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1.
Braz. j. oral sci ; 20: e219022, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1254545

ABSTRACT

Minimally invasive dentistry is based on conservative techniques for the treatment of initial caries lesions, the so-called white spot lesions. One of the conservative maneuvers includes the use of enamel resin infiltrant: a low viscosity material that penetrates the enamel pores to stop lesion progression. Aim: Therefore, this case report aimed to describe the clinical case of a 28-year-old female patient under routine consultation, in which a radiographic examination showed the presence of two incipient caries lesions in the left upper premolars. Methods: The application of a resin infiltrating agent (Icon®, DMG ­ Hamburg, Germany) was chosen as treatment to stop caries lesions progression. Conclusion: The use of this conservative technique can be considered a promising approach for the prevention of dental tissue wear, and the resin infiltrant is considered an effective material


Subject(s)
Humans , Female , Composite Resins , Dental Caries , Conservative Treatment
2.
Rev. colomb. cir ; 37(1): 156-161, 20211217. fig
Article in Spanish | LILACS | ID: biblio-1357604

ABSTRACT

Introducción. El prolapso uretral es una entidad poco común, con una incidencia estimada de 1 en 3000 mujeres. Se presenta cuando la mucosa uretral sobresale espontáneamente más allá del meato uretral. Es una patología poco diagnosticada dada su baja frecuencia y de allí la importancia de conocer sobre su presentación, diagnóstico y tratamiento. El objetivo de este artículo fue presentar el caso de una paciente de 10 años con diagnóstico de prolapso uretral y su manejo quirúrgico. Caso clínico. Paciente femenina de 10 años, que consultó por cuadro clínico de 1 año de evolución consistente en dolor en región urogenital, que se irradiaba a hipogastrio, asociado a pujo y disuria, a quien se le diagnosticó prolapso uretral y se realizó corrección quirúrgica de mucosa uretral prolapsada mediante técnica de Kelly-Burnham modificada. Conclusión. El prolapso uretral es una entidad que con frecuencia es diagnosticada erróneamente pues su diagnóstico es eminentemente clínico. Si bien se ha descrito el tratamiento médico en primera instancia, éste tiene una alta tasa de recurrencia, por lo que en estos casos se prefiere la resección quirúrgica del tejido prolapsado.


Introduction. Urethral prolapse is a rare entity, with an estimated incidence of 1 in 3,000 women. It occurs when the urethral mucosa spontaneously protrudes beyond the urethral meatus. It is a poorly diagnosed pathology given its low frequency and hence the importance of knowing about its presentation, diagnosis and treatment. The objective of this article was to present the case of a 10-year-old patient with a diagnosis of urethral prolapse and its surgical management. Clinical case. A 10-year-old female patient, who consulted for a 1-year clinical picture consisting of pain in the urogenital region, radiating to the hypogastrium, associated with pushing and dysuria, who was diagnosed with urethral prolapse and a surgical correction of the urethral mucosa was performed prolapsed by modified Kelly-Burnham technique. Conclusion. Urethral prolapse is an entity that is frequently misdiagnosed because its diagnosis is eminently clinical. Although medical treatment has been described in the first instance, it has a high recurrence rate, so surgical resection of the prolapsed tissue is preferred in these cases.


Subject(s)
Humans , Prolapse , Urethra , Pediatrics , General Surgery , Conservative Treatment
3.
Rev. argent. cir ; 113(4): 482-486, dic. 2021. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1356959

ABSTRACT

RESUMEN Los quistes hepáticos simples (QHS) son las lesiones hepáticas más frecuentes. Cursan habitualmente asintomáticas, aunque cuando alcanzan gran tamaño pueden causar síntomas. El objetivo del presente artículo es presentar una complicación excepcional de los QHS. Presentamos a una mujer de 61 años con historia de QHS múltiples que acude a Urgencias por dolor abdominal brusco sin antecedente traumático. Ante la sospecha de rotura quística espontánea, se realiza tomografía computarizada (TC) abdominal que confirma el diagnóstico. Se decide tratamiento conservador con buena evolución. Tras el episodio agudo es intervenida quirúrgicamente realizándose destechamiento de los quistes. a rotura de los QHS es una complicación excepcional que habitualmente cursa con dolor abdominal. Debido a su baja frecuencia no existe un tratamiento estándar. Se acepta que el tratamiento conservador es una buena opción en pacientes sin signos de peritonitis, mientras que la cirugía urgente está indicada en pacientes con abdomen agudo.


ABSTRACT Simple liver cysts (SLC) are the most common liver tumors. They are usually asymptomatic but large cysts may produce symptoms. The aim of this article is to report a rare complication of SLC. We report the case of a 61-year-old woman with a history of multiple SLCs who sought medical care due to sudden abdominal pain not associated with trauma. A probable diagnosis of spontaneous rupture was made, and the patient underwent computed tomography (CT) scan of the abdomen which confirmed the suspicion. Conservative treatment was decided, with favorable outcome. After the acute episode the patient underwent surgery and the cysts were unroofed. Rupture of SLC is a rare complication that usually presents with abdominal pain. There is no standard of care due to the low incidence of this complication. The conservative approach is a good option in patients without signs of peritonitis, while emergency surgery is indicated in patients with acute abdomen.


Subject(s)
Humans , Female , Middle Aged , Rupture, Spontaneous , Cysts/diagnostic imaging , Conservative Treatment , Abdomen, Acute/surgery , Liver , Women , Wounds and Injuries , Cysts , Diagnosis , Abdomen , Abdomen, Acute
4.
Rev. ADM ; 78(5): 283-290, sept.-oct. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1348323

ABSTRACT

Los cambios en la vida, así como también en el campo de la Odontología, deben ser para mejorar siempre en todos los aspectos posibles. Y muchos de los cambios recientes en la Odontología Restauradora están encaminados a la utilización de materiales estéticos para remplazo de restauraciones metálicas previas, sin generar certeza total de ser mejores opciones. Esto ha generado un marcado incremento en la tendencia a practicar, más enfáticamente, el remplazo de restauraciones previas (AU)


Changes in life, as so in the field of Dentistry, should always be for the improvement on most possible aspects. Many of the recent changes in Restorative Dentistry are focus on the use of cosmetic materials to replace previous metallic restorations, without total certainty of being better options. This has generated a marked increase in the tendency to practice, more emphatically, the replacement of previous restorations (AU)


Subject(s)
Humans , Male , Female , Dental Restoration Failure , Dental Caries/therapy , Dental Materials , Dental Restoration, Permanent , Recurrence , Metal Ceramic Alloys , Esthetics, Dental , Conservative Treatment
5.
Coluna/Columna ; 20(3): 174-180, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1339749

ABSTRACT

ABSTRACT Objective To evaluate the immediate correction capacity of the Wood-Chêneau-Rigo brace (WCR), produced using digital technological resources and robotic engineering, in primary and secondary curves of adolescent idiopathic scoliosis (AIS). Methods A retrospective study was conducted of 138 patients with a diagnosis of AIS and who received a WCR brace from a laboratory that makes orthoses and orthopedic prostheses between 2019 and 2021. These individuals were submitted to an independent analysis of the radiographic parameters by a single researcher, the main outcome of which was the standardized measurement of the main and secondary curves using the Cobb method. The radiographs analyzed were performed in orthostasis before and immediately after the adaptation of the brace on the patient. The correction capacity was calculated as the ratio of the difference between the pre- and post-brace curves to the pre-brace curve. Results The mean correction with the WCR was 48.4% for the main curve and 41.0% for the secondary curve. The level of correction of the main curve was significantly higher in patients with a main curve with the apex of convexity in the thoracolumbar region (p = 0.004), especially in the left thoracolumbar region (p = 0.010); curves of magnitude between 10º and 24.9º (p <0.001); and curves classified as simple (p <0.001). Conclusion The use of the WCR, which is produced using modern technological resources, was effective in the immediate correction of AIS. Long-term studies on this new modality of conservative scoliosis treatment are necessary. Level of evidence III; Retrospective study.


RESUMO Objetivo Avaliar a capacidade de correção imediata do colete Wood-Chêneau-Rigo (WCR), produzido com recursos tecnológicos digitais e de engenharia robótica, em curvas primárias e secundárias de escoliose idiopática do adolescente (EIA). Métodos Realizou-se um estudo retrospectivo com 138 pacientes com diagnóstico de EIA que adquiriram o colete WCR entre 2019 e 2021 em um laboratório de produção de órteses e próteses ortopédicas. Esses indivíduos foram submetidos à análise independente dos parâmetros radiográficos por um único pesquisador, tendo como desfecho principal a medida padronizada das curvas principal e secundária pelo método de Cobb. As radiografias analisadas foram realizadas em ortostase antes e imediatamente depois da adaptação do colete no paciente. A capacidade de correção foi calculada pela razão entre a diferença das curvas pré e pós-colete e a curva pré-colete. Resultados A média de correção da curva primária com o WCR foi de 48,4% e a da curva secundária foi de 41,0%. O nível de correção da curva primária foi significativamente maior nos pacientes com curva principal com ápice da convexidade na região toracolombar (p = 0,004), principalmente toracolombar à esquerda (p = 0,010); curvas com magnitude entre 10º e 24,9º (p < 0,001) e curvas do tipo simples (p < 0,001). Conclusões O colete WCR, produzido com modernos recursos tecnológicos, foi eficaz na correção imediata da EIA. São necessários estudos a longo prazo sobre essa nova modalidade de tratamento conservador da escoliose. Nível de Evidência III; Estudo retrospectivo.


RESUMEN Objetivo Evaluar la capacidad de corrección inmediata del corsé de Wood-Chêneau-Rigo (WCR), producido con recursos tecnológicos digitales e ingeniería robótica, en curvas primarias y secundarias de la escoliosis idiopática del adolescente (EIA). Métodos Se realizó un estudio retrospectivo de 138 pacientes con diagnóstico de EIA que adquirieron el corsé WCR entre 2019 y 2021 en un laboratorio de producción de ortesis y prótesis ortopédicas. Estos individuos fueron sometidos a un análisis independiente de los parámetros radiográficos por un solo investigador, siendo el resultado principal la medición estandarizada de las curvas principal y secundaria por el método de Cobb. Las radiografías analizadas se tomaron en bipedestación antes e inmediatamente después de la adaptación del corsé al paciente. La capacidad de corrección se calculó por la razón entre la diferencia entre las curvas de antes y de después del uso del corsé y la curva de antes del corsé. Resultados La corrección promedio de la curva primaria con el WCR fue del 48,4% y de la curva secundaria fue del 41,0%. El nivel de corrección de la curva primaria fue significativamente más grande en pacientes con una curva principal con vértice de la convexidad en la región toracolumbar (p = 0,004), principalmente toracolumbar a la izquierda (p = 0,010); curvas con magnitud entre 10º y 24,9º (p < 0,001) y curvas simples (p < 0,001). Conclusiones El uso corsé WCR, producido con modernos recursos tecnológicos, fue efectivo en la corrección inmediata de la EIA. Se necesitan estudios a largo plazo sobre esta nueva modalidad de tratamiento conservador de la escoliosis. Nivel de evidencia III; Estudio retrospectivo.


Subject(s)
Humans , Scoliosis , Analysis of Variance , Conservative Treatment
6.
Rev. Asoc. Odontol. Argent ; 109(2): 107-118, ago. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1348414

ABSTRACT

Objetivos: Realizar una revisión de la literatura sobre métodos de rehabilitación mínimamente invasivos, y presentar un caso clínico acerca de un nuevo procedimiento denominado sistematización adhesiva temporaria (SAT), destinado a pacientes que presentan pérdida de sustancia dentaria y que se caracteriza como un abordaje terapéutico predecible para transferir el proyecto rehabilitador (encerado) a la boca del paciente mediante 3 pasos bien definidos y con objetivos específicos. Caso clínico: Un paciente adulto joven de sexo masculino con desgastes severos por bruxismo es rehabilitado temporalmente con resinas compuestas (SAT) para devolver la anatomía perdida en forma adhesiva y conservadora, siguiendo un protocolo de abordaje terapéutico predecible denominado EGOP (estéticamente guiado y oclusalmente protegido). Este procedimiento, que es considerado muchas veces de transición previo a las restauraciones finales, nos permite evaluar la estética, la oclusión y mejorar la comunicación entre el equipo de trabajo para poder realizar el cambio por restauraciones cerámicas en forma gradual. En aquellos pacientes que necesitan rehabilitaciones totales producto del desgaste dentario severo, la SAT puede ser una herramienta que facilite al odontólogo la posibilidad de restablecer los patrones oclusales y estéticos perdidos sin la necesidad de realizar desgastes dentarios y provisionales como se hacía clásicamente (AU)


Aims: To carry out a literature review on minimally-invasive rehabilitation methods and to present a clinical case on a new procedure called Temporary Adhesive Systemization (TAS), intended for patients that show a considerable loss of dental substance, characterized by a predictable therapeutic approach to transfer the rehabilitation diagnosis wax-up through 3 well defined steps and with specific objectives to the patient´s dentition. Clinical case: A young adult male patient with severe wear due to bruxism is temporarily rehabilitated with composite resins (TAS) to return the lost anatomy in a conservative way, following a predictable therapeutic approach protocol called EGOP (aesthetically guided and occlusally protected). This procedure, which is often considered transitional prior to final restorations, allows us to evaluate aesthetics, occlusion, improve communication between the working team and to be able to gradually change for ceramic restorations. In patients that need full rehabilitation due to severe dental erosion, TAS is a predictable procedure that helps the dentist to re-establish the loss of aesthetical and occlusal patterns, without the need of preparing the teeth for the classic provisional restorations (AU)


Subject(s)
Humans , Male , Middle Aged , Tooth Erosion/therapy , Bruxism/rehabilitation , Dental Restoration, Temporary , Esthetics, Dental , Tooth Wear/therapy , Conservative Treatment , Ceramics , Dental Bonding , Lithium Compounds , Composite Resins , Dental Occlusion
7.
Rev. colomb. cardiol ; 28(4): 374-377, jul.-ago. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1351935

ABSTRACT

Resumen La coagulación intravascular diseminada es un proceso sistémico caracterizado por la activación generalizada de la coagulación, que tiene el potencial de causar trombosis vascular, hemorragia y falla orgánica. En raras ocasiones, las anomalías vasculares, como el aneurisma aórtico abdominal, pueden desencadenar coagulación intravascular diseminada crónica. Los aneurismas aórticos grandes, su disección y su expansión son factores de riesgo. En estos casos predominan los síntomas subclínicos y la coagulopatía solo se identifica mediante pruebas de laboratorio. Existe evidencia limitada basada en la experiencia de series de casos de coagulación intravascular diseminada crónica como complicación en pacientes con aneurisma aórtico abdominal. Además, la duración y la respuesta terapéutica a la heparina no se conocen bien, principalmente en los pacientes con manejo conservador. Se considera un desafío diagnóstico y terapéutico debido a la baja frecuencia de presentación. A continuación, se describen las características clínicas y paraclínicas, así como el tratamiento, de un paciente con aneurisma aórtico abdominal asociado con coagulación intravascular diseminada crónica.


Abstract Disseminated intravascular coagulation is a systemic process characterized by the widespread activation of coagulation with the potential for causing vascular thrombosis, hemorrhage and organ failure. Rarely, vascular anomalies like abdominal aortic aneurysm can trigger chronic disseminated intravascular coagulation. Large aortic aneurysms, dissection and expansion are risk factors. In these cases, subclinical symptoms predominate and coagulopathy is only identified by laboratory tests. Nowadays there is limited evidence based on experience from case series of chronic disseminated intravascular coagulation as complication in patients with abdominal aortic aneurysm. Furthermore, duration and therapeutic response with heparin therapy are not well known, mainly in those patients with conservative management. It is considered a diagnostic and therapeutic challenge due to the low presentation frequency. The clinical characteristics, laboratory and treatment of a patient with abdominal aortic aneurysm associated with chronic disseminated intravascular coagulation are described below.


Subject(s)
Humans , Aortic Aneurysm, Abdominal , Disseminated Intravascular Coagulation , Blood Coagulation , Risk Factors , Conservative Treatment
8.
Rev. bras. ginecol. obstet ; 43(7): 570-577, July 2021. tab, graf
Article in English | LILACS | ID: biblio-1347252

ABSTRACT

Abstract Sacral colpopexy is one of the standard procedures to treat apical pelvic organ prolapse. In most cases, a synthetic mesh is used to facilitate the colposuspension. Spondylodiscitis is a rare but potentially serious complication that must be promptly diagnosed and treated, despite the lack of consensus in the management of this complication.We report one case of spondylodiscitis after a laparoscopic supracervical hysterectomy and sacral colpopexy treated conservatively. We also present a literature review regarding this rare complication. A conservative approach without mesh removal may be possible in selected patients (stable, with no vaginal lesions, mesh exposure or severe neurologic compromise). Hemocultures and culture of imageguided biopsies should be performed to direct antibiotic therapy. Conservative versus surgical treatment should be regularly weighted depending on clinical and analytical progression. A multidisciplinary team is of paramount importance in the follow-up of these patients.


Resumo A colpopexia sacral é um dos procedimentos padrão para tratar o prolapso de órgãos pélvicos apical. Na maioria dos casos, uma tela sintética é usada para facilitar a colposuspensão. A espondilodiscite é uma complicação rara, mas potencialmente grave, que deve ser prontamente diagnosticada e tratada, apesar da falta de consenso no manejo dessa complicação. Relatamos um caso de espondilodiscite após histerectomia supracervical laparoscópica e colpopexia sacral tratada conservadoramente. Também apresentamos uma revisão da literatura sobre essa complicação rara. Uma abordagem conservadora sem remoção da tela pode ser possível em pacientes selecionadas (estáveis, sem lesões vaginais, exposição da tela ou comprometimento neurológico grave). Hemoculturas e cultura de biópsias guiadas por imagem devemser realizadas para direcionar a antibioticoterapia. O tratamento conservador versus o cirúrgico deve ser avaliado regularmente, dependendo da progressão clínica e analítica. Uma equipe multidisciplinar é de suma importância no acompanhamento desses pacientes.


Subject(s)
Humans , Female , Discitis/etiology , Uterine Prolapse/surgery , Laparoscopy , Gynecologic Surgical Procedures , Surgical Mesh/adverse effects , Pelvic Organ Prolapse/surgery , Conservative Treatment
9.
Rev. bras. ortop ; 56(3): 368-371, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1288671

ABSTRACT

Abstract Objective To determine the modifiable risk factors associated with severity of plantar fasciitis and to formulate an objective scoring system for indexing plantar fasciitis in the non-athletic population. Methods This was a prospective observational study. The main outcome measure was the association of a modifiable risk factor, which was measured with the Pearson coefficient (R-value) and the level of significance, which was kept as p < 0.05. Result In a sample size of 50 patients, the body mass index (BMI) and ill-cushioned shoes were found to be significantly associated with pain in plantar fasciitis. All the other risk factors were either non-modifiable or had no significant association. Conclusion Based on available data and further interpretation, an index was be formulated, named as Ranjeet-Kunal Index for Scoring Plantar fasciitis (RKISP), which can be successfully used for not only grading plantar fasciitis but also prognosticating the conservative management of the same, thus deciding the modality of treatment.


Resumo Objetivo Determinar os fatores de risco modificáveis associados à gravidade da fasciíte plantar e formular um sistema objetivo de pontuação para indexação da doença na população não atlética. Métodos Estudo observacional prospectivo. A principal medida de desfecho foi a associação de um fator de risco modificável, mensurada pelo valor de R (coeficiente de Pearson) e pelo nível de significância de p < 0,05. Resultados Em uma amostra de 50 pacientes, o índice de massa corporal (IMC) e calçados com amortecimento inadequado foram associados de maneira significativa à dor na fasciíte plantar. Todos os demais fatores de risco eram não modificáveis ou não apresentaram associação significativa. Conclusão Com base nos dados à disposição e sua interpretação, um índice, denominado Índice de Ranjeet-Kunal de Pontuação da Fasciíte Plantar (RKISP, em inglês) , foi formulado e utilizado com sucesso não apenas na classificação da fasciíte plantar, mas também na determinação do prognóstico de seu tratamento conservativo, auxiliando a escolha da modalidade terapêutica.


Subject(s)
Humans , Risk Factors , Fasciitis, Plantar , Chronic Pain , Conservative Treatment
10.
Rev. bras. ortop ; 56(3): 394-398, May-June 2021. graf
Article in English | LILACS | ID: biblio-1288668

ABSTRACT

Abstract Osteonecrosis is a disease that rarely affects the bones of the foot. When present, it is more common in the talus and in the navicular. Cases of osteonecrosis of the intermediate cuneiform are extremely rare, and after a thorough bibliographic review, we found only five reports in the literature, all of them in pediatric patients. Below, we present the case of an adult patient with osteonecrosis of the intermediate cuneiform that was resistant to conservative treatment. Thus, we proposed a surgical approach with good results. Level of Evidence V; Therapeutic Studies; Expert Opinion.


Resumo A osteonecrose é uma doença que raramente afeta os ossos do pé. Quando presente, ela é mais comum no tálus e no navicular. Casos de osteonecrose do cuneiforme intermédio são extremamente raros, e após uma revisão bibliográfica minuciosa encontramos apenas cinco relatos na literatura, sendo todos eles em pacientes pediátricos. A seguir, apresentamos o caso de um paciente adulto com osteonecrose do cuneiforme intermédio resistente ao tratamento conservador. Portanto, propusemos uma abordagem cirúrgica com bom resultado. Nível de Evidência V; Estudos Terapêuticos; Opinião de Especialista.


Subject(s)
Humans , Adult , Osteonecrosis , Tarsal Bones , Conservative Treatment
11.
Odontol. Clín.-Cient ; 20(1): 68-73, jan.-mar. 2021. ilus, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1367957

ABSTRACT

A queilite actínica (QA) é uma desordem potencialmente maligna que se desenvolve principalmente no lábio inferior, decorrente da exposição crônica a luz solar. O objetivo desse estudo é elucidar, a partir de uma revisão da literatura, as abordagens não cirúrgicas mais atuais para o tratamento da QA. Foi realizada uma busca nas bases de dados PubMed, Scielo e Cochrane, sendo obtidos 280 artigos e após aplicação dos critérios de elegibilidade, foram utilizados no presente traba lho 16 estudos. Várias abordagens, como, diclofenaco sódico, mebutato de ingenol, imiquimode, 5-fluorouracil, fludroxicortida e terapia fotodinâmica, são apontadas e estudadas como forma de tratamento para a QA. Entretanto, faltam trabalhos para que se estabeleça um consenso sobre a terapêutica não-cirúrgica mais adequada... (AU)


Actinic cheilitis (AC) is a potentially malignant disorder that develops mainly on the lower lip, result ing from a chronic exposure to sunlight. The objective of this study is to elucidate, from a literature review, the most current non-surgical approaches for the treatment of AC. A search was performed in the PubMed, Scielo and Cochrane databases, obtaining 280 papers and after applying the eligibility cri teria, 16 studies were used in the present study. Various approaches, such as diclofenac sodium, ingenol mebutate, imiquimod, 5-fluorouracil, fludroxycortide and photodynamic therapy are pointed out and studied as a form of treatment for AC. However, there is a lack of work to establish a consensus on the most appropriate non-surgical therapy... (AU)


Subject(s)
Photochemotherapy , Cheilitis/drug therapy , Conservative Treatment , Lip Diseases , Sunlight , Lip
12.
Rev. habanera cienc. méd ; 20(2): e3247, mar.-abr. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1251795

ABSTRACT

Introducción: El reemplazo de restauraciones defectuosas representa la mayor parte de la práctica del odontólogo, lo que lleva a una perdida mayor del remanente dentario ante cada reemplazo. Objetivo: Determinar si existe variación del criterio clínico en alumnos frente a la decisión de recambio en restauraciones de resina compuesta previo y posterior al reacondicionamiento. Material y Métodos: Estudio analítico transversal. Se contó con una muestra de 40 estudiantes de quinto año de un universo de 72. Se utilizó un set fotográfico, que contaba con restauraciones defectuosas, en uno o más parámetros según los criterios RYGE/USPHS, las cuales posteriormente se reacondicionaron, por lo que se contaba con las fotografías del antes y del después del tratamiento conservador. Se realizó una encuesta a partir de las fotografías mostradas en la cual debían indicar la elección de tratamiento. Resultados: Se observó que hay una gran variación de elección de tratamiento previo a ser reparadas con tratamientos conservadores: 38 por ciento y no conservador de 62 por ciento y frente a la misma restauración de resina posterior a haber sido intervenida la elección de tratamiento conservador fue de 83 por ciento y no conservador 17 por ciento. Mediante el Test de McNemar se obtuvo un p<0.0001 entre elección de tratamiento conservador por sobre el no conservador posterior a haber sido realizada el reacondicionamiento de la restauración. Conclusiones: Existe un cambio en la percepción sobre la indicación de tratamiento de restauraciones defectuosas, a favor de una alternativa conservadora, después de que han sido intervenidas con procedimientos mínimamente invasivos(AU)


Introduction: The replacement of defective restorations, which leads to a greater loss of the dental remnant before each replacement, represents the large majority of the dentist's practice. Objective: To determine if there is any variation in students´ clinical criterion in relation to the decision of replacement of composite resin restorations prior to and following reconditioning. Material and Methods: A cross-sectional analytical study was conducted. The sample was composed of 40 fifth-year students in a universe of 72. A set of photographs showing defective restorations in one or more parameters evaluated according to RYGE / USPHS criteria was used. They were later reconditioned, so there were photographs prior to and following conservative treatment. Based on the photographs shown, a survey in which they had to indicate the choice of treatment was performed. Results: We observed that there is a great variation in the choice of treatment prior to the repair with conservative treatments (38 percent) and non-conservative ones (62 percent), compared to the same resin restoration after the choice of conservative treatment (83 percent) and non-conservative one (17 percent). Using the McNemar Test, p<0.0001 was obtained between the choice of conservative treatment over the non-conservative one after the restoration reconditioning had been performed. Conclusions: There is a change in perception of the indication of treatment to repair defective restorations towards a conservative alternative after they have undergone minimally invasive procedures(AU)


Subject(s)
Humans , Students , Composite Resins , Dentists , Conservative Treatment , Cross-Sectional Studies , Surveys and Questionnaires , Dental Restoration, Temporary/methods , Reference Parameters
13.
Rev. argent. cir ; 113(1): 83-91, abr. 2021. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1288177

ABSTRACT

RESUMEN Antecedentes: la ascitis es una complicación de frecuente aparición en el paciente cirrótico que al producir un aumento de la presión intraabdominal puede originar una hernia de la pared abdominal; el defecto umbilical latente es su localización más habitual. Objetivo: presentar la incidencia y los beneficios que ofrece la resolución electiva de la patología um bilical en estos pacientes. Material y método: se presentan 15 pacientes, todos masculinos, que fueron intervenidos por hernia umbilical sintomática en forma electiva en el medio hospitalario. El período comprende desde enero del año 2015 a enero de 2019. El 100% de los enfermos cursa un cuadro de cirrosis hepática, con antecedentes de etilismo crónico. Se efectuó la reparación de la hernia con cierre del defecto y malla supraaponeurótica de polipropileno en la mayoría de los casos. Resultados: los pacientes fueron evaluados desde el punto de vista clínico con la escala (score) de Child en el preoperatorio. Se procedió a la evacuación de la ascitis en todos los casos y el control posoperatorio se efectuó cada 30 días los primeros 6 meses. Luego dos veces al año. No se evidenció recidiva. Dos pacientes no volvieron al control luego del año de la cirugía y 1 paciente falleció por la enfermedad de base a los 6 meses de la cirugía. Conclusiones: los enfermos con cirrosis hepática y hernia umbilical deben ser intervenidos quirúrgica mente en forma electiva. La observación y abstención quirúrgica conllevan el riesgo de rotura del saco herniario con alta morbimortalidad.


ABSTRACT Background: Background: Ascites is a common complication in patients with cirrhosis, and elevated intraabdominal pressure can lead to the development of abdominal wall hernias, particularly in patients with latent umbilical defects. Objectives: The aim of this study was to report the incidence and benefits of elective surgery for the management of umbilical hernias in cirrhotic patients with ascites. Material and methods: Between January 2015 and January 2019 15 patients with symptomatic umbi lical hernia underwent elective surgery in a public hospital; 100% were men with a history of alcoho lism and were hospitalized due to liver cirrhosis. The defect was closed, and a polypropylene mesh was placed in the supra-aponeurotic plane in most cases. Results: The preoperative risk was estimated using the Child-Pugh score. Ascites was evacuated in all the cases. Patients were followed-up every 30 days during the first 6 months and then twice a year. There were no hernia recurrences. Two patients were lost to follow-up 12 months after surgery and 1 patient died 9 months after the procedure due to progression of cirrhosis. Conclusions: Patients with liver cirrhosis and umbilical hernia should undergo elective surgery. Wat chful waiting is associated with higher risk of hernia rupture and high morbidity and mortality.


Subject(s)
Humans , Hernia, Umbilical/complications , Liver Cirrhosis , Ascites , Hernia, Abdominal , Conservative Treatment , Hernia , Hernia, Umbilical/drug therapy
14.
Rev. colomb. reumatol ; 28(1): 76-79, ene.-mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1341364

ABSTRACT

RESUMEN La enfermedad de Dieterich o necrosis avascular de la cabeza de los metacarpianos es una enfermedad muy poco frecuente, con poco más de 50 casos reportados en la literatura. De etiología desconocida, clínicamente se puede manifestar de forma variable, desde asintomática hasta con evidente inflamación y limitación funcional dolorosa de la articulación metacarpofalángica afectada. Presentamos el caso de un paciente de 82 anos que presentaba dolor a nivel de la articulación metacarpofalángica del tercer dedo de la mano derecha, de un año de evolución, sin causa aparente. La exploración física no evidenciaba limitación funcional, ni dolor; tampoco se objetivó eritema, tumefacción o efecto masa. Se realizó un estudio radiológico con diagnóstico de enfermedad de Dieterich avanzada, estableciendo tratamiento conservador con antiinflamatorios no esteroideos con mejoría clínica significativa.


ABSTRACT Dieterich's disease, or avascular necrosis of the metacarpal head, is a very rare disease, with just over 50 cases reported in the literature. Of unknown aetiology, it can manifest clinically in a variable way, from asymptomatic to obvious inflammation and painful functional limitation of the affected metacarpophalangeal joint. The case is presented of an 82-yearold patient who presented with pain at the level of the metacarpophalangeal joint of the third finger of the right hand of 1 year of duration without apparent cause. The physical examination showed no functional limitation or pain. Furthermore, no erythema, swelling, or mass effect was observed. A radiological study was carried out, leading to a diagnosis of advanced Dieterich's disease. Conservative treatment was started with nonsteroidal anti-inflammatory drugs, with a significant clinical improvement.


Subject(s)
Humans , Male , Aged, 80 and over , Osteonecrosis , Disease , Rare Diseases , Diagnosis , Conservative Treatment , Head , Metacarpophalangeal Joint
15.
Rev. bras. ortop ; 56(1): 18-23, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1288641

ABSTRACT

Summary Cervical and root pain due to herniated disc is one a common cause of a visit to an orthopedic surgeon. It is important to know how to diagnose, treat and initially. What are the best options to treat a herniated disc nowadays? The present article reviews the literature and updates on the clinical and surgical treatment of cervical disc herniation.


Resumo A dor cervical e radicular devido à hérnia de disco é uma causa comum de uma visita a um cirurgião ortopédico. É importante saber diagnosticar, tratar e inicialmente. Quais são as melhores opções para tratar a hérnia de disco hoje em dia? Este artigo faz uma revisão da literatura e atualização sobre o tratamento clínico e cirúrgico da herniação do disco cervical.


Subject(s)
Humans , Cervical Vertebrae , Conservative Treatment , Intervertebral Disc Displacement , Intervertebral Disc Displacement/surgery , Intervertebral Disc Displacement/diagnosis , Intervertebral Disc Displacement/therapy
16.
Rev. Ciênc. Plur ; 7(1): 235-244, jan. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1284540

ABSTRACT

Introdução:As manchas dentárias, dentre elas a hipoplasia do esmalte,corresponde a um dos motivos que fazem com que os pacientes busquem alterações no seu sorriso.O tratamento proposto deve ser sempre o mais conservador possível e buscar devolver a autoestima do paciente. Objetivo:Este trabalho objetivou apresentarum relato de caso clínico de paciente do sexo feminino, 26 anos, insatisfeita com a estética do seu sorriso por apresentar dentes escurecidos e hipoplasia de esmalte na face vestibular, em incisivo superior.Descrição do caso:Ao exame clínico foi observado escurecimento fisiológico e hipoplasia de esmalte no incisivo lateral superior esquerdo (22).O plano de tratamento proposto foi clareamento dental pela técnica associada (técnica de consultório + técnica caseira), remoção da mancha hipoplásica de formaminimamente invasiva e restauração em resina composta direta. Conclusões:Através de um correto diagnóstico, associado a uma técnica e seleção de material adequado, foi possível conseguir excelência estética com preservação de estrutura dentária sadia (AU).


Introduction:Dental stains, including enamel hypoplasia, correspond to one of the reasons that make patients seek changes in their smile. The proposed treatment should always be as conservative as possible and seek to restore the patient's self-esteem.Objective:This study aimedto present a clinical case report of a 26-year-old female patient, dissatisfied with the aesthetics of her smile as she had darkened teeth and enamel hypoplasia on the vestibular face, in anupper incisor. Case description:On clinical examination, physiological darkening and enamel hypoplasia were observedon the left upper lateral incisor (22). The proposed treatment plan was dental bleaching using the associated technique (In-office bleaching+ at-home bleaching), removal of the hypoplastic stain in a minimally invasive manner and restoration in direct composite resin.Conclusions:Through a correct diagnosis, associated with a technique and selection of suitable material, waspossible to achieve aesthetic excellence with preservation of healthy dental structure (AU).


ntroducción: Las manchas dentales, incluida la hipoplasia del esmalte, corresponden a una de lasrazones que hacenquelos pacientes busquencambios em susonrisa. El tratamiento propuestosiempredebe ser lo másconservador posible y tratar de restablecerla autoestima del paciente.Objetivo: Este estudio tuvo como objetivo presentarun informe de caso clínico de una paciente de 26 años de edad, insatisfechacon la estética de susonrisa, ya que habíaoscurecidolosdientes y la hipoplasia del esmalte en lasuperficie vestibular, en el incisivo superior.Descripcióndel caso: Enelexamen clínico, se observó oscurecimiento fisiológico e hipoplasia del esmalte en el incisivo lateral superior izquierdo (22). El plan de tratamiento propuestofueel blanqueamiento dental utilizando la técnica asociada (técnica de consultorio + técnica casera), eliminación de la mancha hipoplásica de maneramínimamente invasiva y restauraciónen resina compuestadirecta. Conclusiones: A través de un diagnóstico correcto, asociado con una técnica y selección de material adecuado, fueposible lograr laexcelencia estética conlapreservación de una estructura dental sana (AU).


Subject(s)
Humans , Female , Adult , Tooth Bleaching , Composite Resins , Dental Enamel Hypoplasia , Conservative Treatment , Brazil , Photography, Dental/instrumentation , Incisor
17.
Rev. Fac. Odontol. (B.Aires) ; 36(83): 57-66, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1343658

ABSTRACT

El objetivo de este reporte de caso clínico es presentar una rehabilitación integral adhesiva resuelta por alumnos de grado de la Facultad de Odontología de la Universidad de Buenos Aires (FOUBA), bajo un protocolo de abordaje terapéutico que simplifica su realización. Esta sistematización hace foco en un abordaje completamente aditivo con la finalidad de devolver la salud, la función y la estética de manera predecible. Un paciente de 55 años concurrió a la consulta por motivos estéticos. En el diagnóstico se evidenciaron desgastes severos producto de la parafunción. Se realizó una rehabilitación oral adhesiva seleccionando a la cerámica vítrea como material restaurador. El diagnóstico y la comprensión de su etiología son fundamentales para realizar un tratamiento conservador con restauraciones adheridas y con alto grado de predictibilidad, que se prolongará en el tiempo, gracias a la utilización de una placa orgánica y a los controles de mantenimiento correspondientes (AU)


Subject(s)
Humans , Male , Middle Aged , Bruxism/rehabilitation , Ceramics , Dental Bonding , Esthetics, Dental , Patient Care Planning , Periodontitis/therapy , Argentina , Schools, Dental , Dental Cavity Preparation , Conservative Treatment , Inlays , Mouth Rehabilitation
19.
Acta otorrinolaringol. cir. cabeza cuello ; 49(3): 216-220, 2021. tab, ilus, graf, tex
Article in Spanish | LILACS, COLNAL | ID: biblio-1292715

ABSTRACT

Los carcinomas adenoides quísticos son tumores extremadamente raros, para los cuales la cirugía es el pilar terapéutico; sin embargo, el abordaje quirúrgico puede estar contraindicado en función del tamaño tumoral, el compromiso de estructuras adyacentes o enfermedades concurrentes. En estos casos, la radioterapia externa definitiva puede ofrecer un adecuado control tumoral y alivio de síntomas. El presente reporte de caso describe un paciente con un tumor irregular que rodea la circunferencia de la tráquea, el cual genera disminución de la luz traqueal, en quién se decidió realizar una reducción de volumen de la lesión tumoral con argón plasma, seguido de colocación de un stent en Y (traqueal, bronquial izquierdo y bronquial derecho) y, posteriormente, realizar un tratamiento definitivo con radioterapia externa con técnica de intensidad modulada a dosis de 60 Gy en fraccionamiento de 2 Gy. Tres meses después del tratamiento, el paciente se presenta sin evidencia radiológica de adenopatías en la base del cuello o axila, con un stent endotraqueal permeable, sin estenosis y con una disminución del volumen tumoral, por lo que fue posible el retiro del stent.


Adenoid cystic carcinomas are extremely rare tumors, for which surgery is the mainstay of therapy; however, the surgical approach may be contradictory depending on tumor size, involvement of adjacent structures or concurrent diseases. In these cases, definitive external beam radiation therapy can offer adequate tumor control and symptom relief. The present case report describes a patient with an irregular tumor that surrounds the circumference of the trachea, causing a decrease in the tracheal lumen, in whom it was decided to perform a volume reduction of tumor with argon plasma, followed by placement of a Y-stent (tracheal, left bronchial and right bronchial), and subsequent definitive treatment with external radiotherapy with intensity modulated technique at doses of 60 Gy in 2 Gy fractionation. Three months after treatment, the patient presents without radiological evidence of lymphadenopathy at the base of the neck or axilla, with a patent endotracheal stent, with no stenosis and a decrease in tumor volume, for which the removal of the Stent was feasilble.


Subject(s)
Humans , Carcinoma, Adenoid Cystic , Tracheal Neoplasms , Radiotherapy, Intensity-Modulated , Conservative Treatment
20.
Rev. Esc. Enferm. USP ; 55: e20200396, 2021. graf
Article in English | LILACS, BDENF | ID: biblio-1287963

ABSTRACT

ABSTRACT Objective: To develop and validate Nursing Diagnoses statements of the International Classification for Nursing Practice (ICNP®) aimed at the care of people with chronic kidney conditions undergoing conservative treatment. Method: This is a methodological research structured in sequenced construction stages, cross-mapping, content validation by the Delphi Technique by specialist nurses, and categorization of Nursing Diagnoses. Results: Forty-two specialist nurses participated in the first round and 34 in the second. A total of 179 Nursing Diagnoses statements were prepared, categorized according to Roy's adaptation model, of which 160 were validated for content, with Content Validity Index ≥ 0.80. Conclusion: The Diagnoses developed and validated show the modes of adaptation to health of people with chronic kidney conditions undergoing conservative treatment, influenced by biological, psychological, social, and cultural needs, with the Physiological Mode being the most prevalent.


RESUMEN Objetivo: Elaborar y validar enunciados de Diagnósticos de Enfermería de la Clasificación Internacional para Práctica de Enfermería (CIPE®) orientados al cuidado de personas en condiciones renales crónicas en tratamiento conservador. Método: Investigación metodológica estructurada en etapas secuenciadas de construcción, mapeo cruzado, validación de contenido por la Técnica Delphi por enfermeros expertos y categorización de los Diagnósticos de Enfermería. Resultados: Participaron 42 enfermeros expertos en la primera etapa y 34 en la segunda. Fueron elaborados 179 enunciados de Diagnósticos de Enfermería, categorizados según los modos adaptativos de Roy, de los cuales 160 fueron validados cuanto al contenido, con Índice de Validez de Contenido ≥ 0,80. Conclusión: Los Diagnósticos elaborados y validados muestran los modos de adaptación a la salud de personas en condiciones renales crónicas en tratamiento conservador que han sido influidas por necesidades biológicas, psicológicas, sociales y culturales, siendo el Modo Fisiológico el que más predominó.


RESUMO Objetivo: Elaborar e validar enunciados de Diagnósticos de Enfermagem da Classificação Internacional para a Prática de Enfermagem (CIPE®) voltados para o cuidado de pessoas em condições renais crônicas em tratamento conservador. Método: Pesquisa metodológica estruturada em etapas sequenciadas de construção, mapeamento cruzado, validação de conteúdo pela Técnica Delphi por enfermeiros especialistas e categorização dos Diagnósticos de Enfermagem. Resultados: Participaram 42 enfermeiros especialistas na primeira rodada e 34 na segunda. Foram elaborados 179 enunciados de Diagnósticos de Enfermagem, categorizados segundo os modos adaptativos de Roy, dos quais 160 foram validados quanto ao conteúdo, com Índice de Validade de Conteúdo ≥ 0.80. Conclusão: Os Diagnósticos elaborados e validados retratam os modos de adaptação à saúde de pessoas em condições renais crônicas em tratamento conservador, influenciadas por necessidades biológicas, psicológicas, sociais e culturais, sendo o Modo Fisiológico o mais predominante.


Subject(s)
Nursing Diagnosis , Renal Insufficiency, Chronic , Standardized Nursing Terminology , Classification , Conservative Treatment
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