the National Institute of Educational Studies and Research Anísio Teixeira, the Information System for Primary Care and the QualisAPS Platform were accessed on the actions developed from 2018 to 202, the structuring of the program, and its inclusion in the action plans of family health and oral health teams. Through descriptive statistics and content analysis it was evident an increase in the adhesion of schools to the PSE and a predominance of records related to oral health and vaccine verification, in both periods, with quantitative reduction due the pandemic period. The reality of the Federal District reveals that the interrelation of the Program with PHC and the support of QualisAPS enable a continuous planning process, bringing prospects for strengthening the actions.

SARS-CoV-2 infection among Brazilian dentists: a seroprevalence study

Abstract: This cross-sectional study aimed to determine the seroprevalence of SARS-CoV-2 infection among Brazilian dentists and its associated factors. Stratified random sampling of dentists from 33 administrative regions of the Federal District (Brazil) was performed. The presence of antibodies was verified by the OnSite COVID-19 IgG/IgM Rapid Test. Participants answered a survey about sociodemographic characteristics, exposure to COVID-19, and professional practice. A chi-square test was performed between serostatus and exposure variables. Mann-Whitney tests were carried out for quantitative variables. Odds ratio (OR) and 95% confidence intervals (95%CI) were calculated. A series of binomial logistic regression models was performed. The seroprevalence of SARS-CoV-2 infection among 324 selected dentists was 19.1%. There was a statistically significant association between seropositivity and previous confirmed diagnosis of COVID-19, loss of taste or smell, diagnosis of COVID-19 in a household member, and treatment of a patient with fever. Dentists with a previous confirmed diagnosis of COVID-19 had 29.5 [12.7-68.4] higher odds to exhibit positive serology test results. Dentists with confirmed diagnosis of COVID-19 in a household member had 2.5 [1.1-5.3] times higher odds to exhibit positive serology test results. Professionals with loss of taste or smell in the last 15 days had 5.24 [1.1-24.1] times higher odds to exhibit positive serology test results, and, for those who had treated patients with fever, there were 2.99 [1.03-8.7] times higher odds to exhibit negative serology test results. There was a similar prevalence rate of infection among dentists and in the general population. Nevertheless, this finding applies to the epidemiological situation in 2020, before the development of vaccines and the emergence of SARS-CoV-2 Delta variant.

Como as características dos LEDs de segunda e terceira geração podem influenciar a dureza de compósitos restauradores: uma revisão da literatura / How the second and third LED generation features can influence the hardness of restorative composites: a review of the literature.

Objetivo: Várias fontes de luz têm sido utilizadas desde que os materiais fotoativados foram introduzidos na odontologia. Diodos emissores de luz (LEDs) se popularizaram como a principal opção para a polimerização dos materiais restauradores. O objetivo nessa revisão da literatura foi avaliar a influência das fontes de luz emitidas por diodo (LEDs) de segunda e terceira geração sobre a dureza de compósitos restauradores. Revisão de literatura: Nas bases de dados PubMed e Google Scholar foram pré-selecionados 239 artigos na língua inglesa entre os anos de 2010 e 2020, utilizando os termos: lightcuring, LED light sources, and dental LEDs. Dos 239 artigos inicialmente selecionados, 37 artigos foram avaliados devido aos critérios de inclusão/exclusão no estudo. Considerações finais: Vários estudos apontaram diferenças importantes na dureza dos compósitos restauradores testados, tanto na superfície de topo quanto na base. No entanto, essas diferenças estavam mais associadas a características como: estado de conservação do LED, irradiância, tempo de ativação, espectro de emissão dos aparelhos e sua compatibilidade ao fotoiniciador presente no compósito. Assim, podemos considerar que o monitoramento das condições do aparelho, e a escolha correta da fonte de luz de acordo com o compósito a ser utilizado são essenciais para maximizar a dureza dos compósitos restauradores, pois embora os aparelhos de terceira geração sejam preferencialmente indicados para compósitos com fotoiniciadores alternativos, os aparelhos que emitem luz azul apresentam vantagens quando o compósito é ativado apenas pela Canforoquinona.(AU)

Objective: Several light sources have been used since the light-curing materials were introduced in dentistry. Light-emitting diodes (LEDs) have become popular as the main option for the polymerization of restorative materials. This literature review aimed to evaluate the influence of second and third generation Light-emitting Diode (LEDs) sources on the hardness of restorative composites. Literature Review: In the PubMed and Google Scholar databases, 239 scientific papers in English were pre-selected between 2010 and 2020 using light-curing, LED light sources, and dental LEDs. After reading, 37 articles were selected to compose the review. Several studies have pointed out significant differences in the hardness of the tested restorative composites, both on the top and base surfaces. However, these differences were more associated with characteristics such as: LED conservation conditions, irradiance, curing time, the emission spectrum of the devices and their compatibility with the photoinitiator used in the composite. Final Considerations: Thus, it can be considered that monitoring the condition of the device and the correct choice of light sources according to the composite to be used is essential to maximize the hardness of the restorative composites, because although third-generation devices are preferably indicated for composites with alternative photoinitiators, devices that emit blue light have advantages when the composite is activated only by Camphorquinone.(AU)

Crop residues activity against the free-living stages of small ruminant nematodes / Atividade de resíduos de culturas contra os estágios de vida livre de nematoides de pequenos ruminantes

Abstract The nematicidal effect of different organic materials was evaluated in order to develop a non-chemical alternative soil treatment for control of the free-living stages of small ruminant gastrointestinal nematodes. The selected organic materials were residues from the juice industry of acerola, cashew, grape, guava, papaya and pineapple, as well as castor residue from the biodiesel industry. LC90 results showed that pineapple residue was the most efficient inhibitor of larval development, followed by castor, grape, cashew, acerola, guava and papaya. Castor residue was also a good source of nitrogen and was used in a greenhouse experiment to prevent larval development in contaminated goat faeces that was deposited in pots containing the grasses Brachiaria brizantha (var. Paiaguás) or Megathyrsus maximus x M. infestum (var. Massai). Castor residue caused a significant (P < 0.05) reduction (85.04%) in Paiaguás grass contamination (L3.dry mass-1) and a reduction of 17.35% in Massai grass contamination (P > 0.05), with an increase in the biomass production of Massai (251.43%, P < 0.05) and Paiaguás (109.19%, P > 0.05) grasses. This strategy, called Econemat®, with good results in vitro shows to be promising on pasture increasing phytomass production.

Resumo O efeito nematicida de diferentes materiais orgânicos foi avaliado, com o objetivo de desenvolver um tratamento alternativo não químico do solo para o controle dos estágios de vida livre de nematoides gastrintestinais de pequenos ruminantes. Os materiais orgânicos selecionados foram resíduos da indústria de suco de acerola, caju, uva, goiaba, mamão e abacaxi, além do resíduo de mamona da indústria de biodiesel. Os resultados da LC90 mostraram que o resíduo de abacaxi foi o mais eficiente inibidor do desenvolvimento larval, seguido pela mamona, uva, caju, acerola, goiaba e mamão. O resíduo de mamona também se mostrou uma boa fonte de nitrogênio, sendo usado em experimento em casa de vegetação para prevenir o desenvolvimento larval em fezes contaminadas, depositadas em vasos, contendo as gramíneas Brachiaria brizantha (var. Paiaguás) ou Megathyrsus maximus x M. infestum (var. Massai). O resíduo de mamona reduziu (85,04%) significativamente (P < 0,05) a contaminação no capim-Paiaguás (L3.dry massa-1), 17,35% no capim Massai (P> 0,05), e aumentou a produção de biomassa das gramíneas Massai (251,43%, P <0,05) e Paiaguás (109,19%, P> 0,05). Essa estratégia, chamada Econemat®, com bons resultados in vitro, mostra-se promissora nas pastagens aumentando a produção de fitomassa.

Comparative analysis of myocardial protection with htk solution and hypothermic hyperkalemic blood solution in the correction of acyanogenic congenital cardiopathies - a randomized study

Abstract Objective: The goal of the present study was to compare the myocardial protection obtained with histidine-tryptophan-ketoglutarate (HTK) cardioplegic solution (Custodiol®) and with intermittent hypothermic blood solution. Methods: Two homogenous groups of 25 children with acyanotic congenital heart disease who underwent total correction with mean aortic clamping time of 60 minutes were evaluated in this randomized study. Troponin and creatine kinase-MB curves, vasoactive-inotropic score, and left ventricular function were obtained by echocardiogram in each group. The values were correlated and presented through graphs and tables after adequate statistical treatment. Results: It was observed that values of all the studied variables varied over time, but there was no difference between the groups. Conclusion: We conclude that in patients with acyanotic congenital cardiopathies submitted to total surgical correction, mean aortic clamping time around one hour, and cardiopulmonary bypass with moderate hypothermia, the HTK crystalloid cardioplegic solution offers the same myocardial protection as the cold-blood hyperkalemic cardioplegic solution analyzed, according to the variables considered in our study model.

Apresentação Atípica de Leucemia Linfoide Aguda em Criança: Relato de Caso / Atypical Presentation of Acute Lymphoid Leukemia in Child: Case Report / Presettación Atípica de Leucemia Linfoide Aguda en Niño: Relato de Caso

Introdução: A leucemia linfoblástica aguda (LLA) é a neoplasia maligna mais comum em crianças e a principal causa de morte por câncer nessa faixa etária. A hipercalcemia associada a lesões osteolíticas francas é uma rara apresentação da LLA. Relato do Caso: Paciente de 9 anos, sexo masculino, 37kg, apresentava cefaleia, dor e impotência funcional em membro inferior direito há 15 dias. Exames laboratoriais evidenciaram elevação de velocidade de hemossedimentação e proteína C reativa com hipercalcemia. Nos exames de imagem, apresentava desmineralização óssea e lesões osteolíticas difusas. Aspirado de medula óssea (MO) evidenciou 10% de blastos, o que não caracterizou leucemia. Pela melhora do quadro clínico, o paciente seguiu com investigação diagnóstica ambulatorialmente. Biópsia de lesão lítica em quadril e novo aspirado de MO detectaram maior número de blastos e confirmaram o diagnóstico de LLA. Iniciou tratamento com protocolo do Grupo Brasileiro de Tratamento de Leucemias na Infância, 2009. Após dois anos, estava bem e sem doença. Conclusão:A hipercalcemia está associada a apenas 0,6% a 4,8% dos casos de LLA. O paciente em questão apresentava apenas dores ósseas difusas e hipercalcemia, sem a sintomatologia habitual, o que torna seu quadro clínico ainda mais raro, sendo tal apresentação muito escassa na literatura. Apesar de incomuns, hipercalcemia e lesões osteolíticas difusas podem ser as primeiras e únicas manifestações de LLA na faixa pediátrica. O presente relato torna-se importante ao auxiliar a formulação de diagnósticos precoces da leucemia infantil, mesmo na vigência de um quadro clínico atípico.

Introduction: Acute lymphoblastic leukemia (ALL) is the most common malignant neoplasm in children and the leading cause of cancer death in this age group. Hypercalcemia associated with frank osteolytic lesions is a rare presentation of ALL. Case Report: 9-year-old male, 37 kg, presented with headache, pain and functional impotence in the lower right leg for 15 days. Laboratory tests showed elevation of erythrocyte sedimentation rate and C-reactive protein with hypercalcemia. Imaging studies revealed bone demineralization and diffuse osteolytic lesions. Bone marrow aspiration showed 10% of blasts, which did not characterize leukemia. Due to the improvement of his clinical condition, the patient continued the clinical investigation as an outpatient. Biopsy of lytic lesion in the hip and new bone marrow aspirations detected higher number of blasts and confirmed the diagnosis of ALL. Treatment was initiated, following the protocol of the Brazilian Group of Treatment of Leukemia in Childhood, 2009. After two years, he was well and without disease. Conclusion: Hypercalcemia is associated with only 0.6% to 4.8% of all ALL cases. The patient presented only diffuse bone pain and hypercalcemia, without the usual symptoms, which makes his clinical condition even rarer, with such presentation being very scarce in the literature. Although uncommon, hypercalcemia and diffuse osteolytic lesions may be the first and only manifestations of ALL in the pediatric range. The present report is important in helping to formulate early diagnosis of childhood leukemia, even in the presence of an atypical clinical condition.

Introducción: La leucemia linfoblástica aguda (LLA) es la neoplasia maligna más común en los niños y principal causa de muerte por cáncer en ese grupo de edad. La hipercalcemia asociada a lesiones osteolíticas francas es una rara presentación de LLA. Relato del Caso: Paciente de 9 años, masculino, 37kg, presentaba cefalea, dolor e impotencia funcional en miembro inferior derecho hace 15 días. Los exámenes de laboratorio evidenciaron elevación de velocidad de sedimentación globular y proteína C reactiva con hipercalcemia. En los exámenes de imagen, presentaba esmineralización ósea y lesiones osteolíticas difusas. Aspirado de médula ósea (MO) evidenció el 10% de blastos, lo que no caracterizó la leucemia. Debido a la mejora del cuadro clínico, el paciente siguió la investigación diagnóstica ambulatoriamente. La biopsia de lesión lítica en cadera y nuevo aspirado de MO detectaron mayor número de blastos y confirmaron el diagnóstico de LLA. Se inició tratamiento con protocolo del Grupo Brasileño de Tratamiento de Leucemias en la Infancia, 2009. Conclusión: La hipercalcemia está asociada a sólo 0,6% a 4,8% de los casos de LLA. El paciente en cuestión presentaba sólo dolores óseos difusas e hipercalcemia, sin la sintomatología habitual, lo que hace el cuadro clínico del paciente aún más raro, siendo tal presentación muy escasa en la literatura. A pesar de inusual, hipercalcemia y lesiones osteolíticas difusas pueden ser las primeras y únicas manifestaciones de LLA en niños. El presente relato se vuelve importante al ayudar a la formulación de diagnósticos precoces de la leucemia infantil, incluso en la vigencia de un cuadro clínico atípico.

Autopercepção da saúde bucal de universitários fumantes, não fumantes e fumantes passivos / Self-perception of oral health of smoking, non-smoking and passive smoking university students

Este estudo teve como objetivo analisar a autopercepção da saúde bucal de universitários adultos jovens, correlacionando-a com status tabágico. Foi um estudo transversal com universitários entre 18 e 21 anos. Cada estudante, ao concordar em participar da pesquisa, preencheu um questionário sobre suas experiências com o tabagismo, percepção de saúde bucal e necessidade de tratamento odontológico. Em seguida, cada participante expirou em um monoxímetro, aparelho que avalia a presença de monóxido de carbono na respiração, para confirmação do status tabágico autorreferido. Foram aplicados 103 questionários, dos quais 4 foram excluídos devido a discrepâncias entre o status tabágico autorreferido e o resultado do monoxímetro, restando 99 participantes (49 do sexo feminino e 50 do masculino), idade média 18,7±1,1 anos. Quanto ao status tabágico confirmado pelo monoxímetro, 54 (54,5%) participantes nunca fumaram nem experimentaram cigarros; 29 (29,3%) não fumavam, mas experimentaram cigarros; 6 (6,1%) não fumavam, mas fumaram no passado; e 10 (10,1%) eram fumantes. Quanto à exposição ao tabagismo passivo, 38 (38,4%) participantes se declararam expostos. Em relação à autopercepção da saúde bucal, 1,9% dos participantes não fumantes, 10% dos fumantes e 3,2% dos fumantes passivos classificaram sua saúde bucal como ruim; 5,6%, 10% e 6,4% classificaram sua necessidade de tratamento odontológico como muita, respectivamente (diferenças estatísticas não significativas, alpha=0,05). Concluiu-se que a prevalência do tabagismo observada entre participantes desta pesquisa ficou abaixo da média nacional entre universitários. Quanto à autopercepção de saúde bucal e necessidade de tratamento, não houve diferença em relação ao status tabágico.

This study aimed to analyze the self-perception of oral health of young adult university students, correlating it with smoking status. It was a cross-sectional study with university students between 18 and 21 years old. Each academic, after agreeing to participate in the research, completed a questionnaire about their experiences with smoking, perception of oral health and need for dental treatment. Then, each participant expired on a monoximeter, equipment that measures the presence of carbon monoxide in the breath, to confirm the self-reported smoking status. There were administered 103 questionnaires, which 4 were excluded due to discrepancies between the self-reported smoking status and the monoximeter result, totaling 99 participants (49 were female and 50 male), mean age 18.7±1.1 years. About the smoking status confirmed by the monoximeter, 54 (54.5%) participants had never smoked or tried cigarettes; 29 (29.3%) did not smoke but tried cigarettes; 6 (6.1%) did not smoke but smoked in the past; and 10 (10.1%) were smokers. About the exposure to passive smoking, 38.4% declared themselves exposed. About the self-perception of oral health, 1.9% of non- smoking participants, 10% of smokers and 3.2% of passive smokers reported having bad oral health and 5.6%, 10% and 6.4% reported much need for dental treatment, respectively (statistical differences not significant, alpha=0,05). It was concluded that the prevalence of smoking observed among participants of this study was below the national average for university students. About the self-perception of oral health and the need for dental treatment, no difference was observed in smoking status.

Avaliação dos níveis de metais pesados no pantanal dos Marimbus, Bahia, Brasil / Evaluation of heavy metals in levels of wetland Marimbus, Bahia, Brazil

RESUMO A concentração de metais pesados zinco (Zn), chumbo (Pb), cromo (Cr), níquel (Ni), cobre (Cu) e cádmio (Cd) tem aumentado nos últimos anos nos compartimentos aquáticos em função do uso indiscriminado de fertilizantes na agricultura, da falta de saneamento e do descarte de resíduos industriais não tratados. O objetivo deste trabalho foi investigar a disponibilidade dos metais pesados nas águas e em Salvinia auriculata Aubl. das áreas alagadas dos Marimbus, Bahia. As amostras foram submetidas à digestão ácida (HNO3; HClO4) e as análises dos metais pesados utilizaram um aparelho de absorção atômica de chama ar-acetileno. Nas águas, foram detectados teores de chumbo e zinco com valores dentro dos limites permissíveis para águas de classe 1, conforme Resolução CONAMA nº 357/2005 (BRASIL, 2005). Em S. auriculata, observou-se acumulação de concentração de metais na seguinte ordem Zn>Cr>Pb>Ni>Cu. Conclui-se que a presença da S. auriculata nos corpos hídricos funciona como importante removedor de metais pesados e sua presença nos ambientes aquáticos é extremamente relevante para permitir os diversos usos que esse espaço proporciona.

ABSTRACT In recent years, concentration of heavy metals like zinc (Zn), lead (Pb), chromium (Cr), nickel (Ni), copper (Cu) and cadmium (Cd) has increased over the past years in water bodies due to indiscriminate use of fertilizers in agriculture, lack of sanitation and irregular disposal of untreated industrial waste. The main goal of this study was to investigate the presence of heavy metals in the water and in the Salvinia auriculata Aubl. found in flooded areas of Marimbus, Bahia. The samples were subjected to acid digestion (HNO3, HClO4) and the analyses of heavy metals used an air-acetylene flame atomic absorption spectrometer. The detected levels of lead and zinc found in the water samples were within the limits set for water class 01 by CONAMA no. 357/2005 (BRASIL, 2005). An accumulation of metal concentration in the order of Zn>Cr>Pb>Ni>Cu was observed in S. auriculata. Thus, the presence of S. auriculata in water bodies serves as an important remover of heavy metals and their presence in aquatic environments is extremely important to allow the various uses such environments may provide.

Light curing resin cements containing iodonium salts promote suitable apical bonding of posts to radicular dentin

Abstract The aim of this study was to analyze the efficiency of experimental light-curing resin cements (ERCs) with a ternary photo-initiator system containing diphenyliodonium hexafluorphosphate (DPI) and different amines on retention of glass-fiber posts to dentin (GFP). ERCs formulations: a 1:1 mass ratio of 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenylpropane and triethyleneglycol dimethacrylate. Camphorquinone was used as initiator. Six experimental groups were established according to the amine used: [ethyl-4-(dimethylamino)benzoate-EDMAB or 2-(dimethylamino)ethyl methacrylate-DMAEMA] and the concentration of DPI (0, 0.5 mol%, 1 mol%). The resin cements Variolink II (dual- and light-cured versions) were used as commercial reference. Eighty recently extracted bovine incisors (n = 10) were selected for this study. The roots were prepared and the fiber posts were cemented with the resin cement specified for each experimental group. Specimens from coronal, middle, and apical thirds of the root were subjected to push-out bond strength test 24 hours after bonding. Data were subjected to split-plot ANOVA and the Tukey test (p = 0.05). ERCs containing DPI showed statistically significant higher bond strengths compared with ERCs without DPI. ERCs containing DPI were statistically similar to VARIOLINK II - dual-cured and superior to VARIOLINK II - light-cured (except for EDMAB - 1DPI in the medium third and DMAEMA - 1DPI in the coronal third). Different amines did not influence post retention. The apical root region showed the lowest bond strength for the groups EDAB-0DPI, DMAEMA-0DPI and VARIOLINK II light-cured. Light-cured ERCs containing DPI were efficient for GFP retention to radicular dentin, with similar behaviour to that of dual-curing commercial resin cement.

Two water environment adaptation models enhance motor behavior and improve the success of the lactate minimum test in swimming rats

Abstract AIMS This study was designed to investigate the effects of 14 water environment adaptation days on motor behavior and physiological condition of swimming rats. METHODS Sixty male Wistar rats were divided into four groups-baseline (Bl) and control (Co) groups-which did not perform the water environment adaptation; and sub (SubAnT) and (SupraAnT) anaerobic threshold groups, which performed 14 water environment adaptation days with sub or supra anaerobic threshold progressive loads (from the tenth day), respectively. The climbing-swimming prevalence (i.e. motor behavior) was analyzed during the water environment adaptation days. Lactate minimum test (LMT) parameters and muscular/hepatic glycogen content in addition to serum creatine kinase were also measured. RESULTS Animals from SubAnT and SupraAnT groups presented a lower climbing-swimming pattern throughout the extent of the experiment (p=0.000), especially after the 5th session. These results were achieved without an improvement in the LMT results or glycogen/creatine kinase. In addition, improvements of 26.6% and 25% for the LMT success rate (i.e. LMT reliability) were obtained only for SubAnT and SupraAnT animals. CONCLUSION Overall, we demonstrated that a water environment adaptation period is necessary for lowering the climbing-swimming pattern without physiological improvement.(AU)

Restaurações de resinas compostas em dentes posteriores: controlando os efeitos da contração de polimerização / Composite resin restorations in posterior teeth: controlling the efects of the polymerization shrinkage

A contração de polimerização da resina composta pode desenvolver tensões na interface dente-restauração e estrutura dental remanescente, resultando em deformação de cúspide, sensibilidade pós-operatória e fenda marginal. Este artigo apresenta, por meio da associação de evidência científica e relato de caso, uma reflexão de como o clínico pode minimizar os efeitos da contração de resina composta em dentes posteriores. Ainda persistem dúvidas sobre resinas em dentes posteriores, um dos procedimentos mais prevalentes em saúde bucal. A associação de estudos laboratoriais e simulação computacional, por meio de elementos finitos, pode auxiliar na solução de problemas clínicos constantes. A odontologia baseada em evidências, que dá suporte à tomada de decisão, é fundamental para o sucesso clínico desses procedimentos...

The polymerization shrinkage of composite resin is responsible for developing stresses in the tooth/restoration interface and the remaining tooth structure, causing cusp deflection, pos-operative sensitivity and marginal gap. This article presents thoughts based in scientific evidence associated to a case report, on how clinicians may minimize the effects of the polymerization shrinkage in posterior teeth. There are still remaining doubts about posterior composite resin restorations, one of the most prevalent dental procedures. The association of laboratory studies and computer simulation using finite element analysis can assist clinicians to solve frequent problems. Evidence-based Dentistry supporting the decision-making process is critical to the clinical success of these restorative procedures...

Atuação da comissão de farmácia e terapêutica em um hospital de ensino / Performance of the pharmacy and therapeutics committee in ateaching hospital

Introdução: As atividades hospitalares caracterizam-se por um acentuado dinamismo em consequência do surgimento de novas tecnologias em saúde, tais como medicamentos. Uma unidade hospitalar, devido suas características de ensino, pesquisa e atendimentos de alta complexidade, possui maior concentração de diferentes tipos de tecnologias em saúde. O Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto –USP (HCFMRP-USP) é uma instituição hospitalar, de qualidade comprovada, inserido no SUS como referência terciária/quaternária e que conta com a Divisão de Assistência Farmacêutica (DAF) para desenvolvimento das ações de atenção a saúde. A DAF para auxílio da gestão de recursos, seleção e padronização de medicamentos adotou como estratégia a Comissão de Farmácia e Terapêutica (CFT). ACFT é uma instância colegiada, de caráter consultivo e deliberativo, estabelecida pela Organização Mundial de Saúde como ferramenta de estratégia para monitorar e promover a qualidade no uso do medicamento,porém estudos que sobre a atuação das CFTs no Brasil são incipientes. Desta forma, este estudo pretende apresentar a CFT do HCFMRP-USP. Objetivos: apresentar a composição, atribuições e metodologia de trabalho da CFT, bem como desenvolver uma análise crítica de seu atual funcionamento. Metodologia:Foi realizado estudo descritivo e exploratório com o objetivo de descrever o atual funcionamento da CFT do HCFMRP-USP. Foram buscadas portarias, regulamentações internas e foi realizada revisão bibliográfica sobre a CFT. Para Análise crítica do atual funcionamento, foi selecionado dentre os itens padronizados pela comissão aquele que se enquadrasse como pertencente a classificação A e V, após o cruzamento das curvas ABC e VEN, cujo item selecionado foi o medicamento Sevoflurano...

Introduction: The hospital activities are characterized by a highly dynamism as a result of new health technologies such as medicines. A hospital due its characteristics of teaching, research and high complexity care, has the highest concentration of different types of health technologies. The Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto – USP (HCFMRP-USP) is a hospital, with proven quality, inserted in the SUS as a tertiary/quaternary referral and has the Pharmaceutical Services Division (DAF) for development of actions of health care. To aid resource management, selection and standardization of drugs, DAF adopted the strategy of Pharmacy and Therapeutics Committee (CFT). The CFT is a collegial, consultative and deliberative body, established by the World Health Organization as a strategy tool to monitor and promote the quality in the use of medicine, but studies of CFTs are incipient in Brazil. Thus, this study aims to present the CFT of HCFMRP–USP. Objectives: To introduce the composition, responsibilities and working methods of CFT, as well as a critical analysis of its current operation. Methods: A descriptive study aimed to describe the current functioning of the CFT of HCFMRP-USP was performed. Ordinances, internal regulations were surveyed and a bibliographic review of the CFT was performed. To the critical analysis ofthe current operating, was selected by the committee from the standard one that would fit classification asbelonging to “A” and “V” items after the crossing of the curves ABC and VEN, whose selected item was the medicine Sevoflurane...

Reconstrução estética do sorriso: a necessidade da abordagem multidisciplinar / Esthetic reconstruction of the smile: the need for a multidisciplinary approach

Atualmente a estética tem sido o principal motivo pelo qual diversos pacientes buscam o consultório odontológico. Em muitas situações, as cerâmicas são os materiais de escolha para a restauração dos dentes anteriores, no entanto diversos fatores devem ser avaliados na decisão do melhor protocolo a ser realizado. Uma visão ampla sobre o quadro apresentado também é necessária, observando-se a necessidade de realização não só de procedimentos restauradores, mas também ortodônticos e periodontais. Diante disso, o presente artigo demonstra a abordagem multidisciplinar na obtenção da estética dos dentes anteriores, através de cirurgia plástica periodontal e finalização do caso utilizando resinas compostas diretas. A combinação dessas técnicas permitiu devolver harmonia e naturalidade ao sorriso, restabelecendo as características da região anterior.

Currently, aesthetics has been the main reason why many patients seek the dental office. In many situations, ceramics is the material of choice for the restoration of anterior teeth. However, many factors must be evaluated when deciding the best protocol to be performed. A comprehensive view of the situation presented is also required, observing, not only, the need to perform restorative, but orthodontic and periodontal procedures. In view of this, the present article demonstrates a multidisciplinary approach in obtaining the aesthetics of anterior teeth through periodontal plastic surgery, finalizing the case using direct composite resins. The combination of these techniques made it possible to restore harmony and naturality to the smile, by restoring the characteristics of the anterior region.

Laminados cerâmicos: detalhes dessa abordagem minimamente invasiva / Ceramic veneers: details of this minimally invasive approach

A remodelação estética do sorriso pode ser realizada de duas maneiras: por meio de restaurações diretas, utilizando-se resinas compostas; ou com restaurações indiretas, utilizando-se coroas, facetas e/ou laminados cerâmicas. A abordagem minimamente invasiva, em foco nos últimos anos, tem-se mostrado efetiva na obtenção de excelentes resultados estéticos, com restaurações imperceptíveis. Desse modo, o presente trabalho demonstra, mediante relato de caso clínico, a abordagem minimamente invasiva, suas vantagens e desvantagens, utilizadas para a remodelação de dois laterais conoides, a qual influenciou a harmonia dos elementos anteriores e a estética do sorriso.

The aesthetic reshaping of the smile can be reached, basically, in two ways: direct restorations using composite resins; or using indirect restorations, such as full crowns and laminate veneers. A minimally invasive approach in focus in the last years, has obtained great results, with imperceptible restorations. In this way, this case report demonstrates the pros and cons of the minimal invasive approach for reshaping lateral conoid shaped incisors, which directly influenced the harmony of the maxillary anterior teeth and the aesthetics of the smile.

Effect of pre- heating on hardness of methacrylate- and silorane- based composites

AIM: To evaluate the effect of composite pre-heating on the microhardness of different monomer resin-based. MATERIALS AND METHOD: Circular specimens of methacrylate- and silorane-based composite resins pre-heated at 23, 39, and 55˚ C were carried out, and cured using a halogen light-curing unit at 650 mW/cm². After 24 h, the specimens were polished and Knoop hardness number (KHN) was measured using a microhardness tester with 50-g load for 15 s. The data were analyzed with ANOVA and Tukey's tests (α = 0.05). RESULTS: Top surface presented higher KHN than bottom, methacrylate-based composite showed higher KHN compared to silorane, and pre-heating increased the KHN of the composites tested. CONCLUSION: Pre-heating can be used to improve the microhardness of methracrylate- and silorane-based composites.

Lectin, hemolysin and protease inhibitors in seed fractions with ovicidal activity against Haemonchus contortus / Lectina, hemolisina e inibidores de protease em frações de sementes com atividade ovicida contra Haemonchus contortus

Bioactive molecules of plant species are promising alternatives for the chemical control of gastrointestinal nematodes in ruminants. Extracts of native and exotic seed species from Brazil's semi-arid region were tested in vitro in an egg hatch assay and the bioactivity of their proteins was investigated. Each seed species was subjected to three extractions with three types of solvents. All the seeds showed ovicidal activity, which varied according to the solvents. Higher ovicidal activity was found in the molecule fractions of low molecular weight (<12 kDa) for Albizia lebbeck, Ipomoea asarifolia, Jatropha curcas, Libidibia ferrea, Moringa oleifera and Ricinus communis (P<0.05, Bonferroni test). The two fractions of Crotalaria spectabilis showed the same ovicidal activity (P>0.05, Bonferroni test). Hemagglutinating activity was detected in the fractions of C. spectabilis and M. oleifera fractions, hemolysin activity in the A. lebbeck and M. oleifera fractions, serine protease inhibitory activity in the A. lebbeck, I. asarifolia, J. curcas, M. oleifera and R. communis fractions, cysteine protease inhibitor activity in the M. oleifera fraction, and no protein activity in the L. ferrea fraction. The results of this work reveal new plant species with a potential for use in controlling nematode parasites in goats, thus opening a new field of research involving plant protein molecules with ovicidal properties.

Moléculas bioativas de espécies vegetais são alternativas promissoras ao controle químico dos nematoides gastrintestinais em ruminantes. Extratos de sementes de espécies nativas e exóticas do Semiárido Brasileiro foram testados in vitro em ensaio de eclosão de ovos e investigada a natureza proteica da bioatividade. Três extrações com três solventes foram feitas para cada semente estudada. Todas as sementes apresentaram atividade ovicida, variando com o solvente utilizado. Maior taxa de inibição da eclosão concentrou-se nas frações de moléculas de baixa massa molecular (<12 kDa) para Albizia lebbeck, Ipomoea asarifolia, Jatropha curcas, Libidibia ferrea, Moringa oleifera e Ricinus communis (P<0,05, teste de Bonferroni). Crotalaria spectabilis mostrou atividade nas duas frações, sem diferença entre elas (P>0,05, teste de Bonferroni). Observou-se atividade hemaglutinante nas frações de C. spectabilis e M. oleifera, de hemolisina em A. lebbeck e M. oleifera, de atividade inibidora de protease da serina em A. lebbeck, I. asarifolia, J. curcas, M. oleifera e R. communis, de atividade inibidora de protease da cisteína em M. oleifera e nenhuma atividade proteica na fração de L. ferrea. Os resultados revelaram novas espécies botânicas com potencial de controle de nematoides em caprinos e um novo campo de pesquisa, o estudo de moléculas de origem proteica com atividade ovicida.

Influência do status tabágico na autopercepção de saúde bucal de universitários / Influence of smoking status in self-percieved oral health of undergraduated students

Objetivo: correlacionar a autopercepção de saúde bucal de estudantes universitários com o status tabágico. Metodologia: estudo transversal com acadêmicos de uma Instituição de Ensino Superior de Anápolis-GO, que responderam a um questioná- rio autoaplicado, contendo 10 perguntas sobre o status tabágico, exposição à poluição tabágica ambiental (PTA), e autopercep- ções de saúde bucal e de necessidade de tratamento odontoló- gico. Resultados: Dos 445 participantes, 69% eram não fumantes (NF), 23% fumantes passivos (FP), 2% ex-fumantes (EF) e 6% fumantes (F). Fumantes, agregados com EF, apresentaram chance 4,8 vezes maior de conviver com amigos fumantes, 5,5 vezes maior de exposição à PTA no ambiente universitário, e 7 vezes maior de exposição 8 horas/dia ou mais à PTA, quando comparados aos FP. Quanto à autopercepção de saúde bucal, mais EF e F avaliaram sua saúde bucal como “ruim” (p<0,0001), e sua necessidade de tratamento odontológico como “muita” (p=0,0004), em relação aos NF e FP. O percentual de participantes que afirmaram nunca ter recebido instruções de higiene oral foi maior entre F e EF do que entre NF e FP (p=0,0008). Conclusão: F e EF foram mais propensos a considerar sua saúde bucal ruim e muita sua necessidade de tratamento odontológico, comparados a NF e FP.

Objective: To correlate oral health self-perception of college students to smoking status. Methodology: cross sectional study with students of a University from Anápolis-GO, which answered a self-applied questionnaire containing 10 questions about smoking status, exposure to Environmental Tobacco Smoke (ETS), and self-perceptions of oral health and dental treatment needs. Results: among the 445 participants, 69% were non- -smokers (NS), 23% passive smokers (PS), 2% former smokers (FS) and 6% were smokers (S). Smokers, households with FS showed 4.8 times more chance to live with friends who smoked, 5.5 times higher exposure to ETS in the university environment, and seven times greater exposure 8 hours/day or more to ETS, compared to PS. As for self-perceived oral health, more FS and S rated their oral health as "poor" (p <0.0001), and their dental treatment need as "a lot" (p = 0.0004), compared to NS and PS. The percentage of participants who reported ever having received oral hygiene instructions was greater between among S and FS than NS and PS (p = 0.0008). Conclusion: S and FS were more likely to consider their oral health “poor” and “a lot” their need for dental treatment, compared to NS and PS.

Effect of Fluoride-Treated Enamel on Indirect Cytotoxicity of a 16% Carbamide Peroxide Bleaching Gel to Pulp Cells

The aim of this study was to evaluate the possibility of fluoride solutions applied to enamel to protect pulp cells against the trans-enamel and transdentinal cytotoxicity of a 16% carbamide peroxide (CP) bleaching gel. The CP gel was applied to enamel/dentin discs adapted to aicial pulp chambers (8 h/day) during 1, 7 or 14 days, followed by fluoride (0.05% or 0.2%) application for 1 min. The extracts (culture medium in contact with dentin) were applied to MDPC-23 cells for 1 h, and cell metabolism (MTT assay), alkaline phosphatase (ALP) activity and cell membrane damage (flow cytometry) were analyzed. Knoop microhardness of enamel was also evaluated. Data were analyzed statistically by ANOVA and Kruskal-Wallis tests (α=0.05). For the MTT assay and ALP activity, significant reductions between the control and the bleached groups were observed (p<0.05). No statistically significant difference occurred among bleached groups (p>0.05), regardless of fluoride application or treatment days. Flow cytometry analysis demonstrated 30% of cell membrane damage in all bleached groups. After 14 days of treatment, the fluoride-treated enamel presented significantly higher microhardness values than the bleached-only group (p<0.05). It was concluded that, regardless of the increase in enamel hardness due to the application of fluoride solutions, the treated enamel surface did not prevent the toxic effects caused by the 16% CP gel to odontoblast-like cells.

Resumo O objetivo do presente estudo foi avaliar o possível efeito protetor de soluções fluoretadas aplicadas sobre o esmalte dentário frente à citotoxicidade trans-amelodentinária de um gel clareador com 16% de peróxido de carbamida (PC). O gel de PC foi aplicado sobre discos de esmalte/dentina adaptados a câmaras pulpares aiciais (8 h/dia) durante períodos de 1, 7 ou 14 dias, seguido de aplicação de soluções fluoretadas (0,05% ou 0,2%) durante 1 min. Os extratos (meio de cultura em contato com a dentina) foram aplicados sobre células MDPC-23 durante 1 h, seguido de análise do metabolismo celular (teste do MTT), atividade de fosfatase alcalina (ALP) e danos à membrana celular (citometria de fluxo). A microdureza Knoop do esmalte dental foi avaliada. Os dados foram analisados pelos testes de ANOVA e Kruskal-Wallis. Para o teste do MTT e atividade de ALP, redução significante entre os grupos controle e clareados foram observados (p<0,05). Nenhuma diferença entre os grupos clareados foi observada (p>0,05), independente da aplicação das soluções fluoretadas ou tempo de tratamento. A análise por citometria de fluxo demonstrou lesão à membrana celular em torno de 30% para todos os grupos clareados. Após 14 dias de tratamento, os espécimes clareados e fluoretados apresentaram aumento significante na microdureza do esmalte (p<0,05). Pôde-se concluir que apesar do aumento na dureza do esmalte decorrente da aplicação das soluções fluoretadas, este tratamento não preveniu os efeitos tóxicos causados pelo gel com 16% de PC sobre as células odontoblastóides. .

Influence of different shades and LED irradiance on the degree of conversion of composite resins

The aim of this study was to evaluate the degree of conversion (DC) of two composite resins with different shades that were light cured by light-emitting diodes (LEDs) of different irradiances. Specimens (5 mm ' 2 mm) were prepared with a nanofilled (Filtek Supreme - A2E, A2D, and WE) or microhybrid resin (Opallis - A2E, A2D, and EBleach Low) and were randomly divided into 12 groups (n = 5 each) according to the composite resin and light-curing unit (Elipar FreeLight 2, 1250 mW/cm²; Ultralume 5, 850 mW/cm²). After 24 h, the DC was measured on two surfaces (top and bottom) with Fourier Transform infrared spectroscopy (FTIR). Data were statistically analyzed with two-way ANOVA and Tukey test (a = 0.05). Statistical differences among the surfaces were observed in all experimental conditions, with higher values on the top surface. The microhybrid resin presented the highest DCs for shades A2E and A2D on the top surface. The LED with higher irradiance promoted better DCs. Taken together, the data indicate that the shade of a composite resin and the irradiance of the light source affect the monomeric conversion of the restorative material.