Superior bioavailability of the calcium salt form of ß-hydroxy-ß-methylbutyrate compared with the free acid form.

We investigated the bioavailability of the calcium salt (HMB-Ca) and the free acid (HMB-FA) forms of ß-hydroxy-ß-methylbutyrate (HMB). Sixteen young individuals received the following treatments on three different occasions in a counterbalanced crossover fashion: (1) HMB-FA in clear capsules; (2) HMB-Ca in gelatine capsules; (3) HMB-Ca dissolved in water. All treatments provided 1 g of HMB. Blood samples were taken before and on multiple time points following ingestion. The following parameters were calculated: peak plasma (Cmax), time to peak (Tmax), slope of HMB appearance in blood, area under the curve (AUC), half-life time (t1/2) and relative bioavailability (HMB-Ca in water set as reference). All treatments led to rapid and large increases in plasma HMB. HMB-Ca in capsules and in water showed similar plasma HMB values across time (p = 0.438). HMB-FA resulted in lower concentrations vs. the other treatments (both p < 0.001). AUC (HMB-Ca in capsules: 50,078 ± 10,507; HMB-Ca in water: 47,871 ± 10,783; HMB-FA: 29,130 ± 12,946 µmol L-1 × 720 min), Cmax (HMB-Ca in capsules: 229.2 ± 65.9; HMB-Ca in water: 249.7 ± 49.7; HMB-FA: 139.1 ± 67.2 µmol L-1) and relative bioavailability (HMB-Ca in capsules: 104.8 ± 14.9%; HMB-FA: 61.5 ± 17.0%) were lower in HMB-FA vs. HMB-Ca (all p < 0.001). HMB-Ca in water resulted in the fastest Tmax (43 ± 22 min) compared to HMB-Ca in capsules (79 ± 40 min) and HMB-FA (78 ± 21 min) (all p < 0.05), while t1/2 was similar between treatments. To conclude, HMB-Ca exhibited superior bioavailability compared to HMB-FA, with HMB-Ca in water showing faster absorption. Elimination kinetics were similar across all forms, suggesting that the pharmaceutical form of HMB affects the absorption rates, but not its distribution or elimination.

Antimicrobial activity of limonene: integrative review / Actividad antimicrobiana del limoneno: revisión integrativa

Limonene is the main component of citrus essential oils, and can reach a concentration of up to 96%. Popularly known for its potential therapeutic effects on the body, among these we point out its broad antimicrobial activity against various types of pathogens. Therefore, the purpose of this study was to address the antimicrobial and antifungal properties of limonene compared to microorganisms of interest in dentistry, based on a bibliometric study and literature review. The following databases were analyzed: PubMed, Google Scholar, SciELO and Science Direct, from which ten articles published between 2011-2021 were selected. Most of results indicate a satisfactory antimicrobial potential, besides providing important data and perspectives regarding the indication and clinical use, in addition to innovative therapeutic modalities for diseases that affect the oral cavity, such as tooth decay, periodontal disease and candidosis.

El limoneno es el componente principal de los aceites esenciales cítricos, y puede alcanzar una concentración de hasta el 96%. Popularmente conocido por sus potenciales efectos terapéuticos en el organismo, entre ellos se destacan su amplia actividad antimicrobiana frente a diversos tipos de patógenos. Por lo tanto, el objetivo de este estudio fue abordar las propiedades antimicrobianas y antifúngicas del limoneno en comparación con microorganismos de interés en la odontología, a partir de un estudio bibliométrico y una revisión bibliográfica. Se analizaron las siguientes bases de datos: PubMed, Google Scholar, SciELO y Science Direct, de las cuales se seleccionaron diez artículos publicados entre 2011-2021. La mayoría de los resultados indican un potencial antimicrobiano satisfactorio, además de proporcionar datos y perspectivas importantes con respecto a la indicación y el uso clínico, así como modalidades terapéuticas innovadoras para enfermedades que afectan la cavidad oral, como caries, enfermedad periodontal y candidosis.

Extracorporeal Pedicles for Free Flap Reconstruction in Diabetic Lower Extremity Wounds.

Diabetic foot ulcers are a severe complication of diabetes, and their management requires a multidisciplinary approach for optimal management. When treating these ulcers, limb salvage remains the ultimate goal. In this article, we present the "hanging" free flap for the reconstruction of chronic lower extremity diabetic ulcers. This two-staged approach involves standard free flap harvest and inset; however, following inset the "hanging" pedicle is covered within a skin graft instead of making extraneous incisions within the undisturbed soft tissues or tunnels that can compress the vessels. After incorporation, a second-stage surgery is performed in 4 to 6 weeks which entails pedicle division, flap inset revision, and end-to-end reconstruction of the recipient vessel. Besides decreasing the number of incisions on diabetic patients, our novel technique utilizing the "hanging" pedicle simplifies flap monitoring and inset and allows reconstruction of recipient vessels to reestablish distal blood flow.

Ethnobotanical knowledge of herbalists about medicinal plants from the semiarid region in northeastern Brazil / Conocimiento etnobotánico de herbolarios sobre plantas medicinales de la región semiárida del noreste de Brasil

Medicinal plants have been used since ancient times to treat illnesses. This study aimed to identify through questionnaire the medicinal plants most frequently sold on public and street markets in some municipalities of Paraíba state, northeastern Brazil, and the knowledge of herbalists about their therapeutic indications and forms of use. The sample consisted of 28 herbalists. Fifteen plants with a dental indication were identified, including barbatimão (Stryphnodendron adstringens), aroeira (Myracrodruon urundeuva), gengibre (Zingiber officinale), romã (Punica granatum), cajueiro-roxo (Anacardium occidentale), mulungu (Erythrina velutina) and quixaba (Sideroxylon obtusfolium), as well as 21 plants used for the treatment of general diseases, including barbatimão (S. adstringens), aroeira (M. urundeuva), cajueiro-roxo (A. occidentale), quixaba (S. obtusfolium), boldo (Peumus boldus) and erva doce (Pimpinella anisum). Bottled preparations ("garrafadas")and teas were the most frequently indicated forms of use. The results suggest that herbalists have a vast traditional knowledge of the therapeutic potential of commercialized plants.

Las plantas medicinales se han utilizado desde la antigüedad para tratar enfermedades. Este estudio tuvo como objetivo identificar a través de cuestionario las plantas medicinales más vendidas en mercados públicos y callejeros en algunos municipios del estado de Paraíba, noreste de Brasil, y el conocimiento de los herbolarios sobre sus indicaciones terapéuticas y formas de uso. La muestra estuvo formada por 28 herbolarios. Se identificaron quince plantas con indicación dental, entre las que se encuentran barbatimão (Stryphnodendron adstringens), aroeira (Myracrodruon urundeuva), jenjibre (Zingiber officinale), romã (Punica granatum), cajueiro-roxo (Anacardium occidentale), mulungu (Erythrina velutina) y quixaba (Sideroxylon obtusfolium), así como 21 plantas utilizadas para el tratamiento de enfermedades generales, incluidas barbatimão (S. adstringens), aroeira (M. urundeuva), cajueiro-roxo (A. occidentale), quixaba (S. obtusfolium), boldo (Peumus boldus) y erva doce (Pimpinella anisum). Las preparaciones embotelladas ("garrafadas") y los tés fueron las formas de uso más frecuentemente indicadas. Los resultados sugieren que los herbolarios tienen un vasto conocimiento tradicional del potencial terapéutico de las plantas comercializadas.

The First Dorsal Metacarpal Artery Perforator Free Flap: The Comet Flap.

BACKGROUND: Distal extremity defects pose a particular challenge to the reconstructive surgeon; however, advances in perforator flaps have expanded the potential reconstructive options. In this article, the authors present their experience in reconstructing distal extremity defects using a thin, cutaneous free flap based on the perforator of the first dorsal metacarpal artery: the comet flap. METHODS: A retrospective review was performed on all patients who presented with a distal extremity defect and underwent reconstruction using a comet flap between 2015 and 2019. Patient demographics, flap anatomy and harvest, and postoperative course were reviewed and analyzed. RESULTS: A total of 16 patients were included. The mean patient age was 36.5 years. Trauma was the most common cause. The average defect size was 5.4 × 3.2 cm. The average pedicle length of the comet flap ranged from 3.5 to 30 cm, depending on involvement of the radial vessels. All donor sites underwent uncomplicated closure with local rhomboid flaps. One flap was complicated by an acute venous thrombosis that was successfully treated operatively. The flap survival rate was 95 percent. All patients were able to maintain their preoperative range of motion and were satisfied with their final outcome. Follow-up time ranged from 6 to 50 months. CONCLUSIONS: Local flaps remain an important reconstructive approach for distal extremity defects; however, in complex soft-tissue injuries, free tissue transfers become necessary. The comet flap is a safe, versatile, and reliable flap for reconstructing upper and lower extremity defects that can be performed in a single procedure under regional anesthesia. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Nonsurgical management of an extensive periapical lesion combined with photodynamic therapy: a case report / Manejo não cirúrgico de lesão periapical extensa combinada com terapia fotodinâmica: relato de caso

Introduction: the major goal of endodontic treatment (ET) is the complete elimination and/or maximum possible reduction of bacteria and irritants in the root canal system (RCS). However, persistence of bacterial debris refractory to therapy may leading to ET failure, being necessary to realize conventional or surgical retreatment. Objective: this is a case report on the nonsurgical management of an extensive chronic periapical lesion in teeth 12 and 11 in an adult female patient with history of endodontic treatment failure. She presented with painless swelling and a fistula adjacent to tooth 11. Methodology: conventional ET combined with photodynamic therapy (PDT) was recommended, in addition to calcium hydroxide applications. Regular clinical and radiographic follow-up made over a 2-year period revealed progression of bone regeneration, without sign and symptoms, with a satisfactory outcome. Conclusion: this case report shows that the combination of conservative ET with PDT provided satisfactory results with the resolution of the chronic endodontic infection and bone repair of the extensive periapical lesion.

Introdução: o principal objetivo do tratamento endodôntico (TE) é a eliminação completa e/ou máxima redução possível de bactérias e irritantes no sistema de canais radiculares (SCR). Porém, a persistência de detritos bacterianos refratários à terapia pode levar ao insucesso do TE, sendo necessária a realização do retratamento convencional ou cirúrgico. Objetivo: este relato de caso descreve o manejo não cirúrgico de uma extensa lesão periapical crônica nos dentes 12 e 11 em paciente adulta do sexo feminino com histórico de fracasso endodôntico. A mesma queixava-se de inchaço indolor, com presença de fístula adjacente ao dente 11. Metodologia: preconizou-se a realização do TE convencional associado à terapia fotodinâmica (PDT), com três sessões de troca de hidróxido de cálcio, concluindo-se posteriormente o tratamento. Reavaliações clínicas e radiográficas periódicas ao longo de 2 anos revelaram a progressão da consolidação óssea, com um desfecho satisfatório. Conclusão: este relato de caso mostra que a combinação do TE conservador associado à PDT teve resultados satisfatórios na resolução de infecção endodôntica crônica e no reparo ósseo de lesão periapical extensa.

Phytochemical composition, antifungal activity, in vitro and in vivo toxicity of Syzygium cumini (L) Skeels leaves extract / Composición fitoquímica, actividad antifúngica, toxicidad in vitro e in vivo del extracto de hojas de Syzygium cumini (L) Skeels

This study determined phytochemical composition, antifungal activity and toxicity in vitro and in vivo of Syzygium cumini leaves extract (Sc). Thus, was characterized by gas chromatography coupled to mass spectrometry and submitted to determination of Minimum Inhibitory (MIC) and Fungicidal concentrations (MFC) on reference and clinical strains of Candida spp. and by growth kinetics assays. Toxicity was verified using in vitro assays of hemolysis, osmotic fragility, oxidant and antioxidant activity in human erythrocytes and by in vivo acute systemic toxicity in Galleria mellonella larvae. Fourteen different compounds were identified in Sc, which showed antifungal activity (MIC between 31.25-125µg/mL) with fungistatic effect on Candida. At antifungal concentrations, it demonstrated low cytotoxicity, antioxidant activity and neglible in vivotoxicity. Thus, Sc demonstrated a promising antifungal potential, with low toxicity, indicating that this extract can be a safe and effective alternative antifungal agent.

Este estudio determinó la composición fitoquímica, la actividad antifúngica y la toxicidad in vitro e in vivo del extracto de hojas de Syzygium cumini (Sc). Así, se caracterizó mediante cromatografía de gases acoplada a espectrometría de masas y se sometió a determinación de Concentraciones Mínimas Inhibitorias (CMI) y Fungicidas (MFC) sobre cepas de referencia y clínicas de Candida spp. y mediante ensayos de cinética de crecimiento. La toxicidad se verificó mediante ensayos in vitro de hemólisis, fragilidad osmótica, actividad oxidante y antioxidante en eritrocitos humanos y por toxicidad sistémica aguda in vivo en larvas de Galleria mellonella. Se identificaron catorce compuestos diferentes en Sc, que mostraron actividad antifúngica (CMI entre 31.25-125 µg/mL) con efecto fungistático sobre Candida. En concentraciones antifúngicas, demostró baja citotoxicidad, actividad antioxidante y toxicidad in vivo insignificante. Por lo tanto, Sc demostró un potencial antifúngico prometedor, con baja toxicidad, lo que indica que este extracto puede ser un agente antifúngico alternativo seguro y eficaz.

Phytochemistry, antifungal and antioxidant activity, and cytotoxicity of byrsonima gardneriana (A. Juss) extract.

OBJECTIVE: To determine the phytochemical composition of Byrsonima gardneriana (A. Juss) leaf extract (BGE) and its antifungal activity against Candida spp., antioxidant potential and in vitro cytotoxicity. MATERIAL AND METHODS: BGE was obtained and submitted to Gas Chromatography Coupled to Mass Spectrometry for phytochemical analysis. The ethanolic extract was tested for its antifungal activity against C. albicans and non-albicans reference strains and clinical isolates in addition to inhibition of C. albicans growth kinetics. It was also tested for antioxidant potential in the presence of phenylhydrazine and reactive oxygen species (ROS). And cytoxicity in human erythrocytes. The data were analyzed by one-way Analysis of Variance (ANOVA) followed by Tukey's or Dunnett's post-hoc test, with α = 0.05. RESULTS: Pyroglutamic acid (90.77 %), eucalyptol (89.61 %) and octanoic acid (76.22 %) were the major compounds detected in BGE, P (%) is the percent probability of compound identification, according to the mass spectra library. The extract showed fungistatic activity, with MIC of 125 µg/mL against most tested strains. While BGE showed low hemolytic activity on all blood types tested herein, it could not prevent osmotic stress in human erythrocytes. The extract did not have oxidizing effects in the presence of phenylhydrazine, but it showed antioxidant potential against ROS when tested at 31 µg/mL and 62 µg/mL. CONCLUSION: B. gardneriana extract showed antifungal activity against Candida spp., demonstrated low hemolytic potential, no oxidant activity in human erythrocytes and antioxidant activity against ROS. This study opens avenues for the study of BGE as a promising biocompatible antifungal agent.

Cigarro Eletrônico: Mocinho ou vilão? / Cigarrillo Electrónico: ¿Bueno o malo? / Electronic Cigarette: Good guy or bad guy?

RESUMEN Objetivo: Discutir los efectos sobre la salud causados por el uso de cigarrillos electrónicos. Material y métodos: Para ello, se realizó una búsqueda en la base de datos PubMed/Medline de artículos completos publicados en los últimos 10 años. Se utilizaron un total de 21 artículos, según los criterios de inclusión establecidos, con mayor prevalencia de estudios transversales. Resultados: Se encontró que los cigarrillos electrónicos pueden incluso ayudar en el cese del tabaquismo convencional, sin embargo, sus usuarios no están exentos de sufrir complicaciones de salud sistémicas. Estos contienen sustancias tóxicas y no deben considerarse completamente seguros e inofensivos. Conclusiones: se necesitan más estudios para determinar las implicaciones para la salud a largo plazo del uso de este deben considerarse completamente seguros e inofensivos.

SUMMARY Objective: to discuss the health effects caused by the use of electronic cigarettes. Material and Methods : A search was performed in the PubMed/Medline database of complete articles published in the last 10 years. A total of 21 articles were used, according to the established inclusion criteria, with a higher prevalence of cross-sectional studies. Results: It was verified that electronic cigarettes may even help in the cessation of conventional smoking, however, their users are not exempt from suffering systemic health complications. They present toxic substances and should not be considered totally safe and harmless. Conclusions : Further studies are still needed to determine the implications of the use of this electronic device on the health of its users in the long term.

Screwed and cement implant prosthesis: current clinical considerations / Prótese sobre implante cimentada e parafusada: considerações clínicas atuais

ABSTRACT Introduction: There is no consensus as to which cemented or screwed retention system is best to avoid bone loss around the implant from a fixed implant-supported restoration. Objective: To evaluate the prosthesis retention systems on screw and cemented implants, regarding: bone loss, survival and failure rate, biological complications and microbiological analysis. Methods: A search was made for scientific articles that contemplated the subject through the databases Pubmed and SciELO, without period restriction. The titles, abstracts and then access to the full text has been verified. Results: It was found that excess cement may play an important role in the development of peri-implant disease. Technical failures are most seen in prosthesis retained by screws, and biological complications in cemented crowns. The success rate for both restraint systems is high, and retention-independent implant prosthesis treatment provides predictability. Conclusion: The appropriate retention system for the patient depends on several factors, including indication, advantages and disadvantages, retention provided, aesthetics and clinical performance.

RESUMO Introdução: Não há consenso sobre qual sistema de retenção, cimentado ou parafusado, é o melhor para evitar perda óssea ao redor do implante de uma restauração fixa implanto-suportada. Objetivo: Avaliar os sistemas de retenção de próteses sobre implantes parafusadas e cimentadas, quanto aos fatores: perda óssea, taxa de sobrevivência e de falhas, complicações biológicas e análises microbiológicas. Métodos: Foi realizada uma busca por artigos científicos que contemplassem o tema através das bases de dados Pubmed e SciELO, sem restrição de período. Os títulos, resumos e em seguida o acesso ao texto completo foi verificado. Resultados: Foi observado que o excesso de cimento pode desempenhar um papel importante no desenvolvimento da doença peri-implantar. Falhas técnicas são mais observadas em próteses retidas por parafusos e complicações biológicas em coroas cimentadas. A taxa de sucesso para os dois sistemas de retenção é alta e o tratamento com próteses sobre implantes independente da retenção oferece previsibilidade ao caso. Conclusão: O sistema de retenção apropriado para o paciente depende de diversos fatores, incluindo a indicação, vantagens e desvantagens, retenção fornecida, estética e desempenho clínico.

Pleomorphic adenoma of buccal mucosa: a case report and review of the literature.

BACKGROUND: Salivary gland neoplasms are rare, accounting for 3% to 5% of all head and neck tumors, and involvement of the minor salivary glands is uncommon. Pleomorphic adenoma (PA) is the most common benign neoplasm, which mainly affects the parotid gland. However, involvement of the cheek mucosa is very rare. OBJECTIVE: This study reports a case of PA in the cheek mucosa. In addition, the etiopathogenesis, clinical and morphological features and differential diagnoses of PA are discussed, emphasizing the importance of knowledge about the characteristics of this tumor for a correct diagnosis. CASE REPORT: A 50-year-old woman presented with a nodular lesion of endophytic growth in the left cheek mucosa. The lesion was small and well-delimited and had a normal mucosa color and intact surface. An excisional biopsy of the lesion was performed, and the diagnosis was PA. CONCLUSION: Although the occurrence of PA in the minor salivary glands of the cheek mucosa is uncommon, the early establishment of a correct diagnosis and initiation of appropriate treatment are important because they permit effective management of the condition and improvement in the prognosis of patients.

Use of erythrocytes in cytotoxicity and toxicity assays of medicinal plant extracts: analysis of their application and bibliometric study / Utilización de eritrocitos en ensayos de citotoxicidad y toxidez de extractos de plantas medicinales: análisis de su aplicación y estudio bibliométrico

Plant species have been used for therapeutic purposes since ancient times and are still in use today since these products represent a source of raw material for the production of phytotherapeutic formulations. Screening and investigation of plants with pharmacological potential require the evaluation of characteristics related to their action, efficacy and safety in different steps. Among these steps, pre- clinical trials are used to evaluate the properties of the test product in in vitro experiments, such as cytotoxicity assays. Within this context, this study consists of a bibliometric analysis of some in vitro cytotoxicity and toxicity assays in erythrocytes used during bioprospecting of medicinal plants. The results demonstrated the wide application of erythrocytes to evaluate the biological effects of medicinal plant extracts. The methods were found to be valid and effective for the preliminary investigation of the in vitro cytotoxicity and toxicity of plant products.

El uso de especies vegetales para fines terapéuticos es una práctica histórica y todavía bastante actual, ya que estos productos pueden representar una fuente de materia prima para la producción de formulaciones fitoterápicas. En investigación de plantas con potencial farmacológico requiere la evaluación de su acción, eficacia y seguridad, a través de diferentes etapas. Entre estas, en los ensayos preclínicos se evalúan las propiedades del producto-prueba en experimentos in vitro, tales como ensayos de citotoxicidad, entre otros. En este aspecto, el presente estudio consiste en un análisis bibliométrico acerca de algunas pruebas de citotoxicidad y toxicidad in vitro en eritrocitos realizados en los ensayos de bioprospección de plantas medicinales. Los resultados evidencian la amplia utilización de eritrocitos para la evaluación de los efectos biológicos de extractos de plantas medicinales, apuntándolos como métodos válidos y eficaces para la investigación preliminar de la citotoxicidad y toxicidad in vitro de productos vegetales.

Effect of Brazilian green propolis on microorganism contaminants of surface of Gorgonzola-type cheese.

Blue cheeses are susceptible to yeast and bacterial growth on their surface, which causes spoilage during ripening process and the formation of slime. The dairy industry frequently control the proliferation of undesirable microorganisms with natamycin and high salt concentration. The green propolis is a complex of substances that presents antimicrobial properties with great potential as preservative in the food industry. The aims of the present study were to identify the mesophilic aerobic microorganisms present on the surface of Gorgonzola-type cheese, evaluate the antifungal and antibacterial effects of the ethanol extract of green propolis (EEP) on the development of those microorganisms and verify the effects of EEP on the sensory quality of cheese. Ten yeast species belonging to genera Yarrowia, Candida, Debaryomyces and Saccharomyces were identified, as well as seven species of bacteria belonging to genera Staphylococcus, Bacillus, Enterococcus, Corynebacterium and Proteus. The EEP showed minimum biocide concentration (MBC), between 0.3% (weight/weight) and 5% for Bacillus cereus and Proteus vulgaris, respectively. Saccharomyces cerevisiae was the most sensitive species (MBC of 0.63%) and Candida parapsilosis the most resistant one (MBC of 5%). In the sensory analysis, the cheeses involved with EEP at 5% concentration did not differ from the control, while at 10%, there was a slight decrease in acceptance. The EEP has potential and feasibility to be used in Gorgonzola-type cheese, inhibiting the main bacteria and yeasts without affecting largely the sensory characteristics of the product.

Análise e caracterização do panorama da distribuição de Cirurgiões-Dentistas no Brasil / Analysis and characterization of the dentist's distribution overview in Brazil / Análisis y caracterización del panorama de la distribución de odontólogos en Brasil

Dentre a categoria odontológica, Cirurgiões-Dentistas (CDs) são os únicos profissionais que tem atribuição exclusiva de prestar assistência clínica direta ao público de forma independente, apresentando um papel importante na Odontologia. O objetivo deste trabalho é caracterizar o panorama da distribuição de CDs no Brasil, considerando-a entre estes profissionais em si e entre a população brasileira, apresentando considerações sobre o perfil profissional e mercadológico dos CDs. O trabalho consiste em um levantamento de dados acerca dos números de CDs no Brasil e do número de habitantes da população brasileira. Os dados mostram que existem 309.088 CDs em exercício no Brasil, os quais concentram-se principalmente nos estados de São Paulo, Minas Gerais, Rio de Janeiro e Paraná. Em nível nacional, há 1CD para 617,1 habitantes.Dentre os estados, Distrito Federal, São Paulo, Santa Catarina, Rio de Janeiro e Paraná apresentam os menores valores proporcionais. As regiões brasileiras Sudeste e Sul concentram os maiores percentuais de CDs do país, enquanto o Norte possui o menor percentual. Paralelamente, Sudeste e Centro-Oeste apresentam as menores proporções de CD/habitantes, enquanto o Nordeste apresenta a maior razão dessa distribuição. Os resultados apontam o atual perfil de distribuição profissional e mercadológica de CDs no Brasil, evidenciando disparidades entre as diferentes localidades do país, podendo assim representar um indicador importante acerca do planejamento mercadológico para os CDs, bem como fornecer reflexões acerca da discrepância entre a quantidade de CDs e o quadro de saúde bucal ainda presente no país(AU)

Among the dental category, dentists are the only professionals that have exclusive attribution of providing direct clinical assistance to the public independently, presenting an important prominence in Dentistry. The aim of this paper is to characterize the dentists' distribution overview in Brazil, considering it among these professionals in them and among the Brazilian population, presenting considerations in the job market. The paper consists of a survey of data about the numbers of dentists in Brazil and the number of inhabitants of the Brazilian population. The data show that there are 309.088 practicing dentists in Brazil, which are mainly concentrated in the states of São Paulo, Minas Gerais, Rio de Janeiro and Paraná. At the national level, there is 1 dentist for 617,1 inhabitants. Among the states, the Federal District, São Paulo, Santa Catarina, Rio de Janeiro and Paraná present the lowest proportional values. The Brazilian regions Southeast and South concentrate the largest percentage of dentists in the country, while the North has the lowest percentage. At the same time, the Southeast and Center-West have the lowest proportions of dentists/inhabitants, while the Northeast has the highest ratio of this distribution. The results show the current profile and job market of these professionals in Brazil, evidencing disparities between the different localities in the country, thus being able to represent an important indicator about market planning for dentists, as well as to provide reflections on the discrepancy between the quantity of dentists and the oral health situation still present in the country(AU)

Entre la categoría odontológica, los odontólogos son los únicos profesionales que tienen atribución exclusiva de prestar asistencia clínica directa al público de forma independiente, presentando un papel importante en la Odontología. El objetivo de este trabajo es caracterizar el panorama de la distribución de odontólogos en Brasil, considerándola entre estos profesionales en sí y entre la población brasileña, presentando consideraciones sobre el perfil profesional y mercadológico de los mismos. El trabajo consiste en un levantamiento de datos sobre los números de odontólogos en Brasil y del número de habitantes de la población brasileña. Los datos muestran que existen 309.088 odontólogos en ejercicio en Brasil, los cuales se concentran principalmente en los estados de São Paulo, Minas Gerais, Río de Janeiro y Paraná. A nivel nacional, hay 1 odontólogo para 617,1 habitantes. En los estados, Distrito Federal, São Paulo, Santa Catarina, Río de Janeiro y Paraná presentan los menores valores proporcionales. Las regiones brasileñas Sudeste y Sur concentran los mayores porcentuales de odontólogos del país, mientras que el Norte tiene el menor porcentaje. Paralelamente, Sudeste y Centro-Oeste presentan las menores proporciones de odontólogos/habitantes, mientras que el Nordeste presenta la mayor razón de esa distribución. Los resultados apuntan al actual perfil de distribución profesional y mercadológica de odontólogos en Brasil, evidenciando disparidades entre las diferentes localidades del país, pudiendo así representar un indicador importante acerca del planeamiento mercadológico, así como proporcionar reflexiones acerca de la discrepancia entre la cantidad de profesionales y el cuadro de salud bucal todavía presente en el país(AU)

Effects of soil attributes and straw accumulation on the sorption of hexazinone and tebuthiuron in tropical soils cultivated with sugarcane.

Brazil is the largest sugarcane producer in the world in which hexazinone (3-cyclohexyl-6-dimethylamino-1-methyl-1,3,5-triazine-2,4-dione) and tebuthiuron (1-(5-tert-butyl-1,3,4-thiadiazol-2-yl)-1,3-dimethylurea) are heavily used. Sugarcane harvesting is changing from the manual system with previous straw burning to the mechanized system without straw burning. The lack of burning results in soil organic carbon accumulation mainly in clayey soils, which should affect herbicides availability and fate. Therefore, we evaluated sorption of these herbicides in soil samples with and without straw burning. Both herbicides presented low apparent sorption coefficients (mean K(d,app)= 0.6 and 2.4 L kg(-1) for hexazinone and tebuthiuron, respectively), suggesting that they may leach to groundwater. Moreover, their sorption correlated primarily with soil organic carbon (SOC), but iron oxide contents extracted with ammonium oxalate (Fe2O3(AOX)) also affected it (K(d,app) = -0.228 + 0.0397 SOC + 0.117 Fe2O3(AOX) for hexazinone and K(d,app) = -1.407 + 0.201 SOC + 0.348 Fe2O3(AOX) for tebuthiuron). Soil organic carbon accumulation due to straw maintenance in the field positively affected sorption of both herbicides, but its effects were not enough to classify them as "non-leachers."

Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy.

PURPOSE: To compare the postoperative results of phacotrabeculectomy with implantation of PMMA, foldable silicone or foldable hydrofobic acrylic intraocular lens (IOL). SETTING: Glaucoma unit, The Royal Liverpool University Hospital, Liverpool, United Kingdom. METHODS: We studied a total of 124 eyes of three consecutive groups of patients with glaucoma and cataract that underwent phacotrabeculectomy with implantation of a PMMA (30 eyes), a foldable silicone (57 eyes) or a foldable acrylic (37 eyes) IOL. Postoperative Snellen visual acuity and intraocular pressure (IOP), and early and late complications were assessed. All data were analyzed by means of chi2 test, Fisher's exact test, ANOVA/MANOVA tests or a combination whenever appropriate. RESULTS: In all three groups the early and late mean postoperative IOPs were significantly lower than the preoperative ones (p<0.001), with no intergroup differences (p=0.48). The number of eyes with early postoperative hypertension (IOP>25 mmHg) and hypotony (IOP<7 mmHg) was similar in the three groups (p=0.91 and p=0.92 respectively). All groups showed improvement in mean visual acuity (p<0.001), and the differences among the groups were not significant (p=0.79). By 9-12 months after surgery IOPs lower than 22 mmHg without glaucoma medication were found in 76.9% in the PMMA group, 76.6% in the silicone group and in 76.9% in the acrylic group. At the same interval, best visual acuity of 6/12 or better was attained in 80.8%, 83% and 80.8%, in the PMMA, silicone and acrylic groups respectively. The silicone group had significantly more postoperative fibrin reaction into the anterior chamber (p=0.01) and giant cell deposits on the IOL (p<0.0001) than the PMMA and the acrylic groups. The rate of Yag laser posterior capsulotomy was lower with the acrylic IOL (0%) than with the silicone (12.2%) or PMMA (13.3%) IOLs (p=0.08). CONCLUSION: In patients with glaucoma and cataract, phacotrabeculectomy with PMMA, silicone or acrylic IOL was equally effective in lowering the IOP and improving visual acuity. However, incidence of fibrin reaction and lens deposits was higher in those eyes which received a silicone IOL. The PMMA and the acrylic groups did not differ with respect to postoperative complications, but those eyes with an acrylic IOL had a lower rate of posterior capsule opacification.

Comparison of PMMA, foldable silicone and foldable acrylic hydrophobic intraocular lenses in combined phacoemulsification and trabeculectomy

PURPOSE: To compare the postoperative results of phacotrabeculectomy with implantation of PMMA, foldable silicone or foldable hydrofobic acrylic intraocular lens (IOL). SETTING: Glaucoma unit, The Royal Liverpool University Hospital, Liverpool, United Kingdom. METHODS: We studied a total of 124 eyes of three consecutive groups of patients with glaucoma and cataract that underwent phacotrabeculectomy with implantation of a PMMA (30 eyes), a foldable silicone (57 eyes) or a foldable acrylic (37 eyes) IOL. Postoperative Snellen visual acuity and intraocular pressure (IOP), and early and late complications were assessed. All data were analyzed by means of c² test, Fisher's exact test, ANOVA/MANOVA tests or a combination whenever appropriate. RESULTS: In all three groups the early and late mean postoperative IOPs were significantly lower than the preoperative ones (p<0.001), with no intergroup differences (p=0.48). The number of eyes with early postoperative hypertension (IOP>25 mmHg) and hypotony (IOP<7 mmHg) was similar in the three groups (p=0.91 and p=0.92 respectively). All groups showed improvement in mean visual acuity (p<0.001), and the differences among the groups were not significant (p=0.79). By 9-12 months after surgery IOPs lower than 22 mmHg without glaucoma medication were found in 76.9 percent in the PMMA group, 76.6 percent in the silicone group and in 76.9 percent in the acrylic group. At the same interval, best visual acuity of 6/12 or better was attained in 80.8 percent, 83 percent and 80.8 percent, in the PMMA, silicone and acrylic groups respectively. The silicone group had significantly more postoperative fibrin reaction into the anterior chamber (p=0.01) and giant cell deposits on the IOL (p<0.0001) than the PMMA and the acrylic groups. The rate of Yag laser posterior capsulotomy was lower with the acrylic IOL (0 percent) than with the silicone (12.2 percent) or PMMA (13.3 percent) IOLs (p=0.08). CONCLUSION: In patients with glaucoma and cataract, phacotrabeculectomy with PMMA, silicone or acrylic IOL was equally effective in lowering the IOP and improving visual acuity. However, incidence of fibrin reaction and lens deposits was higher in those eyes which received a silicone IOL. The PMMA and the acrylic groups did not differ with respect to postoperative complications, but those eyes with an acrylic IOL had a lower rate of posterior capsule opacification.

Esfincterotomia externa transuretral no tratamento da bexiga neurogênica / Transurethral external sphincterotomy in neurogenicd bladder treatment

A esfincterotomia externa transuretral é, atualmente, o método reconhecido de tratar disfunçäo do esfíncter externo da uretra. Onze pacientes do sexo masculino foram submetidos a este procedimento, realizado em posiçäo anteromediana (12 horas). As indicaçöes cirúrgicas forma 3 casos de cateter permanente, 5 com resíduo urinário e micçäo difícil e 3 com dilataçäo importante do aparelho urinário superior. Todos os 3 pacientes com cateter puderam ser mantidos sem os mesmos. Entre o grupo de resíduo alto, 3 obtiveram diminuiçäo a menos de 50 ml, mas um refez o problema e foi reoperado com sucesso. finalmente, entre os 3 com hidronefrose, houve 2 resultados bons