Accuracy of the dental pulp sensibility test using cold spray for the diagnosis of pulp diseases: an observational clinical study

The dental pulp sensibility test is one of the main auxiliary resources for the diagnosis of pulp pathologies, and its accuracy is still debatable. This cross-sectional observational study evaluated the accuracy of the pulp sensibility test (PST) using cold spray (1,1,1,2-tetrafluoroethane) for the diagnosis of pulp diseases and determined the effect of individual and clinical variables on the reliability of this test. The paper was designed following the STROBE statement. Sixty patients with indications for primary endodontic treatment were selected and examined from August 2017 to July 2018. Data collection was performed through interviews, clinical/radiographic examinations and the PST. The results of the cold test, along with data on sex, age, the tooth type regarding the root number, and the presence of restorations and caries, as well as the recent consumption of analgesics, were recorded. The presence of bleeding within the pulp chamber was used as the gold standard to compare with the clinical diagnosis and to identify the true-positive, false-positive, true-negative, and false-negative responses. The accuracy of PST achieved in subgroups of individual and clinical variables was compared using the chi-square test with a significance level of 5% (p < 0.05). The PST with the use of cold spray showed a sensitivity of 0.88, a specificity of 1.00, a positive predictive value of 1.00, a negative predictive value of 0.86, and an accuracy of 0.93. The accuracy of the cold spray was not affected by individual or clinical variables. The PST with the use of cold spray is an accurate and reliable method for determining the diagnosis of pulp diseases, especially in cases of pulp vitality or irreversible pulpitis.

Exame preventivo de papanicolaou: percepção das acadêmicas de enfermagem de um centro universitário do interior de Goiás / Nursing students perception on Papanicolaou test / Prueba de papanicolaou: percepcion de alumnas de enfermeria de un centro universitario del interior del estado de Goias

O câncer de colo de útero representa uma neoplasia maligna que ocorre com muita frequência no Brasil, causando grande número de óbitos. Vários são os fatores de risco que levam ao câncer de colo uterino, embora essa neoplasia possa ser prevenida, principalmente, quando diagnosticada precocemente. O objetivo com este estudo foi conhecer as vivências das acadêmicas de enfermagem diante do exame de Papanicolaou, desvelando seu conhecimento sobre a importância do procedimento, frequência e sentimentos experimentados durante sua realização. Trata-se de uma pesquisa descritiva, com abordagem qualitativa, realizada com 20 acadêmicas de uma faculdade de enfermagem no interior do Estado de Goiás. O 2º período foi considerado porque é um momento em que as alunas ingressaram recentemente no curso; o 4º e o 6º período, porque é quando elas já estão em processo de formação específica, fazendo estágios e compreendendo a rotina do curso; e o 8º período, porque é quando elas já estão prestes a concluir o curso. O instrumento de coleta de dados utilizado foi a entrevista semiestruturada. Os resultados da pesquisa mostraram que, mesmo com os sentimentos de vergonha, constrangimento e desconforto experimentados pelas acadêmicas, no geral elas realizam o exame e sabem sobre a importância da prevenção para evitar a doença. Os depoimentos obtidos permitiram refletir sobre a necessidade de repensar a prática do exame preventivo, bem como desvelar procedimentos que assegurem cuidados aliados a condutas humanizadas a esse e procedimento, tão necessário para diminuir a incidência de câncer cervical.

The cervical cancer is a malign neoplasm that occurs frequently in Brazil and it is the cause of many deaths. There are several risk factors that lead to cervical cancer, even though it can be prevented if diagnosed early on. This study aimed to understand nursing students' experiences with the Pap test and to identify their knowledge about this procedure's importance, its frequency and the feelings experienced during the test's performance. This is a descriptive research with a qualitative approach conducted with 20 students of a nursing school in the state of Goiás' countryside. First year students were chosen as they had been recently admitted to the university; second and third year's as they are in the process of specialization, in an internship program and understand better the course's routine; last year students because they are close to course's completion. The data was collected through semi-structured interviews. The results indicated that the shame, embarrassment and discomfort experienced by the students were not an obstacle to perform the test and that they are aware of its importance to the disease's prevention. The statements obtained allow us to reflect on the need to rethink the practice of Pap smear and to ensure that its procedures associate care with a humane conduct as it is an essential test to cervical cancer prevention and control.

El cáncer de cuello uterino es una neoplasia maligna qué ocurre con mucha frecuencia en Brasil y que también causa muchas muertes. Hay varios factores de riesgo qué conllevan a este tipo de cáncer que puede ser prevenido, principalmente, cuando se tiene un diagnóstico precoz. El presente estudio tuvo como objeto conocer la experiencia de alumnas de enfermería con la prueba de Papanicolaou e identificar la importancia que le atribuyen a dicho procedimiento, frecuencia y sentimientos durante la realización de la prueba. Se trata de una investigación cualitativa descriptiva llevada a cabo con 20 alumnas de una facultad de enfermería del interior del Estado de Goiás. Fueron consideradas alumnas del 1er año porque eran recién ingresadas, del 2º y 3º porque estaban en proceso de formación con prácticas y conocían bien la rutina del curso y del último año porque estaban cerca de terminar los estudios. Los datos se recogieron mediante entrevistas. Los resultados indicaron que, a pesar de la vergüenza y molestia, las alumnas realizaban la prueba y conocían la importancia de la prevención para evitar la enfermedad. Los testimonios permitieron reflexionar sobre la necesidad de repensar la práctica de la prueba preventiva y garantizar que el procedimiento aúne cuidados y conductas humanizadas puesto que se trata de una prueba fundamental para disminuir la incidencia del cáncer cervical.