Endodontia no contexto da Atenção Primária à Saúde: estudo retrospectivo de uma série de casos / Endodontic treatments at the Primary Health Care: retrospective study of case series

Este estudo teve como objetivo avaliar as endodontias realizadas dentro do contexto da Atenção Primária à Saúde. O estudo, de desenho retrospectivo, foi realizado a partir de atendimentos de uma Unidade de Saúde do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição. Os critérios clínicos e radiográficos foram avaliados, sendo considerado o desfecho do estudo a permanência do dente tratado em boca. Uma análise descritiva foi realizada e curvas de Kaplan-Meier foram obtidas para estabelecer a sobrevida dos tratamentos. Do total de 260 tratamentos, 149 dentes foram avaliados. As mulheres foram a maioria (64,4%), sendo a faixa etária predominante a de 40 a 59 anos (48,3%). Majoritariamente os dentes apresentavam um canal (71,1%). A taxa de sobrevida foi de 86,7%. Em conclusão, os achados do estudo vêm ao encontro de outros estudos presentes na literatura, permitindo considerar a possibilidade de ofertar este tipo de tratamento em nível de Atenção Primária à Saúde.

This study aimed to evaluate endodontic treatments carried out in the primary health care. The retrospective study evaluated the treatments performed in one Basic Health Unit, from the Communitarian Health System (Conceição Hospital Group). The success was evaluated using clinical and radiographic information. The outcome was the permanence of the tooth in the mouth. Descriptive analysis was performed and Kaplan-Meier curves were obtained to determine survival rates. From the 260 dental treatments carried out, 149 were evaluated. Most of the patients were women (64.4%), mainly aged between 40 to 59 years-old (48.3%). Most treated teeth had a single root canal (71.1%). The overall survival rate was 86.7%. In conclusion, the survival rate for endodontic treatments carried out at the service was high allowing the consideration to develop protocols to perform this kind of treatment in other units of Primary Health care.

Periprosthetic fractures of the proximal femur: beyond the Vancouver classification.

The majority of periprosthetic femoral fractures are treated surgically.Surgical treatment may be revision only, revision in combination with open reduction and internal fixation (ORIF), or ORIF only.The treatment decision is dependent on whether the stem is loose or not, but loose stems are not always identified, resulting in unsatisfactory treatments.This article presents an algorithmic approach to identifying loose stems around proximal femoral periprosthetic fractures, taking patient history, stem design, and plain radiographs into consideration. This approach may help identifying loose stems and increase the probability of effective treatments. Cite this article: EFORT Open Rev 2020;5:449-456. DOI: 10.1302/2058-5241.5.190086.

Population fluctuation of predatory and sanitary importance mites (Acari) in commercial laying hens: Ecological interactions.

This study aimed to evaluate the mite fauna and their ecological interactions in commercial laying hen farms in the state of Rio Grande do Sul, Brazil. It was conducted from August 2013 through August 2014 with two sampling strategies (feathers and traps) in three different production systems: automated (A1,2,3), semi-automated (S1,2) and free-range (FR). A total of 38,383 mites were collected belonging to 23 families and 33 species, most of which were collected in feathers (74%) followed by traps (26%). There was higher abundance at S1 (10,774-28.1%) and S2 (11,023-28.7%) followed by FR (6972-18.2%), A1 (1896-4.9%), A2 (4775-12.4%), and A3 (2943-7.7%). Higher richness was observed at S1 (23 species), S2 (18 species), and FR (19 species). Megninia ginglymura (Mégnin) (Analgidae) was the species with the highest health importance, eudominant on feathers, and its populations seems to be related with increased temperature. Tuccioglyphus setosus Horn et al. (Pyroglyphidae) seems to be influenced by relative air humidity and temperature. Predators with the highest populations were Cheyletus malaccensis (Oudemans) (Cheyletidae), Typhlodromus transvaalensis (Nesbitt) (Phytoseiidae), Blattisocius keegani (Fox), and Blattisocius dentriticus (Berlese) (Blattisocidae).

The effect of foot type on the Achilles tendon moment arm and biomechanics.

BACKGROUND: The aim was to calculate the Achilles tendon moment arm in different degrees of plantarflexion for pes planus, pes cavus and normal arched feet. METHODS: 99 patients (99 radiographs; 40 males, 59 females; mean age 49 years, SD 15) with a healthy ankle joint and a preoperative weightbearing lateral radiograph of the foot were included. Three groups (pes planus, pes cavus and normal-arched feet) with equal sample sizes (n=33) were formed. On radiographs, the angle formed between a horizontal line and the line connecting the insertion of the Achilles tendon with the center of rotation of the ankle, was measured. The interrater reliabilities (ICC) of the angle alpha were compared on radiographs and on MRIs. Using the angle alpha, the Achilles tendon moment arm was calculated in different plantarflexion positions. RESULTS: The ICC of alpha was higher on radiographs (0.84, [0.73-0.91]) than on MRIs (0.61, [0.27-0.81]). The average alpha was statistically significantly different (normal arched foot 31 degrees (°), pes planus 24°, pes cavus 36°, p=0.021), resulting in a significant shorter Achilles tendon moment arm for pes cavus than for pes planus (p<0.0001) and normal arched feet (p=0.006) in neutral position. CONCLUSION: The data suggests that it is feasible to use radiographs to measure the Achilles tendon moment arm. The maximum Achilles tendon moment arm is reached at different angles of ankle flexion for pes cavus, pes planus and normal-arched feet. This has to be taken into consideration when planning surgeries.

Endodontia no contexto da Atenção Básica: perspectivas e probabilidades

Este estudo tem por objetivo avaliar as endodontias realizadas em uma Unidade de Saúde do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição. Tratou-se de um estudo com base em avaliações clínicas e radiográficas dos tratamentos realizados no período compreendido entre os anos de 2004 a 2014. Identificaram-se 260 tratamentos endodônticos (dentes uni e birradiculares), dos quais foram realizadas 149 (57,0%) avaliações. A maioria dos examinados foram mulheres (64,4%), sendo a faixa etária predominante a de 40 a 59 anos (48,3%). A maioria dos dentes apresentou um canal tratado (71,1%), exigindo na maioria dos casos duas sessões de atendimento (67,1%). A endodontia de pré-molares totalizou 84 dentes (56,3%) sendo que estes também foram os dentes mais perdidos: dos 25 (16,8%) dentes ausentes no momento da avaliação, 18 (72,0%) foram pré-molares e, dentre estes, 10 (55,5%) correspondiam aos 1°s pré-molares superiores. No presente estudo o desfecho principal foi a permanência do dente em boca, de modo que a sobrevida dos tratamentos foi de 86,0%. O aspecto radiográfico foi passível de avaliação em 65 (52,4%) dentes. Por fim, vale ressaltar que analisar esta proposta de intervenção pode trazer contribuições para a criação de novos protocolos com o intuito de aprimorar a técnica em nível de Atenção Básica, bem como induzir a formulação de políticas públicas para tal fim

Ectoparasitism of commercial laying hen by Megninia ginglymura (Mégnin) (Acari): population dynamic and distribution on the body regions.

Ectoparasites are temporary or permanent skin dwellers. Megninia ginglymura (Mégnin) (Analgidae) causes economic damage in commercial poultry farms as a result of lower egg production or even death of the host. Little is known about Megninia ginglymura's life cycle and infestation. This study aimed to evaluate the preference of M. ginglymura for different body regions of the host Gallus gallus L. and its abundance and population dynamics in different laying hen houses. Samples were collected from August 2013 to August 2014 in three different commercial laying hen systems: automatic production systems (A1,2,3); semiautomatic systems (S1 (free of pesticides) and S2) and free-range system (FR). Ten laying hen were sampled each laying hen house and it were collected feathers were collected from different body regions form 10 hens in each laying house. A total of 28,305 specimens belonging to M. ginglymura were collected. Higher abundance was noted in S1 (9,234), S2 (9,121), and FR (5,873) and lower in A2 (2,211), A3 (1,628), and A1 (238). The dorsum (back of the body) region showed the highest abundance, mean abundance, and prevalence, representing 29.5% of the total specimens collected. The cloacal region was the second with 21.1% of the total of this ectoparasite. The abdomen and neck represented 20.8% and 19.6%, respectively. The inner wings presented the lowest abundance, mean abundance, and prevalence in all laying hen houses (9.0% of specimens). The prevalence was significantly different in automatic, semiautomatic, and free-range systems. The population peaks seems to coincide with periods of high temperatures and precipitation. Populations of this species already exhibit resistance to synthetic chemical pesticide.

Two new genera of pyroglyphid mites, Tuccioglyphus and Marioglyphus, with a key to genera of the World (Acari: Pyroglyphidae).

We describe Tuccioglyphus setosus gen. et sp. nov. from the litter of commercially reared laying hens as well as wild birds in Brazil. The new genus Tuccioglyphus presents a mixture of character states between the two conventional subfamilies, Pyroglyphinae and Dermatophagoidinae. Based on this new unusual genus, we discuss character states delimiting these and other major subfamilies of the house dust mite family, Pyroglyphidae, as well as its most important and species-rich genus Dermatophagoides. An additional new genus, Marioglyphus gen. n., is proposed for Hughesiella valerioi Vargas and Smiley. Both Tuccioglyphus and Marioglyphus are related to the genus Hughesiella. A key to pyroglyphid genera of the World is presented.

Influence of laying hen systems on the mite fauna (Acari) community of commercial poultry farms in southern Brazil.

Intensive production of confined laying hens affects their welfare and increases the risk of epidemics. Ectoparasites as hematophagous and feather mites cause low productivity and decreased egg quality. This study aimed to determine the diversity of mites captured with traps in different commercial systems of laying hens (Gallus gallus L.) (Phasianidae) in Taquari Valley, Rio Grande do Sul, Brazil. Samplings were conducted from August 2013 to August 2014, totaling 21 sampling events in three different commercial laying hen systems: automatic production systems (A(1), (2), (3)), semiautomatic systems (S(1), (2)), and free-range system (FR). A total of 9981 mites belonging to 21 families, 31 genera, and 35 species were found. Acaridae, Caligonellidae, and Cheyletidae showed the highest richness with four species each. Megninia ginglymura (Mégnin, 1877) (Analgidae) was the most abundant ectoparasite species with 1328 specimens and was present in all commercial laying hen systems. No hematophagous mites were found. Cheyletus malaccensis(Cheyletidae) (3503), Typhlodromus transvaalensis (Phytoseiidae) (304), and Blattisocius keegani (Blattisocidae) (181) were the predators present in all systems. The similarity with control system (S(1)--without pesticide) was low (36.5 %) when compared to all other commercial laying hen systems, and it had the highest richness. In FR, low populations of mites and highest diversity were observed. The commercial laying hen system and the management influence the mite fauna in poultry farms.

Custo das hospitalizações por infecções focais dentárias em um município do sul do Brasil / Cost of hospitalizations for dental focal infections in a city in southern Brazil

Infecções focais dentárias podem causar complicações sistêmicas e resultar em internação hospitalar. Conduziu-se estudo descritivo de casos de infecções focais dentárias, perfil dos pacientes internados no Pronto-Socorro de Pelotas-RS, e estimativa dos custos dessas internações no período de 2008/2013 com dados provenientes da Faculdade de Odontologia da UFPel. A descrição das variáveis foi realizada por frequências absolutas e relativas, mediana, média/desvio-padrão. A estimativa do custo foi realizada por meio da média dos valores das Autorizações de Internações Hospitalares com CID K04/K05, repassados pela SMS-Pel. Dos 417 registros coletados, 52,8% eram mulheres, tinham entre 18-39 anos de idade (55,9%) e eram oriundos de Pelotas-RS (95%). A média etária foi de 25,5 anos (± 13,7 anos). Dos 417 indivíduos atendidos, 88,5% foram medicados, prevalecendo combinações de medicamentos (67,6%). A falta de registros foi observada para todas as variáveis, exceto sexo. Foram identificadas 63 internações. O custo médio para o município foi de R$ 347,67. Das urgências observadas, 6,9% eram decorrentes de infecções focais dentárias, sensíveis a intervenções na Atenção Básica. Considerando custos em internações de urgências odontológicas, e, sendo possível preveni-las, sugerem-se novas abordagens sobre o tema. É necessário qualificar registros para adequado monitoramento dessa demanda, verificando seu impacto na redução das internações... (AU)

Dental focal infections can cause systemic complications and result in hospitalization. We conducted a descriptive case study of dental focal infections, patients characteristics admitted to the Emergency Room of Pelotas, and estimated costs of hospital admissions in the period 2008/2013 with data from the School of Dentistry Federal University of Pelotas. The description of the variables was performed by absolute and relative frequencies, median, mean and standard deviation. The cost estimate was performed using average values of Authorizations Hospitalizations with ICD K04 / K05, provided by the SMS-Pel. Of the 417 selected records, 52.8% were women, aged between 18-39 years old (55.9%) and originating from Pelotas (95%). Mean age was 25.5 years (± 13.7 years). Of total 417 individuals, 88.5% were prescribed, whichever drug combinations (67.6%). The lack of records was found for all variables except sex. Were identified 63 hospitalizations. The average cost for the city was (R$ 347.67). Of the emergencies observed, 6.9% were due to sensitive interventions in primary care dental focal infections. Considering costs for dental emergencies admissions, and prevent thembeing possible, were suggest new approaches to the topic. It is necessary to qualify records for proper monitoring of this demand, checking its impact in reducing hospitalizations... (AU)

'Eventless' InsP3-dependent SR-Ca2+ release affecting atrial Ca2+ sparks.

Augmented inositol 1,4,5-trisphosphate receptor (InsP3R) function has been linked to a variety of cardiac pathologies, including cardiac arrhythmia. The contribution of inositol 1,4,5-trisphosphate-induced Ca(2+) release (IP3ICR) in excitation-contraction coupling (ECC) under physiological conditions, as well as under cellular remodelling, remains controversial. Here we test the hypothesis that local IP3ICR directly affects ryanodine receptor (RyR) function and subsequent Ca(2+)-induced Ca(2+) release in atrial myocytes. IP3ICR was evoked by UV-flash photolysis of caged InsP3 under whole-cell configuration of the voltage-clamp technique in atrial myocytes isolated from C57/BL6 mice. Photolytic release of InsP3 was accompanied by a significant increase in the Ca(2+) release event frequency (4.14 ± 0.72 vs. 6.20 ± 0.76 events (100 µm)(-1) s(-1)). These individual photolytically triggered Ca(2+) release events were identified as Ca(2+) sparks, which originated from RyR openings. This was verified by Ca(2+) spark analysis and pharmacological separation between RyR and InsP3R-dependent sarcoplasmic reticulum (SR)-Ca(2+) release (2-aminoethoxydiphenyl borate, xestospongin C, tetracaine). Significant SR-Ca(2+) flux but eventless SR-Ca(2+) release through InsP3R were characterized using SR-Ca(2+) leak/SR-Ca(2+) load measurements. These results strongly support the idea that IP3ICR can effectively modulate RyR openings and Ca(2+) spark probability. We conclude that eventless and highly efficient InsP3-dependent SR-Ca(2+) flux is the main mechanism of functional cross-talk between InsP3Rs and RyRs, which may be an important factor in the modulation of ECC sensitivity.

The relationship between freely chosen cadence and optimal cadence in cycling.

PURPOSE: The main aim of this study was to compare the freely chosen cadence (FCC) and the cadence at which the blood lactate concentration at constant power output is minimized (optimal cadence [Copt]). The second aim was to examine the effect of a concomitant change of road incline and body position on FCC, the maximal external power output (Pmax), and the corresponding Copt. METHODS: FCC, Copt, and Pmax were analyzed under 2 conditions: cycling on level ground in a dropped position (LGDP) and cycling uphill in an upright position (UHUP). Seven experienced cyclists participated in this study. They cycled on a treadmill to test the 2 main hypotheses: Experienced cyclists would choose an adequate cadence close to Copt independent of the cycling condition, and FCC and Copt would be lower and Pmax higher for UHUP than with LGDP. RESULTS: Most but not all experienced cyclists chose an adequate cadence close to Copt. Independent of the cycling condition, FCC and Copt were not statistically different. FCC (82.1 ± 11.1 and 89.3 ± 10.6 rpm, respectively) and Copt (81.5 ± 9.8 and 87.7 ± 10.9 rpm, respectively) were significantly lower and Pmax was significantly higher (2.0 ± 2.1%) for UHUP than for LGDP. CONCLUSION: Most experienced cyclists choose a cadence near Copt to minimize peripheral fatigue at a given power output independent of the cycling condition. Furthermore, it is advantageous to use a lower cadence and a more upright body position during uphill cycling.

Prevalência de fluorose dentária em adolescentes de escolas municipais da área urbana do município de Pelotas/RS, 2010 / Prevalence of dental fluorosis among adolescents of public schools in the urban area of Pelotas/RS, 2010

Objetivo: Conhecer prevalência e severidade da fluorose dentária em adolescentes de 12 anos de idade de escolas municipais de Pelotas/RS em 2010. Métodos: Realizou-se estudo transversal descritivo, utilizando-se recomendações da Organização Mundial da Saúde, por seis examinadoras treinadas. Selecionou-se amostra aleatória sistemática de alunos das 39 escolas municipais da área urbana. O dente parâmetro para classificação da fluorose foi registrado e, de forma exploratória, foram identificadas exposições a produtos com flúor: tipo de água e quantidade de dentifrício. Resultados: Foram examinados adolescentes de 32 (86,5 por cento) das 37 escolas que tiveram alunos sorteados, perfazendo o número de 228 (91,2 por cento do total). Não foram observados casos de fluorose moderada ou severa e apenas 2 casos de fluorose leve. As condições que mais prevaleceram foram fluorose questionável (68,4 por cento) e muito leve (21 por cento); sendo os pré-molares superiores os mais afetados, com 122 observações (59,2 por cento). O tipo de água relatada pelos escolares como mais consumida foi a de abastecimento público (75,5 por cento); e a quantidade de dentifrício mais utilizada foi a estimada em 0,75 g ou mais (86 por cento). Não se observou associação estatística entre presença de fluorose dentária e uso de dentifrício em quantidade acima do recomendado. Conclusão: Verificou-se alta prevalência e baixa severidade de fluorose dentária; situação esperada onde teores de flúor na água de abastecimento público estão dentro dos recomendados, como é o caso de Pelotas. A maior parte dos escolares relatou usar quantidade de dentifrício acima do indicado. Sua contribuição na prevalência de fluorose dentária deve ser investigada por meio de outros delineamentos.

Objective: To know the prevalence and severity of dental fluorosis in 12 years old adolescents of schools of Pelotas/RS in 2010. Materials and Methods: We conducted a cross sectional study, using for six trained examiners the recommendations of the World Health Organization. We selected an aleatory systematic sample of students from 39 municipal schools in the urban area. The tooth parameter for classification of fluorosis was recorded, and the basis, we identified products with exposure to fluoride water type and amount of dentifrice. Results: We examined 32 adolescents (86.5 percent) of 37 schools were randomly selected students, bringing the number of 228 (91.2 percent of total). There were no cases of moderate or severe fluorosis and only 2 cases of mild fluorosis. The conditions that more it prevailed were questionable fluorosis (68.4 percent) and very mild (21 percent) being the upper premolars the most affected, with 122 observations (59.2 percent). The type of water reported by the scholars as the more consumed was a public supply (75.5 percent); and the amount of used toothpaste was 0,75g or more (86 percent). There was no significant statistical association between the presence of dental fluorosis and dentifrice in use above the recommended amount. Conclusion: We observed high prevalence and low severity of dental fluorosis; expected situation where levels of fluoride in public water supplies are the recommended, as is the case of Pelotas. Most of the students reported using amount of dentifrice indicated above. His contribution in the prevalence of dental fluorosis should be investigated by means of others designs studies.

Shoulder abduction moment arms in three clinically important positions.

The abduction moment arms of 4 shoulder muscles were calculated in clinically important positions to evaluate the best test situation for the supraspinatus based on its mechanical advantage.Moment arms of the supraspinatus, infraspinatus, and middle and anterior deltoid in 18 individuals were computed using individual magnetic resonance imaging data and a computer-assisted design tool for simulation. Three tests with the arm in the neutral position (arm hanging on side), at 90 of scaption,and at 90 of scaption and full internal humeral rotation (Jobe test) were investigated. The supraspinatushas a greater mechanical advantage vs the other tested muscles in the neutral arm position. In the Jobe position, the supraspinatus' abduction moment arm is reduced with increased internal humeral rotation.Comparing these results with the literature indicates that this new method is adequate for calculation of moment arms and may be used in any desired joint configuration.

Neuromechanics of muscle synergies during cycling.

Muscle synergies have been proposed as building blocks that could simplify the construction of motor behaviors. However, the muscles within synergistic groups may have different architectures, mechanical linkages to the skeleton, and biochemical properties, and these put competing demands on the most appropriate way to activate them for different mechanical tasks. This study identifies the extent to which synergistic patterns of muscle activity vary when the mechanical demands on a limb were altered, and additionally identifies how consistent the spectral profiles of the electromyographic (EMG) intensities were across the different movement tasks. The muscle activities were measured with surface EMG across 10 muscles in the leg during cycling at a range of loads and velocities. The EMGs were quantified by their intensities in time-frequency space using wavelet analysis; the instantaneous patterns of activity identified using principal component analysis, statistically compared and further visualized using the varimax rotation. Variability (35.7%) in the patterns of activity between the muscles were correlated with the torque and velocity of the pedal crank. Anatomic groups of muscles share a common mechanical action across a joint; uncoupling between such muscles was identified in 68.8% of the varimax patterns that encompassed all 10 muscles and 20.8-29.5% of the activity patterns when the anatomic groups were analyzed separately. The EMG spectra showed greatest heterogeneity for the gastrocnemii. These results show that the activity of muscles within anatomic groups is partially uncoupled in response to altered mechanical demands on the limb.