Effects of Red and Infrared Laser Therapy in Patients with Tinnitus: A Double-Blind, Clinical, Randomized Controlled Study Combining Light with Ultrasound, Drugs and Vacuum Therapy.

BACKGROUND: tinnitus is a symptom with no specific cause known to date, and there are no associated pharmacogenomics of hearing disorders and no FDA-approved drugs for tinnitus treatment. The effectiveness of drug treatments is not reproducible on idiopathic patients and inexistent in refractory patients. Personalized treatments for these patients are a great clinical need. Our study investigated the outcome of potential alternative and complementary treatment modalities for idiopathic and refractory tinnitus patients. METHODS: we were the first to evaluate the tinnitus handicap inventory (THI) score changes over the course of treatment up to 15 days after complete cessation of treatment for novel transmeatal low-level laser therapy (LLLT) modalities using light alone, as well as LLLT combined with vacuum therapy (VT), ultrasound (US), Ginkgo biloba (GB) and flunarizine dihydrochloride (FD), while also comparing all treatment outcomes with laser puncture (LP), FD alone and GB alone. RESULTS: a positive treatment outcome (superior to a placebo effect) was achieved by using either LP or transmeatal LLLT, whereas short-term antagonistic effects of VT, US, GB and FD when combined with LLLT. For transmeatal LLLT, an improvement in the treatment outcome was observed by increasing the irradiation time from 6 min to 15 min (with 100-mW of applied laser power at 660 nm). Finally, a lasting therapeutic effect higher than the placebo was observed at 15 days after treatment upon combining LLLT with VT, GB or by using FD alone, by using the transmeatal LLLT alone or by using LP. CONCLUSIONS: LP and Transmeatal LLLT can be promising alternative treatments for idiopathic and refractory tinnitus patients. Future studies should investigate the long-term effects of LLLT in tinnitus patients, as well as the dosimetry and wavelength of transmeatal LLLT.

Can photobiomodulation restore anosmia and ageusia induced by COVID-19? A pilot clinical study.

Along with other COVID-19 clinical manifestations, management of both olfactory and gustatory dysfunction have drawn a considerable attention. Photobiomodulation (PBM) has emerged to be a possible effective therapy in restoring taste and smell functionality, but the evidence is scarce. Hence, the present pilot study is aimed to evaluate the effectiveness of intranasal and intraoral PBM administrations in management of anosmia and ageusia respectively. Twenty Caucasian subjects who diagnosed with anosmia and ageusia were recruited. Visual analogue scale was utilised to evaluate patients' self-reported for both olfactory and gustatory functionality. The laser-PBM parameters and treatment protocols for anosmia and ageusia were as follows respectively: 660 nm, 100 mW, two points intranasally, 60 J/session, 12 sessions; dual wavelengths (660 nm and 808 nm), 100 mW, three points intraorally, 216 J/session, 12 sessions. Our results showed a significant functionality improvement of both olfactory and gustatory functionality. Extensive studies with large data and long-term follow-up period are warranted.

Publication Trends Studies Involving Disabled Persons with Dental Care Needs: A 20-Year Bibliometric Analysis

ABSTRACT Objective: To evaluate scientific production on disabled persons with dental care needs over a 20-year period. Material and Methods: The search was conducted in the PubMed database using the MeSH terms "Disabled Persons" AND "Dentistry". Three researchers selected articles based on readings of the title, abstract and full text. The articles were categorized according to periodical, country, study design, subject and classification of comorbidities and associated disorders. Three hundred ninety-seven articles published in 140 periodicals were included. Results: The periodicals Special Care in Dentistry (54), Dental Clinics of North America (14) and British Dental Journal (14) accounted for 21% of the publications. The studies were conducted in 50 countries, with the United States accounting for 33%. More than half (52%) of the studies had a cross-sectional design. The main subject addressed was oral diagnosis and most of the comorbidities were generalized disabilities. Conclusion: Although a large number of the periodicals have contributed to knowledge building on disabled persons with dental care needs, the number of articles is small compared to other fields of dentistry. Moreover, important gaps in knowledge persist and projects with better methodological designs are needed to offer a more substantial contribution to clinical practice.

Enhanced thermal and photo-stability of a para-substituted dicumyl ketone intercalated in a layered double hydroxide.

A ketodiacid, 4,4'-dicarboxylate-dicumyl ketone (3), has been intercalated into a Zn, Al layered double hydroxide (LDH) by a coprecipitation synthesis strategy. The structure and chemical composition of the resultant hybrid material (LDH-KDA3) were characterized by powder X-ray diffraction (PXRD), FT-IR, FT-Raman and solid-state 13C{1H} NMR spectroscopies, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), thermogravimetric analysis (TGA), and elemental analysis (CHN). PXRD showed that the dicarboxylate guest molecules assembled into a monolayer to give a basal spacing of 18.0 Å. TGA revealed that the organic guest starts to decompose at a significantly higher temperature (ca. 330°C) than that determined for the free ketodiacid (ca. 230°C). Photochemical experiments were performed to probe the photoreactivity of the ketoacid in the crystalline state, in solution, and as a guest embedded within the photochemically-inert LDH host. Irradiation of the bulk crystalline ketoacid results in photodecarbonylation and the exclusive formation of the radical-radical combination product. Solution studies employing the standard myoglobin (Mb) assay for quantification of released CO showed that the ketoacid behaved as a photoactivatable CO-releasing molecule for transfer of CO to heme proteins, although the photoreactivity was low. No photoinduced release of CO was found for the LDH system, indicating that molecular confinement enhanced the photo-stability of the hexasubstituted ketone. To better understand the behavior of 3 under irradiation, a more comprehensive study, involving excitation of this compound in DMSO-d6 followed by 1H NMR, UV-Vis and fluorescence spectroscopy, was undertaken and further rationalized with the help of time-dependent density functional theory (TDDFT) electronic quantum calculations. The photophysical study showed the formation of a less emissive compound (or compounds). New signals in the 1H NMR spectra were attributed to photoproducts obtained via Norrish type I α-cleavage decarbonylation and Norrish type II (followed by CH3 migration) pathways. TDDFT calculations predicted that the formation of a keto-enol system (via a CH3 migration step in the type II pathway) was highly favorable and consistent with the observed spectral data.

Removal of Imidacloprid from Water by Microalgae Nannochloropsis sp. and Its Determination by a Validated RP-HPLC Method.

The large-scale use of pesticides is one of the main causes of the dramatic degradation of our environment. Pesticides such as imidacloprid (IMID) have been linked to declines in bee health and toxicity to other beneficial insects. They pose a threat to human health due to their persistence in the environment and accumulation in the food chain. Therefore, it is essential to test possible environmentally-friendly solutions for their elimination. The present study evaluates the efficiency of microalgae Nannochloropsis sp. for the removal of IMID from synthetic wastewater. The influence of aeration, light, and the presence of UV radiation on the degradation of IMID were factors considered in the study. A rapid RP-HPLC method was developed and validated for the analysis and quantification of IMID in the context of bioremediation with microalgae. Nannochloropsis sp. removed 4.39 µg mL-1 from an initial content of 9.59 µg mL-1 (reaching approximately 50%) of IMID in the first 20 h. This study demonstrated that the removal of IMID by the marine microalgae Nannochloropsis sp. is both effective and light-dependent.

Compound odontoma causing impaction of primary tooth in a 4-year-old child: case report / Impacção de dente decíduo por presença de odontoma composto em criança de 4 anos: relato de caso

Objetivo: relatar um caso raro de impacção de um incisivo decíduo inferior pela presença de odontoma composto, bem como descrever a sua abordagem clínica. Relato de caso: paciente do sexo masculino, com 4 anos de idade, apresentava ausência do incisivo lateral decíduo inferior esquerdo. O exame radiográfico mostrou impacção do incisivo não erupcionado próximo a estruturas radiopacas sugestivas de odontoma composto. O paciente foi acompanhado por dois anos, momento em que se realizou abordagem cirúrgica do caso. Após a cirurgia, a hipótese de diagnóstico de odontoma composto foi confirmada e com o acompanhamento ocorreu a erupção dos incisivos centrais permanentes inferiores. O paciente foi encaminhado para tratamento ortodôntico. Considerações finais: esse relato de caso aborda um caso raro de odontoma composto associado à não erupção de dente decíduo, uma vez que odontomas costumam ser detectados preferencialmente na segunda década de vida do paciente, sendo associados à impacção de dentes permanentes. Além disso, apresenta um protocolo de abordagem clínica para esses casos quando diagnosticados em idade precoce no paciente infantil.(AU)

Objective: to report a rare case of impaction of a primary mandibular incisor due to the presence of a compound odontoma and describe its clinical management. Case report: a 4-year-old boy presented with a "missing" primary left mandibular lateral incisor. Radiographs showed impaction of the unerupted incisor by adjacent radiopaque structures consistent with a compound odontoma. The patient was recalled periodically for 2 years, at which time surgical excision was performed. The diagnosis of compound odontoma was confirmed histologically, and the permanent mandibular central incisors erupted uneventfully; the patient was referred for orthodontic treatment. Final considerations: this case report describes an unusual case of compound odontoma associated with an unerupted deciduous tooth; odontomas are rare in this age range, occurring predominantly in the second decade of life and in association with impaction of permanent teeth. We also propose a protocol for clinical management of such early-onset cases.(AU)

New Post-COVID-19 Biosafety Protocols in Pediatric Dentistry

Abstract The most recent Severe Acute Respiratory Syndrome - COVID-19 - caused by coronavirus infection (SARS-CoV-2) has high-virulence transmission and direct human contagiousness by proximity. Thus, the considerable occupational risk in pediatric dentistry is evident, given the nature and form of procedures performed in an outpatient setting. Thus, the aim of this paper was to identify and contextualize technical and scientific information available to date aimed at preventing and minimizing risks for patients, caregivers and professionals. The results indicate that protective measures are being developed considering procedures according to risks and benefits, and five points stand out: 1. Regulation of resumption of elective procedures, screening and scheduling patients; 2. Restructuring clinical environment and infection control; 3. Improvement of personal protective equipment and biosafety recommendations; 4. Maximization of the use of non-invasive techniques, use of high-powered dental suction, and absolute isolation of the operative field; and 5. Minimization of the use of air-water syringe, dental spittoon and high-speed handpiece. The measures to be taken require reflection for the restart of a "new clinical practice", especially aiming at behavioral and structural changes regarding operational biosafety.

Aging, sexuality and nursing care: the elderly woman's look.

OBJECTIVE: to analyze the perception of elderly women about sexuality and practice of nursing care in this context. METHOD: a descriptive qualitative study. Fifty elderly women from Guanambi City - Bahia State were interviewed in 2016. Data collection technique was direct interview by using an unstructured script. Analysis of the semantic content described was carried out, and two empirical categories: the elderly woman's view of nursing care in the promotion of sexual health and experience of sexuality in the elderly; and nursing care in the context of women's aging. RESULTS: it has been noted that the elderly women are afraid to talk about sexuality, especially with health professionals. By influences of society, they often exclude this issue of health care for elderly women. FINAL CONSIDERATIONS: changes must be thought about assistance provided in relation to sexuality.

Fatores relacionados à qualidade de vida da mulher idosa no município de Guanambi (BA) / Factors related to the quality of life of older women in the municipality of Guanambi, BA

A qualidade de vida é um conjunto de fatores subjetivos e objetivos, que deve ser avaliada, sobretudo no envelhecimento, para compreender as necessidades de vida e saúde dos idosos e propor estratégias de melhoria da qualidade de vida de cada indivíduo. Objetivo: analisar os fatores relacionados à qualidade de vida damulher idosa na cidade de Guanambi (BA), no ano de 2016. Materiais e Métodos: estudo quantitativo, transversal e de caráter descritivo, realizado com 550 idosas. Os instrumentos utilizados na coleta de dados foram um formulário semi-estruturado de diagnóstico situacional e o World Health Organization Quality of Life (WHOQOL-Bref) para mensurar a qualidade de vida desse segmento populacional. A análise foi realizada por meio da estatística univariada, com cálculos de Qui-Quadrado χ2 , e regressão logística simples. Resultados: As idosas eram em sua maioria analfabetas, aposentadas, sem cônjuge, negras, vivendo em lares multigeracionais e 68,2% com uma percepção positiva quanto a sua qualidade de vida, mesmo vivendo em situações adversas. Os fatores que estiveram relacionados à qualidade de vida foram os sociodemográficos, condições de saúde e o estilo de vida, sendo que esses fatores apresentados negativamente contribuem para maior incapacidade, vulnerabilidade e dependência da idosa. Conclusão: O bem-estar da idosa é afetado pela redução de recursos nas dimensões educacionais, psicossociais e econômicas, com isso, a pesquisa sinalizou a necessidade de implantação de ações, voltadas para assistência de saúde, atividades recreativas e de socialização, que possibilitem autonomia e independência, para a melhoria da qualidade de vida. (AU)

Quality of life is a set of subjective and objective factors, which should be evaluated, especially in aging, to understand the life and health needs of older adults and propose strategies to improve the quality of life of each individual. Objectives: to analyze the factors related to the quality of life of older women in the city of Guanambi, BA, in the year 2016. Materials and Methods: a quantitative cross-sectional study with a descriptive character, carried out with 550 older women. The instruments used in the data collection were a semi-structured form of situational diagnosis and the World Health Organization Quality of Life (WHOQOL-Bref) to measure the quality of life of this population segment. The analysis was performed using univariate statistics, with chi-square χ2 calculations, and simple logistic regression. Results: The older adults were mostly illiterate, retired, without spouses, black, living in multigenerational households and 68.2% with a positive perception about their quality of life, even living in adverse situations. The factors that were related to quality of life were sociodemographic, health conditions and lifestyle, and these factors negatively contribute to greater incapacity, vulnerability and dependence of the older adults. Conclusion: The well-being of the older adults is affected by the reduction of resources in the educational, psychosocial and economic dimensions, with this, the research signaled the need to implement actions aimed at health care, recreation and socialization activities, which allow autonomy and independence, to improve the quality of life. (AU)

Aging, sexuality and nursing care: the elderly woman's look / Envejecimiento, sexualidad y cuidados de enfermería: la mirada de la mujer anciana / Envelhecimento, sexualidade e cuidados de enfermagem: o olhar da mulher idosa

ABSTRACT Objective: to analyze the perception of elderly women about sexuality and practice of nursing care in this context. Method: a descriptive qualitative study. Fifty elderly women from Guanambi City - Bahia State were interviewed in 2016. Data collection technique was direct interview by using an unstructured script. Analysis of the semantic content described was carried out, and two empirical categories: the elderly woman's view of nursing care in the promotion of sexual health and experience of sexuality in the elderly; and nursing care in the context of women's aging. Results: it has been noted that the elderly women are afraid to talk about sexuality, especially with health professionals. By influences of society, they often exclude this issue of health care for elderly women. Final considerations: changes must be thought about assistance provided in relation to sexuality.

RESUMEN Objetivo: analizar la percepción de la mujer anciana sobre sexualidad y la práctica del cuidado de enfermería en ese contexto. Método: estudio cualitativo descriptivo. Se entrevistaron a 50 mujeres mayores de la ciudad de Guanambi - estado de Bahía, en 2016. La técnica de recolección de datos fue la entrevista directa con la utilización de un itinerario no estructurado. Se realizó el análisis de contenido semántica descrito, siendo planteadas dos categorías empíricas: la mirada de la mujer anciana sobre el cuidado de enfermería en la promoción de la salud sexual y en la vivencia de la sexualidad en la tercera edad; el proceso del cuidado de enfermería en el contexto del envejecimiento de la mujer. Resultados: se notó que las ancianas tienen temor de hablar sobre sexualidad, principalmente con los profesionales de la salud. Por las propias influencias de la sociedad, muchas veces excluyen esa temática del cuidado de la salud de la mujer anciana. Consideraciones finales: se resalta que los cambios deben ser pensados sobre la asistencia prestada en lo que se refiere a la sexualidad.

RESUMO Objetivo: analisar a percepção da mulher idosa sobre sexualidade e a prática do cuidado de enfermagem nesse contexto. Método: estudo qualitativo descritivo. Foram entrevistadas 50 mulheres idosas de Guanambi - Bahia, em 2016. A técnica de coleta de dados foi a entrevista direta com utilização de um roteiro não estruturado. Foi feita a análise de conteúdo semântica descrita, e foram levantadas duas categorias empíricas: o olhar da mulher idosa sobre o cuidado de enfermagem na promoção da saúde sexual e na vivência da sexualidade na terceira idade; o processo do cuidar de enfermagem no contexto do envelhecimento da mulher. Resultados: notou-se que as idosas têm receio de falar sobre sexualidade, principalmente com os profissionais da saúde. Pelas próprias influências da sociedade, muitas vezes excluem essa temática do cuidado da saúde da mulher idosa. Considerações finais: ressalta-se que mudanças devem ser pensadas sobre a assistência prestada no que cerne à sexualidade.

A velhice no olhar dos acadêmicos de enfermagem, direito e pedagogia / The old age through the view of academics of nursing, law and pedagogy

Este estudo propõe analisar os significados da velhice atribuídos por acadêmicos da Universidade Estadual de Santa Cruz, considerando a importância dessa temática, visto que a velhice faz parte do processo de evolução humana e esta tem se tornado um fenômeno global. Trata-se de uma pesquisa qualitativa, realizada no período de 2014 a 2016 por meio de entrevista semiestruturada, que contou com a participação de vinte e dois acadêmicos dos cursos de Enfermagem, Pedagogia e Direito. Os dados analisados revelaram que a maioria dos acadêmicos apresenta uma maneira singular de entender a velhice. As expectativas estão voltadas para uma vida longeva, um envelhecimento ativo e pautado no respeito. O fato de envelhecer não vem expresso nas falas como algo negativo, mas foram direcionadas preocupações para uma velhice não compartilhada, com ausência do núcleo familiar e a falta de mecanismos na sociedade que garantam de forma efetiva os direitos dos idosos. Apesar das significações e representações positivas no que se refere à velhice, percebeu-se em alguns relatos a falta de proximidade com essa fase. Esta pesquisa mostrou a necessidade de se discutir enquanto sociedade sobre as questões que envolvem os idosos, assim como sobre o preparo do envelhecimento enquanto pessoa que também está envelhecendo, haja vista os reflexos para uma sociedade de idosos, que já é uma realidade. (AU)

This study proposes an analysis of the meanings of old age attributed by academics of the State University of Santa Cruz, considering the importance of this subject, since old age is part of the process of human evolution, which has become a global phenomenon. This is a qualitative research, carried out from 2014 through 2016 by means of a semi-structured interview, which was attended by twenty-two academics from the Nursing, Pedagogy and Law courses. The data analyzed revealed that most academics present a unique way of understanding old age. Expectations are focused on a long life and on an active and respectful aging. The fact of aging is not expressed in the speeches as something negative, but concerns were directed towards an unshared old age, with absence of the family nucleus, and the lack of mechanisms in society that effectively guarantee the rights of the elderly. Despite the positive meanings and representations regarding old age, it has come to attention in some reports the lack of proximity to this phase. This research showed the need to discuss the issues that involve the elderly as a society, as well as discuss the preparation of aging as a person who is also aging, taking into account the reflexes on an elderly society that is already a reality. (AU)

Gerenciamento intra-hospitalar dos resíduos químicos perigosos manuseados pela enfermagem / Intra-hospital management of hazardous chemical waste handled by nurses / Gestión intrahospitalaria de los residuos químicos peligrosos manejados por la enfermería

Objetivo: avaliar as etapas de gerenciamento dos resíduos químicos perigosos - formaldeído e ortoftaldeído, manuseados pela enfermagem. Método: pesquisa descritiva e coleta de dados realizada de setembro a dezembro de 2012, no Hospital Universitário da Universidade de São Paulo, por meio da aplicação da Ficha de Informação de Gerenciamento de Resíduo Químico Perigoso dos resíduos formaldeído e ortoftaldeído gerados, respectivamente, no centro obstétrico e endoscopia. Projeto aprovado por Comitê de Ética em Pesquisa. Resultados: a análise estatística dos dados evidenciou que foram atendidas 3 (13%) especificações do total de 23 (100%) necessárias, com prevalência da identificação, seguida da segregação e nenhuma do transporte interno dos resíduos. Há necessidade de a instituição cumprir as especificações de identificações gerais em relação ao número total de avaliações nos recipientes de resíduos de formaldeído e ortoftaldeído. Conclusão: esta pesquisa proporcionou importantes diretrizes para a elaboração do Plano de Gerenciamento de Resíduos Químicos Perigosos da atenção hospitalar.

Objective: to evaluate the stages in management of hazardous chemical waste handled by nursing staff. Method: in this descriptive study, data was collected from September to December 2012 at São Paulo University Hospital, by applying the Hazardous Chemical Waste Management Information Sheet for formaldehyde and ortho-phthalaldehyde waste in the obstetric center and endoscopy, respectively. The study was approved by the research ethics committee. Results: data analysis showed that 3 (13%) of the 23 (100%) required specifications were met, predominantly identification, followed by segregation, and that none on internal waste transportation were met. The institution needs to comply with general identification specifications regarding the total number of evaluations of formaldehyde and orthophthaldehyde waste containers. Conclusion: this study also yielded important guidelines for preparation of the hospital care Hazardous Chemical Waste Management Plan.

Objetivo: evaluar las etapas de la gestión de los residuos químicos peligrosos - formaldehído y ortoftaldehído, manejados por la enfermería. Métodos: investigación descriptiva y recolección de datos realizada, de septiembre a diciembre de 2012, en el Hospital Universitario de la Universidad de São Paulo, por medio de la aplicación de la Ficha de Información de Gestión de Residuo Químico Peligroso de los residuos de formaldehído y ortoftaldehído generados, respectivamente, en el Centro de Obstetricia y Endoscopía. Proyecto aprobado por el Comité de Ética en Investigación. Resultados: el análisis estadístico de los datos mostró que fueron atendidas 3 (13%) especificaciones del total de 23 (100%) requeridas, con prevalencia de la identificación, seguida por la segregación y ninguna relacionada al transporte interno de los residuos. Es necesario que la institución cumpla con las especificaciones de identificaciones generales en relación al número total de evaluaciones en los recipientes de residuos de formaldehído y ortoftaldehído. Conclusión: la investigación proporcionó importantes directrices para la elaboración del Plan de Gestión de Residuos Químicos Peligrosos de la atención hospitalaria.

Eruption hematoma in deciduous and permanent dentition: Case reports / Hematoma de erupção em dentição decídua e permanente: relato de casos clínicos

Cisto de erupção é um cisto de tecido mole decorrente de uma dilatação do espaço folicular em torno da coroa do dente em erupção, causado pelo acúmulo de líquido ou de sangue. Quando a cavidade cística que circunda a coroa do dente contém sangue, a lesão é denominada hematoma de erupção. O objetivo deste trabalho foi relatar dois casos clínicos de hematomas de erupção, assintomáticos, um relacionado à dentição decídua e o outro à dentição permanente. O tratamento dos casos foi baseado no acompanhamento, sem necessidade de intervenção cirúrgica e foi observada a correta erupção dos dentes.

Eruption cyst is a soft tissue cyst, resulting from dilation of the follicular space around the crown of the erupting tooth, caused by the accumulation of fluid or blood. When the cystic cavity surrounding the crown of the tooth contains blood, the lesion is called an eruption hematoma. The objective of this study was to report two clinical cases of asymptomatic eruptive hematomas, one related to deciduous dentition and the other to permanent dentition. The treatment of the cases was based on follow-up, without the necessity of surgical intervention and the correct eruption of the teeth was observed.

Pre-emptive Intracoronal Radiolucency in First Permanent Molar.

Pre-eruptive intracoronal radiolucency (PECR) is characterized by the existence of a radiographic radiolucent area inside the coronal dentin prior to dental eruption. It is a rare clinical entity of unknown etiology, usually asymptomatic and diagnosed through routine radiographs. The aim of this article is to report the treatment of a PECR in an 8-year-old girl. Surgical procedure to expose the crown was conducted; upon tooth eruption, the radiolucent lesion was accessed and the tooth was restored. The case has an 18-month follow-up and emphasis on aspects linked to diagnosis and clinical approach was discussed. How to cite this article: Ilha MC, Kramer PF, Ferreira SH, Ruschel HC. Pre-eruptive Intracoronal Radiolucency in First Permanent Molar. Int J Clin Pediatr Dent 2018;11(2):151-154.

Relação dialógica com o cliente sobre transplante renal: cuidado educativo de enfermagem* / Dialogic relationship with patients regarding kidney transplantation: nursing educational care / Relación dialógica con el paciente sobre trasplante renal: cuidado educativo de enfermería

Objetivo: descrever os saberes de clientes renais crônicos sobre o transplante renal e discutir as contribuições desses saberes nos cuidados educativos de Enfermagem. Método: pesquisa convergente- assistencial, com 11 portadores de doença renal crônica aptos ao transplante, em hospital universitário da cidade do Rio de Janeiro. Realizaram-se entrevistas individuais entre março de 2016 a fevereiro de 2017. A análise foi de conteúdo temático. Resultados: os resultados trazem à reflexão que as pessoas em condições crônicas necessitam de ações integradas com a participação de várias áreas do saber em saúde. Torna-se indispensável que o cliente compartilhe a experiência de quem vive a cronicidade com os profissionais da saúde por meio do diálogo crítico-reflexivo. Conclusão: o diálogo possibilitou a reflexão sobre a construção e reconstrução de saberes e práticas sobre o transplante renal e revelou corresponsabilidade entre profissionais, clientes e seus familiares no processo recuperação do procedimento cirúrgico e manutenção do enxerto (AU).

Objective: to describe the knowledge of chronic kidney patients about kidney transplantation, and discuss the contributions of this knowledge to nursing educational care. Method: this is a convergent-care study with 11 chronic kidney disease patients who were eligible for transplantation, at a university hospital in the city of Rio de Janeiro. Individual interviews were conducted between March 2016 and February 2017, and their content submitted to thematic content analysis. Results: the results bring the reflection that chronically ill people need integrated actions with the participation of several areas of health knowledge. It is imperative that patients share the experience of those who live with chronic illnesses with health professionals through a critical-reflexive dialogue. Conclusion: the dialogue allowed the reflection on the construction and reconstruction of knowledge and practices about kidney transplantation, and revealed co-responsibility among professionals, patients and their families in the process of recovery from the surgical procedure, and graft maintenance (AU).

Objetivo: describir os saberes de pacientes renales crónicos sobre trasplante renal y discutir las contribuciones de tales saberes en cuidados educativos de Enfermería. Método: Investigación convergente-asistencial, sobre 11 pacientes con insuficiencia renal crónica aptos para trasplante, en hospital universitario de Rio de Janeiro. Se realizaron entrevistas entre marzo de 2016 y febrero de 2017. Fue aplicado análisis de contenido temático. Resultados: Expresan la reflexión de que las personas con condiciones crónicas necesitan acciones integradas, con participación de varias áreas del saber en salud. Resulta indispensable que el paciente comparta la experiencia de quien vive la cronicidad con los profesionales de salud mediante el diálogo crítico-reflexivo. Conclusión: El diálogo permitió reflexionar sobre la construcción y reconstrucción de saberes y prácticas sobre trasplante renal, y reveló corresponsabilidad entre profesionales, pacientes y sus familiares en el proceso de recuperación del procedimiento quirúrgico y de preservación del injerto (AU).

Impact of Temporomandibular Joint Discectomy on Condyle Morphology: An Animal Study.

PURPOSE: Temporomandibular disorders lead to parafunctional activity that may alter bone remodeling of mandibular components. This animal study aimed to assess the impact of temporomandibular joint discectomy on condylar bone microarchitecture. MATERIALS AND METHODS: A total of 30 one-month-old Wistar rats were assessed and divided into 3 equal groups (2 test groups and 1 control group) of 10. The first test group underwent disc removal, the second test group underwent disc and condylar cartilage removal, and the 10 remaining rats were analyzed as sham-operated controls, following a split-mouth design. The rats were killed humanely 2 months after surgery, and the respective mandibles were scanned with micro-computed tomography for quantitative morphometric analysis. RESULTS: There were significant differences among the 3 groups analyzed (disc removal, disc and condylar cartilage removal, and sham-operated control) for bone volume fraction (ratio of bone volume to total volume, P = .044), structure model index (P < .001), fractal dimension (P = .024), and porosity (P = .023). In addition, operated and contralateral nonoperated sides significantly differed for all variables in at least 1 of the test groups (P < .05) but not in the control group (P > .05). CONCLUSIONS: Within the limitations of this study, our results suggest that discectomy may lead to alterations of the mandibular condylar morphology.

Traumatismos alveolodentários e fatores associados em crianças assistidas em um curso de Odontologia no sul do Brasil / Traumatic dental injuries and associated factors in children assisted in a school of Dentistry in Southern Brazil

Aim: To estimate the prevalence of traumatic dental injuries (TDI) and investigate demographic and socioeconomic factors associated among children attending at School of Dentistry, Southern Brazil. Methods: A cross-sectional study was carried out with 374 children attending the Pediatric Clinic, from School of Dentistry at the Universidade Luterana do Brasil, Canoas, Southern Brazil. Information from parents/caregivers on socioeconomic factors were obtained with an structured questionnaire. Children were clinically examined and TDI was recorded following Andreasen criteria. Poisson regression with robust variance was employed to determine factors associated with TDI. Results: A total of 15.0% of children exhibited TDI (95% CI 11.5-19.0%). The most common dental injuries involved hard tissues (enamel fracture, enamel and dentine fracture). Adjusted analysis revealed that the probability of TDI was almost 90% higher in older children (10 to 12 years) compared to children who were 7 to 9 years old; (PR 1.89; 95% CI 1.05­3.43), two fold higher in children from older mothers (≥ 35 years) (PR 2.01; 95% CI 1.23­3.30), and 66% higher in children from mothers with lower education (≤8 years) (PR 1.66; 95% CI 1.02­2.70). Conclusion: Our findings showed a high prevalence of TDI. Moreover, sociodemographic factors, specially, maternal schooling and aging were associated with the outcome. Epidemiological studies of specific groups allowed in the organization of health services and elaboration of preventive and curative strategies.

Objetivo: estimar a prevalência de traumatismos alveolodentários (TAD) e investigar fatores sociodemográficos associados em crianças assistidas em um Curso de Odontologia no Sul do Brasil. Métodos: Um estudo transversal foi realizado com 374 crianças atendidas na Clínica Infantil do Curso de Odontologia da Universidade Luterana do Brasil, Canoas, Brasil. Informações sobre fatores sociodemográficos foram obtidas com pais ou cuidadores por meio de um questionário estruturado. As crianças foram clinicamente examinadas e TAD foram registrados, conforme critério de Andreasen. Regressão de Poisson com variância robusta foi empregada para determinar os fatores associados com o desfecho. Resultados: A prevalência de TAD foi de 15,0% (IC 95% 11,0-19,0%). As lesões mais comuns foram lesões aos tecidos duros (fratura de esmalte e de esmalte e dentina), especialmente na dentição permanente. A análise ajustada mostrou que a probabilidade de TAD foi quase 90% maior em crianças de maior idade (10 a 12 anos) em relação a crianças de 7 a 9 anos (RP 1,89; IC 95% 1,05­3,43), duas vezes maior em filhos de mães com maior idade (≥ 35 anos) (RP 2,01; IC 95% 1,23­3,30) e 66% maior em crianças de mães com menor escolaridade (≤8 anos) (RP 1,66; IC 95% 1,02­2,70). Conclusão: Observou-se uma alta prevalência de TAD. Além disso, fatores sociodemográficos, especialmente escolaridade e idade materna, estiveram associados ao desfecho. Estudos epidemiológicos de grupos específicos permitem a organização de serviços de saúde e a elaboração de estratégias preventivas e curativas.

A fatal and metabolic experimental hemorrhagic shock in immature swine

Abstract Purpose: To use blood lactate (BL) as an end-point metabolic marker for the begin resuscitation of volume replacement in experimental hemorrhagic shock. Methods: Group I (n=7) was not bled (Control). Animals in Group II (n=7) were bled to a MAP of 30mmHg in thirty minutes. Hemodynamic and metabolic data were recorded at Baseline, at 30, 60 and 120 minutes after Baseline. The animals were intubated in spontaneous breathing (FIO2=0.21) with halothane. Results: Group I all survived. In Group II all died; no mortality occurred before a BL<10mM/L. Beyond the end-point all animals exhibited severe acidemia, hyperventilation and clinical signs of shock. Without treatment all animals died within 70.43±24.51 min of hypotension shortly after reaching an average level of BL 17.01±3.20mM/L. Conclusions: Swine's breathing room air spontaneously in hemorrhagic shock not treated a blood lactate over 10mM/L results fatal. The predictable outcome of this shock model is expected to produce consistent information based on possible different metabolic and hemodynamic patterns as far as the type of fluid and the timing of resuscitation in near fatal hemorrhagic shock.

Planta física dos abrigos de resíduos químicos perigosos da atenção hospitalar / Physical plant of hazardous shelteres with chemical waste from hospital care

Objetivo: avaliar as especificações da planta física dos abrigos de resíduos químicos perigosos gerados em hospital. Metodologia: pesquisa descritiva, realizada no Hospital Universitário da Universidade de São Paulo. Os dados foram coletados por meio da Ficha de Informação de Gerenciamento de Resíduo Químico Perigoso. Resultados: os dados evidenciaram 11 especificações, sendo sete (63,63%) não conformidades no armazenamento interno e seis (54,54%) conformidades no armazenamento externo. Os resultados apontaram os aspectos a serem revistos pelo hospital quanto à adequação da planta física dos abrigos de resíduos químicos perigosos no aguardo da coleta externa. Indicaram, ainda, diretrizes quanto às normas para construção dos abrigos, subsidiando o Plano de Gerenciamento de Resíduos Químicos Perigosos. Conclusão: o Plano tornou possível a prevenção de acidentes e doenças relacionados ao trabalho e a promoção da saúde humana e ambiental, como fatores de sustentabilidade no setor saúde hospitalar.

Objective: to evaluate the specifications of the physical plant for residues of dangerous hazardous chemical waste shelters generated at a hospital. Methodology: This is a descriptive research that takes place at University Hospital of the University of Sao Paulo. Data collection was carried out through the Chemical Waste Management Data Sheet Dangerous. Results: The data showed 11 specifications, 7 (63.63%) non-conformities in the internal storage and 6 (54.54%) conformities in external storage. The results pointed out the aspects to be reviewed by the Hospital, with respect to the adequacy of the physical plant of hazardous chemical waste shelters, awaiting external collection. They also offered guidelines for the standards of construction of shelters, supporting the Waste Management Plan of hazardous chemicals. Conclusion: With this Plan it was possible to prevent accidents and diseases related to work and the promotion of human and environmental health and sustainability factors within the hospital sector.

Objetivo: evaluar las especificaciones de la planta física de los lugares de almacenamiento de residuos químicos peligrosos generados en hospital. Metodología: Investigación descriptiva realizada en el Hospital Universitario de la Universidad de São Paulo. La recolección de datos se realizó mediante Hoja de Información de Gestión de Residuos Químicos Peligrosos. Resultados: Los datos mostraron que 11 especificaciones, 7 (63.63%) del almacenamiento interno no estaba en conformidad y 6 (54,54%) cumplian los requisitos de almacenamiento externo. Los resultados también mostraron los aspectos que deben ser revisados por el Hospital, como la adecuación de la planta física, los lugares de almacenamiento de residuos químicos peligrosos, en espera del transporte externo. También fueron ofrecidas directrices como normas para la construcción de depósitos, apoyo al Plan de Gestión de Residuos Químicos Peligrosos. Conclusión: Con el Plan se hizo posible la prevención de accidentes y enfermedades relacionadas al trabajo y a la promoción de la salud humana y ambiental, como factores de sostenibilidad en el sector salud hospitalario.

Motivos do absenteísmo em uma equipe de enfermagem ambulatorial / Absenteism reasons in an ambulatorial nursing team

Objetivo: identificar os motivos dos absenteísmos por licenças médicas dos trabalhadores do ambulatório. Método: estudo exploratório, de abordagem quantitativa, realizado no ambulatório de um hospital de ensino de grande porte, com 30 profissionais da equipe de enfermagem. Os dados foram coletados com um questionário, tabulados em planilha do Microsoft Excel® versão 2010 e apresentados em tabelas Resultados: os resultados foram apresentados considerando os motivos dos afastamentos dos profissionais enfermeiros, tais como distúrbios osteomusculares, distúrbios psiquiátricos, distúrbios cardiovasculares, doenças infectoparasitárias e cirurgias. Constatou-se que a maioria dos afastamentos do trabalho é devido aos distúrbios osteomusculares (52,1%), seguidos por distúrbios psiquiátricos (26%), distúrbios cardiovasculares(13%), doenças infectoparasitárias (4,3%) e cirurgias (4,3%). Conclusão: os achados desta pesquisa podem estar relacionados a diversos fatores, inclusive cargas presentes na dinâmica do trabalho que estão diretamente relacionadas às doenças encontradas neste estudo.