Análise da qualidade de instrumentos rotatórios utilizados por acadêmicos de odontologia / Quality analysis of rotatory instruments used by undergraduate dentistry students

Avaliar, por meio de questionário e análise morfológica em microscopia eletrônica de varredura, a qualidade de instrumentos rotatórios usados por acadêmicos de odontologia. Material e Método: 24 alunos do 5º ao 8º períodos foram aleatoriamente selecionados e abordados quanto: freqüência de uso, período de troca, meio de armazenagem, forma de limpeza, métodos de desinfecção e esterilização, disposição de auto-uso. Para a análise morfológica foram recolhidas pontas diamantadas #1014 (P) e brocas carbide esféricas #2 (B) (n = 48) com tempo médio de uso de 6 meses a 1 ano, as quais foram analisadas por meio de microscopia eletrônica de varredura observando: corrosão, integridade das lâminas de corte, retenção de resíduos, perda de diamante. Os dados foram analisados de forma descritiva. Resultados: o questionário mostrou: 67% usavam P e B semanalmente; 62% nunca as trocaram; 67% armazenavam em broqueiro de metal; 54% utilizavam água, sabão e escova para limpeza e 17% não limpavam; 50% utilizavam imersão em álcool para desinfecção; 58% não esterilizavam os instrumentos rotatórios; 29% relatavam não concordar com o uso em si mesmo de P e B. A análise morfológica em MEV mostrou que, em B: 42% apresentavam corrosão leve; 79% perda parcial da integridade das lâminas; 60% apresentavam pequena quantidade de resíduo; 79% eram inadequadas para uso, e, em P: 67% possuiam corrosão leve; 90% presença de resíduo; 48% perda de diamante; 83% eram inadequadas para o uso. Conclusão: concluiu-se que não há relação dos atos de armazenagem, limpeza e esterilização de instrumentos com qualidade morfológica dos instrumentos rotatórios. As brocas e as pontas diamantadas empregadas não apresentavam qualidade adequada para o uso clínico.

To evaluate the rotatory instruments quality of academics by questionnaire and morphologic analysis by electronic scanning microscopy. Materials and Methods: twenty four students in different dental school program periods were asked about use frequency, exchange, period of exchange, storage form, cleaning form, disinfection and sterilization methods, capacity of rotatory instruments self use. For morphologic analysis had been collected diamond burs #1014 (P) and carbide burs #2 (B) (n = 48), with average use time among 6 months and 1 year, which had been analyzed by electronic scanning microscopy observing: corrosion, blade integrity, residues retention, and diamond loss. The data had been tabulated and analyzed of descriptive form. Results: the questionnaire showed: 67% use P and B weekly, 62% never had changed them; 67% store in metallic bur stand, 54% use water, soap and brush for cleaner and 17% do not clean, 50% use alcohol immersion for disinfection, 58% do not sterilized the rotatory instruments , 29% do not agree use P and B in itself. The SEM analyses showed that in B: 42% few corrosion; 79% partial loss of blade integrity; 60% small amount of residue; 79% inadequate for use and, in P: 67% few corrosion; 90 % presence of residue; 48% diamond loss; 83% inadequate for use. Conclusion: it can be conclude that there is not relation of storage form, cleaning form and instruments sterilization with the morphologic rotatory instruments quality. Burs and diamond burs used by academics do not present quality for clinical use.

Nontuberculosis mycobacteria at a multiresistant tuberculosis reference center in Bahia: clinical epidemiological aspects

OBJETIVO: Examine the prevalence and clinical/epidemiological aspects of patients with nontuberculous mycobacteria (NTM) isolated from sputum provided by an outpatient clinic specializing in the treatment of multiresistant tuberculosis (MRTB) in Bahia, Brazil. METHODS: All patients followed at the MRTB outpatient clinic of the Octávio Mangabeira Specialized Hospital (HEOM) were evaluated retrospectively from July 1998 to July 2003. All patients underwent direct examinations and cultures to identify the mycobacteria species found during initial and subsequent evaluations. The following variables were recorded: age, gender, clinical symptoms and signs, pre-existing lung disease, prior TB treatment, HIV serology, and NTM species. Categorical and quantitative variables were respectively characterized using proportions and measures ± SD. RESULTS: NTM were isolated in 19 of 231 patients (8.2 percent; 95 percentCI: 5.2 percent-12.3 percent), with the following species distribution: 58 percent (11/19) M. chelonae/abscessus; 16 percent (3/19) M. avium-intracellular complex; 16 percent (3/19) M. kansasii; and 11 percent (2/19) M. fortuitum. HIV serology was positive for just one patient (5 percent), from whom M. chelonae/abscessus was isolated. Productive coughing was observed in all cases. American Thoracic Society (ATS) diagnostic criteria for NTM lung disease were observed in 14 patients (74 percent). CONCLUSION: The prevalence of NTM isolated from patients referred to the MRTB outpatient clinic in Bahia was 8.2 percent (CI 95 percent: 5.2 percent-12.3 percent); rapid-growth mycobacteria (M. chelonae/M. fortuitum) were the most frequently isolated (68 percent).