Physical, chemical, mechanical, and micromorphological characterization of dental needles.

BACKGROUND: In anesthetic techniques, touching bones can cause needle bending. Theoretically, a needle should support such deflection without fracturing. However, it is possible that a needle may fracture depending on the quality and type of needle used. This study evaluated the physical, chemical, and micromorphological characteristics of long and short dental anesthetic needles, as well as the mechanical properties of flexural load and bending resistance when needles are subjected to different bending angles. METHODS: Long and short needles (30G, Jets, Misawa, Selekto, Terumo, Unoject and 27G, Dencojet, Injex, Jets, Misawa, Procare, Setoject XL, Terumo) were evaluated. Scanning electron microscopy was used to evaluate the needle bevels and energy-dispersive X-ray spectroscopy was used for the chemical analysis of needle compositions. Flexural loading and bending strength assessments were performed using a universal testing machine by bending the needles (n = 5) to angles of 30°, 60°, or 90°, or until fracture occurred. RESULTS: The Injex 27G, Jets 27G, and Septoject XL 27G needles were all less than 30 mm in length. There were small percentage variations in the chemical compositions of the needles. Superior smoothness was observed for the Unoject 30G needle, which exhibited the highest fracture resistance at 60°. The Jets 30G needle exhibited greater resistance to fractures at 90°. The Procare 27G needle exhibited the highest load resistance to bending, followed by the Septoject XL 27G needle, and both needles were tied for the lowest fracture resistance. No needle fractured when bent to 30° or at less than three bends to 60° or 90°. CONCLUSIONS: Greater needle resistance to bending increases the probability of early fracturing. Thinner and shorter needles are more resistant than longer and thicker needles. Performing a single bend does not result in any significant risk of fracture or obliterate the lumen, allowing for the continued passage of anesthetic liquid.

Cisto ósseo solitário em mandíbula: relato de caso clínico / Solitary bone cyst of the mandible: clinical case report

Objetivo: apresentar um caso clínico de paciente com cisto ósseo solitário em mandíbula e sua evolução após o tratamento de exploração e curetagem cirúrgica por meio de achados radiográficos. Caso clínico: paciente do sexo masculino, 45 anos, compareceu à clínica da Faculdade de Estudos Administrativos ­ Fead. Ao exame clínico, os tecidos se apresentavam dentro dos padrões de normalidade e ao exame radiográfico observou-se área radiolúcida unilocular, limites regulares e bem definidos em região anterior de mandíbula entre ápices dos dentes 33, 32, 31, 41 e 42, sem deslocamento desses. Para confirmação do diagnóstico, além do exame clínico, foi necessário realizar a tomografia de feixe cônico e exploração cirúrgica. Após a exploração cirúrgica foi realizada a curetagem das paredes ósseas e a proservação do caso para acompanhar a sua evolução. Considerações finais: por ser uma lesão de comportamento não agressivo, responde bem a este tipo de tratamento, sendo notável sua melhora durante o período de acompanhamento.(AU)

Objective: To present a clinical case report of a patient with solitary bone cyst of the mandible and its evolution after exploration and surgical curettage treatment through radiographic findings. Case report: A 45-year-old male patient attended the clinic of the School of Administrative Studies - FEAD. The clinical examination showed normal tissues and the radiographic examination showed unilocular radiolucent area and regular and well-defined boundaries in the anterior mandible between the apexes of teeth 33, 32, 31, 41, and 42, without displacement. To confirm the diagnosis, in addition to the clinical examination, cone beam tomography and surgical exploration were required. After the surgical exploration, bone wall curettage and case proservation were performed to monitor the evolution. Final considerations: Considering it is a non-aggressive lesion, it responds well to this type of treatment, with considerable improvement during follow-up.(AU)

Anesthetic management of late pressure angioedema / Manejo anestésico de angioedema de pressão tardio

Abstract Background and objectives: Late pressure angioedema is a rare form of angioedema in which light pressure stimulus can lead to edema after 1-12 h. This uncommon and unreported entity is especially important in patients who undergo general anesthesia, for whom the usual harmless supine position, intravenous catheter insertion, standard monitoring, airway management and ventilation can lead to life threatening consequences as the trigger is a physical stimulus. Case report: In this report, we describe a successful perioperative anesthetic management of a 30 year old patient, proposed for intra-ocular lens insertion, with a severe form of the disease with peri-oral, tongue and limb edema presentation. Conclusion: Due to lack of quality evidence, our conduct was based on the pathophysiology mechanisms of the syndrome, histamine and pro-inflammatory cytokines release, with special focus on a careful peri-operative assessment and prophylaxis, minimization of all the possible pressure stimulus, especially in the airway structures, and a strict post-operative monitoring.

Resumo Justificativa e objetivos: Angioedema de pressão tardio é uma forma rara de angioedema na qual um leve estímulo de compressão pode levar a edema após 1-12 horas. Essa entidade incomum e pouco relatada é especialmente importante em pacientes submetidos à anestesia geral, nos quais a habitual posição supina inofensiva, inserção intravenosa do cateter, monitoração padrão, manejo das vias aéreas e ventilação podem levar a consequências fatais, pois o gatilho é um estímulo físico. Relato de caso: Neste relato, descrevemos o manejo anestésico perioperatório bem-sucedido de um paciente de 30 anos idade, agendado para inserção de lente intraocular, com uma forma grave da doença, apresentava edema perioral, língual e nos membros. Conclusão: Devido à falta de evidências de qualidade, nossa conduta teve como base os mecanismos fisiopatológicos da síndrome, a liberação de histamina e citocinas pró-inflamatórias, com foco especial em uma avaliação cuidadosa no perioperatório e profilaxia, diminuição de todos os estímulos compressíveis possíveis, especialmente nas estruturas das vias aéreas, e um acompanhamento rigoroso no pós-operatório.

[Anesthetic management of late pressure angioedema]. / Manejo anestésico de angioedema de pressão tardio.

BACKGROUND AND OBJECTIVES: Late pressure angioedema is a rare form of angioedema in which light pressure stimulus can lead to edema after 1-12h. This uncommon and unreported entity is especially important in patients who undergo general anesthesia, for whom the usual harmless supine position, intravenous catheter insertion, standard monitoring, airway management and ventilation can lead to life threatening consequences as the trigger is a physical stimulus. CASE REPORT: In this report, we describe a successful perioperative anesthetic management of a 30 year old patient, proposed for intra-ocular lens insertion, with a severe form of the disease with peri-oral, tongue and limb edema presentation. CONCLUSION: Due to lack of quality evidence, our conduct was based on the pathophysiology mechanisms of the syndrome, histamine and pro-inflammatory cytokines release, with special focus on a careful peri-operative assessment and prophylaxis, minimization of all the possible pressure stimulus, especially in the airway structures, and a strict post-operative monitoring.

Comparison of 64-Detector-Multislice and Cone Beam Computed Tomographies in the Evaluation of Linear Measurements in the Alveolar Ridge.

This study compared the accuracy of linear measurements of the alveolar ridge in images obtained using 64-detector-multislice computed tomography (CT) and cone beam CT (CBCT). Eight sites were selected corresponding to the regions of molars, premolars, canines, and incisors in six dry human jaws. After the completion of multislice CT and CBCT, the jaws were sectioned into specific regions. Results showed there was no statistically significant difference between the measurements obtained from the CT images and those obtained from dry jaws (actual measurements) for all the evaluated sites (molars, premolars, and anterior teeth). There was also no statistically significant difference between the measurements obtained by the two CT methods.

Impact of a 12-month exercise program on the temporal parameters of the foot rollover during walking in postmenopausal women.

OBJECTIVE: A randomized controlled trial was undertaken to determine the impact of a 12-month exercise program on the temporal characteristics of the foot rollover during walking, based on plantar pressure data. METHODS: One hundred twenty one postmenopausal women aged 41 to 77 years comprised the sample and were randomly recruited from the community. Exercise and control women were tested before and at the end of the trial. The temporal characteristics were assessed with the women walking barefoot at a self-selected speed over a 9-meter-long walking track having a built-in pressure platform. The initial and final contacts at the lateral and medial heel, metatarsal heads I to V, and the hallux (medial and lateral) were measured. RESULTS: Women from the exercise group presented a latter time of making contact in the relative metatarsal 4, metatarsal 5 (absolute and relative), and medial heel (absolute and relative) and earlier relative initial contact in toe 1. In the modification rates, postmenopausal women from the exercise group presented (1) latter final contact (absolute and relative) in metatarsal 5, (2) latter relative final contact in metatarsal 4, and (3) earlier relative initial contact in toe 1. Postmenopausal women from the control group presented an earlier initial contact in metatarsal 3 (absolute and relative). Repeated-measures analysis of variance demonstrated a time effect in most variables considered. CONCLUSIONS: The exercise program is effective in improving the gait pattern in postmenopausal women who adhere, and time has the main effect.

Temporal parameters of the foot roll-over during walking: influence of obesity and sarcopenic obesity on postmenopausal women.

OBJECTIVES: The purpose of this study was to establish a reference dataset for temporal parameters on postmenopausal women during walking and to explore the effect of obesity and sarcopenic obesity on the same parameters. METHODS: Based on plantar pressure data collected from 239 postmenopausal women, the initial contact, final contact, time to peak pressure and the duration of contact at the 10 anatomical areas of the foot considered were measured. Body composition was evaluated by octopolar bioimpedance. RESULTS: Non-obese and non-sarcopenic started with heel contact followed by a latero-medial contact of the metatarsals and finally the hallux (the sarcopenic obese group ended in the toes 2-5). After heel off, the forefoot started to push off at the lateral metatarsals, followed by a more central push off and finally over the hallux (the sarcopenic obese group presented a greater oscillation in the metatarsals). The stance phase was divided into four distinct phases: initial contact (22.30%), forefoot contact (19.98%), foot flat (13.40%) and forefoot push off (44.32%). Sarcopenic obese spent more time in the forefoot contact phase (relative and absolute) and less time in the initial contact phase (%). CONCLUSIONS: These findings provide a reliable and representative reference dataset for temporal characteristics of foot roll-over during walking of postmenopausal women. Sarcopenic obesity affects significantly the temporal characteristics of foot roll-over during walking in this population. Such findings are of concern to clinicians interested in the promotion of activity to reduce obesity and gain or maintain muscle, since sarcopenic obesity affects normal walking, which might increase injuries.

Exercise effects in plantar pressure of postmenopausal women.

OBJECTIVE: The aim of this study was to investigate the effect of a 12-month moderate-to-vigorous exercise program on plantar pressure among postmenopausal women. METHODS: A total of 121 white postmenopausal women participated in a randomized controlled trial (60 women in the exercise group and 61 women in the control group). Women in the exercise group attended training sessions of 60 minutes, 3 days per week, on nonconsecutive days. Weight and basal metabolic rate were evaluated by bioimpedance, and height was evaluated with a stadiometer. Plantar pressure data were collected using the Footscan platform and Software 7.1. RESULTS: After the 1-year intervention, women from the exercise group had (1) lower body mass index, (2) equal basal metabolic rate, (3) lower peak pressures, and (4) lower absolute impulses compared with the women from the control group. Interaction between the exercise group and practice time was found for most of the maximal peak pressure areas (except for metatarsal 4), for all absolute impulse values, and for relative impulses in the hallux, metatarsal 4, midfoot, and medial heel. CONCLUSIONS: This study seems to prove that women who exercise have decreased loading of maximal peak pressures and absolute impulses and, consequently, self-reported pain, soreness, and discomfort in the lower extremity. An interaction effect between group and practice time was found for most of the variables considered, meaning that this 12-month exercise program is effective in the improvement of the biomechanic parameters of plantar pressure.

Contribution of plantar pressure to the prevention and quantification of the muscle-skeletal injury risk in hiking trails--a pilot study.

Hiking trails have been growing in popularity in the health and well-being promotion. Consequently, the foot became an object of study in order to understand the discomfort and pain in the lower limb. The aims of the work were: 1) to detect tendencies for behaviour of maximum values of plantar pressure (MaxP) during the walk on different slopes, 2) to contribute to the methodology of the difficulty level of hiking trails. Equations show strong tendencies (R2 > 0.8) of behaviour of MaxP in the lateral zones of the heel, 4th and 5th metatarsus as well as in the plantar zone of the hallux. The analysis of the difficulty level of the hiking trails branches deserves a separate presentation, including the technical difficulty analysis (with a compulsory emphasis on the biomechanics) and information on the caloric consumption and on the slopes of each branch.

Aspectos imunohematologicos, genéticos e clínicos da aloimunizaçäo por anticorpos anti-C: relato de dois casos / Imunohematologics, genetics and clinics aspects of two cases about aloimunization of antibody anti-C

Os autores estudaram dois casos de recém-nascidos que apresentaram hiperbilirrubinemia por antigeno irregular do sistema Rh - c - sendo analisados seus aspectos imunohematologicos, genéticos e clínicos