O guia brasileiro de atividade física: análise a partir da concepção ampliada de saúde / The brazilian guidelines to physical activity: analysis from the expanded conception of health / La guía brasileña de actividad física: análisis desde la concepción ampliada de la salud

Trata-se de uma pesquisa de caráter documental, com abordagem descritiva e exploratória, com o objetivo de analisar o conteúdo do Guia de Atividade Física para a População Brasileira (GAFPB) a partir da concepção ampliada de saúde. As categorias identificadas foram: Bem-estar e qualidade de vida; Socialização e fortalecimento de vínculos; Autonomia e empoderamento; Participação Social; Ampliação do acesso e complexidades envolvidas. Já as ausências foram: o conceito de saúde no qual o GAFPB foi baseado; associação a um profissional específico; questões relacionadas a populações vulneráveis. Em conclusão, foi possível identificar a presença da concepção ampliada de saúde no GAFPB ao observar o questionamento do privilégio da dimensão biológica e do caráter impositivo e normativo de intervir, se aproximar do debate sobre o desenvolvimento humano e pela relativização do enfoque na quantidade de atividades físicas que deve ser realizada.

This is documentary research with a descriptive and exploratory approach, the objective was to analyze in a categorical-thematic way the content of the Physical Activity Guidelines for the Brazilian Population (GAFPB) based on the expanded conception of health. The categories identified were: Well-being and quality of life; Socialization and strengthening of bonds; Autonomy and empowerment; Social Participation; Expansion of access and complexities involved. The absences were the presentation of the concept of health on which the GAFPB was based; association with a specific professional; issues related to vulnerable populations. In conclusion, it was possible to identify the presence of the expanded conception of health in the GAFPB by questioning the privilege of the biological dimension and the imposing and normative character of intervening, approaching the debate on human development and relativizing the focus on the amount of physical activities that must be performed.

Se trata de una investigación documental con abordaje descriptivo y exploratorio, el objetivo fue analizar de forma categórica-temática el contenido de la Guía de Actividad Física para la Población Brasileña (GAFPB) a partir de la concepción ampliada de la salud. Las categorías identificadas fueron: Bienestar y calidad de vida; Socialización y fortalecimiento de vínculos; Autonomía y empoderamiento; Participación social; Ampliación de acceso y complejidades involucradas. Las ausencias fueron la presentación del concepto de salud en el que se basó la GAFPB; vinculación con un profesional específico; temas relacionados con las poblaciones vulnerables. En conclusión, fue posible identificar la presencia de la concepción ampliada de la salud en el GAFPB al cuestionar el privilegio de la dimensión biológica y el carácter imponente y normativo de intervenir, acercándose al debate sobre el desarrollo humano y relativizando el enfoque en la cantidad de actividades físicas deben ser realizadas.

Confecção de guia multifuncional para planejamento de reabilitação implantossuportada: relato de caso / Preparation of a multifuncional guide for the planning of implant-supported rehabilitations: case report / Elaboración de una guía multifuncional para la planificación de rehabilitación implantosoportada: informede caso

Introdução:Em busca da estética e da função mastigatória,é cada vez mais crescente aprocurapor reabilitações implantossuportadas. O guia multifuncional surgepara orientar a disponibilidade óssea e contribuir no planejamento da instalação tridimensional dos implantes, seguindo os princípios do planejamento reverso.Objetivo:Descrever, por meio de um caso clínico, a possibilidade de obtenção de resultados de excelente previsibilidade em coroas unitárias implantossuportadas, por meio do uso de guias multifuncionais, no planejamento do início ao fim de tratamento.Relato decaso:Paciente A.M.F, 44 anos, sexo feminino, compareceu à clínica de Prótese dentária do Departamento de Odontologia/UFRN com queixa de insatisfação da sua prótese removível e harmonia do sorriso. Ao exame clínico e radiográfico, observou-se ausência do elemento 12, apresentando um espaço interoclusal de 5mm e distância médio-distal de 7mm. Foi confeccionado o guia em resina acrílica, o qual foi preenchido o espaço desdentado com um dente de estoque. Em seguida, o dente deste guia teve seu centro perfurado com uma broca esférica para peça reta na região de cíngulo e com isso, preenchida com guta percha em bastão. Após isso, o paciente foi encaminhado para realizar uma tomografia computadorizada cone beam com o guia multifuncional em posição.As imagens obtidas permitiram o planejamento para instalação do implante, como inclinação e posicionamento favorável, bem como ausência de disponibilidade óssea na região. Além disso, o guia funcionou em outras etapas do tratamento da paciente, como na fase provisória.Conclusão:Os guias auxiliam em diversas fases do tratamento e permitem maior previsibilidade dos resultados em reabilitações protéticas unitárias implantossuportadas, apresentando-se como um dispositivo promissorpara ocorreto posicionamento do implante (AU).

Introduction:In search of esthetics and improved masticatory function, the demand for implant-supported rehabilitation is increasing. Multifunctional guides emerge to assess bone availability and help plan the three-dimensional installation of implants, following the principles of reverse planning. Objective:To describe, through a clinical case, the possibility of obtaining excellent predictability in implant-supported single crowns, through the use of multifunctional guides, inthe planning of a treatment from beginning to end. Case report:Patient A.M.F, 44 years old, female, came to the Prosthodontics clinic at the Department of Dentistry/UFRN complaining of dissatisfaction with her removable prosthesis and the harmony of her smile. Clinical and radiographic examination revealed the absence of element 12, with an interocclusal space of 5mm and a mid-distal distance of 7mm. The acrylic resin guide was made and the edentulous space was filled with a stock tooth. The center of theguide tooth was then drilled with a spherical straight-bit burr in the cingulum region and filled with gutta-percha stick. The patient was then referred for a cone beam computed tomography with the multifunctional guide in position. The images obtained allowed planning for implant installation, such as favorable inclination and positioning, as well as the absence of bone availability in the region. In addition, the guide was effective during other stages of the patient's treatment, such as the provisional phase.Conclusion:The guides assist in various phases of treatment and allow greater predictability of results in implant-supported single prosthetic rehabilitations, presenting themselves as a promising device for correct implant positioning (AU).

Introducción:En busca de estética y función masticatoria, la demanda de rehabilitaciones implantosoportadas es cada vez mayor. La guía multifuncional hasurgido para orientar la disponibilidad ósea y ayudar a planificar la instalación tridimensional de implantes, siguiendo los principios de la planificación inversa. Objetivo: Describir, a través de un caso clínico, la posibilidad de obtener una excelente predictibilidad en coronas unitarias implantosoportadas, mediante el uso de guías multifuncionales, en la planificación desde el início hasta el final del tratamiento. Informe de caso: Paciente A.M.F, 44 años, sexo femenino, compareció a la clínica de Prostodoncia del Departamento de Odontología/UFRN quejándose estar insatisfecha con su prótesis removible y con la armonía de su sonrisa. El examen clínico y radiográfico reveló la ausencia del elemento 12, con un espacio interoclusal de 5 mm y una distancia medio-distal de 7 mm. Se confeccionó una guía de resina acrílica y se rellenó el espacio edéntulo con un diente provisorio. A continuación, se perforó el centro del diente guía con una broca recta esférica en la región del cíngulo y se le rellenó con gutapercha en barra. Posteriormente, el paciente fue remitido a una tomografía computarizada cone beamcon la guía multifuncional en posición. Las imágenes obtenidas permitieron planificar la instalación del implante, como inclinación y posicionamiento favorables, así como la ausencia de disponibilidad ósea en la región. La guía también funcionó en otras fases del tratamiento del paciente, como en la fase provisional. Conclusión:Las guías ayudan en varias fases del tratamiento y permiten una mayor previsibilidadde los resultados en rehabilitaciones protésicas unitarias implantosoportadas, presentándose como un dispositivo prometedor para el correcto posicionamiento de los implantes (AU).

Elaboração de um guia sobre saúde vocal infantil / Elaboration of a guide on children's vocal health / Elaboración de una guía sobre salud vocal infantil

Introdução: Materiais educativos sobre cuidados com a voz dão apoio no atendimento clínico e prevenção de disfonia, entretanto, são escassos. Portanto, este estudo objetivou elaborar e avaliar um guia sobre saúde vocal infantil para pais e crianças. Descrição: A elaboração do guia abrangeu: Levantamento Bibliográfico nas bases de dados Biblioteca Virtual em Saúde (BVS) e Público/editora MEDLINE (PubMed); Escrita dos temas; Organização/escrita dos conteúdos/referências; Seleção de imagens. Estruturação do guia: Produção da voz; Sinais/sintomas mais comuns de alterações vocais; Causas dos distúrbios vocais infantis; Consequências do distúrbio vocal infantil; Profissionais envolvidos no diagnóstico e tratamento; Mito e Verdade sobre voz; Como prevenir o distúrbio vocal infantil; Atividades amigas da voz. A avaliação foi em grupo focal, via Google Meet, com três juízes mestrandos em Fonoaudiologia, que discutiram qualitativamente estética, conteúdo e organização. A discussão foi coordenada pela coorientadora e as indicações, realizadas por consenso entre os juízes: Estética - ajustar local das referências, elaborar jogo de trilha, uniformizar desenhos/cores e criar mascote; Conteúdo - material relevante, diminuir textos, adequar a linguagem para crianças, usar links/QR-Code para informações extras e acrescentar orientações para professores; Organização - tópicos em ordem hierárquica, conteúdo relacionado ao tema e separar assuntos por capítulos. Considerações Finais: Foram apontadas mudanças, porém, os juízes ressaltaram a importância deste material na clínica fonoaudiológica e na promoção de saúde vocal. O grupo focal foi importante para a primeira avaliação do guia. (AU)

Introduction: Educational materials on voice care support in clinical care and dysphonia prevention, however, are scarce. Therefore, this study aimed to elaborate and evaluate a guide on child vocal health for parents and children. Description: The elaboration of the guide covered: Bibliographic Survey in the databases Biblioteca Virtual em Saúde (BVS) and MEDLINE Public/Publisher (Pubmed); Themes writing; Organization/writing of the contents/references; Selection of images. Structure of the guide: Voice production; Most common signs/symptoms of vocal disorders; Causes of voice disorders in childhood; Consequences of voice disorders in childhood; Professionals involved in diagnosis and treatment; Myth and Truth about voice; How to prevent vocal disorder in childhood; Voice-friendly activities. The evaluation was in a focus group, via Google Meet, with three Master Judges in Speech Therapy, who discussed qualitatively aesthetics, content and organization. The discussion was coordinated by the co-supervisor and the following recommendations were consensus among the judges: Aesthetics - adjust location of references, elaborate track game, standardize drawings/colors and, create mascot; Content -relevant material, decrease texts, tailor language for children, use/QR-Code links for extra information and, add guidance for teachers; Organization - topics in hierarchical order, content according to theme and separate subjects by chapters. Final Considerations: Improvements were pointed out, however, the judges emphasized the importance of this material in the speech therapy clinic and vocal health promotion. The focus group was important for the guide's first evaluation. (AU)

Introducción: Los materiales educativos sobre cuidados con la voz dan apoyo en la atención clínica y prevención de la disfonía, sin embargo, son escasos. Por lo tanto, este estudio tuvo como objetivo elaborar y evaluar una guía sobre salud vocal infantil para padres e hijos. Descripción: La elaboración de la guía abarcó: Levantamiento Bibliográfico en las bases de datos Biblioteca Virtual en Salud (BVS)/MEDLINE Público/Editor (PubMed); Escritura de los temas; Organización/escritura de los contenidos/referencias; Selección de imágenes. Estructuración de la guía: Producción de la voz; Signos/síntomas más comunes de alteraciones vocales; Causas de los trastornos vocales infantiles; Consecuencias del trastorno vocal infantil; Profesionales involucrados en el diagnóstico y tratamiento; Mito y Verdad sobre voz; Cómo prevenir el trastorno vocal infantil; Actividades amigas de la voz. La evaluación fue en grupo focal, vía Google Meet, con tres jueces maestres en Fonoaudiología, que discutieron cualitativamente estética, contenido y organización. La discusión fue conducida por la coordinadora y las indicaciones, realizadas por consenso entre los jueces: Estética - ajustar lugar de las referencias, elaborar juego de pista, uniformizar dibujos/colores y crear mascota; Contenido - material relevante, disminuir textos, adecuar el lenguaje para niños, usar links/QR-Code para informaciones extras y añadir orientaciones para profesores; Organización - tópicos en orden jerárquico, contenido relacionado al tema y separar asuntos por capítulos. Consideraciones Finales: Se señalaron cambios, sin embargo, los jueces resaltaron la importancia de este material en la clínica fonoaudiológica y en la promoción de salud vocal. El grupo focal fue importante para la primera evaluación de la guía. (AU)

Student’s perception of creative study guide posters in pharmacology: The Kurukshetra model

Background: One of the major challenges for pharmacology teachers is how to capture students’ interests and engage them in the subject, to create an engaging and enjoyable learning process. “Creative study guide posters” is one such novel educational tool that can help achieve these goals. Aims and Objectives: The authors tried to recreate visual artwork in the subject of pharmacology to engage students and at the same time make learning easy and fun-filled. Materials and Methods: In this study, 2nd year medical students participated and prepared creative study guide posters on antimicrobials and microbes in the form of two armies. On the one hand, antimicrobial drugs depicted the good army, consisting of the name of the drug, drug group, and mechanism of action, while on the other hand, the microorganisms depicted the evil army, consisting of the names of the common microbes, representing the battle of Kurukshetra as in the Indian epic of Mahabharata. Results: The majority of the students found this model interesting and useful for revising antimicrobials. About 82.3% of students agreed that their concepts of antimicrobials improved after this activity. About 86.46% of students believed that this model would foster interactive learning. Only 65.63% of students felt that the traditional methods of revising topics were better than this activity. Conclusion: Creative instruction encourages students to think independently, paricipate actively, and express themselves freely. Creative study guide poster activities help with better student engagement, reinforcing concepts, and better retention than just passing information passively in classrooms.

Janelas Pericárdicas: O Valor Limitado do Diagnóstico da Biópsia Pericárdica não Guiada / Pericardial Windows: The Limited Diagnostic Value of Non-Targeted Pericardial Biopsy

Resumo Fundamento A janela pericárdica, além de promover a drenagem pericárdica, também pode fornecer amostras do pericárdio para exame anatomopatológico. No entanto, a contribuição dessas biópsias para a elucidação da etiologia do derrame pericárdico tem sido debatida. Objetivo Analisar o valor diagnóstico da biópsia pericárdica não guiada obtida de procedimentos de janela pericárdica. Métodos Foram revisados retrospectivamente dados de 80 pacientes submetidos a biópsia pericárdica parietal de 2011 a 2020. A significância estatística foi considerada quando p < 0,05. Resultados Cinquenta pacientes eram do sexo masculino (62,5%) e 30 do sexo feminino (37,5%). A mediana de idade foi de 52 anos (intervalo interquartil: 29 a 59) e 49 anos (intervalo interquartil: 38 a 65), respectivamente (p = 0,724). A etiologia suspeita do derrame pericárdico foi neoplásica em 31,3%, incerta em 25%, tuberculose em 15%, autoimune em 12,5%, síndrome edemigênica em 7,5% e outras condições diversas em 8,8%. A abordagem mais frequente para drenagem pericárdica e biópsia foi a subxifoide (74%), seguida pela videotoracoscopia (22%). Em 78,8% das biópsias, os achados histopatológicos foram compatíveis com inflamação inespecífica, e apenas 13,7% de todas as biópsias produziram um diagnóstico histopatológico conclusivo. Aqueles que sofriam de câncer e derrame pericárdico apresentaram maior proporção de achados histopatológicos conclusivos (32% apresentavam infiltração neoplásica pericárdica). A taxa de mortalidade hospitalar foi de 27,5% e 54,5% dos pacientes que morreram no hospital tinham câncer. Nenhuma morte foi atribuída ao tamponamento cardíaco ou ao procedimento de drenagem. Conclusão Nossos resultados mostraram que a janela pericárdica é um procedimento seguro, mas teve pouco valor para esclarecer a etiologia do derrame pericárdico e nenhum impacto na terapia planejada para o diagnóstico primário além da descompressão cardíaca.

Abstract Background Pericardial window, in addition to promoting pericardial drainage, can also provide samples of the pericardium for anatomopathological examination. However, such biopsies' contribution to clarifying the etiology of pericardial effusion has been debated. Objective To analyze the diagnostic value of non-targeted pericardial biopsy obtained from pericardial window procedures. Methods Data from 80 patients who had undergone parietal pericardial biopsies from 2011 to 2020 were retrospectively reviewed. Statistical significance was considered if p < 0.05. Results Fifty patients were male (62.5%,) and 30 were female (37.5%). The median age was 52 years (interquartile range: 29 to 59) and 49 years (interquartile range: 38 to 65), respectively (p = 0.724). The suspected etiology of pericardial effusion was neoplastic in 31.3%, unclear in 25%, tuberculosis in 15%, autoimmune in 12.5%, edemagenic syndrome in 7.5%, and other miscellaneous conditions in 8.8%. The most frequent approach for pericardial drainage and biopsy was subxiphoid (74%), followed by video-assisted thoracoscopy (22%). Overall, in 78.8% of the biopsies, the histopathologic findings were compatible with nonspecific inflammation, and only 13.7% of all biopsies yielded a conclusive histopathological diagnostic. Those suffering from cancer and pericardial effusion had a higher proportion of conclusive histopathologic findings (32% had pericardial neoplastic infiltration). The hospital mortality rate was 27.5%, and 54.5% of the patients who died in the hospital had cancer. No deaths were attributed to cardiac tamponade or the drainage procedure. Conclusion Our results showed that pericardial window is a safe procedure, but it had little value to clarify the pericardial effusion etiology and no impact on the planned therapy for the primary diagnosis besides the cardiac decompression.

Associação entre consumo de marcadores alimentares, orientação nutricional e número de refeições em usuários da ESF / Association between consumption of food markers, nutritional counseling and number of meals in FHS users

Resumo Introdução: O número de refeições/dia tem sido associado a uma alimentação saudável, mas há controvérsias sobre a direção dessa associação. A orientação nutricional, estratégia essencial para construção de estilos de vida saudáveis na população atendida pela Estratégia Saúde da Família, pode ser fundamental nessa relação. Objetivo: Verificar se o consumo regular de marcadores alimentares está associado ao número de refeições diárias e ao recebimento de orientação nutricional. Método: Estudo transversal realizado com usuários da Estratégia Saúde da Família de um município gaúcho. Consumo regular de marcadores alimentares e características nutricionais (número de refeições/dia e recebimento de orientação nutricional) foram avaliados por aplicação de questionário. A associação entre características nutricionais e consumo regular de marcadores alimentares foi analisada utilizando-se regressão de Poisson. Resultados: Dos 529 indivíduos analisados, 2/3 referiram realizar de três a quatro refeições/dia e 30% afirmaram ter recebido orientação nutricional. A frequência de consumo regular de marcadores alimentares variou de 1,7% para frituras a quase 60% para feijão. Indivíduos que receberam orientação nutricional apresentaram menor prevalência de consumo regular de doces e refrigerantes (RP=0,64; IC95% 0,43-0,97). Número de refeições/dia foi positivamente associado ao consumo de lácteos; frutas e hortaliças; frituras, embutidos e salgados. Para os dois últimos grupos, observou-se associação apenas para quem não recebeu orientação nutricional. Conclusões: Os resultados sugerem que consumo regular de marcadores alimentares se associa com recebimento de orientação nutricional e número de refeições.

Abstract Background: The number of meals/day has been associated with a healthy diet, but there are controversies about the direction of this association. Nutritional counseling, an essential strategy for building healthy lifestyles in the population served by the Family Health Strategy (FHS), can be fundamental in this relationship. Objective: To verify whether the regular consumption of food markers is associated with the number of daily meals eaten and receiving nutritional counseling. Method: Cross-sectional study carried out with users of the Family Health Strategy in a city in the state of Rio Grande do Sul, Brazil. Regular consumption of food markers and nutritional characteristics (number of meals/day and receiving nutritional counseling) were assessed by applying a questionnaire. The association between nutritional characteristics and regular consumption of food markers was analyzed using Poisson regression. Results: Of the 529 individuals analyzed, 2/3 reported having three to four meals/day and 30% stated they had received nutritional counseling. The frequency of regular consumption of food markers ranged from 1.7% for fried foods to almost 60% for beans. Individuals who received nutritional counseling had a lower prevalence of regular consumption of sweets and soft drinks (PR=0.64; 95%CI 0.43-0.97). Number of meals/day was positively associated with dairy consumption; fruits and vegetables; fried foods, sausages and pastries. For the last two groups, an association was observed only for those who did not receive nutritional counseling. Conclusions: The results suggest that regular consumption of food markers is associated with receiving nutritional counseling and number of meals.

Brazilian guidelines for the pharmacological treatment of the pulmonary symptoms of cystic fibrosis. Official document of the Sociedade Brasileira de Pneumologia e Tisiologia (SBPT, Brazilian Thoracic Association) / Diretrizes brasileiras para o tratamento farmacológico pulmonar na fibrose cística. Documento oficial da Sociedade Brasileira de Pneumologia e Tisiologia

ABSTRACT Cystic fibrosis (CF) is a genetic disease that results in dysfunction of the CF transmembrane conductance regulator (CFTR) protein, which is a chloride and bicarbonate channel expressed in the apical portion of epithelial cells of various organs. Dysfunction of that protein results in diverse clinical manifestations, primarily involving the respiratory and gastrointestinal systems, impairing quality of life and reducing life expectancy. Although CF is still an incurable pathology, the therapeutic and prognostic perspectives are now totally different and much more favorable. The purpose of these guidelines is to define evidence-based recommendations regarding the use of pharmacological agents in the treatment of the pulmonary symptoms of CF in Brazil. Questions in the Patients of interest, Intervention to be studied, Comparison of interventions, and Outcome of interest (PICO) format were employed to address aspects related to the use of modulators of this protein (ivacaftor, lumacaftor+ivacaftor, and tezacaftor+ivacaftor), use of dornase alfa, eradication therapy and chronic suppression of Pseudomonas aeruginosa, and eradication of methicillin-resistant Staphylococcus aureus and Burkholderia cepacia complex. To formulate the PICO questions, a group of Brazilian specialists was assembled and a systematic review was carried out on the themes, with meta-analysis when applicable. The results obtained were analyzed in terms of the strength of the evidence compiled, the recommendations being devised by employing the GRADE approach. We believe that these guidelines represent a major advance to be incorporated into the approach to patients with CF, mainly aiming to favor the management of the disease, and could become an auxiliary tool in the definition of public policies related to CF.

RESUMO A fibrose cística (FC) é uma doença genética que resulta em disfunção da proteína reguladora de condutância transmembrana da FC (CFTR), que é um canal de cloro e bicarbonato expresso na porção apical de células epiteliais de diversos órgãos. A disfunção dessa proteína resulta em manifestações clínicas diversas, envolvendo primariamente os sistemas respiratório e gastrointestinal com redução da qualidade e expectativa de vida. A FC ainda é uma patologia incurável, porém o horizonte terapêutico e prognóstico é hoje totalmente distinto e muito mais favorável. O objetivo destas diretrizes foi definir recomendações brasileiras baseadas em evidências em relação ao emprego de agentes farmacológicos no tratamento pulmonar da FC. As perguntas PICO (acrônimo baseado em perguntas referentes aos Pacientes de interesse, Intervenção a ser estudada, Comparação da intervenção e Outcome [desfecho] de interesse) abordaram aspectos relativos ao uso de moduladores de CFTR (ivacaftor, lumacaftor + ivacaftor e tezacaftor + ivacaftor), uso de dornase alfa, terapia de erradicação e supressão crônica de Pseudomonas aeruginosa, e erradicação de Staphylococcus aureus resistente a meticilina e do complexo Burkholderia cepacia. Para a formulação das perguntas, um grupo de especialistas brasileiros foi reunido e realizou-se uma revisão sistemática sobre os temas, com meta-análise quando aplicável. Os resultados encontrados foram analisados quanto à força das evidências compiladas, sendo concebidas recomendações seguindo a metodologia GRADE. Os autores acreditam que o presente documento represente um importante avanço a ser incorporado na abordagem de pacientes com FC, objetivando principalmente favorecer seu manejo, podendo se tornar uma ferramenta auxiliar na definição de políticas públicas relacionadas à FC.

Conhecimento e percepção de autoeficácia e eficácia coletiva de professores sobre o Guia Alimentar / Knowledge and perception of self-efficacy and collective efficacy of teachers about the Food Guide

Introdução: No processo de educação em saúde para que o indivíduo mude seus hábitos de saúde, é necessário que tenha conhecimentos, apresente crenças de autoeficácia positivas e compartilhe a eficácia coletiva. Objetivo: Avaliar o conhecimento e a percepção de autoeficácia e eficácia coletiva de professores sobre o Guia Alimentar para a População Brasileira. Método: Realizou-se estudo transversal no período de dezembro de 2019 a dezembro de 2020. A população do estudo foi composta por 1.491 professores da Educação Básica da rede pública municipal de ensino de Montes Claros, Minas Gerais. Para a amostra, estimou-se o tamanho mínimo de 511 professores e foi utilizado um questionário on-line para coleta de dados. Quanto a avaliação do conhecimento, percepção de autoeficácia e eficácia coletivados professores sobre o Guia Alimentar, utilizaram-se escalas autoadministradas e previamente validadas. Os dados coletados foram categorizados e processados eletronicamente através do software Statistical Package for the Social Science (SPSS), versão 22.0. Resultados: Na análise do desempenho dos professores quanto ao Guia Alimentar, observou-se que 79,7% (474) dos profissionais apresentaram baixo conhecimento; 70,4% (419), baixa autoeficácia; e 69,1% (411), baixa eficácia coletiva. O alto conhecimento entre os docentes foi associado à maior renda percapita (p= 0,004). A alta autoeficácia foi associada ao maior grau de escolaridade (p= 0,031). A alta autoeficácia coletiva foi associada às variáveis renda (p=0,035) e escolaridade (p=0,004). Conclusão: Os professores do presente estudo demonstraram baixo conhecimento e baixa percepção de autoeficácia e eficácia coletiva sobre o Guia Alimentar.

Introduction: In the process of health education to change the individual's health habits, they need to have knowledge, present positive self-efficacy beliefs and share collective efficacy. Objective: To evaluate the knowledge and perception of self-efficacy and collective efficacy of teachers about the Food Guide for the Brazilian Population. Method: A cross-sectional study was conducted from December 2019 to December 2020. The study population consisted of 1,491 Basic Education teachers from the municipal public school system of Montes Claros, Minas Gerais. For the sample, the minimum size of 511 teachers was estimated and an online questionnaire was used to collect data. As for the evaluation of knowledge, perception of self-efficacy and collective efficacy of teachers about the Food Guide, self-administered and previously validated scales were used. The data collected were categorized and processed electronically through the Statistical Package for the Social Sciences (SPSS) software, version 22.0. Results: In the analysis of teachers' performance regarding the Food Guide, 79.7% (474) of the professionals had low knowledge; 70.4% (419), low self-efficacy; and 69.1% (411), low collective efficacy. High knowledge among teachers was associated with higher per capita income (p = 0.004). High self-efficacy was associated with higher educational level (p = 0.031). High collective self-efficacy was associated with the variables income (p=0.035) and schooling (p=0.004). Conclusion: The teachers of this study showed low knowledge and low perception of self-efficacy and collective efficacy about the Food Guide.

Multi-disciplinary treatment of severe palatal radicular groove of maxillary lateral incisor: A case report and literature review / 中南大学学报(医学版)

Palatal radicular groove is a developmental malformation of maxillary incisors, lateral incisors in particular, which often causes periodontal destruction. This paper reports a case of combined periodontal-endodontic lesions induced by palatal radicular groove, which was initially misdiagnosed as a simple periapical cyst. After root canal therapy and periapical cyst curettage, the course of disease was prolonged, resulting in the absence of buccal and maxillary bone plates in the affected tooth area. After the etiology was determined, the affected tooth was extracted and guide bone tissue regeneration was performed at the same time, followed by implantation and restoration at the later stage, leading to clinical cure. The palatal radicular groove is highly occult, and the clinical symptoms are not typical. If the abscess of the maxillary lateral incisor occurs repeatedly, and the abscess of the maxillary lateral incisor has not been cured after periodontal and root canal treatment, cone-beam computed tomographic and periodontal flap surgery should be considered.

Clinical decision making of implant guidance methods guided by new classification of surgical area mouth ope-ning / 华西口腔医学杂志

When selecting implant guidance methods or judging whether the patient can be implanted, many doctors ignore or only use visual inspection to estimate a patient's mouth opening. This phenomenon often leads to failure to complete the implantation due to insufficient mouth opening or the deflection of the implant due to limited angle, resulting in the high incidence of corresponding complications. The main reason is that doctors lack accurate analysis and control of the overall geometric conditions of the intraoral surgical area, and three-dimensional position blocking of surgical instruments occurs during the operation. In the past, mouth opening was defined as the distance between the incisor edges of the upper and lower central incisors when the patient opens his mouth widely, and the implant area could be in any missing tooth position. When it is in the posterior tooth area, the specific measurement scheme of the mouth opening could not be simply equivalent to the previous measurement method in the anterior tooth area. However, how to measure quickly and conveniently the mouth opening of any surgical area to determine whether it could be implanted and meet the needs of the selected guidance method remains unclear. This paper introduces new concepts, establishes new classification and corresponding accurate measurement scheme of implant area, and establishes a decision tree of implant methods guided by the actually measured value. Results provide a quantitative basis for rational formulation and implementation of implant treatment.

Application of improved 3D digital guide plate-assisted guided puncture in microballoon compression for primary trigeminal neuralgia / 口腔疾病防治

Objective @#To investigate the clinical efficacy and application value of an improved 3D-printed guide plate for the treatment of primary trigeminal neuralgia (PTN) by percutaneous microballoon compression (PMC). @*Methods @# This prospective study included 42 patients with primary trigeminal neuralgia treated at the Department of Stomatology, Xuzhou Central Hospital, from September 2019 to January 2022. The group was divided by the random number table method into the experimental group (adopting 3D printing technology to make guide plates to guide the puncture, 22 cases) and the control group (adopting the traditional Hartel anterior approach to position the puncture, 20 cases). The intraoperative success rate of the first puncture, puncture time, operative time, radiation exposure of patients and postoperative complications were compared between the two groups. Postoperative Barrow Neurological Institute Scale (BNI) scores, facial numbness, diminished corneal reflexes and chewing weakness were recorded. The t-test, rank-sum test and chi-square test were used for statistical analysis, with P<0.05 indicating a statistically significant difference. @*Results @#The experimental group was significantly better than the control group in terms of the success rate of the first puncture (χ2 = 21.51, P<0.001), puncture time (Z = -5.51, P<0.001), operative time (t = 9.37, P<0.001), and the number of C-arm scans (Z = -4.59, P<0.001). Postoperative BNI scores of the experimental group included 21 cases of grade Ⅰ (91.5%) and 1 case of grade Ⅱ, while the control group included 17 cases of grade Ⅰ (85.0%), 2 cases of grade Ⅱ (10.0%) and 1 case of grade Ⅲ (5.0%), with no statistical significance (P>0.05). In the experimental group, 16 patients had postoperative masseter weakness, 1 had keratitis and 10 had perilabial herpes, while in the control group, 18 patients had postoperative masseter weakness, 2 had keratitis, 11 had perilabial herpes and 1 had monocular blindness. There was no significant difference in postoperative complications between the two groups (P>0.05). At 12 months of follow-up, there was no recurrence in either the experimental or control group. @* Conclusions @#3D digital guide plate-guided percutaneous microballoon compression for primary trigeminal neuralgia can improve the accuracy and safety of puncture to a certain extent, obviously shorten the operation time, reduce radiation exposure of the patients, improve the success rate of the operation, meaning it has a high clinical application value.

Clinical application of a digital positioning guide template during the extraction of maxillary wholly impacted supernumerary teeth / 口腔疾病防治

Objective@#To evaluate the clinical efficacy of positioning guide templates for maxillary wholly impacted supernumerary teeth to provide technological solutions for clinical applications. @*Methods @#After approval by the hospital ethics committee and informed consent given by the patients. Data from 136 patients with maxillary wholly impacted supernumerary teeth from January 2016 to April 2022 were analyzed retrospectively. The patients were divided into two groups according to the usage of the positioning guide template. The experimental group included patients using the positioning guide template (71 cases), and the control group did not use the positioning guide template (65 cases). The operation time and complications were statistically analyzed to evaluate the clinical efficacy after surgery. @*Results @# All operations were successfully completed. The average operation time in the experimental group was (21.5 ± 3.4) min, significantly shorter than that in the control group (27.2 ± 4.9) min. There were statistically significant differences between the experimental and control groups (t = 7.599, P<0.001). One week after the operation, there were no complications in the experimental group, and there were 2 cases of adjacent tooth injury and 3 cases of gingival numbness in the control group.@* Conclusion @# A digital positioning guide template can effectively shorten the time of maxillary wholly impacted supernumerary teeth extraction and is an effective means to assist clinical maxillary wholly impacted supernumerary teeth extraction.

Application of 3D printing percutaneous guide plate in closed reduction and cannulated screw internal fixation of femoral neck fracture / 中国骨伤

OBJECTIVE@#To investigate the application of 3D printing percutaneous surgical guide plate in closed reduction and cannulated screw internal fixation of femoral neck fracture.@*METHODS@#The clinical data of 12 patients with femoral neck fracture from March 2019 to March 2022 were retrospectively analyzed. Patients were divided into observation group and control group according to different operation plans, with 6 cases in each group. The observation group received percutaneous operation guide plate assisted closed reduction and hollow screw internal fixation, while the control group received closed reduction and hollow compression screw internal fixation. The operation time, intraoperative blood loss, fluoroscopy times, and Kirschner needle puncture times were compared between two groups. The location of screws were recordedon postoperative X-ray films, follow-up time, time of complete fracture healing, Harris score of hip joint and the incidence of complications were recorded on postoperative X-ray films.@*RESULTS@#The operation time of observation group (32.17±6.18) min was shorter than that of control group (53.83±7.31) min (P<0.05). The amount of intraoperative bleeding in the observation group (18.33±2.94) ml was less than that in the control group (38.17±5.56) ml(P<0.05). The times of fluoroscopy in the observation group (7.50±1.05) were less than those in the control group (21.00±4.82) (P<0.05). The number of Kirschner needle punctures (8.00±0.63) in observation group was less than that in control group (32.67±3.08) (P<0.05). The follow-up time was(12.88±0.74) months in observation group and (12.83±0.72) months in control group, there was no significant difference between two groups (P>0.05). One year after operation, Harris score of hip joint in the observation group was(82.00±4.52) points, while that in the control group was(81.00±3.41) points, there was no significant difference between two groups(P>0.05). The time of complete fracture healing in the observation group was (7.50±1.05) months, while that in the control group was (7.67±1.21) months, there was no significant difference between two groups(P>0.05). The parallelism of the screws in the observation group was (0.50±0.11) ° and (0.76±0.15) °, which were lower than that in the control group (1.57±0.31) ° and (1.87±0.21) ° (P<0.05). The screw distribution area ratio (0.13±0.02) cm2 in the observation group was higher than that in the control group (0.08±0.01) cm2 (P<0.05). No complications such as necrosis of femoral head, nonunion of fracture, shortening of femoral neck and withdrawal of internal fixation occurred in both groups.@*CONCLUSION@#The application of 3D printing percutaneous surgical guide plate improves the accuracy and safety of closed reduction and cannulated screw internal fixation for femoral neck fracture. It has the advantages of minimally invasive, reducing radiation exposure, fast and accurate, shortening the operation time and reducing intraoperative bleeding.

Brazilian society of rheumatology methodological guide for the development of evidence-based clinical guidelines in rheumatology

Abstract Clinical practice guidelines (CPG) are developed to align standards of health care around the world, aiming to reduce the incidence of misconducts and enabling more effective use of health resources. Considering the complexity, cost, and time involved in formulating CPG, strategies should be used to facilitate and guide authors through each step of this process. The main objective of this document is to present a methodological guide prepared by the Epidemiology Committee of the Brazilian Society of Rheumatology for the elaboration of CPG in rheumatology. Through an extensive review of the literature, this study compiles the main practical recommendations regarding the following steps of CPG drafting: distribution of working groups, development of the research question, search, identification and selection of relevant studies, evidence synthesis and quality assessment of the body of evidence, the Delphi methodology for consensus achievement, presentation and dissemination ofthe recommendations, CPG quality assessment and updating. This methodological guide serves as an important tool for rheumatologists to develop reliable and high-quality CPG, standardizing clinical practices worldwide.

Guía de valoración pediátrica de urgencias en Cuba

La valoración pediátrica de urgencias tiene características especiales respecto al resto de la atención pediátrica. El diagnóstico final será una prioridad secundaria. Es una evaluación clínica, cuyo intento principal es la identificación de aspectos anatómicos y fisiológicos anormales, la estimación de la gravedad de la enfermedad o lesión y la determinación de la necesidad de tratamiento urgente. El objetivo de esta colaboración es brindar una sistemática clara, con una secuencia de valoraciones y acciones que sirvan de base para la toma de decisiones clínicas orientadas a la estabilización del paciente y a evitar situaciones que pueden amenazar la vida en poco tiempo. El triángulo de evaluación pediátrica, la secuencia ABCDE, una breve anamnesis y examen enfocado que identifique el motivo de consulta de mayor prioridad, signos de alarma que pueden cambiar la prioridad y las reevaluaciones frecuentes serán los pilares de la actuación médica. Con el propósito de respetar el derecho del niño al disfrute del más alto nivel posible de salud, de garantizar la calidad asistencial y la seguridad de los pacientes pediátricos con entidades agudas o traumatismos, el grupo nacional de pediatría desarrolló y aprobó la guía de valoración pediátrica de urgencias en Cuba. Mediante la aplicación de esta guía se puede optimizar el proceso de valoración pediátrica de urgencias de forma que los pacientes de este segmento de edad reciban el nivel de cuidados médicos más apropiado para su situación clínica.

The pediatric emergency assessment has special characteristics with respect to the rest of pediatric care. The final diagnosis will be a secondary priority. It is a clinical evaluation, and the main purpose of it is the identification of abnormal anatomical and physiological aspects, the estimation of the severity of the disease or injury and the determination of the need for urgent treatment. The objective of this collaboration is to provide a clear system, with a sequence of assessments and actions that serve as a basis for clinical decision-making aimed at stabilizing the patient and avoiding life-threatening situations in a short time. The pediatric assessment triangle, the ABCDE sequence, a brief history and focused examination that identifies the highest priority reason for consultation, warning signs that may change priority and frequent re-evaluations will be the pillars of medical action. To respect the right of the child to have access to the highest possible level of health, to guarantee the quality of care and its safety in the face of acute conditions or trauma, the National Group of Pediatrics developed and approved the guide for pediatric emergency assessment in Cuba. Through its application, the pediatric emergency evaluation process can be optimized so that patients of this age segment receive the most appropriate level of medical care for their clinical situation.

Guía metodológica para la enseñanza de los pasos y carreras en gimnasia rítmica. Multimedia / Guia metodológico para o ensino de passos e corridas em ginástica rítmica. Multimídia / Methodological guide for the teaching of steps and runs in rhythmic gymnastics. Multimedia

RESUMEN Introducción: El trabajo de investigación que se muestra en este artículo, ofrece una respuesta a la carencia de documentos orientadores para el direccionamiento del proceso de enseñanza aprendizaje de los pasos y carreras como elementos técnicos de enlace en los ejercicios competitivos de gimnasia rítmica; lo que a su vez, constituye un apoyo a la aplicación del Programa Integral de Preparación del Deportista (PIPD 2017-2020) y de soporte de capacitación a las entrenadoras encargadas de la preparación de las gimnastas. Objetivo: Ello encaminó el objetivo de la investigación a la elaboración de una guía metodológica en formato multimedia que sirva a las entrenadoras en el proceso de enseñanza de estos elementos contenidos en el PIPD. Materiales y métodos: Los métodos de investigación de nivel teórico utilizados (análisis y síntesis, enfoque de sistema) y los de nivel empírico (la encuesta, la entrevista y el criterio de especialista, el análisis de documentos y la observación de videos). Resultados: Se demuestra la afectación agravada de la enseñanza por los diversos modelos técnicos metodológicos actuantes. Conclusiones: Se concluye planteando que una guía metodológica debe contener la descripción técnica y su metodología de enseñanza, los errores más comunes, elementos de preparación especial para la consecución y las recomendaciones.

RESUMO Introdução: O trabalho de pesquisa mostrado neste artigo, oferece uma resposta à falta de documentos orientadores para a direção do processo de ensino-aprendizagem das etapas e corridas como elementos técnicos de ligação nos exercícios competitivos da ginástica rítmica; o que, por sua vez, constitui um apoio para a aplicação do Programa Integral de Preparação do Atleta (PIPD 2017-2020) e de apoio ao treinamento dos treinadores encarregados da preparação dos ginastas. Objetivo: Isto levou o objetivo da pesquisa à elaboração de um guia metodológico em formato multimídia que serve aos treinadores no processo de ensino destes elementos contidos no PIPD. Materiais e métodos: Os métodos de pesquisa utilizados foram teóricos (análise e síntese, abordagem de sistema) e empíricos (pesquisa, entrevista e critérios especializados, análise de documentos e observação de vídeo). Resultados: A afetação agravada do ensino pelos vários modelos metodológicos de atuação técnica é demonstrada. Conclusões: Conclui-se propondo que um guia metodológico deve conter a descrição técnica e sua metodologia de ensino, os erros mais comuns, elementos de preparação especial para a realização e recomendações.

ABSTRACT Introduction: The research work shown in this article offers a response to the lack of guiding documents for the direction of the teaching-learning process of the steps and runs as technical elements of connection in the competitive exercises of rhythmic gymnastics; which, in turn, constitutes support for the application of the Comprehensive Program for the Preparation of the Athlete (PIPD 2017-2020) and training support for the coaches in charge of preparing the gymnasts. Objective: This directed the objective of the research to the elaboration of a methodological guide in multimedia format that serves the trainers in the process of teaching these elements contained in the PIPD. Materials and methods: The theoretical level research methods used (analysis and synthesis, system approach) and the empirical level (survey, interview and specialist criteria, document analysis and video observation). Results: The aggravated affectation of teaching by the various acting methodological technical models is demonstrated. Conclusions: It is concluded by stating that a methodological guide must contain the technical description and its teaching methodology, the most common errors, elements of special preparation for achievement and recommendations.

Guia de boas práticas de enfermagem à parturiente em maternidade pública no norte do Brasil / Guide to good nursing practices for parturient women in a public maternity hospital in northern Brazil

Resumo: Este trabalho apresenta a elaboração de um Guia de Boas Práticas de Enfermagem na Assistência à Parturiente, a fim de guiar a prática dos profissionais de enfermagem envolvidos nesse cuidado, desde a admissão na maternidade até o pós-parto imediato. O objetivo da pesquisa foi desenvolver com os profissionais de enfermagem um guia para nortear o cuidado prestado à parturiente. Trata-se de pesquisa metodológica que percorreu as fases de reconhecimento da realidade, construção do instrumento e consenso entre a equipe com relação ao material elaborado. Na fase de reconhecimento, realizou-se visita no local de pesquisa e reuniões com a gerente de enfermagem e coordenadora do Núcleo de Educação Permanente da maternidade cenário da pesquisa, a fim de conhecer a realidade e as necessidades do serviço, no que tange a protocolos e guias de práticas. Na fase de construção do instrumento, procedeu-se à busca de protocolos, políticas governamentais, diretrizes governamentais, resoluções, guias, bem como artigos científicos publicados pertinentes ao tema. Após a busca, desenvolveram-se oficinas presenciais seguindo roteiro baseado na metodologia de Quatro Erres (RS), com as fases de reconhecimento, revelação, repartir e repensar. As oficinas contaram com a participação de 31 profissionais de enfermagem, sendo três enfermeiros obstetras, seis residentes de enfermagem em obstetrícia, oito enfermeiros generalistas e 14 técnicos em enfermagem. Durante as oficinas, foi possível perceber as fragilidades, potencialidades e o conhecimento dos participantes relacionado às Boas Práticas de Atenção ao Parto. Ao final das oficinas, elaborou-se um quadro contendo os temas dos capítulos e as referências para serem utilizadas na elaboração do guia pela pesquisadora. O quadro foi aprovado por consenso entre os participantes. Como produto desta pesquisa, produziu-se um guia disponibilizado no formato digital e físico, composto por sete capítulos, totalizando quarenta e três páginas. Conclui-se que o objetivo da pesquisa foi alcançado, e a tecnologia desenvolvida poderá auxiliar a equipe de enfermagem na realização do cuidado de enfermagem baseado nas boas práticas, bem como auxiliará no processo de educação permanente em saúde, possibilitando a replicação. Agência do registro: Câmara Brasileira do Livro. Número do produto: ISBN 978-65-00-58214-7 DA-2022-028946

Abstract: This paper presents the elaboration of a Guide to Good Nursing Practices in Assistance to Parturient Women in order to guide the practice of nursing professionals involved in this care, from admission to the maternity ward until the immediate postpartum period. The objective of the research was to develop a guide with the nursing professionals to guide the care provided to the parturient woman. This is a methodological research that went through the stages of recognition of reality, construction of the instrument and consensus among the team regarding the elaborated material. In the recognition phase, a visit was made to the research site and meetings were held with the nursing manager and coordinator of the Permanent Education Center of the maternity hospital where the research was carried out, in order to learn about the reality and needs of the service in terms of protocols and guidelines for practices. In the construction phase of the instrument, a search was made for protocols, government policies, government guidelines, resolutions, guides, as well as published scientific articles relevant to the topic. After the search, face-to-face workshops were carried out following a guiding script in the Quatro Erres (RS) methodology, with the phases o frecognition, revelation, sharing and rethinking. The workshops were attended by 31 nursing professionals, including 03 obstetric nurses, 06 nursing residents in obstetrics, 08 generalist nurses and 14 nursing technicians. During the workshops, it was possible to perceive the weaknesses, strengths and knowledge of the participants related to Good Practices in Childbirth Care. At the end of the workshops, it was possible to prepare a table containing the themes of the chapters and references to be used in the elaboration of the guide by the researcher. The framework was approved by consensus among the participants. As a result of this research, a guide was made available in digital and physical format, consisting of seven chapters, totaling forty-three pages. It is concluded that the objective of this research was achieved, and the technology developed will be able to help the nursing team in carrying out nursing care based on good practices, as well as helping in the process of permanent education in health, enabling its replication. Registration agency: Brazilian Book Chamber. Product number: ISBN 978-65-00-58214-7 DA-2022-028946

O Guia Alimentar para População Brasileira (GAPB): uma análise à luz da teoria social / The Food Guide for The Brazilian Population: an analysis in the light of social theory

Resumo O Guia Alimentar para a População Brasileira (GAPB) é um documento oficial que aborda princípios e recomendações de uma alimentação adequada e saudável e se configura como um instrumento de apoio às ações de educação alimentar e nutricional (EAN). O objetivo deste artigo é analisar o conteúdo do guia, que é um dos principais instrumentos das políticas públicas relacionadas à alimentação no Brasil, à luz de conceitos da teoria social, em especial teorias da modernidade, da identidade e dos riscos. Na análise minuciosa do conteúdo do guia, foi constatado que o texto considerou a diversidade alimentar cultural e biológica das regiões brasileiras. Teve base de referência os alimentos e não os nutrientes, tornando a compreensão das recomendações ilustrativas fáceis de serem assimiladas pelo público. Preocupou-se em evitar os riscos alimentares, levando em consideração a questão da aquisição de alimentos adequados e saudáveis. Entretanto, identificou-se dois riscos não abordados: o problema dos alimentos processados e ultraprocessados (UP); e a omissão de alerta referente aos alimentos transgênicos (OGMs). Embora construído de forma inovadora, estimulando tempo, atenção e companhia à mesa, o GAPB necessita uma revisão.

Abstract The Food Guide for the Brazilian Population (GAPB) is an official document that addresses principles and recommendations for an adequate and healthy diet, and it is configured as a support tool for food and nutrition education actions. This article aims to analyze the guide content, which is one of the main instruments of public policies related to food in Brazil, in the light of the concepts of social theory, especially theories of modernity, identity, and risks. In the detailed analysis of the guide content, we found that the document considered the cultural and biological food diversity of Brazilian regions. It is based on food not on nutrients, making illustrative recommendations easy to public understanding. It avoided food risks, considering the issue of acquiring adequate and healthy food. However, two risks were not addressed: the problem of processed and ultra-processed foods (PU); and the omission of warnings regarding transgenic foods (GMOs). Although the guide has been designed in an innovative way, stimulating time, attention, and companionship at the table, the GAPB needs revision.

Guía de Práctica Clínica en atresia esofágica / Clinical practice guide on esophageal atresia

La atresia esofágica es una de las anomalías congénitas más frecuentes en la práctica quirúrgica neonatal. Se estima que tiene una incidencia de 1 por cada 3500 recién nacidos vivos a nivel mundial. La preparación de guías de actuación y protocolos asistenciales es tendencia en la práctica médica actual. Esta Guía de Práctica Clínica se elaboró respondiendo a la necesidad de protocolizar la atención médico-quirúrgica de la atresia esofágica. En el Centro Territorial de Cirugía Neonatal de Holguín, donde se regionaliza la atención a neonatos de las cinco provincias orientales del país con afecciones congénitas y quirúrgicas de alta complejidad, la atresia esofágica fue la afección quirúrgica más frecuente en los últimos diez años, con una supervivencia ascendente que alcanzó 94,4 por ciento en 2019. La guía que se presenta se aprobó en el Primer Consenso Nacional de Guías de Prácticas Clínicas en Cirugía Pediátrica, en Varadero, Matanzas en 2019. Incluye las principales pautas para el diagnóstico, tratamiento y seguimiento de los pacientes afectados y se considera una herramienta eficiente para mejorar los resultados en la asistencia médica y quirúrgica neonatal(AU)

Esophageal atresia is one of the most common congenital anomalies in neonatal surgical practice. It is estimated to have an incidence of 1 per 3500 live newborns globally. The preparation of action guides and care protocols is a trend in current medical practice. This Clinical Practice Guide was prepared in response to the need to protocolize the medical-surgical care of esophageal atresia. In the Territorial Center for Neonatal Surgery of Holguín, where the care of neonates from the five eastern provinces of the country with congenital and surgical conditions of high complexity is regionalized, esophageal atresia was the most frequent surgical condition in the last ten years, with an ascending survival that reached 94.4 percent in 2019. The guideline presented was approved in the First National Consensus of Clinical Practice Guidelines in Pediatric Surgery, in Varadero, Matanzas in 2019. It includes the main guidelines for the diagnosis, treatment and follow-up of affected patients and is considered an efficient tool to improve outcomes in neonatal medical and surgical care(AU)

Otimização das etapas de confecção do protocolo Branemark com carga tardia utilizando o guia multifuncional / Optimization of the Branemark protocol late load preparation steps using the multifunctional guide

O "planejamento reverso" em implantodontia busca alcançar um melhor prognóstico para a reabilitação do paciente, permitindo uma maior previsibilidade para o tratamento a partir do momento em que se planeja a reabilitação oral protética antes mesmo de planejar os implantes osseointegráveis. O dispositivo de resina acrílica chamado guia multifuncional representa a disposição final dos dentes na reabilitação e auxilia demasiadamente na etapa protética em casos em que não é possível a carga imediata. Ainda, otimiza o número de consultas do tratamento pois orienta a relação maxilomandibular, dimensão vertical e correta posição dos dentes. O presente trabalho tem como objetivo apresentar um caso clínico da utilização do guia multifuncional para moldagem dos implantes em caso de protocolo Branemark com dois tempos cirúrgicos, mostrando sua utilidade para diminuição do número de consultas na etapa de confecção da prótese total inferior definitiva. Diante dos resultados obtidos na realização do caso, foi possível concluir que nos casos de protocolo Branemark quando não é possível realizar a carga imediata, o guia multifuncional pode ser aproveitado e utilizado com sucesso, para a moldagem e confecção da prótese definitiva, diminuindo o número de consultas e otimizando o tratamento.

Reverse planning in implantology aims to improve patient's rehabilitation prognosis allowing greater treatment predictability from the prosthetic planning and before the implants installation. The acrylic resin device called multifunctional guide represents the final teeth disposition and is very useful in the prosthetic step when immediate loading is not possible. And it optimizes appointments treatment number since it guides the maxillomandibular relation, vertical dimension and correct teeth position. The aim of this study was to present a clinical case using the multifunctional guide for implant molding a two steps Branemark protocol, showing its usefulness to reduce the appointments number during the inferior total denture preparation step. Based on these results, it was possible to conclude that in Branemark protocol, when it immediate loading is not possible, the multifunctional guide can be used successfully for molding and making the final prosthesis, reducing the number of visits and optimizing treatment.