Lesiones cervicales no cariosas: una revisión sistemática / Non carious cervical lesions: a systematic review

Introducción: las lesiones cervicales no cariosas (NCCL, por sus siglas en inglés) son un grupo de lesiones que afectan el área cervical del órgano dental causando hipersensibilidad dentinaria y defectos estéticos. Objetivo: analizar la literatura sobre las lesiones cervicales no cariosas, su etiología, consideraciones anatómicas, características morfológicas de la lesión y tratamientos no restaurativos. Material y métodos: se realizó una búsqueda en la base de datos PubMed, utilizando las palabras clave: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, recopilando un total de 78 artículos. Resultados: es necesario determinar la etiología antes de seleccionar las estrategias de tratamiento para las lesiones cervicales no cariosas. Conocer los distintos tipos de tejidos que componen al órgano dentario facilita la comprensión de los factores que participan en el desarrollo de las lesiones cervicales no cariosas. Esto permite que el tratamiento se enfoque más en la causa del problema que en los síntomas. Con esto podemos modificar diversos factores de manera interceptiva, los tratamientos de terapia con láser y compuestos tópicos son una estrategia mínimamente invasiva. Conclusiones: la mejor manera de describir a las lesiones cervicales no cariosas sería como una enfermedad multifactorial. Se debe prestar especial atención en los métodos de diagnóstico, identificando cofactores que propicien el avance de la lesión, como son la fricción y la biocorrosión. Esta revisión brinda datos que asocian a los factores oclusales como una de las principales causas de una enfermedad que afecta a más de la mitad de la población adulta (AU)

Introduction: non-carious cervical lesions (NCCL) are a group of lesions that affect the cervical area of the dental organ causing dentin hypersensitivity and cosmetic defects. Objective: to know, through a systematic review, the current state of non-carious cervical lesions. Material and methods: a search was conducted in the PubMed database, using the keywords: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, compiling a total of 78 articles. Results: determining etiology is necessary before selecting treatment strategies for non-carious cervical lesions (NCCL). Know the different types of tissues that make up the dentary organ, facilitate the understanding of the factors involved in the development of noncarious al cervical lesions. This allows treatment to focus more on the cause of the problem than on symptoms. With this we can modify various factors in an interceptive way, laser therapy treatments and topical compounds, are a minimally invasive strategy. Conclusions: the best way to describe non-carious al cervical lesions would be as a multifactorial disease to which special attention should be paid to both diagnostic methods, identifying cofactors that promote the progression of injury, such as friction and biocorrosion. This review provides data that associates occlusal factors as one of the main causes of a disease that affects more than half of the adult population (AU)

Research on friction and wear behaviors of silicon-lithium spray coating on zirconia ceramics / 北京大学学报(医学版)

OBJECTIVE@#To study microstructure, friction and wear behaviors of silicon-lithium spray coating on the surface of zirconia ceramics and to preliminarily evaluate its esthetic so as to provide support and guidance for the clinical application.@*METHODS@#Zirconia ceramic specimens were randomly divided into three groups: coating group (two subgroups), polishing group (two subgroups), and glazing group (four subgroups), with 10 samples in each subgroup. The two subgroups of coating group were the zirconia ceramics with the untreated and preliminary polishing surfaces sprayed with silicon-lithium coating, respectively. The two subgroups of polishing group were preliminary polishing and fine polishing of zirconia ceramics, respectively. The four subgroups of glazing group were preliminarily polished zirconia ceramics glazed with Biomic and Stain/Glaze products, respectively; and untreated zirconia ceramics glazed with Biomic and Stain/Glaze products, respectively. The above 8 subgroups of zirconia ceramic specimens were used as friction pairs with 80 steatite ceramics for 50 000 chewing cycles under 50 N vertical load and artificial saliva lubrication using chewing simulation. Scanning electron microscope was used to observe the microstructure of the surface and section of the coating group, and the thickness of the coating and glazing were measured. The linear roughness of the coating and polishing groups was mea-sured using a laser confocal scanning microscope. Vickers hardness was measured using a microhardness tester and the esthetic of zirconia ceramic full crown sprayed with silicon-lithium coating was preliminarily evaluated. White light interferometer was used to measure the width, the maximum depth and the volume of the wear scars of each group, and the wear depth of steatite ceramics and wear rate of zirconia ceramic specimens were calculated. Kruskal-Wallis nonparametric test and Dunn's multiple comparisons test were used to analyze the wear depth of each group (α=0.05).@*RESULTS@#The microstructures of the silica-lithium spray coatings on the untreated and preliminarily polished zirconia ceramic surfaces showed the protruding defects, and the line roughness of coating group was larger than that of the polishing group. The median thickness of the silica-lithium spray coating on the preliminarily polished zirconia ceramic was 13.0 μm (interquartile range, IQR: 11.6, 17.9), while that of the silica-lithium spray coating on the untreated zirconia ceramic was 4.4 μm (IQR: 4.1, 4.7). The Vickers hardness and wear rate of the coating group were between the polishing group and the glazing group. The wear depths of the wear scars of steatite ceramics were the glazing group, coating group, and polishing group in descending order, and there was statistically significant difference between glazing and polishing groups (P < 0.05). With the increase of polishing procedure, the wear depth of steatite ceramics decreased in each subgroups. The orders of maximum depth and volume of wear scars of zirconia ceramic were the glazing group, coating group, and polishing group in descending order, and there was statistically significant difference in the maximum depth of wear scars between glazing and polishing groups (P < 0.05).@*CONCLUSION@#The silica-lithium spray coating on the zirconia ceramic, can be used as a new method for zirconia ceramic surface treatment, because it can increase the esthetic of zirconia ceramics compared with polishing and reduce the wear of steatite ceramics compared with glazing.

Soft tissue and incisor position changes in class I bimaxillary subjects after retraction using friction and frictionless mechanics

Aim: Bimaxillary protrusion is a common condition observed irrespective of race and ethnicity and is a chief concern for patients who seek orthodontic treatment. The aim of this study was to compare and evaluate changes in soft tissue structures and incisor positions in class I bimaxillary protrusion subjects undergoing orthodontic therapy when friction and frictionless mechanics were used. Methods: Two groups with a total of 40 patients aged 18­30 years diagnosed with class I bimaxillary protrusion treated by extracting first premolars were considered for this study. Patients treated with friction mechanics were included in Group 1 and those treated with frictionless mechanics in Group 2. The digital lateral cephalograms were calibrated and analyzed using Nemoceph software. Selected landmarks were marked on pre- and post-treatment cephalograms and assessed for intra- and inter-group soft tissue and incisor position changes. Student's t-test was used to analyze the collected data using SPSS 20 software. Result: Intragroup comparison revealed significant changes in both groups. Inter-group comparison of the selected parameters between groups 1 and 2 showed differences but without any statistical significance, except for the inter-incisal angle. Conclusion: Pre- and post-treatment comparison analysis revealed significant soft tissue changes in both groups. However, the comparison between friction and frictionless mechanics showed no statistically significant changes

Evaluation of Lubrication Coatings for Intravascular Catheters, Wires, and Delivery System / 中国医疗器械杂志

Lubrication coating is widely used to reduce the friction between the interventional devices and the blood vessels, improves the surface biocompatibility of the interventional device, and also brings the coating stability problems and related risks. This paper describes the coating-related content from the equipment description, performance verification, technical requirements, etc., to reduce the risk of the coating to an acceptable level.

Lesão por fricção em idosos / Skin tears in the elderly / Skin tears en los ancianos

Objetivos:identificar na literatura científica o conhecimento produzido sobre lesões por fricção em idosos. Métodos: trata-se de uma revisão integrativa de literatura (2014-2019), realizada a partir de busca nas bases de dados/plataformas National Library of Medicine, Biomedical Answers e Biblioteca Virtual em Saúde, com descritores e os operadores booleanos "and" e "or". Resultados: a partir da busca bibliográfica, seleção e análise, oito artigos compuseram a amostra. Para lesão por fricção em idosos emergiram quatro pilares do cuidado: manutenção da homeostase orgânica e tissular com foco na nutrição e hidratação apropriada; evitar traumas na pele senil, proporcionando um ambiente seguro com dispositivos adequados; e a sistematização da assistência e educação em saúde do cuidado com a pele do idoso. Conclusão: como mecanismos de prevenção, encontram-se a realização da prevenção primária por meio de um plano de cuidados singular e as atividades de educação em saúde, focadas nos fatores de risco e nas vulnerabilidades, minimizando danos e complicações

Objectives:to identify in the scientific literature the knowledge produced about skin tears injuries in the elderly. Methods: it is an integrative literature review (2014-2019), carried out by searching the databases/platforms National Library of Medicine, Biomedical Answers and Biblioteca Virtual em Saúde, with descriptors and the Boolean operators "and" and "or ". Results: from the bibliographic search, selection and analysis, eight articles made up the sample. For skin tears injuries in the elderly, four pillars of care emerged: maintenance of organic and tissue homeostasis with a focus on proper nutrition and hydration; avoid trauma to senile skin, providing a safe environment with suitable devices; and the systematization of health care and education for elderly skin care. Conclusion: as prevention mechanisms, primary prevention is achieved through a unique care plan and health education activities, focused on risk factors and vulnerabilities, minimizing damage and complications

Objetivos:identificar em la literatura científica El conocimiento producido sobre las lesiones skin tears en el anciano. Métodos: Se trata de una revisión integradora de la literatura (2014-2019), realizada em las plataformas/bases de datos de la National Library of Medicine, Biomedical Answersy Virtual Health Library, com descriptores y operadores booleanos "and" y "or". Resultados: Tras la búsqueda, selección y análisis previo de los artículos, se seleccionaron ocho para componer la muestra. Para las lesiones por desgarro de la piel en los ancianos, surgieron cuatro pilares de atención: mantener la homeostasis orgánica y tisular común enfoque en una nutrición e hidratación adecuadas; evitar traumatismos em la piel senil, proporcionando un entorno seguro con dispositivos adecuados; y la sistematización de la atención a la salud y la educación para el cuidado de la piel del anciano. Conclusión: Como mecanismos de prevención, la prevención primaria se puede encontrar a través de um plan de atención único y actividades de educación para la salud enfocadas em lós factores de riesgo y vulnerabilidades, minimizando daños y complicaciones

Escovas de limpeza em centrais de materiais e esterilização: características e cuidados / Cleaning brushes in Central Materials and Sterilization

A limpeza é a primeira e mais essencial etapa antes que qualquer processo de desinfecção ou esterilização possa ocorrer. Nesta etapa ocorre a fricção manual dos materiais com escovas apropriadas a fim de eliminar sujidades. A depender das características, estas escovas podem ter um custeio elevado para os serviços de saúde, especialmente em países com recursos limitados como o Brasil. Elucidar, em tempo oportuno, o que traz a literatura sobre as características necessárias às escovas de limpeza em Centrais de Materiais e Esterilização (CME), especialmente sobre a necessidade de serem autoclavadas.

Prevalence of skin tears in hospitalized adults and older adults / Prevalencia de lesiones por fricción en adultos y adultos mayores hospitalizados / Prevalência de lesões por fricção em adultos e idosos hospitalizados

ABSTRACT Objective: To identify the prevalence, related factors and to classify Skin Tears in hospitalized adults and older adults. Method: Prevalence study with adults and older adults in inpatient and intensive care units of a hospital in the South Region of Brazil. The STAR Skin Tear Classification System was used to analyze the lesions. Data were collected by physical examination and consultation of medical records. The Poisson Regression Prevalence Ratio with robust variance was calculated. Results: The participants were 148 patients. There were 29 Skin Tears (mean 1.6 ± 0.7) in 18 individuals (prevalence of 12.2%). The variables age, friable skin, enteral feeding catheter, degree of dependence, use of antihypertensives, micronutrients, diuretics, antidepressants, and antifungals were associated with lesions in the bivariate analysis. In the final multivariate model, antihypertensives PR 2.42 (95%CI 1.01-5.77), antidepressants PR 2.72 (95%CI 1.1-6.33) and micronutrients PR 4.93 (95%CI 1.64-14.80) maintained a relationship. Conclusion: The prevalence of injuries was 12.2%, showing they are present in the health care setting, especially in nursing care. Care protocols need to be developed for the prevention, identification and early treatment of ST.

RESUMEN Objetivo: Identificar la prevalencia y los factores relacionados de las Lesiones por Fricción en adultos y adultos mayores hospitalizados. Método: Se trata de un estudio de prevalencia realizado entre adultos y adultos mayores en las unidades de internación y de tratamiento intensivo de un hospital del Sur de Brasil. Se utilizó el STAR, Skin Tear Classification System, para analizar las lesiones. Los datos se recogieron mediante examen físico y consulta de prontuario. Se calculó la Razón de Prevalencia por Regresión de Poisson con varianza robusta. Resultados: Participaron 148 pacientes. Se encontraron 29 Lesiones por Fricción (media 1,6±0,7) en 18 individuos (prevalencia del 12,2%). Las variables edad, piel friable, alimentación por catéter enteral, grado de dependencia, uso de antihipertensivo, micronutriente, diurético, antidepresivo y antimicótico estaban asociadas a las lesiones en el análisis bivariado. En el modelo final multivariado, antihipertensivo RP 2,42 (IC 95% 1,01-5,77), antidepresivo RP 2,72 (IC 95% 1,1-6,33) y micronutriente RP 4,93 (IC 95% 1,64-14,80) se mantuvieron relacionados. Conclusión: La prevalencia de las lesiones era del 12,2%, lo que demuestra su presencia en el escenario de la atención en salud, sobre todo en los cuidados de enfermería. Es necesario elaborar protocolos asistenciales para su prevención, identificación y tratamiento precoz.

RESUMO Objetivo: Identificar a prevalência, os fatores relacionados e classificar as Lesões por Fricção em adultos e idosos hospitalizados. Método: Estudo de prevalência com adultos e idosos em unidades de internação e de tratamento intensivo de um hospital do Sul do Brasil. Utilizou-se a STAR Skin Tear Classification System para análise das lesões. Os dados foram coletados por exame físico e consulta em prontuário. Calculou-se a Razão de Prevalência por Regressão de Poisson com variância robusta. Resultados: Participaram 148 pacientes. Foram encontradas 29 Lesões por Fricção (média 1,6±0,7) em 18 indivíduos (prevalência de 12,2%). As variáveis idade, pele friável, alimentação por cateter enteral, grau de dependência, uso de anti-hipertensivo, micronutriente, diurético, antidepressivo e de antifúngico foram associadas às lesões na análise bivariada. No modelo final multivariado, anti-hipertensivo RP 2,42 (IC 95% 1,01-5,77), antidepressivo RP 2,72 (IC 95% 1,1-6,33) e micronutriente RP 4,93 (IC 95% 1,64-14,80) mantiveram relação. Conclusão: A prevalência de lesões foi de 12,2%, evidenciando sua presença no cenário de atenção em saúde, sobretudo nos cuidados de enfermagem. Protocolos assistenciais precisam ser elaborados para sua prevenção, identificação e tratamento precoce.

Algoritmos para prevenção e tratamento de lesão por fricção / Algoritmos para prevención y tratamiento de lesión por fricción / Algorithms for the prevention and treatment of friction injury

Resumo Objetivo: Elaborar e validar o conteúdo de algoritmos para prevenção e tratamento de lesão por fricção. Métodos: Para a construção dos algoritmos, foi realizada uma revisão integrativa da literatura após busca nas bases de dados: SciELO, LILACS e MEDLINE. A avaliação dos algoritmos foi realizada por 26 juízes, sendo 10 médicos e 16 enfermeiros, utilizando-se a técnica Delphi. Os resultados foram analisados por meio do Índice de Validade de Conteúdo. Resultados: No primeiro ciclo de avaliação, os itens dos algoritmos foram considerados pelos juízes de "inadequados" a "totalmente adequados". Após as correções sugeridas pelos juízes, os algoritmos foram reenviados para o segundo ciclo de avaliação, no qual todos os itens foram julgados "adequados" ou "totalmente adequados", resultando em um Índice de Validade do Conteúdo de 1,0. Conclusão: Os algoritmos desenvolvidos possuem validade de conteúdo e podem auxiliar profissionais de saúde na avaliação, prevenção e tratamento da lesão por fricção.

Resumen Objetivo: Elaborar y validar el contenido de algoritmos para prevención y tratamiento de lesión por fricción. Métodos: Para la construcción de los algoritmos, se realizó una revisión integradora de la literatura luego de una búsqueda en las bases de datos: SciELO, LILACS y MEDLINE. La evaluación de los algoritmos fue realizada por 26 jueces, de los cuales 10 eran médicos y 16 enfermeros, con la utilización del método Delphi. Los resultados fueron analizados mediante el Índice de Validez de Contenido. Resultados: En el primer ciclo de evaluación, los ítems de los algoritmos fueron considerados desde "inadecuados" a "totalmente adecuados" por los jueces. Luego de las correcciones sugeridas por los jueces, se enviaron los algoritmos para el segundo ciclo de evaluación, en el que todos los ítems fueron considerados "adecuados" o "totalmente adecuados", lo que tuvo como resultado un Índice de Validez de Contenido de 1,0. Conclusión: Los algoritmos elaborados tienen validez de contenido y pueden ayudar a profesionales de la salud en la evaluación, prevención y tratamiento de la lesión por fricción.

Abstract Objective: Develop and validate the content of algorithms for the prevention and treatment of friction injury. Methods: For the construction of algorithms, an integrative literature review was conducted after searching SciELO, LILACS and MEDLINE databases. The algorithms were evaluated by 26 raters - 10 physicians and 16 nurses - using the Delphi technique. The results were analyzed by the Content Validity Index (CVI). Results: In the first evaluation cycle, the items of the algorithms were considered "inadequate" to "totally adequate" by the raters. After adjustments suggested by the raters, the algorithms were submitted to a second evaluation cycle, when all items were considered "adequate" or "totally adequate," resulting in a content validity index of 1.0. Conclusion: The algorithms have valid content and can help health professionals in the evaluation, prevention and treatment of friction injuries.

Prevalence of friction injury and associated factors in elderly in intensive therapy / Prevalencia de lesiones por fricción y factores asociados en personas mayores en terapia intensiva / Prevalência de lesões por fricção e fatores associados em idosos em terapia intensiva

ABSTRACT Objective: to analyze the prevalence of friction injuries and associated factors in the elderly admitted to the Intensive Care Unit. Method: a cross-sectional analytical study, developed in an Intensive Care Unit of a Teaching hospital, with a sample of 101 elderly. Data collection was conducted from November 2017 to May 2018, through interviews, consulting medical records and physical examination. For analysis, descriptive and inferential statistics were performed. Strength of associations between variables measured by odds ratio and 95% confidence intervals. Statistical significance level was set at 5% for all analyzes. Results: the sample studied had a mean age of 71.39 years, mostly male, married and without schooling, with more than one comorbidity, dependent, with dry and scaly skin and bruising on the extremities. The prevalence of friction injury was 28.7%, with an average of 1.93 injuries per elderly. There was a statistically significant association between the occurrence of friction injury with age, comorbidities, dry and scaly skin. Conclusion: the prevalence of friction injury was high and associated with age, comorbidities, dry and scaly skin, and mean duration of corticosteroid use.

RESUMEN Objetivo: analizar la prevalencia de lesiones por fricción y los factores asociados en los ancianos ingresados en la Unidad de Terapia Intensiva. Método: estudio transversal y analítico, desarrollado en una Unidad de terapia intensiva de un hospital universitario, con una muestra de 101 ancianos. La recolección de datos se realizó de noviembre de 2017 a mayo de 2018, mediante entrevistas, consulta de registros médicos y examen físico. Para el análisis, se realizaron estadísticas descriptivas e inferenciales. Fuerza de las asociaciones entre variables medidas por odds ratio e intervalos de confianza del 95%. Nivel de significación estadística establecido en 5% para todos los análisis. Resultados: la muestra estudiada tenía una edad media de 71.39 años, en su mayoría hombres, casados y sin educación, con más de una comorbilidad, dependiente, con piel seca y con descamación y hematomas en las extremidades. La prevalencia de lesiones por fricción fue del 28,7%, un promedio de 1,93 lesiones por ancianos. Hubo una asociación estadísticamente significativa entre la aparición de lesiones por fricción con la edad, comorbilidades, piel seca y descamación. Conclusión: la prevalencia de lesiones por fricción fue alta y se asoció con la edad, las comorbilidades, la piel seca y con descamación, y la media del uso de corticoides.

RESUMO Objetivo: analisar a prevalência de lesões por fricção e fatores associados em idosos internados em Unidade de Terapia Intensiva. Método: estudo transversal e analítico, desenvolvido em Unidade de Terapia Intensiva de Hospital Escola, com amostra de 101 idosos. Coleta de dados realizada de novembro de 2017 a maio de 2018, por meio de entrevista, consulta ao prontuário e exame físico. Para análise, realizou-se estatística descritiva e inferencial. Força das associações entre as variáveis aferida pelo odds-ratio e intervalos de confiança de 95%. Nível de significância estatística estabelecido de 5% para todas as análises. Resultados: a amostra estudada apresentava média de idade de 71,39 anos, maioria do sexo masculino, casados e sem escolaridade, com mais de uma comorbidade, dependentes, com pele seca e descamativa e com hematomas nas extremidades. A prevalência de lesão por fricção foi de 28,7%, média de 1,93 lesões por idoso. Verificou-se associação estatisticamente significativa da ocorrência de lesão por fricção com idade, comorbidades, pele seca e descamativa. Conclusão: a prevalência de lesão por fricção foi elevada e associada à idade, comorbidades, pele seca e descamativa e média do tempo do uso de corticoide.

Efectos de la interrelación arco-bracket, desde el microscopio electrónico de barrido / Effects of the arch-bracket interrelation, from the scanning electron microscope

Los alambres en ortodoncia son elementos activos que tienen la capacidad de almacenar energía y liberar fuerzas. Los brackets permiten la unión directa y selectiva entre el arco de alambre y las piezas dentarias, lo que optimiza el efecto de presiones específicas de forma precisa y controlada, transmitiendo el movimiento en los tres sentidos del espacio. Durante el tratamiento de ortodoncia, estos elementos podrían sufrir alteraciones estructurales impidiendo el movimiento dental óptimo. En el presente trabajo de investigación, se analizó la respuesta que tienen el arco de acero inoxidable 0.019" × 0.025" y el slot de brackets de zafiro, en el sector anterior del maxilar superior, cuando ejercen fricción entre sí, antes y después de ser utilizados clínicamente en un tratamiento de ortodoncia. Para esto, las muestras fueron lavadas con alcohol absoluto al 96 % y secadas para ser observadas en el microscopio electrónico de barrido ambiental (MEB) (ESEM - environmental scanning electron microscope), modelo FEI ESEM QuantaTM 200. Los arcos rectangulares fueron analizados por sus cuatro caras y cuatro aristas (superior, inferior, interna y externa; respectivamente) y los slots de brackets de zafiro fueron observados en un corte sagital y dividido en forma lineal en tres mediciones (interna, media y externa). Los datos obtenidos fueron volcados en una planilla de tabulación de datos para su análisis estadístico, mediante el test de normalidad de Shapiro-Wilk para medidas no paramétricas y el test de Fisher. En conclusión, las zonas más afectadas por el desgaste fueron las caras y aristas internas del arco de acero de 0.019" × 0.025", y la medición interna del slot de brackets de zafiro. Ambas presentaban una pérdida de la solución de continuidad en su estructura, evidenciando un área de mayor fricción(AU)

Orthodontic wires are active elements that have the ability to store energy and release forces. The brackets allow the direct and selective bonding between the wire arch and teeth, optimizing the effect of specific pressures in a precise and controlled way, transmitting movement in the three directions of space. During orthodontic treatment, these elements could undergo structural changes preventing optimal dental movement. In the current research work, the response that the 0.019" × 0.025" stainless steel archwire and the sapphire bracket slot have in the anterior sector of the upper jaw when they exert friction on each other, before and after being clinically used in an orthodontic treatment was analyzed. For this purpose, the samples were washed in 96% absolute alcohol and dried to be observed under the environmental scanning electron microscope ESEM (MEB - microscopio electrónico de barrido ambiental), model FEI ESEM QuantaTM 200. The rectangular archwires were analyzed on their 4 faces and 4 edges (upper, lower, internal and external) and the sapphire brackets slots were observed in a sagittal section and linearly divided into three measurements (internal, medium and external). The data obtained were put in a data tabulation spreadsheet for its statistical analysis by using the Shapiro-Wilk normality test for nonparametric measures, and the Fisher test. In conclusion, the areas most affected by wear were the internal face and edges of the 0.019" × 0.025" steel arch and the internal measurement of the sapphire brackets slot. They both presented loss of continuity in their structure, providing evidence of an area of greater friction(AU)

Prevalência de lesões por fricção em idosos com câncer e fatores associados / Skin tear prevalence and associated factors among elderly people with cancer

Objetivo: analisar a prevalência de lesões por fricção em idosos com câncer e fatores associados. Método: estudo transversal e analítico, realizado com 50 idosos, em serviço de Oncologia de um hospital escola, em Teresina-Piauí, Brasil. Utilizaram-se de entrevista, exame físico e prontuário para coleta dos dados, de fevereiro a abril de 2018. Realizaram-se análise descritiva, aplicação do teste Mann-Whitney para observar diferença das médias e da prova exata de Fischer para verificar associação entre desfecho e variáveis independentes. Resultados: média de idade 69,36 anos, maioria do sexo masculino (52,0%), sem escolaridade (38,0%), com comorbidades (74,0%), em uso de anticoagulante (56%) e corticoide (76%), dependentes (76%) e com déficit cognitivo (32%). A prevalência de lesões foi 18%, com localização predominante em membros superiores (64,6%) e de classificação 2b (50%). Os fatores associados foram hematomas nas extremidades (p-valor=0,003), uso de curativo adesivo (p-valor=0,044) e presença de comorbidades (p-valor=0,050). Conclusão: prevalência de lesões por fricção elevada, associada a fatores clínicos. Sugerem-se outras investigações para viabilizar ações preventivas mais eficazes e definir a epidemiologia dessas lesões, uma vez que são subnotificadas em serviços hospitalares de oncologia. (AU)

Objective: To analyze the skin tear prevalence and associated factors in elderly people. Method: It was a cross-sectional and analytical study conducted with 50 elderly patients in the Oncology department of a school hospital, in Teresina-Piauí, Brazil. Interviews, physical exams and medical records were used for data collection from February to April 2018. Descriptive analysis was performed, with the Mann-Whitney test to observe difference in means and Fisher's exact test to verify the association between outcome and independent variables. Results: Mean age of 69.36 years, mostly male (52.0%), without education (38.0%), with comorbidities (74.0%), anticoagulant (56%) and corticoid (76%) use, dependent (76%), and cognitive deficit (32%). There was an 18% prevalence of injuries, mostly in upper limbs (64.6%) and Category 2b (50%). Associated factors were hematoma in the extremities (p-value=0.003), use of adhesive dressing (p-value=0.044), and presence of comorbidities (p-value=0.050). Conclusion: There was a high skin tear prevalence associated with clinical factors. Further investigations are recommended to enable more effective preventive actions and to define the epidemiology of these lesions, since they are underreported in hospital oncology services. (AU)

Objetivo: analizar la prevalencia de lesiones por fricción y factores asociados en ancianos. Método: estudio transversal y analítico, realizado con 50 ancianos, en servicio de Oncología de hospital escolar, en Teresina-Piauí, Brasil. Se utilizaron entrevistas, examen físico y prontuario para recolección de datos, de febrero a abril de 2018. Se realizaron análisis descriptivos, aplicación del test Mann-Whitney para observar diferencia de las medias y exacto de Fischer para verificar la asociación entre desenlace y variables independientes. Resultados: la media de edad fue 69,36, la mayoría del sexo masculino (52%), sin escolaridad (38,0%), con comorbilidades (74,0%), en uso de anticoagulante (56%) y corticoide (76%), dependientes (76%) y con déficit cognitivo (32%). La prevalencia de lesiones fue de 18%, con localización predominante en miembros superiores (64,6%) y de clasificación 2b (50%). Los factores asociados fueron hematomas en las extremidades (p-valor=0,003), uso de curativo adhesivo (p-valor=0,044) y presencia de comorbilidades (p-valor=0,050). Conclusión: la prevalencia de lesiones por alta fricción estuvo asociada con factores clínicos. Se recomiendan otras investigaciones para permitir acciones preventivas más efectivas y definir la epidemiología de estas lesiones, ya que son subreportadas en servicios hospitalarios de oncología. (AU)

Lubricating conditions: effects on friction between orthodontic brackets and archwires with different cross-sections

Abstract Objective: This study investigated the effect of the condition of lubrication on the friction between brackets and NiTi archwires of different rounded cross-sections. Methods: Brackets (Roth, GAC) were affixed to a device connected to a universal testing machine into which segments of archwire were placed (NiTi, Nitinol, GAC) with cross-sections of 0.012-in, 0.016-in and 0.020-in. Once the wire was in the bracket slot, the following lubricants were applied: human saliva (HS: positive control), distilled water (DI), mucin-based (MUC) or carboxymethylcellulose-based (CMC) artificial saliva. In the negative control group, no lubricant was used. The combination between the wire cross-sections and the lubrication condition generated 15 groups with 15 samples each. Data were submitted to two-way analysis of variance and Tukey's test. Results: There was no significant interaction between the wire cross-section and the condition of lubrication (p= 0.901). Irrespective of whether lubricants were used or not, there was a significant increase in friction with an increase in the cross-section of the wire (p< 0.001). For any wire, the group tested in the presence of MUC was not different from that in which HS was applied. On the other hand, when the application of lubricants was suppressed, significantly higher friction values were observed. The CMC group and the DI group demonstrated intermediate behavior. Conclusions: Friction increased with the increase of the cross-section of the NiTi archwire, but regardless of the archwire, friction with MUC artificial saliva was similar to that of HS and lower than in dry conditions.

Resumo Objetivo: este estudo investigou o efeito das condições de lubrificação no atrito entre braquetes e fios de NiTi de diferentes secções transversais. Métodos: os braquetes (Roth, GAC) foram fixados a um dispositivo conectado a uma máquina de ensaio universal, que recebeu segmentos de fio de NiTi (Nitinol, GAC) com secções de 0,012"; 0,016" ou 0,020". Após o fio ter sido instalado no slot do braquete, aplicou-se um dos seguintes lubrificantes: saliva humana (SH: controle positivo), água destilada (AD) ou saliva artificial à base de mucina (MUC) ou de carboximetilcelulose (CMC). No grupo controle negativo, nenhum lubrificante foi utilizado. As combinações entre as secções dos fios e as condições de lubrificação geraram 15 grupos, com 15 amostras cada. Os dados foram submetidos à análise de variância a dois critérios e ao teste de Tukey. Resultados: não houve interação significativa entre a secção do fio e a condição de lubrificação (p = 0,901). Independentemente de ter sido utilizado ou não lubrificante, observou-se elevação significativa do atrito com o aumento da secção transversal do fio (p < 0,001). Para qualquer um dos fios, o grupo testado na presença de MUC não diferiu daquele em que se aplicou SH. Por outro lado, quando suprimiu-se os lubrificantes, constatou-se atrito significativamente mais elevado. Os grupos CMC e AD demonstraram comportamento intermediário. Conclusões: o atrito se elevou com o aumento da secção transversal dos fios de NiTi, mas a despeito do fio, o atrito com a saliva à base de MUC foi similar àquele com a SH e menor do que sob condição a seco.

A comparative analysis of the frictional resistance of esthetic orthodontic wires / Avaliação do atrito de fios ortodônticos estéticos

Abstract Introduction The orthodontic movement is directly influenced by the ability of orthodontic wires to slide through brackets and tubes. Therefore, the main concern during orthodontic movement corresponds to the frictional forces generated at the bracket-orthodontic wire interface. Objective This study aimed to evaluate the frictional resistance of esthetic orthodontic wires. Material and method Fifty test brackets were obtained and divided into five groups (n = 10) based on the type of rectangular orthodontic wire, as follows: conventional metallic wire (Morelli, Brazil) (G1, control group) and esthetic wires (G2, Ortho Organizer; G3, Tecnident; G4, Trianeiro; and G5, TP Orthodontics). The following materials and conditions were used: 0.019 x 0.025-inch wires, ceramic brackets with edgewise prescription, torque and/or angulation of 0°, and 0.022 x 0.028-inch slots. The specimens were tested for their tensile strength using an Instron universal test machine at a speed of 1.0 mm / min and a load cell of 500N. The tensile strength data were analyzed by one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test, with a 5% significance level. Result The frictional resistance (N) of the metallic orthodontic wire (8.07 ± 0.43) was significantly higher than that of the esthetic wires: Ortho Organizer (4.01 ± 0.25), Tecnident (3.87 ± 0.31), Trianeiro (4.47 ± 0.26) and TP Orthodontics (4.49 ± 0.30) (p <0.05), with no significant difference between them (p> 0.05). Conclusion To conclude, the esthetic orthodontic wires tested herein showed less frictional resistance as compared to the conventional metallic wire.

Resumo Introdução O movimento ortodôntico bem sucedido está diretamente relacionado com a capacidade de os fios ortodônticos deslizarem sobre os bráquetes e tubos ortodônticos. Portanto, durante a movimentação ortodôntica a principal preocupação está diretamente ligada a fricção entre o suporte e o fio. Objetivo O objetivo deste estudo foi avaliar a influência de fios ortodônticos estéticos na resistência ao atrito. Material e método Foram utilizados 50 bráquetes-teste divididos em 5 grupos, de acordo com o fio retangular (n=10): G1 - grupo controle: fio metálico convencional (Morelli, Brasil) e fios estéticos (G2 - Ortho Organizer; G3 - Tecnident; G4 - Trianeiro; e, G5 - TP Orthodontics). Todos os fios apresentavam 0,019 x 0,025 polegadas e o bráquete era cerâmico, prescrição Edgewis e, torque e/ou angulação 0° e, canaleta 0,022 x 0,028 polegadas. O teste de resistência ao atrito sob força de tração foi realizado em uma máquina de ensaio universal Instron à velocidade de 1,0 mm/min e célula de carga de 500N. Os dados de resistência ao atrito foram submetidos à análise de variância (ANOVA) um fator e ao Teste de Tukey com nível de significância de 5%. Resultado O atrito (N) do fio metálico (8,07±0,43) foi significativamente maior que os fios ortodônticos estéticos: Ortho Organizer (4,01±0,25), Tecnident (3,871±0,31), Trident (4,47±0,26) e, TP (4,49±0,30) (p<0,05). Nenhuma diferença estatisticamente significativa foi observada entre os fios estéticos (p>0,05). Conclusão Conclui-se que os fios ortodônticos estéticos apresentam menor resistência ao atrito quando comparado ao fio metálico.

Prevalência de lesões por fricção em idosos institucionalizados / Prevalencia de lesiones por fricción enancianosem institución de salud / Prevalence of skin tears in institutionalized older adults

RESUMO Objetivo: analisar a prevalência de lesões por fricção e os fatores de risco associados em idosos institucionalizados. Método: estudo transversal e analítico, realizado com 54 idosos de instituição de longa permanência em Teresina, Piauí, por meio de entrevista, exame físico e prontuário. Dados coletados entre agosto e setembro de 2017. Realizou-se análise descritiva e inferencial, aplicação do teste t de student para observar a diferença das médias e o Odds Ratio na associação entre o desfecho e as variáveis independentes. Resultados: idade média foi de 77,4 anos, 63% homens, 77,8% analfabetos, 88,9% com comorbidades e 55,6% dependentes para atividades da vida diária. A prevalência da lesão foi 20,4%, maioria localizada nos membros inferiores e de categoria 3, não associada estatisticamente a nenhum fator de risco. Conclusão: observou-se elevada prevalência de lesão por fricção. Destaca-se que estes dados ajudam no conhecimento da epidemiologia dessas lesões e no planejamento de medidas preventivas.

RESUMEN: Objetivo: analizar la prevalencia de lesiones por fricción y los factores de riesgo asociados en ancianos institución de salud. Método: estudio trasversal y analítico, que se realizó con 54 ancianos de institución de larga permanencia en Teresina, Piauí, por medio de entrevista, examen físico y prontuario. Se obtuvieron los datos entre agosto y septiembre de 2017. Se realizó análisis descriptivo y de inferencia, aplicación del test t de student para observar la diferencia de los promedios y el Oddis Ratio en la asociación entre el desfecho y las variables independientes. Resultados: la edad media fue de 77,4 años, 63% hombres, 77,8% analfabetos, 88,9% con comorbilidades y 55,6% dependientes para actividades de la vida diaria. La prevalencia da lesión fue 20,4%, mayoría en los miembros inferiores y de categoría 3, no asociada estadísticamente a ningún factor de riesgo. Conclusión: se observó elevada prevalencia de lesión por fricción. Se destaca que estos datos ayudan en el conocimiento da epidemiologia de esas lesiones y en el planeamiento de medidas preventivas.

ABSTRACT Objective: To analyze the prevalence of skin tears and associated risk factors in institutionalized older adults. Method: cross-sectional and analytical study, conducted with 54 older adults from a long-term care institution in Teresina, Piauí, through interviews, physical examinations and medical records. Data were collected between August and September 2017. Descriptive and inferential analysis was performed, with student's t-test applied to observe the difference of the means and the Odds Ratios in the association between the outcome and the independent variables. Results: mean age was 77.4 years, 63.0% men, 77.8% illiterate, 88.9% with comorbidities and 55.6% dependent for activities of daily living. The prevalence of lesions was 20.4%, mostly located in the lower limbs and of category 3, not statistically associated with any risk factor. Conclusion: there was a high prevalence of skin tears. It should be highlighted that these data help in the knowledge of the epidemiology of these injuries and in the planning of preventive measures.

Dermatoses due to physical forces agents

Physical forces agents may induce distinctive skin changes. Pressure and friction induce callus and corn. Callus and corn arise at sites of friction or pressure, particularly palms and soles, and especially the bony prominences of the joints. Pressure, shearing forces, friction, and moisture are main etiologic factors of pressure ulcer. The pressure ulcer is caused by ischemia of the underlying structures of the skin, fat, and muscles. Skin has long been known to be a very radiosensitive organ. Skin changes after radiation exposure follow a predictable course dictated by radiation dose, timing, and the biology of the human inflammatory reaction. When the skin is exposed to radiation, acute radiation dermatitis, chronic radiation dermatitis, skin cancer, and radiation recall dermatitis may be developed.

Sports-related skin conditions

Skin diseases associated with athletic activities can be classified as skin infections, inflammatory reactions, trauma, and abnormal proliferation, depending on the cause of the condition. Athlete's nodule is a generic term for reactive nodules that occur in athletes. It is particularly common in the foot due to tight sneakers, repetitive pressure or friction, and inappropriate choice of shoes or other sports equipment. The diagnosis of black heel (calcaneal petechiae) should be considered when numerous black spots occur on the soles in patients who frequently engage in abrupt movements, such as starts, stops, or leaps. Palmoplantar eccrine hidradenitis may occur in athletes who play baseball, dance, and climb, activities in which repetitive and strong stimuli are applied to the floor of the hands and feet. Painful fat herniation should be suspected in cases of painful skin-colored firm nodules on the feet of athletes who place a large amount of weight on their feet when moving. Itching, urticaria, angioedema, chest tightness, and syncope occurring within 5 minutes after starting exercise should be suspected to be exercise-induced angioedema/anaphylaxis. Excessive force can cause deformation of nails, as in tennis toe and jogger's toenail. For the diagnosis and treatment of sports-related skin diseases, it is essential to pay attention to patients' hobbies and exercise habits, including sports, and to consider the relationship of those habits with the presumed mechanisms of the skin disease. In addition, thorough pre-exercise warm-ups, increasing strength gradually, and wearing proper equipment will help prevent the occurrence of sports-related skin diseases.

Study on the mechanical properties of sutures in the process of suturing / 生物医学工程学杂志

Suture broken, knot slipping and tissue tearing are the main reasons of wound closure failure in clinical operation. Based on this, we simulated the suturing and healing operation by using a biological materials testing machine and investigated the tensile properties before and after knotting, relaxation property and friction property of three common sutures: silk, polyglactin 910 and polypropylene. Results show that the tensile property decreased after knotting. The tensile strength of polyglactin 910 and elongation of polypropylene were the largest. During the relaxation process, the sutures relaxed the most in the first 2 hours. The relaxation from less to more was: polyglactin 910, silk and polypropylene. Coating or monofilament could obviously reduce the surface roughness of sutures, and thus reduce the friction force of the suture-suture interface. The friction force of the suture-suture interface increased with the increasing load but did no change with the increasing velocity. The results can provide an important theoretical basis for the optimizations of suture design and knotting operation.

Clinical Report by using hybrid telescopic double crown Removable Partial Denture on a few remaining teeth with severe periodontal disease / 대한치과보철학회지

The successful results of the treatment using a double crown denture have been reported in several papers for some of the few remaining teeth in patient. In particular, double crown dentures may be an alternative to treatment in cases where the periodontal status is poor and clasp type removable partial dentures are inappropriate (crown/root ratio > 1). In this case, the patient visited clinic with a chief complaint of difficulty in mastication due to loss of posterior teeth and overall teeth mobility. After teeth with severe periodontitis were extracted, treatment plan of mandible is Kennedy class I removable partial denture (RPD) and treatment plan of maxilla is hybrid telescopic double crown RPD with a friction pin. Patient is well adapted after the prosthetic treatment and we report due to achieving satisfactory results in pronunciation, mastication, retention and aesthetics.

Surface analysis of metal clips of ceramic self-ligating brackets / 대한치과교정학회지

OBJECTIVE: The aim of this study was to analyze the surface composition, roughness, and relative friction of metal clips from various ceramic self-ligating brackets. METHODS: Six kinds of brackets were examined. The control group (mC) consisted of interactive metal self-ligating brackets while the experimental group (CC, EC, MA, QK, and WA) consisted of interactive ceramic self-ligating brackets. Atomic force microscopy-lateral force microscopy and scanning electron microscopy-energy-dispersive X-ray spectroscopy were used to analyze the surface of each bracket clip. RESULTS: All the clips in the experimental groups were coated with rhodium except for the QK clip. The results showed that the QK clip had the lowest average roughness on the outer surface, followed by the MA, EC, WA, and CC clips. However, the CC clip had the lowest average roughness on the inner surface, followed by the QK, WA, MA, and EC clips. The QK clip also had the lowest relative friction on the outer surface, followed by the MA, EC, CC, and WA clips. Likewise, the CC clip had the lowest relative friction on the inner surface, followed by the QK, WA, MA, and EC clips. CONCLUSIONS: The surface roughness and relative friction of the rhodium-coated clips were generally higher than those of the uncoated clips.

Effect of different combinations of bracket, archwire and ligature on resistance to sliding and axial rotational control during the first stage of orthodontic treatment: An in-vitro study / 대한치과교정학회지

OBJECTIVE: This study was performed to explore the effect of different bracket, archwire, and ligature combinations on resistance to sliding (RS) and rotational control in first-order angulation. METHODS: Three types of brackets (multi-level low friction [MLF], self-ligating, and conventional brackets) coupled with four nickel-titanium archwires (0.012, 0.014, 0.016, and 0.018-inch diameter) and two stainless steel ligatures (0.20 and 0.25 mm) were tested in different first-order angulations (0°, 2°, 4°, 6°, 8°, 10°, 15°, 20°) by using an Instron universal mechanical machine in the dry state at room temperature. RS value was evaluated and compared by one-way ANOVA. RESULTS: Under the same angulation, the RS values showed the following order: conventional brackets > MLF brackets > self-ligating brackets. The RS was the highest for conventional brackets and showed a tendency to increase. The RS for MLF brackets coupled with thinner archwires and ligatures showed a similar tendency as the RS for the self-ligating bracket. In contrast, the RS for MLF brackets coupled with thicker archwires and ligatures increased like that for conventional brackets. MLF brackets showed the greatest range of critical contact angles in first-order angulation. CONCLUSIONS: The RS in first-order angulation is influenced by bracket design, archwire, and ligature dimension. In comparison with self-ligating and conventional brackets, MLF brackets could express low friction and rotational control with their greater range of critical contact angles.