RESUMO
Abstract Rotational instrumentation is an alternative for the clinical practice of pediatric dentists. However, there are few records in the literature on the clinical and radiographic aspects of treated teeth over time. Objectives: Compare instrumentation time and filling quality between manual (k-file) and rotary (Hyflex EDM®) files, and clinically and radiographically follow-up the treated teeth for 12 months. Moreover, the characteristics of glass ionomer restorations and their interference in the treatment prognosis over time were evaluated. Methodology: In total, 40 children with pulp involvement in primary molars received treatment with Hyflex EDM® or manual rotary files, performed by an operator. Clinical and radiographic aspects were observed at different times to determine the effectiveness of each technique. Results: The rotary system reduced instrumentation time when compared to the use of manual files (p≤0.05), but there was no difference in filling quality between the groups (p≥0.05). Moreover, both types of instrumentation were effective for 12 months (p≥0.05), and restoration retention influenced the emergence of periapical lesions (p≤0.05). Conclusion: Although rotary files reduce clinical time, the clinical and radiographic aspects of both techniques were similar over 12 months. Moreover, restoration retention has been shown to be related to treatment prognosis.
RESUMO
Este trabalho trata da relação entre depressão e doença cardiovascular (DCV), a qual tem relevância na piora clínica de pacientes portadores de insuficiência cardíaca (IC), bem como no aumento da taxa de hospitalizações e morbimortalidade. A depressão é mais prevalente em pacientes com IC que na população em geral, devido a hipóteses sobre o aumento da estimulação neuro-hormonal e das citocinas, mesmo em presença de menor comprometimento cardíaco. Os desfechos clínicos negativos oriundos desta associação levam ao ônus público e social. Esta revisão abordará os mecanismos psicossociais e fisiopatológicos determinantes desta associação, bem como o tratamento, o diagnóstico e prevenção da depressão em pacientes com insuficiência cardíaca. Espera-se suscitar reflexões sobre o cuidado clínico dos portadores de IC, considerando seus estressores psicossociais de adaptação para melhor monitoramento, logo, detecção precoce desta associação.
This paper deals with the relationship between depression and cardiovascular disease, which has relevance to clinical worsening in patients with heart failure (HF), as well as increased rate of hospitalizations and mortality. Depression is more prevalent in patients with HF in the general population, due to assumptions about the increased neurohormonal stimulation and cytokines, even in the presence of minor cardiac involvement. Outcomes from this negative association lead to public and social burden. This review will discuss the pathophysiological mechanisms and psychosocial determinants of this association, as well as treatment, diagnosis and prevention of depression in patients with heart failure. Expected to generate reflections on the clinical care of patients with HF, considering its adaptation to psychosocial stressors better monitoring, so early detection of this association.
El presente trabajo trata sobre la relación entre depresión y enfermedad cardiovascular, la cual tiene relevancia en el empeoramiento clínico de pacientes con insuficiencia cardíaca, así como en el aumento de la tasa de hospitalización y mortalidad. La depresión tiene mayor prevalencia en pacientes con insuficiencia cardíaca que en la población general, debido a las diversas hipótesis sobre el aumento de la estimulación neurohormonal y de las citoquinas, incluso en presencia de compromiso cardíaco menor. Los resultados clínicos de esta asociación negativa suponen una carga pública y social. En esta revisión se abordarán los mecanismos psicosociales y los determinantes fisiopatológicos de esta asociación, así como el diagnóstico, tratamiento y prevención de la depresión en pacientes con insuficiencia cardíaca. Se espera generar algunas reflexiones sobre la atención clínica de los pacientes portadores de insuficiencia cardíaca, considerando los factores de estrés psicosociales de adaptación para un mejor seguimiento, y por ende, la detección precoz de esta asociación.