Inter-implant Papilla Reconstruction using the Iceberg and 'Garage' Connective Tissue Graft Technique. A Case Report and Technique Illustration.

A 45-year-old female patient presented with a lack of inter-implant papilla after a partially edentulous anterior area was rehabilitated with dental implants. The soft tissue phenotype and inter-implant papilla was augmented using the 'iceberg' connective tissue graft, followed by a second surgical procedure where a strip gingival graft was combined with a connective tissue graft inserted underneath a pouch prepared into the previous 'iceberg' connective tissue graft at the level of the crest ('garage' approach), further enhancing soft tissue volume in that region. This technique aims to improve mucosal thickness and supracrestal tissue height while addressing esthetic concerns associated with multiple implant placements in the anterior region. The final esthetic outcome was excellent, harmonious soft tissue with appropriate thickness, symmetry with adjacent teeth, well-shaped interdental and inter-implant papilla with high patient satisfaction, making this approach a valuable addition to a surgeon's armamentarium. Future clinical studies are needed to evaluate the performance of this novel approach.

Funcionalidade e condições de saúde em idosos de uma cidade do interior da Bahia / Functionality and health conditions of the elderly in a city in the interior of Bahia

Objetivo: avaliar a capacidade funcional de idosos de acordo o WHODAS 2.0. Método: Trata-se de uma pesquisa descritiva, com abordagem quantitativa, de corte transversal e levantamento de campo, realizado na Estratégia de Saúde da Família, com 129 idosos de uma cidade do interior da Bahia, localizada na região centro-sul da Bahia. Foi utilizado um questionário com avaliação sociodemográfica, econômica e condições de saúde, o MEEM para avaliar a função cognitiva e WHODAS para avaliar o nível de funcionalidade dos idosos. A análise dos dados foi feito com auxílio do software Statistical Package for Social Sciences. Resultados: predomínio de idosos até 79 anos (80,6%), sexo feminino (75,5%), solteiro, divorciado, viúvo (57,4%), recebem 1 a 3 salários mínimos (58%). No estado geral de saúde, prevalência de idosos que a consideram boa (44,2%), nunca usam bebida alcoólica e cigarro, representam o mesmo percentual (85,3%). Em relação às doenças crônicas não transmissíveis, maior prevalência para hipertensão arterial sistêmica (37%), seguida de HAS (37,2%), possui a doença há mais de 10 anos (31%). Nos domínios do WHODAS as médias que de maior nível de incapacidade foram a participação na sociedade (12,66 ± 4,91), seguida de cognição (8,41 ± 2,92), e mobilidade (8,24 ± 4,88). E os menores índices de incapacidade foram em atividade da vida com (7,98 ± 7,70), autocuidado (5,00 ± 2,04) e relação interpessoal (4,90 ± 1,57). Já sobre a classificação geral, houve dificuldade moderada (69%) e dificuldade grave (27,9%). Houve correlação significativa entre os domínios Cognição e Autocuidado tanto para os homens (r 0,644) quanto para as mulheres (r 0,684). Na correlação geral os domínios Mobilidade (r 0,756), Participação (r 0,774) tiveram correlação significativa e positiva com a Classificação geral no WHODAS. Considerações finais: este estudo reforça a importância de trabalhos voltados ao processo de envelhecimento e a sua relação com a funcionalidade, contemplando os indivíduos de maneira holística, contribuindo assim para a melhoria e desenvolvimento de cuidados na perspectiva da saúde dessa população.

Objective: Evaluate the functional capacity of the elderly according to WHODAS 2.0. Method: This descriptive research used a quantitative, cross-sectional approach and field survey, carried out in the Family Health Strategy, with 129 elderly people from a city in the interior of Bahia, located in the south-central region of Bahia. A questionnaire with sociodemographic, economic and health conditions - MESM - was used to assess cognitive function, and WHODAS was used to assess the level of functionality of the elderly. Data analysis was performed with the aid of social science statistical package software. Results: predominance of elderly up to 79 years old (80.6%), female (75.5%), single, divorced, widowed (57.4%), receiving from 1 to 3 minimum wages (58%). In the general state of health, prevalence of elderly who consider it good (44.2%), who have never use alcohol or cigarettes, represented the same percentage (85.3%). Regarding chronic non-communicable diseases, there is a higher prevalence for systemic arterial hypertension (37%), followed by HAS (37.2%), have had the disease for more than 10 years (31%). In the WHODAS domains, the means with the highest level of disability were social participation (12.66 ± 4.91), followed by cognition (8.41 ± 2.92), and mobility (8.24 ± 4.88). And the lowest disability rates were in life activity (7.98 ± 7.70), self-care (5.00 ± 2.04), and interpersonal relationship (4.90 ± 1.57). Regarding the general classification, there was moderate difficulty (69%) and severe difficulty (27.9%). There was a significant correlation between the Cognition and Self-Care domains for both men (r 0.644) and women (r 0.684). In the general correlation, the Mobility (r 0.756), and Participation (r 0.774) domains had a significant and positive correlation with the general classification in the WHODAS. Final considerations: this study reinforces the importance of studies focusing on the aging process and its relationship with functionality, contemplating individuals holistically, thus contributing to the improvement and development of care from the health perspective of this population.

Identifying historical and future potential lake drainage events on the western Arctic coastal plain of Alaska.

Arctic lakes located in permafrost regions are susceptible to catastrophic drainage. In this study, we reconstructed historical lake drainage events on the western Arctic Coastal Plain of Alaska between 1955 and 2017 using USGS topographic maps, historical aerial photography (1955), and Landsat Imagery (ca. 1975, ca. 2000, and annually since 2000). We identified 98 lakes larger than 10 ha that partially (>25% of area) or completely drained during the 62-year period. Decadal-scale lake drainage rates progressively declined from 2.0 lakes/yr (1955-1975), to 1.6 lakes/yr (1975-2000), and to 1.2 lakes/yr (2000-2017) in the ~30,000-km2 study area. Detailed Landsat trend analysis between 2000 and 2017 identified two years, 2004 and 2006, with a cluster (five or more) of lake drainages probably associated with bank overtopping or headward erosion. To identify future potential lake drainages, we combined the historical lake drainage observations with a geospatial dataset describing lake elevation, hydrologic connectivity, and adjacent lake margin topographic gradients developed with a 5-m-resolution digital surface model. We identified ~1900 lakes likely to be prone to drainage in the future. Of the 20 lakes that drained in the most recent study period, 85% were identified in this future lake drainage potential dataset. Our assessment of historical lake drainage magnitude, mechanisms and pathways, and identification of potential future lake drainages provides insights into how arctic lowland landscapes may change and evolve in the coming decades to centuries.

Avaliação do nível de dependência funcional do idoso com limitação / Evaluation of functional dependence level of elderly people with limitations

O objetivo deste trabalho foi avaliar o nível de dependência funcional dos idosos com base nas Atividades Básicas da Vida Diária (ABVD) e das Atividades Instrumentais da Vida Diária (AIVD), e investigar o perfil dos idosos e seus cuidadores familiares quanto às características sociodemográficas, econômicas e de saúde. Estudo quantitativo, descritivo e transversal. Realizado na cidade de Vitória de Conquista (BA), com 37 idosos cadastrados no Programa de Atendimento Municipal Domiciliar ao Idoso com Limitação. A coleta dos dados usou o índice de Katz, a escala de Lawton-Brody e um questionário semiestruturado. Predomínio de idosos longevos (51,4%), do gênero feminino (75,7%), e com Hipertensão Arterial (40,5%). Têm dependência moderada (32,4%) para as ABVD, e dependência parcial nas AIVD (81,1%). É razoável afirmar que este resultado apresenta um cenário que se configura em um perfil de vulnerabilidade dos idosos estudados.

Current research evaluates the function dependence of elderly people foregrounded on the Basic Activities of Daily Living (ABVD) and Instrumental Activities of Daily Living (AIVD). Elderly peoples' and caregivers' profiles are also investigated with regard to sociodemographic, economic and health characteristics. Current quantitative, descriptive and transversal study was undertaken in Vitória de Conquista, Brazil, with 37 elderly people enrolled in the Home Care Program with the Elderly with Limitations. Katz index, Lawton-Brody scale and a semi-structured questionnaire were employed. There was a predomination of very aged people (51.4%), females (75.7%), with arterial blood hypertension (40.5%). Moderate dependence (32.4%) for ABVD and partial dependence for AIVD (81.1%). Result presents a scenario of vulnerable profile in the elderly studied.

Sobrecarga dos cuidadores familiares de idosos com dependência funcional / Overload of the family caregivers of the elderly with functional dependence / Sobrecarga de los cuidadores familiares de ancianos con dependencia funcional

O objetivo foi avaliar a sobrecarga dos cuidadores familiares de idosos com dependência funcional. Pesquisa quantitativa, descritiva, transversal, realizada com 50 idosos e seus cuidadores familiares da cidade de Caculé, BA, em quatro unidades de saúde da família. Os resultados demonstram que a sobrecarga foi maior no Mecanismo de Eficácia e Controle (82%), Suporte Familiar (90%) e Satisfação com o Papel e com o Familiar (86%). Dessa forma, existem níveis de sobrecarga relacionados ao cuidado prestado ao idoso com dependência funcional.

The objective was to evaluate the overhead of the family caregivers of the elderly with functional ependence. Quantitative, descriptive and transversal research, performed with 50 seniors and their family caregivers from the Caculé, Bahia, in four Family Health Units. The results demonstrate the overhead was greater Efficiency and Control Mechanism (82%), Family Support (90%) and satisfaction with the role and with the Familiar (86%). Thus, there are levels of overhead related to the care provided to the elderly with functional dependence.

El objetivo fue evaluar la sobrecarga de los cuidadores familiares de ancianos con dependencia funcional. Investigación cuantitativa, descriptiva, transversal, realizada con 50 ancianos y sus cuidadores familiares de la ciudad de Caculé, BA, en cuatro unidades de salud de la familia. Los resultados demuestran que la sobrecarga fue mayor en el Mecanismo de Eficacia y Control (82%), Soporte Familiar (90%) y Satisfacción con el Papel y con el Familiar (86%). De esta forma, existen niveles de sobrecarga relacionados al cuidado prestado al anciano con dependencia funcional.

Discussão anatomo-clínica: Histoplasmose [AIDS]

Trabalho de Monitoria apresentado à Disciplina Patologia Aplicada I, do Curso de Medicina da Universidade Federal da Bahia. Trata-se de um estudo de caso envolvendo uma paciente do sexo feminino, que começou a apresentar um quadro de sintomas da Histoplasmose. Após a piora de seu estado de saúde, foi constatado que estava infectada pelo vírus do HIV. Mostra ainda comentários e especificações sobre a AIDS e sobre a Histoplasmose

Development of a virtual flight simulator.

We present the development of a flight simulator that allows the user to interact in a created environment by means of virtual reality devices. This environment simulates the sight of a pilot in an airplane cockpit. The environment is projected in a helmet visor and allows the pilot to see inside as well as outside the cockpit. The movement of the airplane is independent of the movement of the pilot's head, which means that the airplane might travel in one direction while the pilot is looking at a 30 degrees angle with respect to the traveled direction. In this environment, the pilot will be able to take off, fly, and land the airplane. So far, the objects in the environment are geometrical figures. This is an ongoing project, and only partial results are available now.