RESUMO
En la actualidad, la prevención de caries es lo más importante en la profesión odontológica. Entre los tratamientos de prevención se encuentran los sellantes de fosas y fisuras que, con el pasar del tiempo se ha demostrado su eficiencia; sin embargo, si no se realiza un correcto diagnóstico, este en lugar de ser un aliado, puede resultar contraproducente. En este estudio se hizo un análisis de los factores personales y características dentales del niño que, toman en cuenta los estudiantes, para la colocación de sellantes de fosas y fisuras en las piezas dentales de los pacientes. Se realizó un cuestionario donde cada una de las preguntas representaba un factor y una característica. Como conclusión se obtuvo que los criterios de decisión utilizados por los estudiantes tanto de clínicas II como de clínicas III, fueron acertados. Si se toma la cantidad de criterios aplicados, de los 12 en total, todos ellos informados en la literatura científica, los alumnos de clínicas II utilizan 10 de ellos y los de clínicas III 8 de ellos, por lo que se puede decir que el criterio de los primeros es más acertado que el de los segundos.
The prevention of caries is the important in the dental profession. Among the prevention treatments are the sealants of pit and fissure, whose efficiency has been proven over time, however, if a correct diagnosis is not performed, this rather than being an ally can be counterproductive. In this study an analysis was made of, the personal factors and dental characteristics of the child that are taken into account by the students, for the placement of sealants for pit and fissure in children. It was done through a questionnaire where each of the questions represented a factor and a characteristic. In conclusion, it was obtained that the decision criteria used by the students of both clinics II and clinics III were right.If we take the number of criteria applied,12 in total, all of them reported in the scientific literature, the students of clinics II use 10 of them and those of clinics III 8 of them, so it can be said that the criterion of the first is more accurate than that of the seconds.
RESUMO
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder, compromising the motor neuron, characterized by progressive muscle weakness, with reserved prognosis. The diagnosis is based on inclusion and exclusion clinical criteria, since there is no specific confirmation test. The objective of this research is to critically examine the main diagnosis instrument - El Escorial revisited, from the World Federation of Neurology (1998). Of the 540 patients with initial ALS diagnosis, either probable or definite, seen at UNIFESP-EPM, 190 underwent thorough investigation, following regular clinical and therapeutic treatment for over two years. Thirty patients (15.78 percent) had their diagnosis completely changed. The false-positive diagnoses were related to: early age, clinical presentation of symmetry, weakness greater than atrophy, symptomatic exacerbation. In addition, three patients with myasthenia gravis developed framework for ALS, suggesting the post-synaptic disability as a sign of early disease.
Esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa, que compromete o neurônio motor, caracterizada por fraqueza muscular progressiva, com prognóstico reservado. O diagnóstico é baseado na inclusão e exclusão de critérios clínicos, uma vez que não existe um teste de confirmação específica. O objetivo desta pesquisa é analisar criticamente o instrumento de diagnóstico principal - El Escorial revisited, da Federação Mundial de Neurologia (1998). Dos 540 pacientes com diagnóstico inicial de ELA, seja provável ou definitiva, vistos pela UNIFESP-EPM, 190 foram submetidos a investigação aprofundada, após tratamento clínico e terapêutico regular há mais de dois anos. Trinta pacientes (15,78 por cento) tiveram seu diagnóstico mudado completamente. Os diagnósticos falso-positivos foram relacionados à idade precoce, a apresentação clínica da simetria, a fraqueza superior a atrofia, exacerbação sintomática. Além disso, três pacientes com miastenia gravis desenvolveram quadro de ELA, sugerindo a lesão pós-sináptica como um sinal precoce da doença.