Efeito imediato da mobilização com movimento (MWM) em pacientes com dor lombar: um estudo randomizado controlado / Immediate effect of mobilization with movement (MWM) in patients with low back pain: a randomized controlled trial

Objective: To analyze the effect of the Mobilization With Movement (MWM) of the Mulligan's concept in the perception of nociceptive and neuropathic pain, range of motion (ROM) and joint mobility of individuals with low back pain. Method: This is a randomized and controlled clinical trial, with 30 volunteers with nonspecific low back pain, divided into: Intervention Group (INTG), that received sustained natural apophyseal glides (SNAG) type MWM of the Mulligan's concept; Control Group (CONTG), which received a similar intervention to INTG. Volunteers were assessed using the Numeric Rating Scale for Pain (NRS Pain); the Modified Schober Test (MST) and ROM by goniometry for lumbar spine mobility and Douleur Neuropatique 4 (DN4) questionnaire for assessment of neuropathic and nociceptive pain. Results: INTG showed an increase in lumbar flexion (pre-intervention= 81.21±15.23°; post-intervention= 90.00±19.62°, p< 0.05), mobility of the lumbar spine in MST (pre= 15.33±1.05 post= 16.08±1.02, p< 0.05) and reduction of pain perception by NRS Pain (pre= 5.33±2.26; post= 1.47±2.61 p< 0.05) and in CONTG (pre= 4.07±2.34; post= 2.20±1.93, p< 0.05). Conclusion: The intervention with MWM - SNAGs promoted improved ROM and mobility in flexion of the lumbar spine, associated with reduction from the nociceptive pain in INTG and CONTG.

Objetivo: Analisar o efeito da Mobilization Whith Movement (MWM) do conceito Mulligan na percepção de dor nociceptiva e neuropática, na amplitude e na mobilidade articular de indivíduos com dor lombar. Métodos: Trata-se de um ensaio clínico randomizado e controlado, de 30 voluntários com dor lombar inespecífica, divididos em: Grupo Intervenção (GINT) que recebeu a mobilização articular com deslizamentos apofisários naturais mantidos (MWM - SNAGs); Grupo Controle (GCONT), que recebeu uma mobilização articular placebo. Os voluntários foram avaliados pela escala numérica de dor (EVN); pelo teste modificado de Schober (TMS) para a mobilidade da coluna lombar e pelo DN4 para avaliação da dor neuropática e nociceptiva. Resultados: GINT apresentou aumento da flexão lombar (pré intervenção= 81,21±15,23°; pós-intervenção= 90,00±19,62°, p= <0,05), da mobilidade da coluna lombar no TMS (pré= 15,33±1,05 pós= 16,08±1,02, p= <0,05) e redução da percepção de dor pela EVN (pré= 5,33±2,26; pós= 1,47±2,61= p< 0,05) e no GCONT (pré= 4,07±2,34; pós= 2,20±1,93, p < 0,05). Conclusão: A intervenção com MWM - SNAGs promoveu melhora da ADM e da mobilidade na flexão da coluna lombar, associada com redução da dor nociceptiva no GINT e no GCONT.

Retratamento endodôntico e complementação cirúrgica em dente com fístula persistente: relato de caso / Endodontic retreatment and surgical complementation on a tooth with persistent fistula: case report

Introdução: O preparo químico-mecânico representa uma etapa fundamental, pois promove a antissepsia do complexo sistema de canais radiculares, viabilizando um ambiente biológico favorável para o processo de cura e reparo dos tecidos periapicais. Porém, insucessos podem acontecer em dentes tratados e retratados endodonticamente, sendo a intervenção cirúrgica frequentemente indicada nesses casos. Relato do caso: Paciente do sexo masculino, 32 anos de idade, melanoderma, apresentou-se à clínica-escola de uma faculdade de Odontologia em um município baiano, com queixa principal de "aparecimento de bolha na gengiva e gosto amargo na boca". Ao exame clínico, visualizou-se presença de restauração de resina composta nas faces mesial e palatina, bem como fístula intrabucal ativa na região de fundo de vestíbulo, próximo ao ápice do elemento #22. Por meio de exames clínico e radiográfico, testes de sensibilidade pulpar e rastreamento da fístula, foi estabelecido diagnóstico de tratamento endodôntico concluído, e periapical de abscesso apical crônico. Em seguida, houve indicação de retratamento endodôntico e duas sessões de medicação intracanal com hidróxido de cálcio, seguidas de uma intervenção cirúrgica exploratória. Resultados: O protocolo de tratamento proposto foi eficaz. Constatou-se sucesso clínico, com cicatrização da fístula intrabucal ativa, e radiográfico, com reparação dos tecidos periapicais, além do restabelecimento da estética e função dentária, com acompanhamento de 26 meses. O paciente encontra-se sob acompanhamento semestral. Conclusão: é necessário salientar a relevância de efetuar com segurança um planejamento e prognóstico endodôntico confiável e, igualmente, o acompanhamento do caso, com supervisão clínica e radiográfica periódica (AU).

Introduction: Biological chemical preparation repre- sents a fundamental step, as it promotes asepsis of the complex root canal system, enabling a biological environment favorable to the process of healing and repair of the periapical tissues. However, failures can occur in endodontic treatment and retreatment teeth, where surgical intervention is often indicated in these cases. Description: The patient, a 32-year old man, melanoderma, presented at the school clinic of a School of Dentistry in a city in Bahia, with a chief complaint of "blistering of the gums and bitter taste in the mouth." Clinical examination revealed the presence of composite resin restoration on the mesial and palatine surfaces, and an active intraoral fistula in the vestibular region near the apex of tooth 22. By means of clinical, radiographic, pulp sensitivity tests and sinus tracking, a diagnosis of completed endodontic treatment was established, and periapical diagnosis of a chronic apical abscess. Afterwards, endodontic retreatment was indicated, consisting of two sessions of intracanal medication with calcium hydroxide, followed by an exploratory surgical intervention. Results: The proposed treatment protocol was effective. Clinical and radiographic success with healing of the active intrabuccal fistula and repair of the periapical tissues, as well as reestablishment of esthetics and dental function, was verified, in a period of twenty six months follow-up. At present, the patient is being followed-up semi-annually. Conclusion: it is necessary to emphasize the importance of safely performing reliable endodontic planning and prognosis, as well as follow up of the case, with periodic clinical and radiographic control (AU).

Reliability of the PhysioPlay™ device for assessing the reaction time of cancer patients / Confiabilidade do dispositivo PhysioPlay™ para avaliar o tempo de reação de pacientes com câncer

Objective: To determine the intra-evaluator and inter-evaluator reliability of the Physioplay-Kinect interaction and Trigno device for assessing the reaction time (RT) of cancer volunteers undergoing treatment. Methods: 46 cancer volunteers who underwent treatment modalities participated and were allocated into three groups: Chemotherapy Group (CG), Radiotherapy Group (RG), and Chemotherapy-Radiotherapy Group (CRG). The RT for all volunteers was assessed using the PhysioPlay™ and Trigno device. Results: In the intra-evaluator analysis, excellent levels of reliability (Physioplay: ICC> 0.99; Trigno 8: ICC>0.92) were observed in all groups. In the inter-evaluator analysis, excellent levels of reliability were observed in the CG (Physioplay: ICC= 0.98; Trigno 8: ICC= 0.98); excellent (Physioplay: ICC= 0.98) and good (Trigno 8: ICC= 0.44) levels in the RG; good (Physioplay: ICC= 0.49) and reasonable (Trigno 8: ICC= 0.29) levels in the CRG. Conclusion: The PhysioPlay™ and Trigno device proved to be reliable for assessing the RT of cancer volunteers undergoing treatment

Objetivo: Determinar a confiabilidade intra-avaliador e inter-avaliador da interação Physioplay-Kinect e do dispositivo Trigno para avaliar o tempo de reação (TR) de voluntários com câncer em tratamento. Métodos: 46 voluntários com câncer em tratamento participaram do estudo e foram distribuídos em três grupos: Grupo de Quimioterapia (GQ), Grupo de Radioterapia (GR), e Grupo de Quimioterapia-Radioterapia (GQR). O TR para todos os voluntários foi avaliado utilizando o dispositivo PhysioPlay™ e Trigno. Resultados: Na análise intra-avaliador, foram observados excelentes níveis de confiabilidade (Physioplay: ICC> 0,99; Trigno 8: ICC>0,92) em todos os grupos. Na análise inter-avaliador, foram observados excelentes níveis de confiabilidade no GQ (Physioplay: ICC= 0,98; Trigno 8: ICC= 0,98); excelente (Physioplay: ICC= 0,98) e bom (Trigno 8: ICC= 0,44) níveis no GR; bons (Physioplay: ICC= 0,49) e razoáveis (Trigno 8: ICC= 0,29) níveis no GQR. Conclusão: Os dispositivos PhysioPlay™ e Trigno provaram ser confiáveis para avaliar o TR de voluntários com câncer em tratamento

Face-to-face Assessment of COGTEL in Adolescents: Test-Retest Reliability and Association with School Grades / Aplicação Presencial do COGTEL em Adolescentes: a Fiabilidade Teste-Reteste e a Associação com as Notas Escolares

Abstract The Cognitive Telephone Screening Instrument (COGTEL) has shown to be a brief, reliable, and valid instrument to assess cognitive functioning in adults in face-to-face procedures as well as over the phone. So far, no psychometric evaluation exists on its use in adolescents. The present study set out to evaluate the psychometric properties of the face-to-face application of the COGTEL in adolescents in the school context and to analyse the association with school grades. We assessed cognitive performance using COGTEL in face-to-face assessments of 170 adolescents, with retests after 6 months for test-retest reliability. Predictive validity was assessed using school grades. Test-retest reliability for the COGTEL was good (ICC = .77; p < .001). The partial correlation controlling for age between COGTEL and school grades was medium and positive (r = .40; p < .001). School grades alone explained 42% and 36% of the variance in the COGTEL total score in elementary and secondary students, respectively. The present study suggests that COGTEL is a reliable and valid instrument to assess cognitive functioning in adolescents, with the advantage of feasibility in multiple contexts.

Resumo O Instrumento de Rastreio Cognitivo por Telefone (COGTEL) tem demostrado ser um instrumento fiável, válido e breve para avaliar o funcionamento cognitivo em adultos, quer por telefone, quer de forma presencial. Até à data, não foram estudadas as suas características psicométricas para uso em adolescentes. O presente estudo teve por objetivo avaliar as propriedades psicométricas do COGTEL em adolescentes no contexto escolar, através da aplicação presencial, e analisar a associação dos scores com as notas escolares. O desempenho cognitivo foi avaliado em 170 adolescentes, usando o COGTEL em entrevistas presenciais, com um reteste após 6 meses para avaliar a fiabilidade teste-reteste. A validade preditiva foi avaliada com base nas notas escolares. A fiabilidade teste-reteste para o COGTEL foi boa (ICC = 0.77; p < .001). As correlações parciais, controlando pelo efeito da idade, entre o score total do COGTEL e as notas escolares foram moderadas e positivas (r = .40; p < .001). As notas escolares, individualmente, explicaram 42% e 36% da variância total no score total do COGTEL, em alunos do ensino básico e secundário, respetivamente. O presente estudo sugere que o COGTEL é um instrumento fiável e válido para avaliar o funcionamento cognitivo em adolescentes, com a vantagem de ser aplicável em múltiplos contextos.

Análise da Fadiga Relatada e das Forças Musculares Respiratória e Periférica em indivíduos com Câncer em Tratamento / Analysis of Reported Fatigue and of Respiratory and Peripheral Muscle Strength in Individuals with Cancer Undergoing Treatment / Análisis de la Fatiga Reportada e de las Fuerzas Musculares Respiratoria y Periférica en Individuos con Cáncer Sometidos a Tratamiento

Introdução: Nos últimos anos, o tratamento do câncer evoluiu, possibilitando uma maior sobrevida ao paciente, porém os efeitos colaterais, como a diminuição da imunidade e a fadiga, influenciam o sistema respiratório e muscular. Objetivo: Analisar a fadiga e as forças musculares respiratória e periférica em voluntários com câncer em tratamento e em indivíduos saudáveis. Método: Trata-se de um estudo analítico, observacional, transversal e controlado. Os indivíduos foram distribuídos em dois grupos: um grupo de câncer em quimioterapia e/ou em radioterapia (GCA: n=98; homens=35,72%; mulheres=64,28%; idade=58,13±13,26 anos; índice de massa corporal (IMC=26,23±4,04 kg/m2; tempo de diagnóstico de câncer=27,54±9,61 meses) e um grupo controle (GC: n=86; homens=30,23%; mulheres=69,77; idade=59,24±12,87 anos; IMC=26,76±4,04 kg/m2). Para todos os indivíduos, a fadiga relatada foi avaliada, usando-se a subescala de fadiga do questionário The Functional Assessment of Cancer Therapy-Fatigue (FACT-F). A avaliação das pressões respiratórias máximas foi realizada por meio da manovacuometria e da força de preensão palmar por intermédio da dinamometria manual. Resultados: O GCA apresentou maior índice de fadiga relatada (p<0,001; f2=0,382), valores inferiores para as variáveis respiratórias (PImax: p<0,001; f2=0,441; PEmax: p<0,001; f2=0,361), força de preensão palmar esquerda (p=0,024 f2=0,182), se comparado ao GC. Conclusão: Voluntários com câncer em quimioterapia e/ou em radioterapia apresentaram maiores níveis de fadiga relatada, com reduções da força muscular respiratória e da força de preensão palmar.

Introduction: In recent years, cancer treatment has evolved, allowing longer survival for the patient, but, side effects such as a decreased immunity and fatigue influence the respiratory and muscular systems. Objective: Analyze fatigue, the respiratory and peripheral muscle strength in individuals with cancer undergoing treatment and in healthy individuals. Method: Analytical, observational, cross-sectional, and controlled study. The individuals were divided into two groups: a cancer group in chemotherapy and/or radiotherapy (GCA: n = 98; men = 35.72%; women = 64.28%; age = 58.13 ± 13.26 years; body mass index (BMI) = 26.23 ± 4.04 kg/m2; time of cancer diagnosis = 27.54 ± 9.61 months) and a control group (CG: n = 86; men = 30.23%; women = 69.77; age = 59.24 ± 12.87 years; BMI= 26.76 ± 4.04 kg/m2). For all the individuals, the reported fatigue was assessed using the fatigue subscale of The Functional Assessment of Cancer Therapy-Fatigue (FACT-F) questionnaire. The evaluation of maximal respiratory pressures was performed by manovacuometry and the palmar grip strength by manual dynamometry. Results: The GCA showed the highest reported fatigue index (p<0.001; f2=0.382), lower values for respiratory variables (PImax: p<0.001; f2=0.441; PEmax: p<0.001; f2=0.361), left palmar grip strength (p=0.024; f2=0.182), when compared to the CG. Conclusion: Volunteers with cancer in chemotherapy and/or radiotherapy presented higher levels of reported fatigue, with reductions in respiratory muscle strength and palmar grip strength.

Introducción: En los últimos años, el tratamiento oncológico ha evolucionado, permitiendo una supervivencia más larga para el paciente, pero los efectos secundarios como la disminución de la inmunidad y la fatiga influyen en los sistemas respiratorios y musculares. Objetivo: Analizar la fatiga e las fuerzas musculares respiratoria y periférica en individuos con cáncer sometidos a tratamiento y en individuos sanos. Método: Se trata de un estudio analítico, observacional, transversal y controlado. Los individuos fueran divididos en dos grupos: un grupo de cáncer bajo quimioterapia y/o radioterapia (GCA: no 98; hombres 35,72%; mujeres 64,28%; edad 58,13±13,26 años; indice de masa corporal (IMC) a 26,23±4,04 kg/m2; diagnóstico de cáncer 27,54±9,61 meses) y un grupo de control (CG: no 86; hombres 30,23%; mujeres 69,77; edad de 59,24±12,87 años; IMC 26,76±4,04 kg/m2). Para todos los voluntarios, la fatiga notificada se evaluó utilizando la subescala de fatiga del cuestionario The Functional Assessment of Cancer Therapy-Fatigue(FACT-F). La evaluación de las presiones respiratorias máximas se realizó mediante manovacuometría y fuerza de agarre palmar mediante dinamometría manual. Resultados:El GCA tuvo el índice de fatiga notificado más alto (p<0,001; f2=0,382), valores más bajos para las variables respiratorias (PImax: p<0,001; f2= 0,441; PEmax: p<0,001; f2=0,361), fuerza de agarre palmar izquierda (p=0,024; f2=0,182), en comparación con el GC. Conclusión: Voluntarios con cáncer en quimioterapia y/o radioterapia presentaron mayores niveles de fatiga reportados, con reducciones en la fuerza muscular respiratoria y fuerza de agarre palmar.

Synthesis of novel papulacandin D analogs and evaluation of their antifungal potential

Systemic fungal infections are a growing problem in contemporary medicine and few drugs are licensed for therapy of invasive fungal infections. Differences between fungi and humans, like the presence of a cell wall in fungal cells, can be explored for designing new drugs. (1,3)-β-D-glucan synthase, an enzyme that catalyzes the synthesis of (1,3)-β-D-glucan, a structural and essential component of the fungal cell wall, is absent in mammals and this makes it an excellent target for the development of new antifungal agents. Papulacandins are a family of natural antifungal agents targeting (1,3)-β-D-glucan synthase. In this study we describe the synthesis and biological evaluation of two new Papulacandin analogs as potential (1,3)-β-D-glucan synthase inhibitors.

Fine-tuning multilevel modeling of risk factors associated with nonsurgical periodontal treatment outcome

Abstract This retrospective study evaluated the influence of known risk factors on nonsurgical periodontal treatment (NSPT) response using a pocket depth fine-tuning multilevel linear model (MLM). Overall, 37 patients (24 males and 13 females) with moderate-to-severe chronic periodontitis underwent NSPT. Follow-up visits at 3, 6, and 12 months included measurements of several clinical periodontal parameters. Data were sourced from a previously reported database. In a total of 1416 initially affected sites (baseline PD ≥ 4 mm) on 536 teeth, probing depth (PD) and clinical attachment loss (CAL) reductions after NSPT were evaluated against known risk factors at 3 hierarchical levels (patient, tooth, and site). For each post-treatment follow-up, the variance component models fitted to evaluate the 3-level variance of PD and CAL decrease revealed that all levels contributed significantly to the overall variance (p < 0.001). Patients who underwent NSPT and were continually monitored had curative results. All 3 hierarchical levels included risk factors influencing the degree of PD and CAL reduction. Specifically, the type of tooth, surfaces involved, and tooth mobility site-level risk factors had the strongest impact on these reductions and were highly relevant for the success of NSPT.

Análise intra e interavaliadores da projeção do centro de massa do corpo obtido por fotogrametria / Análisis intra e interevaluadores de la proyección del centro de masa del cuerpo obtenido por fotogrametría / Intra and inter-rater reliability of the projection of the body's center of mass obtained via photogrammetry

RESUMO Para o ótimo controle postural, o centro de massa (COM) do corpo é uma variável que se projeta verticalmente entre os pés, dentro de uma base de suporte. Este estudo teve por objetivo avaliar a confiabilidade inter e intra-avaliadores da projeção do COM na base de sustentação, mensurada com auxílio do Software de Avaliação Postural (SAPO). Cinquenta e sete voluntárias foram avaliadas e todas foram submetidas ao registro fotográfico nas vistas anterior, lateral direita e esquerda, no mesmo instante temporal. As imagens foram entregues a dois examinadores, os quais utilizaram o SAPO. Para a análise estatística, foi utilizado o coeficiente de correlação intraclasse (ICC) e, para estimar a mínima mudança detectável (MMD), foi utilizado o erro padrão (EP). Os resultados demonstraram excelentes níveis de confiabilidade interexaminador e intraexaminador para assimetrias nos planos frontal, sagital e para a projeção do centro de gravidade no plano frontal e lateral (ICC>0,90; 95%IC>0,95; MDD entre 2,16 - 4,87). Os resultados do estudo demonstraram que a análise do COM obtida por meio do SAPO apresentou boa confiabilidade nas análises inter e intra-avaliadores.

RESUMEN Para el óptimo control postural, el centro de masa (COM) del cuerpo es una variable que se proyecta verticalmente entre los pies, dentro de una base de soporte. Este estudio tuvo por objetivo evaluar la confiabilidad inter e intraevaluadores de la proyección del COM en la base de sostenimiento, medida con apoyo del Software de Evaluación Postural (SAPO). Se evaluaron cincuenta y siete voluntarias y todas han sido sometidas al registro fotográfico en las vistas anterior, lateral derecha e izquierda, en el mismo instante temporal. Las imágenes han sido entregadas a dos examinadores, que utilizaron SAPO. Para el análisis estadístico, se utilizó el coeficiente de correlación intraclase (ICC) y, para estimar el mínimo cambio detectable (MMD), se utilizó el error estándar (EP). Los resultados demostraron excelentes niveles de confiabilidad interexaminador e intraexaminador para asimetrías en los planos frontal y sagital y para la proyección del centro de gravedad en el plano frontal y lateral (ICC>0.90, 95% IC>0.95, MDD entre 2.16 - 4.87). Los resultados del estudio demostraron que el análisis del COM obtenido a través de SAPO presentó buena confiabilidad en los análisis inter e intraevaluadores.

ABSTRACT For optimal postural control, the center of mass (COM) of the body is a variable that is projected vertically between the legs, over a support base. This study had as aim assessing the inter- and intra-rater reliability of the projection of the COM over the support base, measured with the aid of the Postural Evaluation Software (SAPO). Fifty-seven volunteers were evaluated and all were subjected to photographic records taken from the anterior, left and right lateral views, at the same time. The pictures were handed over to two raters, who then used SAPO to analyze them. For the statistical analysis, the intra-class correlation coefficient (ICC) was used, and to estimate the minimum detectable change (MDC), the standard error (SE) was used. The results showed excellent levels of inter and intra-rater reliability for asymmetries in the frontal and sagittal planes, and for the projection of the center of gravity in the frontal and lateral planes (ICC>0.90; 95%CI>0.95; MDC between 2.16 - 4.87). The results of the study showed that the analysis of the COM obtained with SAPO had good inter- and intra-rater reliability.

Influência do tratamento do câncer na rotação pélvica avaliada por baropodometria / Influence of cancer treatment on pelvic rotation assessed by baropodometry

Introdução: O câncer tem sido um crescente problema de saúde pública no Brasil. Comumente, a pessoa com câncer pode apresentar diversas alterações posturais, como a rotação da pelve, ocasionadas pela doença e por efeitos adversos secundários às formas de tratamento. Objetivo: Analisar a influência do posicionamento rotacional da pelve de pessoas com câncer por meio da baropodometria. Métodos: Foram incluídos 45 indivíduos, divididos em: Grupo Quimioterapia e/ou Radioterapia (GQR), Grupo Câncer em Acompanhamento (GCA) e Grupo Controle sem Câncer (GCS). Todos os voluntários foram avaliados quanto ao posicionamento da pelve por meio da baropodometria. Resultados: Não foram encontradas alterações significativas no posicionamento rotacional da pelve nas comparações entre os grupos com câncer e grupo controle (p: 0,112; Poder: 0,838; f2: 1,121). Conclusão: Os resultados sugerem que o câncer e suas formas de tratamento não exerceram influência sobre a postura rotacional da pelve. (AU)

Introduction: Cancer has been a growing public health problem in Brazil. Patients with cancer may commonly present a number postural changes such as the pelvis rotation due to the disease itself and also to secondary adverse effects produced by its forms of treatment. Objective: To assess the rotational positioning of the pelvis in cancer patients using computerized baropodometry. Methods: A total of 45 volunteers were divided into: Chemotherapy combined with radiotherapy Group (QRG), Follow up Cancer Group (CAG) and Control Group without Cancer (CG). All subjects were assessed for the positioning of the pelvis using baropodometry Results: No significant changes were found in the rotational positioning of the pelvis in the comparison between the cancer groups and the control group (p: 0,112; Power: 0,838; Effect: 1,121). Conclusion: The results suggest that the cancer and its forms of treatment have no influence on the rotational posture of the pelvis. (AU)

Use of an Osteoplastic Flap for the Prevention of Mastoidectomy Retroauricular Defects

Abstract Introduction After mastoidectomy, patients usually complain of bone depressions in the retroauricular region in the surgical site, especially in procedures that require extensive cortical resections. This causes inconveniences such as difficulty wearing glasses, cleaning, and aesthetics complaints. Objective This study aims to describe a vascularized flap surgical technique that uses the mastoid cortical bone adhered to the periosteum, which is pedicled on the anterior portion and repositioned at the end of the surgery. This ensures the coverage of the mastoid cavity generated by surgery and prevents ear retraction into the cavity. This preliminary report describes the technique and intraoperative and immediate postoperative complications. Methods After retroauricular incision, periosteal exposure is performed. A U-shaped incision is required for the procedure and delimits a periosteum area appropriate to the size of the mastoidectomy. The cortical bone is opened using a 2.5 mm drill around the perimeter of the "U," at a 3 mmdepth. A chisel is introduced through the surface cells of the mastoid, and a hammer evolves into the anterior direction. The flap is lifted, leaving the periosteum adhered to it and forming a cap. The flap is anteriorly fixed to not hinder the surgery, and repositioned at the end. The periosteum is then sutured to the adjacent periosteum. Results The first 14 cases had no intraoperative complications and were firm and stable when digital pressure was applied during the intraoperative and immediate postoperative periods. Conclusion The osteoplastic flap pedicle is a safe and simple procedure, with good results in the immediate postoperative period.

Análise correlacional durante e após os ciclos de quimioterapia com o perfil de ansiedade de pessoas com câncer / Correlational analysis during and after the cycle of chemotherapy with the anxiety profile of people with cancer

Introdução: O sofrimento emocional vivenciado pelos pacientes com câncer, somado aos pensamentos negativos, favorece o aparecimento da ansiedade e da depressão. Objetivo: Correlacionar a ansiedade relatada com os dados ociodemográficos, antropométricos e clínicos de pacientes com câncer durante e após a quimioterapia. Métodos: Foram avaliados 38 voluntários que realizavam quimioterapia (GQ) (idade: 58,24±14,19), e nove voluntários que já finalizaram o tratamento (GC) (idade: 59,78±18,23). Para todos os voluntários, foi utilizado o Inventário de Ansiedade Traço-Estado (IDATE) para mensurar o perfil de ansiedade. Resultados: Para a massa corpórea e IMC do GQ, foi observado um índice de correlação de Spearman r= -0,590 (p<0,001) e r=-0,477 (p=0,002), respectivamente. Para o GC, as mesmas variáveis apresentaram um índice de correlação de Spearman de r= 0,786 (p=0,036) e r= 0,683 (p=0,042), respectivamente. Conclusão: Ambos os grupos apresentaram correlações significativas do nível de ansiedade para as variáveis clínicas, porém o GC apresentou maior correlação do nível de ansiedade com essas variáveis em comparação ao GQ. (AU)

Introduction: The emotional distress experienced by cancer patients added to the negative thoughts favours the occurrence of anxiety and depression. Objective: Correlating the reported anxiety with the sociodemographic and clinical variables of cancer patients during and after chemotherapy. Methods: In this study, 38 volunteers (age: 58.24 ± 14.19) were submitted to chemotherapeutic treatment (TG) and nine volunteers who had already completed the treatment (CG) (age: 59.78 ± 18.23) were evaluated. For all volunteers the State - Trait Anxiety Inventory (STAI) was used to measure the anxiety profile. Results: For the body mass and BMI of the TG, a Spearman's correlation coefficient r = -0.590 (p <0.001) and r=-0.477 (p = 0.002), respectively. For the GC the same variables had a Spearman's correlation coefficient r=0,786 (p=0,036) and r= 0.683 (p=0.042), respectively. Conclusion: Both groups showed significant correlations of anxiety level for the clinical variables, but the CG showed a higher correlation of anxiety level with these variables in comparison with to TG. (AU)

A neurociência na formação dos educadores e sua contribuição no processo de aprendizagem / The formation of educators in neuroscience and their contribution in learning process

O artigo apresenta-se como forma de investigar como se processa a aprendizagem no cérebro, haja vista a necessidade de métodos didáticos que criam condições para que o aluno avance no seu processo de aprendizagem. Essa pesquisa teve a finalidade de aprofundar conhecimentos teóricos e práticos da neurociência com relação aos processos mentais na formação do sujeito. Buscando explorar sua compreensão para que assim possa proporcionar aos professores capacitação, esta possibilitará de forma qualitativa a inserção de seus alunos na cultura letrada. Já que essa cultura não acontece de modo espontâneo, exigindo a mediação com intencionalidade pedagógica do professor, proporcionando a interação constante e significativa dos alunos com os diferentes suportes e práticas de oralidade de leitura e escrita. Portanto, esse estudo desenvolveu uma revisão de literatura científica em artigos publicados entre janeiro de 2004 a janeiro de 2014, na base de dados Bireme (Biblioteca Virtual em Saúde), além de livros, para a estruturação conceitual e referencial teórico do artigo. O período do estudo transcorreu de dezembro de 2013 a fevereiro de 2014. Dessa forma, a pesquisa buscou verificar a interferência do conhecimento da neurociência na formação dos educadores do sistema de ensino da educação básica. O artigo trouxe a compreensão que esse estudo por parte dos educadores faz-se necessário, pois a neurociência considera o conhecimento das funções cerebrais como peça chave para o estímulo de um desenvolvimento cognitivo saudável.

The article is presented as a way to investigate how learning processes in the brain, given the need for teaching methods that create conditions for the student to advance in their learning process. This research aimed to deepen theoretical and practical knowledge of neuroscience in relation to mental processes in the formation of the subject. Seeking to explore their understanding so that it can provide teachers with training, this will enable a qualitative way to enter their students in literacy. Since this culture does not happen spontaneously, requiring mediation with pedagogical intentions of the teacher, providing constant and meaningful interaction of learners with different media and practices of oral reading and writing. Therefore, this study developed a scientific literature review of articles published between January 2004 and January 2014, in the database Bireme (Virtual Health Library), as well as books for the conceptual and theoretical framework structuring the article. The study period was uneventful December 2013 to February 2014. Accordingly, the research analyzes the interference of neuroscience knowledge in teacher training in the educational system of basic education. Article brought to understand that the study of the educators is necessary because neuroscience considers knowledge of brain functions as key to stimulating a healthy cognitive development.

Synthesis, antileishmanial activity and QSAR studies of 2-chloro- N -arylacetamides

ABSTRACT We describe herein the synthesis and evaluation of the antileishmanial activity against promastigote forms of Leishmania amazonensis and cytotoxicity to murine macrophages of a series of 2-chloro-N-arylacetamide derivatives. All compounds were active, except one (compound 3). Compound 5 presented the most promising results, showing good antileishmanial activity (CI50=5.39±0.67 µM) and moderate selectivity (SI=6.36), indicating that further development of this class is worthwhile. Preliminary QSAR studies, although not predictive, furnished some insights on the importance of electronic character of aryl substituent to biological activity, as well as an indirect influence of hydrophobicity on activity.

Synthesis and evaluation of platinum complexes with potential antitumor activity

Abstract A novel series of platinum (II) complexes was synthesized and the complexes were evaluated for their in vitro cytotoxicity against four human cancer cells lines. Five platinum complexes showed activity against at least one tumor cell line. Complexes 3 and 6 were promising, being active, at micromolar concentrations, against all the assayed tumor cell lines. Compound 3 was selected for further studies in mice with Ehrlich solid tumors and it was able to reduce the rate of tumor growth significantly during the first seven days. However, at the end of the experiments, there was no significant difference between the group of animals treated with 3 and the control group. The low solubility of the compound in the assay conditions can explain, at least in part, these results.

Prediction of flexor tendon graft diameter in reconstruction of the anterior cruciate ligament by means of magnetic resonance imaging / Predição do diâmetro do enxerto dos tendões flexores na reconstrução do ligamento cruzado anterior por meio da ressonância nuclear magnética

ABSTRACT OBJECTIVE: To evaluate the diameter of the flexor tendons in preoperative magnetic resonance imaging (MRI) examinations and compare this with the diameter of the graft obtained intraoperatively. METHODS: This was a retrospective longitudinal epidemiological study. Forty-four patients were eligible for the study and their MRI examinations and surgical data were evaluated. The tendons were measured on MRI across their largest diameter in the axial plane, using the medial epicondyle of the femur as the slice level. In the surgery, routine graft preparation was performed, consisting of folding the gracilis and semitendinosus tendons to form a four-strand graft. Its measurement was recorded. RESULTS: To evaluate the association between the variables, Pearson's correlation coefficient was estimated. A significant correlation was found between the measurements of the gracilis and semitendinosus tendons and the final diameter of the graft (p < 0.001). A ROC curve was fitted to the sum of the tendon diameters in order to determine a cutoff point associated with the graft diameter (≤8 mm or >8 mm). If the sum was greater than 5.28 mm, the chance of obtaining a graft larger than 8 mm would be 75%. CONCLUSION: Measurement of the diameters of the gracilis and semitendinosus tendons through a preoperative MRI examination is a simple and effective way to predict the final size of the graft to be used in ACL reconstruction surgery.

RESUMO OBJETIVO: Avaliar o diâmetro dos tendões flexores em exames de ressonância magnética (RNM) pré-operatória e comparar com o diâmetro do enxerto obtido no ato intraoperatório. MÉTODOS: Em um estudo epidemiológico longitudinal retrospectivo, 44 pacientes foram elegíveis ao estudo e tiveram os exames de RNM e dados de cirurgias avaliados. Os tendões foram medidos na RNM no seu maior diâmetro no plano axial com o uso do epicôndilo medial do fêmur como nível de corte. Na cirurgia foi feito preparo de rotina do enxerto, dobraram-se os tendões grácil e semitendinoso, formou-se um enxerto quádruplo que teve sua medida registrada. RESULTADOS: Para a avaliação da associação entre as variáveis foi estimado o coeficiente de correlação de Pearson. Foi encontrada correlação significativa entre as medidas dos tendões grácil e semitendinoso e o diâmetro final do enxerto (p < 0,001). Ajustou-se uma curva ROC para a soma do diâmetro dos tendões, para a determinação de um ponto de corte associado ao diâmetro do enxerto (≤ 8 mm ou > 8 mm). Caso a soma seja maior do que 5,28 mm, a chance de obter um enxerto maior do que 8 mm é de 75%. CONCLUSÃO: A medida do diâmetro dos tendões grácil e semitendinoso no exame da RNM pré-operatória é uma maneira simples e eficaz na predição do tamanho final do enxerto a ser usado na cirurgia de reconstrução do LCA.

Mastoid Obliteration with Autologous Bone in Mastoidectomy Canal Wall Down Surgery: a Literature Overview

Introduction The objectives of mastoidectomy in cholesteatoma are a disease-free and dry ear, the prevention of recurrent disease, and the maintenance of hearing or the possibility to reconstruct an affected hearing mechanism. Canal wall down mastoidectomy has been traditionally used to achieve those goals with greater or lesser degrees of success. However, canal wall down is an aggressive approach, as it involves creating an open cavity and changing the anatomy and physiology of themiddle ear andmastoid. A canal wall up technique eliminates the need to destroy the middle ear and mastoid, but is associated with a higher rate of residual cholesteatoma. The obliteration technics arise as an effort to avoid the disadvantages of both techniques. Objectives Evaluate the effectiveness of the mastoid obliteration with autologous bone in mastoidectomy surgery with canal wall down for chronic otitis, with or without cholesteatoma. Data Synthesis We analyzed nine studies of case series comprehending similar surgery techniques on 1017 total cases of operated ears in both adults and children, with at least 12 months follow-up. Conclusion Mastoid Obliteration with autologous bone has been utilized for many years to present date, and it seems to be safe, low-cost, with low recurrence rates - similar to traditional canal wall down procedures and with greater water resistance and quality of life improvements.

Cochlear Implantation and Single-sided Deafness: A Systematic Review of the Literature

Introduction Current data show that binaural hearing is superior to unilateral hearing, specifically in the understanding of speech in noisy environments. Furthermore, unilateral hearing reduce oné s ability to localize sound. Objectives This study provides a systematic review of recent studies to evaluate the outcomes of cochlear implantation in patients with single-sided deafness (SSD) with regards to speech discrimination, sound localization and tinnitus suppression. Data Synthesis We performed a search in the PubMed, Cochrane Library and Lilacs databases to assess studies related to cochlear implantation in patients with unilateral deafness. After critical appraisal, eleven studies were selected for data extraction and analysis of demographic, study design and outcome data. Conclusion Although some studies have shown encouraging results on cochlear implantation and SSD, all fail to provide a high level of evidence. Larger studies are necessary to define the tangible benefits of cochlear implantation in patients with SSD.

Aesthetic and functional rehabilitation with Alumina: a case report / Reabilitação estética e funcional com Alumina: Relato de caso

A restauração totalmente cerâmica de dentes anteriores é um desafio na atual situação clínica onde há uma variedade de sistemas cerâmicos disponíveis. O objetivo deste estudo é apresentar um relato de caso com a confecção de duas próteses fixas unitárias metal-free em dentes anteriores. Paciente, 30 anos de idade, gênero masculino, estudante, apresentou-se à Faculdade de Odontologia da Universidade Federal do Amazonas, preocupado com a aparência dos dentes. O retratamento endodôntico dos elementos 11 e 12 foi realizado e, em seguida, foram colocados pinos de fibra de vidro. Os preparos dentários foram feitos usando a técnica da silhueta. As coroas foram cimentadas com cimento resinoso. O paciente ficou muito satisfeito com o seu novo sorriso, já que o tratamento proporcionou a reabilitação estética dos dentes anteriores

All-ceramic restoration of anterior teeth is a challenging clinical situation for which a variety of all-ceramic systems are available. The aim of this study is to present a case report of the construction of two single-unit metal-free fixed prostheses in anterior teeth. A 30-year-old male patient came to the Faculty of Dentistry, Federal University of Amazonas, concerned about his teeth. Elements 11 and 12 were endodontically retreated and fiberglass intracanal retainer posts were inserted. Dental crowns were prepared using the silhouette technique. The crowns were cemented with resin cement. The patient was very satisfied with his new smile and the aesthetic rehabilitation of the anterior teeth provided by the treatment

Synergistic, additive and antagonistic effects of fruit mixtures on total antioxidant capacities and bioactive compounds in tropical fruit juices / Efectos sinérgicos, aditivos y antagónicos de mezclas de pulpa frutas en la capacidad antioxidante total y compuestos bioactivos en los zumos de frutas tropicales

The objective of this work was investigate the synergistic, additive and antagonistic effects of fruit mixtures on total antioxidant capacities and bioactive compounds in tropical fruit juices, and optimize its formulation by the response surface methodology based on the responses: total polyphenols (TP), total antioxidant capacity (TAC), ascorbic acid content and sensorial acceptance. Camu-camu, acerola and acai were the major factors that influenced the antioxidant potential of the juice; and the yellow mombin showed a positive effect on the acceptance of the tropical juice. It was observed an antagonistic effect between acerola and camu-camu for the TAC response. The optimum formulation obtained was 20% acerola, 10% camu-camu, 10% yellow mombin, 10% cashew apple and 10% acai, which was responsible for a response of 155.46 mg.100 g-1 of ascorbic acid, 103.01 mg of GAE.100 g-1 of TP, 10.27 μM Trolox g-1 of TAC and approximately 6.1 of acceptance.

El objetivo de este trabajo fue investigar los efectos sinérgicos, aditivos y antagónicos de mezclas de diferentes frutas tropicales en la capacidad antioxidante total (TAC) y compuestos bioactivos presentes en los jugos mixtos, y optimizar su formulación por la metodología de superficie de respuesta basado en las evaluaciones de: polifenoles totales (TP), capacidad antioxidante total (TAC), contenido de ácido ascórbico y la aceptación sensorial. Camu-camu, acerola y acai fueron las frutas que más influyeron en el potencial antioxidante del jugo mixto; y el jobo mostró un efecto positivo en la aceptación del jugo mixto tropical. Se observó un efecto antagónico entre acerola y camu-camu para la TAC. La formulación óptima obtenida contenía 20% acerola, 10% de camu-camu, 10% el jobo, 10% de manzana de marañón y 10% de acai, la cual ha proporcionado contenidos medio de 155,46 mg.100 g-1 de ácido ascórbico, 103,01 mg de GAE.100 g-1 de TP, 10,27 mM Trolox g-1 de TAC y aproximadamente 6.1 de aceptación sensorial.

Intracochlear Schwannoma: Diagnosis and Management

Introduction: Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs) represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI). Objectives: To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions: Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor's size, evidence of the tumor's growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient's other medical conditions...