In Vitro and In Silico Antioxidant Activity and Molecular Characterization of Bauhinia ungulata L. Essential Oil.

Bauhinia ungulata is an antioxidant medicinal plant that has been manipuled in Brazil to lower glycemic index as well is for alternative treatment for diabetes. Therefore, the present hearch has aimed to investigates the antioxidant effects of the essential oil of Bauhinia ungulata L. (EOBU) collected in Amazon region better specified in Boa Vista, Roraima, Brazil, located in the Amazon region. Gas chromatography had been used to characterize the components, and antioxidant assays such as DPPH, TAC, reducing power, Fe2+ chelation, and total phenols had also been performed. The major constituents had molecularly anchored with the human catalase (CAT) enzyme, and maltol has showed as a positive control. Among the 25 revealed components, the main ones have been α-bisabolol (27.2 %), ß-Caryophyllene (12.5 %) and Epi-γ-eudesmol (13.6 %). The EOBU has comproved a TAC value of 618.79 mg of ascorbic acid equivalent, free radical scavenging capacity (DPPH) around 53.7 % and 65.27 %, Fe2+ chelation capacity of 161±6 and 126.7±39.6, for 0.1 mg.mL-1 and 0.5 mg.mL-1 , respectively. The power around the EOBU has appeared percentages equals to 28.66 %, 44.6 %, and 77.03 % in the concentrations tested. As well as, 96.5 % of total phenols. The compounds α-bisabolol (-5.7±0.4 Kcal.mol-1 ) and ß-caryophyllene (-6.1±0.5 Kcal.mol-1 ) have showed good interaction with CAT compared to Maltol (-4.4±0.4 Kcal.mol-1 ). The present work has demonstrated that EOBU functions as a potent antioxidant, capable of scavenging free radicals and reducing oxidative stress damage.

Lippia origanoides essential oil increases longevity and ameliorates ß-amyloid peptide-induced toxicity in Caenorhabditis elegans.

Lippia origanoides essential oil (LOEO) is extensively utilised as food preservative due to its antioxidant and antibacterial activities. In this study, the antioxidant and anti-ageing effects of LOEO was investigated in vivo using the nematode Caenorhabditis elegans. The gas chromatography-mass spectrometry analysis indicated that the main components of LOEO are carvacrol and thymol. LOEO treatment improved physiological parameters such as pharyngeal pumping, locomotion and body size indicating that is not toxic to C. elegans. LOEO treatment showed antioxidant effect in C. elegans by reducing endogenous ROS (Reactive Oxygen Species) production and increasing their survival under oxidative stress. Finally, LOEO treatment significantly extended C. elegans lifespan and alleviated the paralysis induced by ß-amyloid peptide overexpression in the muscle. This work demonstrates for the first time LOEO antioxidant and anti-ageing properties on an organism level providing a valuable proof of principle to support further studies in the development of nutraceuticals or antioxidant phytotherapy.

Systemic scleroderma: imaging findings of diagnosis and clinical management of temporomandibular joint disorders / Esclerodermia sistêmica: diagnóstico por achados imaginológicos e manejo clínico das disfunções temporomandibulares

Scleroderma, an autoimmune disease, directly affects the production of collagen in the connective tissue. In its systemic form, the disease causes oral manifestations such as: limited mouth opening, xerostomia, periodontal disease, thickening of the periodontal ligament and bone resorption of the mandible. This case report aims to draw attention to the difficulties encountered in providing dental care to patients with scleroderma and also to highlight the imaging findings, with emphasis on the temporomandibular joints, which are of interest to dentists about the disease. In the present case, the patient presented bilateral condylar erosion, in addition to disc displacement without reduction. Due to the systemic condition of the patient, it was decided to make an individualized occlusal splint. The limitation of mouth opening is a limiting factor for the manufacture of prostheses and plates, which is why partial prostheses are indicated and are easily removed by the patient. The decisions taken have a great impact on the health and quality of life of patients in these conditions, so there is a need for multidisciplinary involvement in order to arrive at the best treatment plan. After five years of using the stabilizing plate overnight, the patient reports greater comfort and muscle relaxation upon waking up (AU)

Esclerodermia, uma doença autoimune, afeta diretamente a produção de colágeno do tecido conjuntivo. Na forma sistêmica, a doença causa manifestações bucais, como: limitação de abertura bucal, xerostomia, doença periodontal, espessamento do ligamento periodontal e reabsorção da mandíbula. Este relato de caso tem por objetivo chamar atenção para as dificuldades encontradas ao promover atendimento odontológico para pacientes com esclerodermia e também destacar os achados imaginológicos, com ênfase na articulação temporomandibular, que são da doença e de interessa ao cirurgião-dentista. No presente caso, a paciente apresentava erosão condilar bilateral, com deslocamento de disco sem redução. Devido à condição sistêmica da paciente, foi decidido confeccionar uma placa oclusal individualizada. A limitação de abertura bucal é um fator limitante para confecção de próteses e placas, por isso próteses parciais são indicadas, além de serem de fácil remoção pelo paciente. As decisões tomadas tem grande impacto na saúde e qualidade de vida de pacientes nessas condições, deste modo é necessário uma equipe multidisciplinar envolvidas para chegar no melhor plano de tratamento. Após cinco anos fazendo uso da placa estabilizadora durante a noite, a paciente relata maior conforto e relaxamento muscular ao acordar (AU)

Single implant placement in the maxillary aesthetic area with or without connective tissue grafting: A 1-year follow-up randomised clinical trial.

PURPOSE: To evaluate the influence of connective tissue graft on the soft tissue thickness and aesthetics around single implants placed in the aesthetic zone of the maxilla. MATERIALS AND METHODS: Forty-two patients with indications for single implant placement in the aesthetic zone were randomly allocated into two groups: the implant group (implant insertion) and the implant + connective tissue graft group (implant insertion and placement of a 1.50-mm-thick connective tissue graft). Clinical evaluations were performed at baseline, 4 months after surgery (prior to prosthetic reconstruction) and 1 year after crown placement to assess tissue thickness at the crestal aspect and the buccal aspect, buccal defects, keratinised tissue width and proximal bone resorption. Aesthetics were assessed using the pink aesthetic score index, and postoperative discomfort and pain tests were also performed. RESULTS: Only the implant + connective tissue graft group presented a significant increase in tissue thickness at the buccal aspect, with 2.36 ± 0.94 mm at baseline, 3.35 ± 1.00 mm after 4 months and 3.23 ± 0.77 mm after 1 year (P < 0.05), whereas no change was observed in the implant group. The difference between the two groups was significant after 4 months and 1 year (P < 0.05). The implant + connective tissue graft group also showed a greater reduction in buccal defects after 1 year compared to the implant group (∆ -0.50 ± 0.70 mm and ∆ -1.80 ± 1.30 mm, respectively; P < 0.05). After 1 year, a significant intergroup difference in proximal bone resorption was observed, with the implant + connective tissue graft group showing less bone resorption compared to the implant group (0.75 ± 0.20 mm and 0.92 ± 0.30 mm, respectively; P < 0.05). CONCLUSIONS: Placement of a connective tissue graft simultaneous to single implant insertion in the anterior maxillary region can increase the thickness of the peri-implant mucosa and reduce proximal bone resorption.

Essential and fixed oils from Amazonian fruits: proprieties and applications.

The Amazon biome is rich in oilseed plant species, which have essential physical-chemical, nutritional and pharmacological properties, in addition to potential economic value for different biotechnological and industrial applications. In the extraction of fixed oils, some Amazon fruit that are oleaginous matrices are acquiring more prominence, such as tucumã (Astrocaryum vulgare), pupunha (Bactris gasipaes), buriti (Mauritia flexuosa), Brazil nut (Bertholletia excelsa), pracaxi (Pentaclethra macroloba), patawa (Oenocarpus bataua), among others. These oilseed fruits have natural antioxidants, essential fatty acids, and good oxidative stability. The essential oils from these oilseed species have antibiotic and anti-inflammatory properties, in addition to the presence of natural antioxidants, such as carotenoids and tocopherols. Thus, Amazonian oilseed species are valuable resources. For these properties to be preserved during fruit processing, the process of extracting the oil is critical. More studies are needed on their properties and applications, seeking to add commercial value, and the optimization of oils and fats processing to obtain quality products. Therefore, this article aims to present Amazonian fruits' potential to obtain fixed and essential oils and possible application in the food industry.

Effect of copaíba essential oil (Copaifera officinalis L.) as a natural preservative on the oxidation and shelf life of sheep burgers.

We evaluated the effects of the inclusion of copaíba (Copaifera officinalis L.) essential oil at 0.05 and 0.1% as a possible replacement of synthetic additive butylated hydroxytoluene (BHT) in sheep burgers during 14 days of storage in a refrigerated display case (4°C). During the shelf life days, analyzes of antioxidant activity, lipid oxidation, pH, color, cooking loss, texture and consumer acceptability were carried out on refrigerated burgers. The addition of copaíba essential oil showed an antioxidant effect in sheep burgers (P > 0.05), reducing lipid oxidation. Copaiba essential oil added at 0.05% showed the highest antioxidant activity, decreased cooking losses and delaying discoloration (loss of redness) during storage; it further improved, the tenderness of sheep burgers (P < 0.05). The treatments had no effect (P > 0.05) on consumer acceptability. Copaiba essential oil is a promising natural antioxidant to increase the shelf life of meat products, as well as being a viable solution to replace synthetic antioxidant BHT, thereby promoting the fresh-like quality appeal of sheep burgers.

Treatment of Grade III furcation involvement in upper molars: Case Series with 2-16-year follow-up.

Frequently, the clinicians are addressed to decide between the preservation of Grade III furcation molar and the implant replacement, due to the increased access among the population to this therapy over the years and high success rate of the osseointegrated implants. This case series presents clinical and radiographic data collected from 10 patients who underwent 13 root amputations for the treatment of degree Grade III furcation in maxillary molars with follow-up until 16 years. The results showed improvements in probing depth, bleeding on probing, and radiographic aspects. The follow-up time indicates that root amputation is an effective long-term treatment solution, especially when the patient's local, systemic, or financial conditions make it difficult or impossible to implant placement.

Antibiotics for appendicectomy in children and adolescents during the perioperative period: an integrative review / Antibióticos para apendicectomia em crianças e adolescentes no perioperatório: uma revisão integrativa

ABSTRACT Objective: To analyze the preoperative use of antibiotics in children and adolescents requiring appendectomy. Data source: Integrative review was performed in the MEDLINE, Latin American and Caribbean Health Sciences (LILACS) and Cochrane databases and the PubMed portal, with no time limit. The keywords used were: appendicitis, child, adolescent and antibacterial with Boolean AND. The articles included were published in Portuguese, English or Spanish and whose participants were under 18 years of age. Review articles and guidelines were excluded. The studies were classified according to their level of evidence and 24 papers were selected. Data collection and analysis: Seven randomized clinical trial studies (level of evidence II), eight cohorts (level III), seven retrospective observational studies (level V) and two historical documentary analysis (level IV) were selected. The studies addressed antibiotics used in acute appendicitis in both uncomplicated and complicated cases. Antibiotics initiated in the preoperative period showed a decrease in the rates of surgical wound infections. First-line (empiric) regimens were tested for sensitivity to microorganisms in peritoneal material cultures, however the results were controversial. Broad-spectrum antibiotics have been suggested in some studies because they have good coverage, but in others they have not been recommended because of the risk of developing bacterial resistance. Shorter administration time and earlier change to the oral route reduced hospitalization time. Conclusions: There are several clinical protocols with different antibiotics. However, there is no standardization concerning the type of antibiotic drug, time of use, or route.

RESUMO Objetivo: Analisar o uso de antibióticos em crianças e adolescentes no perioperatório de apendicectomia. Fonte de dados: Realizou-se uma revisão integrativa, nas bases de dados MEDLINE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Cochrane e no portal PubMed, sem limite de tempo. As palavras-chave utilizadas foram: apendicite, criança, adolescente e antibacterianos com booleano AND. Os artigos incluídos foram publicados nos idiomas português, inglês ou espanhol e cujos participantes tivessem idade inferior a 18 anos. Os artigos de revisão e diretrizes foram excluídos. A qualidade da evidência foi analisada, e foram selecionados 24 artigos. Síntese dos dados: Sobre os estudos selecionados, sete foram ensaios clínicos randomizados (nível de evidência II), oito coortes (nível III), sete observacionais retrospectivos (nível V) e duas análises documentais históricas (nível IV). Os estudos abordaram antibióticos usados na apendicite aguda em suas formas não complicada e complicada. Os antibióticos iniciados no pré-operatório evidenciaram diminuição nas taxas de infecção da ferida cirúrgica. Os esquemas de primeira linha (empíricos) foram testados em relação à sensibilidade dos microrganismos nas culturas de material peritoneal, no entanto os resultados foram controversos. Sugeriram-se antibióticos de amplo espectro em alguns estudos por apresentar boa cobertura, no entanto em outros eles não foram recomendados, pelo risco de desenvolver resistência bacteriana. O menor tempo de administração e a mudança mais precoce para a via oral reduziram o tempo de internação. Conclusões: Existe um grande número de protocolos clínicos com antibióticos diversos, no entanto não existe padronização em relação ao tipo de antibiótico, tempo de uso nem via.

ANTIBIOTICS FOR APPENDICECTOMY IN CHILDREN AND ADOLESCENTS DURING THE PERIOPERATIVE PERIOD: AN INTEGRATIVE REVIEW.

OBJECTIVE: To analyze the preoperative use of antibiotics in children and adolescents requiring appendectomy. DATA SOURCE: Integrative review was performed in the MEDLINE, Latin American and Caribbean Health Sciences (LILACS) and Cochrane databases and the PubMed portal, with no time limit. The keywords used were: appendicitis, child, adolescent and antibacterial with Boolean AND. The articles included were published in Portuguese, English or Spanish and whose participants were under 18 years of age. Review articles and guidelines were excluded. The studies were classified according to their level of evidence and 24 papers were selected. DATA COLLECTION AND ANALYSIS: Seven randomized clinical trial studies (level of evidence II), eight cohorts (level III), seven retrospective observational studies (level V) and two historical documentary analysis (level IV) were selected. The studies addressed antibiotics used in acute appendicitis in both uncomplicated and complicated cases. Antibiotics initiated in the preoperative period showed a decrease in the rates of surgical wound infections. First-line (empiric) regimens were tested for sensitivity to microorganisms in peritoneal material cultures, however the results were controversial. Broad-spectrum antibiotics have been suggested in some studies because they have good coverage, but in others they have not been recommended because of the risk of developing bacterial resistance. Shorter administration time and earlier change to the oral route reduced hospitalization time. CONCLUSIONS: There are several clinical protocols with different antibiotics. However, there is no standardization concerning the type of antibiotic drug, time of use, or route.

Failure Probability, Stress Distribution and Fracture Analysis of Experimental Screw for Micro Conical Abutment.

The aim of this study was to evaluate the failure probability of two types of abutment screws after compressive load and to analyze the stress distribution with finite element method. Sixty (60) single-tooth implant restorations were assembled on titanium implants (e-fix, A.S. Technology - Titanium Fix). The groups were divided into Conventional screw (Screw neck 1.5 ø mm) and Experimental screw (Screw neck constricted with 1.2 ø mm). Specimens were subjected to single load to failure with compressive test according ISO 14801. The fractured specimens were subjected to stereomicroscopy for measurement of remaining screws inside the implant and characterization of fracture origin. Representative specimens were analyzed by scanning electronic microscopy. For finite element method (FEM), an identical 3D model of the two in vitro test groups were used with similar conditions (30º, 100 N load). The stress in the abutment screw was analyzed by von-Mises criteria. The results of strength means were 4132.5 ± 76 MPa and 4528.2 ± 127.2 for conventional and experimental groups, respectively. During microscopy, the mean (mm) of the remaining screw piece inside the implants were 0.97 ± 0.23 and 1.32 ± 0.12 for conventional and experimental groups, respectively. In FEM, the conventional group showed stress concentered in an unfavorable region (peak of 39.23 MPa), while the experimental group showed more stress areas but less concentration than the conventional group (36.6 MPa). In using the tested experimental geometry, the abutment screw can have its strength improved, and the origin of failure can be more favorable to clinical resolution.

Nova abordagem no tratamento de recessões gengivais associadas à lesão cervical não cariosa / New approach in the treatment of gingival recessions associated with non-carious cervical lesion ­ case report

A recessão gengival está frequentemente associada à lesão cervical não cariosa (LCNC), originando uma lesão combinada que tem um prognóstico de tratamento diferente de quando as duas lesões se apresentam sozinhas. Tratamentos propostos possuem limitações, e o protocolo clínico ideal para o manejo dessas lesões ainda não foi estabelecido. Assim, o objetivo do presente relato de caso foi apresentar uma nova técnica cirúrgico-restauradora para o tratamento de recessões gengivais associadas à LCNC. Para tal, uma restauração parcial em resina composta foi realizada somente na parte coronal da lesão cervical. Em uma segunda sessão, o procedimento cirúrgico para recobrimento radicular com enxerto de tecido conjuntivo foi realizado. Seis meses após o procedimento, a paciente estava satisfeita com o resultado final alcançado, demonstrando que esse protocolo pode ser uma alternativa de tratamento aos protocolos existentes para o tratamento de recessões gengivais associadas à LCNC.

Gingival recession is often associated with non-carious cervical lesion (NCCL), resulting in a combined lesion which has a different treatment prognosis when the two lesions appear alone. Proposed treatments have limitations and the ideal clinical protocol for the management of these lesions has not been established. Thus, the aim of this case report is to present a new surgical-restorative technique for the treatment of gingival recessions associated with NCCL. For this, a composite resin partial restoration was performed only in the coronal part of the cervical lesion. In a second session, the surgical procedure for root coverage with connective tissue graft was performed. Six months after the procedure, the patient was satisfied with the final result achieved, demonstrating that this protocol may be an alternative to the existing protocols for the treatment of gingival recessions associated with NCCL.

Relative positional change of a dental implant in the esthetic zone after 12 years: a case report.

Although the biological process of osseointegration is similar in adults and adolescents, implant placement is contraindicated in young patients until bone growth is complete. However, even in adults, significant craniofacial changes may occur over an individual's lifetime, as a result of discrete and continuous dental eruption, vertical soft tissue augmentation, or facial bone growth. After such changes, implants may be in infraocclusion. The present case report describes the long-term follow-up of a dental implant located in the esthetic zone. The implant, placed when the patient was 20 years old, demonstrated a relative positional change 12 years postinsertion. The possible reasons for the movement and the long-term clinical implications of this type of case are discussed.

Perfuração e reparo da membrana do seio maxilar após extração dentária: resolução cirúrgica e implantar em etapas. Relato de caso com três anos de acompanhamento / Perforation and repair of the maxillary sinus membrane after dental extraction: surgical resolution and implant in stages. Case report with three years of monitoring

O objetivo deste relato foi apresentar um caso clínico no qual o levantamento do seio maxilar foi realizado em uma região com comunicação bucosinusal prévia decorrente da extração dos elementos 16 e 17. A comunicação bucosinusal foi fechada por um retalho mucoperiosteal no mesmo ato cirúrgico das exodontias. Após seis meses de cicatrização, o levantamento do seio maxilar foi associado ao enxerto ósseo bovino (Bio-Oss) e membrana reabsorvível (Bio-Guide). Depois de mais nove meses de cicatrização, dois implantes foram instalados pela técnica convencional, tendo perfeito travamento. As próteses foram confeccionadas após seis meses de osseointegração. A paciente foi acompanhada trimestralmente no primeiro ano e depois semestralmente. Passados três anos do término do tratamento, a paciente mostra-se satisfeita com os resultados. O protocolo apresentado neste caso para resolução da comunicação bucosinusal pós-extração dentária mostrou-se efetivo. Entretanto, o clínico deve considerar outras alternativas cirúrgicas, já que nem todas as perfurações apresentam as mesmas dimensões.

The objective of this report was to present a clinical case in which the maxillary sinus lifting was performed in a region with previous bucosinusal communication due to the extraction of elements 16 and 17. The bucosinusal communication was closed by a mucoperiosteal flap in the same surgical procedure of the exodontia. After six months of healing, maxillary sinus lift was associated with bovine bone graft (Bio-Oss) and reabsorbable membrane (Bio-Guide). After another nine months of healing, two implants were installed by the conventional technique, having perfect locking. The prostheses were made after six months of osseointegration. The patient was followed quarterly in the first year and then in the semiannual period. Three years after the end of treatment, the patient is satisfied with the results. The protocol presented in this case for resolution of oral buccal communication after dental extraction was effective. However, the clinician should consider other surgical alternatives, since not all perforations have the same dimensions.

Tratamento cirúrgico para recobrimento radicular em molar superior / Surgical treatment for root coverage in the upper molar tooth ­ a case report

A recessão gengival é uma condição muito comum atualmente, definida como o deslocamento da margem gengival apicalmente à junção cemento/esmalte, com consequente exposição da superfície radicular ao ambiente bucal. Apesar das recessões gengivais afetarem diversos grupos de dentes, poucos trabalhos tentam elucidar qual é o melhor protocolo de tratamento para as recessões gengivais presentes em molares. Visando um protocolo cirúrgico que proporcione uma satisfatória taxa de recobrimento radicular e um melhor resultado estético, o presente relato de caso teve como objetivo apresentar uma técnica cirúrgica alternativa para o tratamento de recessões gengivais em molares superiores. Para tal, um retalho dividido foi confeccionado por meio de incisões relaxantes e deslocado lateralmente, a partir da área doadora, para o elemento dental com a recessão. Após o deslocamento do retalho, o mesmo foi suturado em posição. Seis meses após o procedimento, o paciente estava satisfeito com o resultado final alcançado, demonstrando que esse protocolo pode ser uma alternativa de tratamento aos protocolos existentes para o tratamento de recessões gengivais.

Gingival recession is a condition defined as the apical positioning of the gingival margin in relation to the cemento-enamel junction, resulting in root exposure in the oral environment. Although gingival recession may affect many groups of teeth, there are few studies that attempt to clarify which is the best treatment protocol for gingival recessions localized in molars. In order to evaluate a surgical approach that lead to a satisfactory root coverage rate and a good esthetic outcome, the aim of this case report is to present an alternative surgical technique for the treatment of gingival recession in upper molar teeth. For this, a split-flap was made through vertical incisions and laterally positioned from the donor area to the affected tooth and sutured in position. Six months after the procedure, the patient was satisfied with the final result achieved, showing that this protocol may be an alternative to the existing treatments for the gingival recession.

TOTAL COST OF HOSPITALIZATION OF PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY RELATED TO NUTRITIONAL STATUS.

BACKGROUND: In the Western world, the population developed an overweight profile. The morbidly obese generate higher cost to the health system. However, there is a gap in this approach with regard to individuals above the eutrofic pattern, who are not considered as morbidly obese. AIM: To correlate nutritional status according to BMI with the costs of laparoscopic cholecystectomy in a public hospital. METHOD: Data were collected from medical records about: nutritional risk assessment, nutricional state and hospital cost in patients undergoing elective laparoscopic cholecystectomy. RESULTS: Were enrolled 814 procedures. Average age was 39.15 (±12.16) years; 47 subjects (78.3%) were women. The cost was on average R$ 6,167.32 (±1830.85) to 4.06 (±2.76) days of hospitalization; 41 (68.4%) presented some degree of overweight; mean BMI was 28.07 (±5.41) kg/m²; six (10%) individuals presented nutritional risk ≥3. There was a weak correlation (r=0.2) and not significant (p <0.08) between the cost of hospitalization of the sample and length of stay; however, in individuals with normal BMI, the correlation was strong (r=0,57) and significant (p<0.01). CONCLUSION: Overweight showed no correlation between cost and length of stay. However, overweight individuals had higher cost of hospitalization than those who had no complications, but with no correlation with nutritional status. Compared to those with normal BMI, there was a strong and statistically significant correlation with the cost of hospital stay, stressing that there is normal distribution involving adequate nutritional status and success of the surgical procedure with the consequent impact on the cost of hospitalization.

RACIONAL: No mundo ocidental, a população desenvolveu um perfil de excesso de peso corporal. Os obesos mórbidos geram custo mais alto para o sistema de saúde. Entretanto, observa-se um hiato no tocante aos indivíduos acima do eutrofismo, mas não considerados obesos mórbidos. OBJETIVO: Correlacionar estado nutricional, segundo o IMC, com custo de internação de colecistectomias videolaparoscópicas. MÉTODO: Coleta de dados dos prontuários sobre: avaliação de risco nutricional, estado nutricional e custo de internação de pacientes submetidos à colecistectomia videolaparoscópica eletiva no período de janeiro de 2012 a dezembro de 2014. RESULTADOS: Foram analisados 814 procedimentos. A idade média foi de 39,15 (±12,16) anos; 47 (78,3%) eram mulheres. O custo de internação foi, em média, de R$ 6.167,32 (±1.830,85) para 4,06 (±2,76) dias de internação. Quarenta e um (68,4%) pacientes apresentavam algum grau de sobrepeso; o IMC médio foi 28,07 (±5,41) kg/m²; seis (10%) indivíduos apresentavam risco nutricional ≥3. Houve correlação fraca (r=0,2) e não significativa (p<0,08) entre o custo de hospitalização e o tempo de permanência. No entanto, em indivíduos com IMC normal, a correlação foi forte (r=0,57) e significante (p<0,01). CONCLUSÃO: Sobrepeso não demonstrou correlação entre custo e tempo de internação. Entretanto, os indivíduos com sobrepeso apresentaram custo maior de internação em relação aos que não tiveram intercorrência, mas sem correlação com o estado nutricional. Em relação aos com IMC normal, houve correlação forte e estatisticamente significante com o custo para tempo de internação, reforçando que há provável distribuição normal envolvendo estado nutricional adequado e sucesso do procedimento cirúrgico com consequente impacto no custo de internação.

Comparison of two power densities on the healing of palatal wounds after connective tissue graft removal: randomized clinical trial.

UNLABELLED: Connective tissue graft (CTG), which is considered to be among the best techniques for treating gingival recession, has presented stable long-term results. However, this technique causes morbidity and discomfort in the palatine region due to graft removal at that site. A previous study reports that photobiomodulation (PBM) using a dosage of 15 J/cm(2) may improve wound healing and the patient's postoperative comfort. However, no other studies in the literature provide the best application dosage or comparisons between protocols for this purpose. The aim of this study is to compare two power densities of PBM on the wound-healing process of the donor palatine area after CTG removal. In this study, 51 patients presenting buccal gingival recession were randomized into one of the following groups: group 1: CTG procedure for root coverage and PBM application at the donor site using a 60 J/cm(2) dose; group 2: CTG and PBM application using a 30 J/cm(2) dose; or group 3: CTG and sham application. The evaluated parameters were the wound remaining area (WRA), scar and tissue colorimetry (TC), tissue thickness (TT), and postoperative discomfort (D), evaluated at baseline and 7, 14, 45, 60, and 90 days after surgery. Group 1 presented statistically significant smaller wounds at day 7 (p > 0.05). None of the patients presented scars at the operated area, and all of the patients reported mild discomfort, with low consumption of analgesic pills. We concluded that the protocol of 60 J/cm(2) provided faster wound healing 7 days after removing the connective tissue graft for root coverage. TRIAL REGISTRATION: ClinicalTrial.org (NCT02580357) https://clinicaltrials.gov/ct2/show/NCT02580357 .

Comparison of two methods of dental prophylaxis: evaluation of arterial pressure and patient comfort in a clinical randomized controlled trial / Comparação entre dois métodos de profilaxia dental: avaliação da pressão arterial e conforto do paciente. Estudo clínico controlado e randomizado

Introduction: The number of hypertensive patients is increasing and prophylaxis with bicarbonate jet are widely performed in clinical practice using large amounts of this substance in a short period of time, which may lead to increased arterial pressure. In the literature there are several studies that analyze the effect of sodium bicarbonate jet on the biofilm and dental structures, but not report the effect on arterial pressure. Aim: Evaluated the change in arterial pressure before and after two procedures of dental prophylaxis, jet baking soda application and conventional prophylaxis, and patient opinion of the comfort of each system was obtained. Material and method: We selected 20 patients aged 18 to 30 in need of prophylaxis to remove biofilm. The patients were placed into three different treatment groups: sodium bicarbonate jet (G1), conventional prophylaxis (G2) and control (G3), with a one month interval between treatments. Patients were divided into groups randomly. Measurements were performed immediately before and after the procedure, 15 and 30 minutes after the end of treatment. Patient comfort was measured using a Visual Analog Scale (VAS) at the end of each treatment. Data were analyzed by analysis of variance. Result: There was a statistically significant difference in the comfort of the procedures, with G2 and G3 being better than G1. Additionally, an increase in the diastolic blood pressure was observed in sodium bicarbonate jet group evaluated just after the procedure. Conclusion: The conventional prophylaxis is more comfortable from the patient stand point and does not alter arterial pressure.

Introdução: A quantidade de pacientes hipertensivos está aumentando e, a profilaxia com jato de bicarbonato de sódio é bastante empregada na prática clínica usando grande quantidade dessa substância em um período curto de tempo que poderia aumentar a pressão arterial. Objetivo: Foi avaliado a alteração da pressão arterial antes e após os dois métodos de profilaxia dental e obtido a opinião de conforto do paciente em relação a esses métodos. Material e método: Selecionou-se 20 pacientes, na faixa etária de 18 a 30 anos, que necessitavam de profilaxia para remoção de biofilme dental e foram submetidos aos três tipos diferentes de tratamento: jato de bicarbonato de sódio (G1), profilaxia convencional (G2), e controle (G3), em intervalos de um mês entre eles. Os pacientes foram divididos de forma randomizada. As aferições realizaram-se antes da profilaxia, imediatamente ao fim do procedimento, 15 e 30 minutos após o término do tratamento. O conforto do paciente foi medido por meio de uma Escala Analógica Visual (VAS) após o final de cada tratamento. Os dados foram analisados por meio de teste de Variância. Resultado: Houve diferença estatisticamente significante quanto ao conforto dos procedimentos, sendo G2 e G3 melhores que G1. Observou-se aumento da pressão arterial diastólica no grupo jato de bicarbonato de sódio imediatamente após a profilaxia. Conclusão: A profilaxia convencional é mais confortável do ponto de vista do paciente e não altera a pressão arterial.

Impact of the Bowel Management Program on the quality of life in children with fecal incontinence.

PURPOSE: Evaluate the impact of implementing Bowel Management Program (BMP) on quality of life (QoL) in children with fecal incontinence (FI). METHODS: Children 3-12 years referred to the Children's Treatment Center of FI were included and categorized accordingto the tendency to constipation (dilated colon; group 1) or diarrhea (non-dilated colon; group 2). Evaluations were performed before and after 3 months of BMP implementation. Perceptions from parents and children about QoL were assessed by the instrument PedsQL4.0 and the severity of FI by the fecal incontinence index (FII) of Wexner scale. RESULTS: 43 children (mean age of 7.7 ± 3.1) were studied. 32 (74.4 %) belonged to group 1 and 11 (25.6 %) to group 2. After 3 months of BMP, it was noticed a significant improvement of the FII (14.5 ± 3.7 versus 2.8 ± 2.5; p < 0.001) in both groups. QoL perception by the parents and children increased on PedsQL4.0 evaluation (p < 0.001). There was a medium inverse statistically significant correlation of the FII and the total PedsQL4.0 score among children and parents (r = -0.47, p = 0.009 and r = -0, 39, p = 0.03, respectively). CONCLUSION: The BMP applied by a multidisciplinary dedicated team significantly improves the QoL of children with FI in the short-term period.

Terapia antibiótica como adjuvante à terapia mecânica para o tratamento de periodontite agressiva generalizada / Antibiotic therapy as adjunctive to mechanical therapy for the treatment of generalized aggressive periodontitis ­ a literature review

O objetivo deste estudo foi avaliar os protocolos de antibióticos propostos em pacientes com periodontite agressiva generalizada (PAgG). Sessões de raspagem supragengival e polimento, instrução de higiene oral e quaisquer outros procedimentos de adequação foram realizados para alcançar um índice de placa < 20%. A raspagem e alisamento radicular (RAR) ou debridamento periodontal (associado ou não à desinfecção com clorexidina), e o debridamento periodontal ultrassônico em sessão única foram adotados. A azitromicina (AZT), a doxiciclina (DOX), o metronidazol (MET), a clindamicina, e a moxifl oxacina (MOX) foram alguns dos medicamentos testados. Alguns protocolos de antimicrobianos mostraram benefícios clínicos (redução do NS e PS, com ganho do NIC). Baseado na ação contra o Aa, a associação AMX + MET parecem ser a de eleição. No entanto, efeitos adversos, como o desconforto gastrointestinal, mal-estar geral, sonolência, náusea, dor de cabeça, gosto metálico ou eventos mais severos (erupção cutânea grave) foram observados. Por outro lado, apenas 0,7% dos pacientes relataram reações adversas com o AZT, que pode ser usado por um período menor (três dias). O uso do MET em concentrações menores (250 mg) não é efetivo. A MOX (apenas um comprimido por dia, custo reduzido) tem boa biodisponibilidade, longa meia-vida, boa penetração tecidual, e excelente tolerabilidade, parecendo tão efi ciente quanto o AMX+MET, e motivando a realização de novos protocolos de tratamento. Embora a análise microbiológica tenha demonstrado que a terapia medicamentosa foi superior em reduzir e/ou suprimir a carga microbiana subgengival, há tendência de recolonização bacteriana, ressaltando a necessidade da terapia periodontal de suporte.

The aim of this study was to evaluate the antibiotic protocols proposed to treat aggressive generalized periodontitis (AgGP) patients. Supragingival scaling and root planing, oral hygiene instructions, and other aid tools were performed to reach < 20% plaque score. The root scaling and planning or periodontal debridement (associated or not to chlorhexidine), and the ultrasonic periodontal debridement (single session) were adopted. The azithromycin (AZT), doxycycline (DOX), metronidazole (MET), clindamycin, and moxifl oxacin (MOX) were some of the investigated agents. Some antimicrobial protocols demonstrated clinical benefi ts (BoP and PD reductions, as well as CAL improvements). Based on the action against Aa, the AMX + MET association seems to be the therapy of choice. However, adverse effects, such as gastrointestinal discomfort, malaise, numbness, nausea, headache, metallic taste, or more severe reactions (cutaneous rash) were observed. On the other hand, only 0.7% of patients reported unpleasant symptoms with AZT, which can be used by a shorter period (three days). The use of MET in lower concentrations (250 mg) is not effective. The MOX (1 tablet once a day, reduced cost) seems to be as effi cient as AMX + MET, motivating the generation of new treatment protocols. Although the microbiological analysis had demonstrated that the antibiotic therapy was superior in reducing and/or eliminate the subgingival bacterial load, there is a trend for microbial recolonization, which emphasizes the need for periodontal supportive therapy.

Total cost of hospitalization of patients undergoing elective laparoscopic cholecystectomy related to nutritional status / Custo total de internação de pacientes submetidos à colecistectomia videolaparoscópica eletiva relacionado ao estado nutricional

ABSTRACT Background: In the Western world, the population developed an overweight profile. The morbidly obese generate higher cost to the health system. However, there is a gap in this approach with regard to individuals above the eutrofic pattern, who are not considered as morbidly obese. Aim: To correlate nutritional status according to BMI with the costs of laparoscopic cholecystectomy in a public hospital. Method: Data were collected from medical records about: nutritional risk assessment, nutricional state and hospital cost in patients undergoing elective laparoscopic cholecystectomy. Results: Were enrolled 814 procedures. Average age was 39.15 (±12.16) years; 47 subjects (78.3%) were women. The cost was on average R$ 6,167.32 (±1830.85) to 4.06 (±2.76) days of hospitalization; 41 (68.4%) presented some degree of overweight; mean BMI was 28.07 (±5.41) kg/m²; six (10%) individuals presented nutritional risk ≥3. There was a weak correlation (r=0.2) and not significant (p <0.08) between the cost of hospitalization of the sample and length of stay; however, in individuals with normal BMI, the correlation was strong (r=0,57) and significant (p<0.01). Conclusion: Overweight showed no correlation between cost and length of stay. However, overweight individuals had higher cost of hospitalization than those who had no complications, but with no correlation with nutritional status. Compared to those with normal BMI, there was a strong and statistically significant correlation with the cost of hospital stay, stressing that there is normal distribution involving adequate nutritional status and success of the surgical procedure with the consequent impact on the cost of hospitalization.

RESUMO Racional: No mundo ocidental, a população desenvolveu um perfil de excesso de peso corporal. Os obesos mórbidos geram custo mais alto para o sistema de saúde. Entretanto, observa-se um hiato no tocante aos indivíduos acima do eutrofismo, mas não considerados obesos mórbidos. Objetivo: Correlacionar estado nutricional, segundo o IMC, com custo de internação de colecistectomias videolaparoscópicas. Método: Coleta de dados dos prontuários sobre: avaliação de risco nutricional, estado nutricional e custo de internação de pacientes submetidos à colecistectomia videolaparoscópica eletiva no período de janeiro de 2012 a dezembro de 2014. Resultados: Foram analisados 814 procedimentos. A idade média foi de 39,15 (±12,16) anos; 47 (78,3%) eram mulheres. O custo de internação foi, em média, de R$ 6.167,32 (±1.830,85) para 4,06 (±2,76) dias de internação. Quarenta e um (68,4%) pacientes apresentavam algum grau de sobrepeso; o IMC médio foi 28,07 (±5,41) kg/m²; seis (10%) indivíduos apresentavam risco nutricional ≥3. Houve correlação fraca (r=0,2) e não significativa (p<0,08) entre o custo de hospitalização e o tempo de permanência. No entanto, em indivíduos com IMC normal, a correlação foi forte (r=0,57) e significante (p<0,01). Conclusão: Sobrepeso não demonstrou correlação entre custo e tempo de internação. Entretanto, os indivíduos com sobrepeso apresentaram custo maior de internação em relação aos que não tiveram intercorrência, mas sem correlação com o estado nutricional. Em relação aos com IMC normal, houve correlação forte e estatisticamente significante com o custo para tempo de internação, reforçando que há provável distribuição normal envolvendo estado nutricional adequado e sucesso do procedimento cirúrgico com consequente impacto no custo de internação.