Translucency parameter of conventional restorative glass-ionomer cements.

OBJECTIVE: To evaluate the translucency parameter (TP) and contrast ratio (CR) of different conventional restorative glass-ionomer cements (GICs). MATERIALS AND METHODS: Eighteen brands of GICs were evaluated. Five disks of each material were made following ISO 9917-1. The luminous reflectance and Central Bureau of the International Commission on Illumination parameters of disks were evaluated using a colorimeter, against backings of white and black, to obtain the translucent parameter and contrast ratio of different brands of glass-ionomer cements. The correlation between translucency parameter and contrast ratio was assessed with the Pearson correlation test. The translucent and contrast ratio parameters values were submitted to the one-way ANOVA and Tukey test for multiple comparisons (p < 0.05). RESULTS: There was a strong inverse relationship between CR and TP (r2  = 0.94, p < 0.001). The contrast ratio decreased as translucency increased. There were significant differences in TP and CR among brands (p < 0.001). CONLUSIONS: GICs exhibit different translucency and contrast ratio behavior. Some brands of GICs presented very low TP and this condition would be unacceptable for areas with esthetic demands. In addition, TP and CR showed a strong linear relationship. CLINICAL SIGNIFICANCE: The results found in this study demonstrated that the knowledge of the translucency and CR of different conventional restorative GICs is important in order to guide clinicians in the selection of restorative GICs for anterior teeth.

Estudo retrospectivo dos procedimentos clínicos e radiográficos em dentes traumatizados submetidos à apicificação / Retrospective study of clinical and radiographic procedures in traumatized teeth submitted to apexification

Introdução: injúrias traumáticas podem resultar em necrose pulpar em dentes permanentes imaturos. Objetivo: o presente estudo teve como objetivo avaliar os procedimentos clínicos e radiográficos do tratamento de dentes permanentes imaturos não vitais após apicificação. Métodos: trata-se de um estudo documental, transversal e retrospectivo, no qual recorreu-se aos prontuários de um núcleo de referência em traumatismos dentários da Universidade Estadual de Maringá (UEM), nos períodos entre 2005 e 2015. Foram incluídos trinta dentes permanentes com necrose pulpar e ápice aberto, cujo tratamento adotado foi a apicificação e obturação do canal radicular. Os seguintes parâmetros foram analisados: idade, sexo, tipo do trauma, dente acometido, estágio de Nolla, lesão periapical, forma do ápice, tipo de tratamento usado e avaliação radiográfica da barreira apical. Utilizou-se o Teste Exato de Fisher (p < 0,05) para avaliar possíveis associações entre a formação total da barreira apical e as variáveis desse estudo. Resultados: dos 30 dentes traumatizados, 19 eram de pacientes do sexo masculino (70,4%) e 8, do sexo feminino (29,6%). A faixa etária envolvida foi de 6 a 10 anos de idade, o dente mais acometido foi o incisivo central superior e a fratura complicada foi a mais prevalente. Entre esses dentes, onze possuíam lesão periapical (36,7%) e a maioria (63,3%) apresentava-se no estágio 9 de Nolla e com ápice em formato convergente (46,66%). Para o tratamento dos dentes com rizogênese incompleta, foram utilizados como medicação intracanal o hidróxido de cálcio (63,3%) e o MTA (6,7%). O número de trocas da medicação à base de hidróxido de cálcio variou de 1 a 9. A frequência de trocas, na maioria dos pacientes, foi mensal e o valor médio da duração dessas trocas foi de 5,8 meses, enquanto a média do tempo total do tratamento foi de 11 meses. Foram realizadas investigações sobre possíveis associações entre a formação completa da barreira apical e outras variáveis, e nenhuma delas mostrou resultados estatisticamente significativos (p > 0,05). Conclusão: tanto o hidróxido de cálcio quanto o MTA foram capazes de induzir a apicificação, bem como a reparação tecidual dos dentes traumatizados avaliados. Pôde-se observar que não houve significância estatística quando comparadas as variáveis, como forma do ápice, lesão periapical, tipo do trauma, tempo total das trocas de hidróxido de cálcio, tempo total do tratamento e controle, associados à calcificação total da porção apical (AU).

Introduction: Traumatic injuries may result in pulp necrosis in immature permanent teeth. Objective: This study aimed at evaluating the clinical and radiographic procedures for treatment of the non-vital immature teeth after apexification. Material and Method: This is a cross-sectional study that used the medical records of a center of reference in dental trauma, from 2005 to 2015. Thirty permanent teeth with pulp necrosis and open apex were included in this study whose treatment adopted was the apexification and filling of the root canal. The following parameters were analyzed: age, gender, type of trauma, impacted tooth, Nollas stage, periapical lesion, apex shape, type of the treatment used, and the radiographic evaluation of the apical barrier. Fishers Exact Test (p<0.05) was applied to evaluate possible associations between the total apical barrier formation and the variables of this study. Results: Most of them were male. The age group involved was from 6 to 10 years old; the most affected tooth was the central upper incisor, and the complicated fracture was the most prevalent. Of these teeth, 36.7% had a periapical lesion; the majority was at Nollas stage 9 and with a convergent apex (46.66%). For the treatment of immature teeth, calcium hydroxide (63.3%) and MTA (6.7%) were used as intracanal medication. Investigations on possible associations between the complete apical barrier formation and other variables were carried out, but without statistically significant results (p>0.05). Conclusion: Both calcium hydroxide and MTA were able to induce apexification, as well as tissue repair of the traumatized teeth evaluated

The use of arthrocentesis in patients with temporomandibular joint disc displacement without reduction.

The aim of this study was to evaluate the efficacy of the use of the arthrocentesis in patients with disc displacement without reduction (DDWOR). Two hundred and thirty-four (234) patients with DDWOR were evaluated and the following data collected: gender; affected side; age (years); duration of the pain (months); patient's perception of pain (measured by Visual Analogue Scale [VAS 0-10]); maximal interincisal distance (MID) (mm); and joint disc position, determined by magnetic resonance imaging. Data were obtained in two different moments: before the arthrocentesis (M1) and three or four months later (M2). Paired t-Student Test, Scores Test and Wilcoxon Test showed a statistical significant difference (p<0.0001) between the M1 and M2 for the variables VAS and MID. There was an alteration in the joint disc position in 93.88% of the cases after arthrocentesis. There was no association between the general characteristics of the patients on the M1 and the results of the arthrocentesis (p>0.05). It can be concluded that the arthrocentesis is efficient in reducing the pain, in increasing interincisal distance, and altering the joint disc position in patients with DDWOR regardless gender, age side and pain duration.

Relationship between leadership, bullying in the workplace and turnover intention among nurses.

AIM: To identify the factors associated with bullying and turnover intention among nurses. BACKGROUND: Previous studies have demonstrated an association between leadership, bullying and turnover intention. However, few studies to date have addressed this topic among nurses. METHODS: A cross-sectional study was conducted using web-based data collection followed by data analysis using logistic regression and multinomial logistic regression models. RESULTS: Having more than one job (odds ratio (OR) = 2.9) and a low relationship-oriented leadership style (OR = 5.8) were positively associated with personal and work-related bullying, respectively. A low relationship-oriented leadership style (OR = 4.0), age of 19-29 years (OR = 4.5) and length of employment at the institution of 5-10 years (OR = 4.9) were positively correlated with a high turnover intention. The following variables were correlated with a moderate turnover intention: a low relationship-oriented leadership style (OR = 3.4), having a bachelor's degree (OR = 2.0) and working in a philanthropic institution (OR = 2.5). Working in a private institution (OR = 0.8) was negatively associated with a moderate turnover intention. CONCLUSIONS: A low relationship-oriented leadership style and social and work factors were associated with bullying and turnover intention. IMPLICATIONS FOR NURSE MANAGERS: Nurse managers, in addition to developing technical skills, need to develop skills to manage human relationships to prevent bullying and turnover among nurses.

Myofascial trigger points in patients with temporomandibular joint disc displacement with reduction: a cross-sectional study.

OBJECTIVE: The objective of this retrospective study was to evaluate the impact of myofascial trigger points (MTrPs) in patients with articular disc displacement with reduction (DDWR) and to identify which clinical variables are associated with the concomitant presence of DDWR and MTrPs. MATERIAL AND METHODS: 130 patients were selected that sought treatment due to joint pain, with ages ≥18 years, of both genders, with DDWR confirmed by magnetic resonance imaging. The sample was divided into two groups: Group 1, patients with DDWR and MTrPs (N=101); and Group 2, patients with DDWR and no MTrPs (N=29). Information on gender, age, pain duration, pain scores, and maximal interincisal distance (MID) were collected. The logistic regression model was used and the odds ratios (OR) was calculated (p<0.05). RESULTS: Group 1 presented statistically significant higher mean pain scores (p=0.007), and smaller MID (p=0.0268) than Group 2. OR were significant for the pain scores (1.429), MID (0.937) and gender (women) (2.810). CONCLUSIONS: Patients with DDWR and MTrPs had increased pain scores and a MID decrease compared to patients with DDWR and no MTrPs. The variables pain scores, MID, and gender (women) showed a significant association with the concomitant presence of DDWR and MTrPs.

Predictors of arthrocentesis outcome on joint effusion in patients with disk displacement without reduction.

OBJECTIVES: The aim of this study was to investigate the preoperative variables in patients with articular disk displacement without reduction that may influence the results of arthrocentesis on joint effusion (JE). STUDY DESIGN: The records of 203 patients with clinical signs and symptoms of unilateral painful disk displacement without reduction and JE, confirmed by magnetic resonance imaging (MRI), and treated with arthrocentesis were selected. The following preoperative data were recorded: sex; age; joint side; pain duration; pain intensity, measurement with the visual analogue scale; and maximum interincisal distance (MID). All patients underwent a second MRI examination 3 to 4 months postoperatively to assess JE. The sample was then divided into 2 groups: group 1 (n = 160) comprised patients with no signs of JE; and group 2 (n = 43) comprised patients still showing signs of JE. Univariate and multivariate analyses were used to compare the groups. RESULTS: Among the studied variables, pain duration (P = .0175), pain intensity (P < .0001), and MID (P = .0085) were shown to affect arthrocentesis outcomes. The longer the pain duration (odds ratio [OR] = 0.930), the more intense was the pain (OR = 0.346), and the smaller the MID (OR = 0.562), the less were the chances of arthrocentesis completely eliminating JE. CONCLUSIONS: Pain duration, pain intensity, and MID can be used as predictors for the effect of arthrocentesis on JE outcomes and considered during treatment planning.

Myofascial trigger points in patients with temporomandibular joint disc displacement with reduction: a cross-sectional study

Abstract Objective The objective of this retrospective study was to evaluate the impact of myofascial trigger points (MTrPs) in patients with articular disc displacement with reduction (DDWR) and to identify which clinical variables are associated with the concomitant presence of DDWR and MTrPs. Material and Methods 130 patients were selected that sought treatment due to joint pain, with ages ≥18 years, of both genders, with DDWR confirmed by magnetic resonance imaging. The sample was divided into two groups: Group 1, patients with DDWR and MTrPs (N=101); and Group 2, patients with DDWR and no MTrPs (N=29). Information on gender, age, pain duration, pain scores, and maximal interincisal distance (MID) were collected. The logistic regression model was used and the odds ratios (OR) was calculated (p<0.05). Results Group 1 presented statistically significant higher mean pain scores (p=0.007), and smaller MID (p=0.0268) than Group 2. OR were significant for the pain scores (1.429), MID (0.937) and gender (women) (2.810). Conclusions Patients with DDWR and MTrPs had increased pain scores and a MID decrease compared to patients with DDWR and no MTrPs. The variables pain scores, MID, and gender (women) showed a significant association with the concomitant presence of DDWR and MTrPs.

B2-kinin receptors in the dorsal periaqueductal gray are implicated in the panicolytic-like effect of opiorphin.

Reported results have shown that the pentapeptide opiorphin inhibits oligopeptidases that degrade brain neuropeptides, and has analgesic and antidepressant effects in experimental animals, without either tolerance or dependency after chronic administration. In a previous study we showed that opiorphin has a panicolytic-like effect in the dorsal periaqueductal gray (dPAG) electrical stimulation test (EST), mediated by the µ-opioid receptor (MOR). This study further analyzes the mechanism of opiorphin panicolytic action, using the EST and drug injection inside the dPAG. The obtained results showed that blockade of the 5-HT1A receptors with WAY-100635 did not change the escape-impairing effect of opiorphin, and combined injection of sub-effective doses of opiorphin and the 5-HT1A-agonist 8-OH-DPAT did not have a significant anti-escape effect. In contrast, the anti-escape effect of opiorphin was antagonized by pretreatment with the kinin B2 receptor blocker HOE-140, and association of sub-effective doses of opiorphin and bradykinin caused a significant anti-escape effect. The anti-escape effect of bradykinin was not affected by previous administration of WAY-100635. Therefore, the anti-escape effect of opiorphin in the dPAG seems to be mediated by endogenous bradykinin, acting on kinin B2 receptors, which previous results have shown to interact synergistically with MOR in the dPAG to restrain escape in two animal models of panic. Chemical compounds: Opiorphin (PubChem CID: 25195667); WAY100635 maleate salt (PubChem CID: 11957721); 8-OH-DPAT hydrobromide (PubChem CID: 6917794); Bradykinin (PubChem CID: 439201); HOE-140 (Icatibant) (PubChem CID: 6918173).

Qualitative Determination of Human Chorionic Gonadotropin in Vaginal Washings for the Early Diagnosis of Premature Rupture of Fetal Membranes / Determinação qualitativa de gonadotrofina coriônica humana no lavado vaginal para o diagnóstico precoce de ruptura prematura de membranas fetais

Abstract Purpose This study aimed to evaluate and validate the qualitative human chorionic gonadotropin β subunit (β-hCG) test of the vaginal fluid washings of pregnant women with premature rupture of fetal membranes (PROM). Methods Cross-sectional study of pregnant women between gestational weeks 24 and 39 who underwent consultations in one of our institutions. They were divided into two groups: group A (pregnant women clinically diagnosed with PROM) and group B (pregnant women without loss of amniotic liquid). The patients were subjected to a vaginal fluid washing with 3 mL of saline solution, which was aspirated subsequently with the same syringe. The solution was immediately sent to the laboratory to perform the vaginal β-hCG test with cut-off points of 10 mIU/mL (β-hCG-10) and/or 25 mIU/mL (β-hCG-25). Results The β-hCG-10 test of the vaginal secretion was performed in 128 cases. The chi-squared test with Yates' correction showed a statistically significant difference between the 2 groups (p = 0.0225). The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy parameters were 77.1%, 43.6%, 52.3%; 70.4%; and 58.6% respectively. The β-hCG-25 test of the vaginal washing was performed in 49 cases. The analysis by Fisher's exact test showed a statistically significant difference between the groups (p = 0.0175). The sensibility, specificity, PPV, NPV, and accuracy parameters were 44.4%, 87.1%, 66.6%; 72.9%; and 71.4% respectively. Conclusions The β-hCG-25 test showed better accuracy for the diagnosis of PROM, and can corroborate the early diagnosis of PROM because it is a simple and quick exam.

Resumo Objetivo Este estudo objetivou validar o exame qualitativo da subunidade β da gonadotrofina coriônica humana (β-hCG) em lavado vaginal de gestantes com ruptura prematura de membranas (RPM) fetais. Métodos Estudo transversal de gestantes com 24 a 39 semanas atendidas em um hospital de Maringá divididas em 2 grupos: grupo A (clinicamente diagnosticadas com RPM) e grupo B (gestantes sem perda de liquido amniótico). As pacientes foram submetidas a lavado vaginal com 3 mL de soro fisiológico, que logo em seguida foi aspirado de volta na mesma seringa e imediatamente enviado ao laboratório para a realização do exame de β-hCG vaginal com pontos de corte de 10 mIU/mL (β-hCG-10) e/ ou 25 mIU/mL (β-hCG-25). Resultados O teste de β-hCG-10 na secreção vaginal foi realizado em 128 casos, e o teste do qui-quadrado com correção de Yates mostrou diferença significante entre os dois grupos (p = 0,0225). Os parâmetros de sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e acurácia foram respectivamente 77,1%; 43,6%; 52,3%; 70,4%; e 58,6%. O teste de β-hCG-25 na secreção vaginal foi realizado em 49 casos, e a análise pelo teste exato de Fisher mostrou diferença significativa entre os grupos (p = 0,0175). Os parâmetros de sensibilidade, especificidade, VPP, VPN e acurácia foram respectivamente 44,4%; 87,1%; 66,6%; 72,9%; e 71,4%. Conclusões O β-hCG-25 apresentou melhor acurácia para o diagnóstico de RPM, e pode corroborar o diagnóstico precoce de RPM por se tratar de um exame simples e rápido.

Qualitative Determination of Human Chorionic Gonadotropin in Vaginal Washings for the Early Diagnosis of Premature Rupture of Fetal Membranes.

Purpose This study aimed to evaluate and validate the qualitative human chorionic gonadotropin ß subunit (ß-hCG) test of the vaginal fluid washings of pregnant women with premature rupture of fetal membranes (PROM). Methods Cross-sectional study of pregnant women between gestational weeks 24 and 39 who underwent consultations in one of our institutions. They were divided into two groups: group A (pregnant women clinically diagnosed with PROM) and group B (pregnant women without loss of amniotic liquid). The patients were subjected to a vaginal fluid washing with 3 mL of saline solution, which was aspirated subsequently with the same syringe. The solution was immediately sent to the laboratory to perform the vaginal ß-hCG test with cut-off points of 10 mIU/mL (ß-hCG-10) and/or 25 mIU/mL (ß-hCG-25). Results The ß-hCG-10 test of the vaginal secretion was performed in 128 cases. The chi-squared test with Yates' correction showed a statistically significant difference between the 2 groups (p = 0.0225). The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy parameters were 77.1%, 43.6%, 52.3%; 70.4%; and 58.6% respectively. The ß-hCG-25 test of the vaginal washing was performed in 49 cases. The analysis by Fisher's exact test showed a statistically significant difference between the groups (p = 0.0175). The sensibility, specificity, PPV, NPV, and accuracy parameters were 44.4%, 87.1%, 66.6%; 72.9%; and 71.4% respectively. Conclusions The ß-hCG-25 test showed better accuracy for the diagnosis of PROM, and can corroborate the early diagnosis of PROM because it is a simple and quick exam.

Objetivo Este estudo objetivou validar o exame qualitativo da subunidade ß da gonadotrofina coriônica humana (ß-hCG) em lavado vaginal de gestantes com ruptura prematura de membranas (RPM) fetais. Métodos Estudo transversal de gestantes com 24 a 39 semanas atendidas em um hospital de Maringá divididas em 2 grupos: grupo A (clinicamente diagnosticadas com RPM) e grupo B (gestantes sem perda de liquido amniótico). As pacientes foram submetidas a lavado vaginal com 3 mL de soro fisiológico, que logo em seguida foi aspirado de volta na mesma seringa e imediatamente enviado ao laboratório para a realização do exame de ß-hCG vaginal com pontos de corte de 10 mIU/mL (ß-hCG-10) e/ou 25 mIU/mL (ß-hCG-25). Resultados O teste de ß-hCG-10 na secreção vaginal foi realizado em 128 casos, e o teste do qui-quadrado com correção de Yates mostrou diferença significante entre os dois grupos (p = 0,0225). Os parâmetros de sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e acurácia foram respectivamente 77,1%; 43,6%; 52,3%; 70,4%; e 58,6%. O teste de ß-hCG-25 na secreção vaginal foi realizado em 49 casos, e a análise pelo teste exato de Fisher mostrou diferença significativa entre os grupos (p = 0,0175). Os parâmetros de sensibilidade, especificidade, VPP, VPN e acurácia foram respectivamente 44,4%; 87,1%; 66,6%; 72,9%; e 71,4%. Conclusões O ß-hCG-25 apresentou melhor acurácia para o diagnóstico de RPM, e pode corroborar o diagnóstico precoce de RPM por se tratar de um exame simples e rápido.

Avaliação de um programa de vigilância ao recém-nascido de risco no Sul do Brasil / Evaluation of a surveillance program to the new born at risk in southern Brazil

Resumo Introdução avaliar programas de saúde contribui eficazmente no planejamento e direcionamento das políticas públicas de saúde. Este estudo objetivou avaliar um Programa de Vigilância ao Recém-nascido de Risco. Método estudo transversal e analítico com dados coletados em 2009, no município de Maringá (PR). Extraíram-se informações maternas, infantis e assistenciais de uma amostra estratificada de prontuários e fichas de acompanhamento das crianças nascidas em 2008, totalizando 250 recém-nascidos de risco. Os dados foram analisados por teste qui-quadrado e regressão logística múltipla. Resultados dentre os recém-nascidos de risco inseridos no programa, 37% apresentaram acompanhamento satisfatório. Verificou-se que a assistência prestada foi por demanda espontânea com acesso de priorização de risco deficiente. O baixo peso ao nascer (OR = 2,30; IC95% = 1,254,23), aliado ao número insuficiente de consultas (OR = 7,11; IC95% = 2,34-21,63), orientações (OR = 2,49; IC95% = 1,24-5,01) e pesagens (OR = 2,05; IC95% = 1,01-4,15), contribuiu para a inadequabilidade no acompanhamento das crianças de risco pelo programa. Conclusão com base nos resultados encontrados sobre a atenção à criança de risco, sugerem-se propostas de reformulação dos critérios de inclusão e estratégias que priorizam uma assistência programada e mais consonante com as preconizações do Ministério da Saúde.

Abstract Introduction The evaluation of health programs effectively contribute to the planning and direction of public health policies. This study aimed to evaluate a surveillance program to the newborn at risk. Objective Cross-sectional analytical study with data collected in 2009, from Maringá-PR. Method We extracted maternal, infant and care information from a stratified sample of records and monitoring reports of children born in 2008, totaling 250 newborns at risk. Data were analyzed by chi-square test and multiple logistic regression. Results Of the newborns at risk included in the program, 37% had satisfactory monitoring. It was found that assistance was a spontaneous demand with an inefficient access of risk priority. Low birth weight (OR=2.30; IC95%=1.25–4.23), coupled with the insufficient number of visits (OR=7.11; IC95%=2.34–21.63), guidelines (OR=2.49; IC95%=1.24-5.01) and weighing (OR=2.05; IC95%=1.01-4.15), contributed to the inappropriate monitoring of children at risk by the program. Conclusion From the results found on the attention to the child at risk, it is suggested recast proposals of the inclusion criteria and strategies that prioritize a scheduled and more consonant assistance with the recommendations of the Ministry of Health.

A non-linear mixed-effects model to describe the effect of acarbose intake on postprandial glycaemia in a single rat / Um modelo não linear de efeitos mistos para descrever o efeito da ingestão de acarbose na glicemia pós-prandial em um único rato

A non-linear mixed-effects model is proposed to assess the impact of acarbose over time on postprandial glycaemia in a single rat. The model is based on two compartments, one representing the entry of glucose in the blood and the other its exit. The rat was submitted to two treatments: ingestion of starch and ingestion of starch plus acarbose. The model showed great suitability, with inferences on the behavior of glucose levels in response to treatments and supplying a richer description than just the area under the curve. The marginal curves for the two treatments are similar during the first moments; however, after reaching the peak of glucose concentration, they progressively became separate due to acarbose treatment and reached the initial levels more quickly. The proposed model, albeit with a single sample unit, showed similar results to those with larger samples; in other words, acarbose significantly attenuates glycaemia after ingestion of starch.

Neste estudo, foi proposto um modelo não linear de efeitos mistos para verificar o impacto da acarbose ao longo do tempo na glicemia pós -prandial de um único rato. Adotou-se um modelo de dois compartimentos: um representando a entrada de glicose no sangue e outro, a saída. O rato foi submetido a dois tratamentos: ingestão de amido e de amido com adição de acarbose. O modelo proposto apresentou um ótimo ajuste, permitindo fazer inferências do comportamento da glicose para os tratamentos e fornecendo uma descrição muito mais rica do que simplesmente a área sob a curva. As curvas marginais para os dois tratamentos foram semelhantes nos primeiros tempos observados, porém, após o pico de concentração de glicose, elas se distanciaram progressivamente com o tratamento da acarbose atingindo os níveis iniciais mais rapidamente. O modelo adotado, com uma única unidade amostral, mostrou resultados similares a outros estudos com maior número de unidades amostrais, isto é, a acarbose pode atenuar consideravelmente a glicemia após ingestão de amido.

Análise, ex vivo, da e cácia e da acurácia de localizadores apicais eletrônicos na determinação do comprimento de trabalho / Ex vivo evaluation of the effectiveness and accuracy of electronic apex locators in the identi cation of the actual working length

Introdução: a utilização dos localizadores apicais eletrônicos (LAEs) é imprescindível na obtenção do comprimento real de trabalho (CRT), visto que o método radiográ co apresenta limitações. Objetivo: o objetivo deste estudo foi comparar a e cácia e acurácia de três LAEs (Root ZX, NovApex e Justy II), na determinação do CRT. Métodos: trinta incisivos humanos extraídos foram selecionados. Após a abertura coronária e preparo cervical, uma lima tipo K #15 foi introduzida no interior do canal até sua ponta atingir o forame apical; o comprimento real foi observado utilizando-se um paquímetro digital e magnificação com microscópio operatório (25x). O CRT de cada dente foi obtido subtraindo-se 1mm do comprimento da lima. Então, os dentes foram inseridos, até o nível cervical, em uma esponja para arranjos orais, posicionada em uma caixa plástica transparente, embebida em solução salina a 0,9%. Um endodontista experiente e calibrado realizou 30 mensurações com cada aparelho, perfazendo um total de 90 medidas. Resultados: por meio da análise de variância (ANOVA), com a qual se verificou a e cácia, demonstrou-se que não houve diferença estatisticamente signi cativa (p = 0,4505) entre os aparelhos. Na comparação entre os três LAEs quanto ao CRT, não houve diferença estatisticamente signi cativa: Root ZX (p = 0,3418); NovApex (p = 0,3031) e Justy II (p = 0,4080). Entretanto na análise de regressão por meio do grá co de dispersão, o NovApex mostrou melhor acurácia do que os outros localizadores apicais eletrônicos, com precisão de 93%. Conclusões: os LAEs utilizados foram eficazes; contudo, apesar de o NovApex ter apresentado maior acurácia, mais estudos devem ser realizados.

Impact of oral human rotavirus vaccine on hospitalization rates for children / Impacto da vacina oral de rotavírus Humano nas taxas de hospitalizações em crianças

Objective: To evaluate the risk of hospitalization for acute diarrhea in children under five, in the period of ten years before and after the oral rotavirus vaccine. Methods: Eco-descriptive-analyticstudy of the rates of hospitalization for acute diarrhea. We used hospitalization rate and the Relative Variation Rate to quantify the difference between the median in the years pre- andpostvaccination. We used logistic regression, odds ratio and attributablerisk to assess for the proportion of cases that could be avoided if exposure was avoided. Results: During the study period, the hospitalization rate was 117.41 per 10,000 children. In the prevaccination period, the median rate of hospitalization was 124.2/10,000 children. After the introduction of the vaccine, hospitalization rates were lower when compared to the median of the pre-vaccination years. Conclusion: There was a reduction in the hospitalization rates for acute diarrhea, thereby suggesting that the use of the vaccine and other associated factors can reduce the number of cases.

Objetivo:Avaliar o risco de hospitalização por diarreias agudas em crianças menores de cinco anos no período de dez anos, antes e depois da vacina oral do rotavírus.Métodos:Estudo ecológico-descritivo-analítico das taxas de hospitalização por diarreias agudas. Utilizou-se a Taxa de Hospitalização e Taxa de Variação Relativa para quantificar a diferença entre a mediana dos anos pré-vacinais e pós-vacinais. Empregou-se a Regressão Logística, o Odds Ratio e Risco Atribuível para verificar a proporção de casos que poderiam ser evitados se a exposição fosse afastada.Resultados:No período estudado a taxa de hospitalização foi de 117,41 por 10.000 crianças. Observouse que, no período pré-vacinal, a mediana da taxa de hospitalização foi de 124,2/10.000 crianças. Após a introdução da vacina, as taxas de hospitalização foram menores quando comparadas à mediana dos anos pré-vacinal.Conclusão:Houve redução nas taxas de hospitalização por diarreias agudas, sugerindo que o uso da vacina e outros fatores associados podem reduzir os casos.

Insulin complexation with hydroxypropyl-beta-cyclodextrin: Spectroscopic evaluation of molecular inclusion and use of the complex in gel for healing of pressure ulcers.

The pressure ulcer healing is a complex process and difficult to be achieved. Insulin is known to promote wound healing, and when complexed with cyclodextrin presents improved solubility, stability and biological activity. Complexation of insulin with hydroxypropyl-beta-cyclodextrin (HPßCD) was performed in this work through the coprecipitation method, providing the inclusion complex (HPßCD-I). The spectroscopic techniques used to analyze the complex were H(1) NMR, FT-Raman and FT-IR/ATR. A gel containing the HPßCD-I complex was prepared and a clinical study was conducted in patients with pressure ulcers. The spectroscopic techniques allowed to confirm the complex formation through the inclusion of aromatic amino acids, such as phenylalanine present in the HPßCD cavity. Data obtained from the FT-Raman and FT-IR/ATR techniques, combined with the H(1) NMR results, showed the effectiveness of these techniques in evaluating the inclusion complex of HPßCD with insulin. Clinical studies demonstrated tissue revitalization and a trend (p=0.06) for a significant difference between the healing effect of the control gel and that with HPßCD-I complex. The creation of the gel prepared with insulin and HPßCD-I complex and its use in patients with pressure ulcers appears to be promising in wound healing and its possible use in hospital care.

Oral lesions and colonization by yeasts in hemodialysis patients.

BACKGROUND: Patients with chronic kidney disease, stage 5, undergoing hemodialysis treatment are frequently colonized by yeasts, with high chance of developing fungal infections. The objective of this study was to assess the presence of yeasts in the oral cavity of these individuals, associating findings with the presence of oral lesions and the use of dental prostheses. METHODS: Clinical examinations of the oral mucosa were performed in 52 patients, when the use of removable dental prostheses and the presence of oral lesions were observed and recorded. Saliva samples were collected to identify yeast specimens and colony-forming units. RESULTS: Colonization by yeasts was found in 42.31% of the patients, 100% of which belonging to the genus Candida, with the predominance of C. albicans (69.23%). Half of the patients (26) presented some type of oral lesion, the majority (63.33%) suggestive of candidiasis, which was confirmed in 57.89% of cases. The chance that these patients carried yeast colonies in the presence of dental prostheses and oral lesions was 6.33 and 2.62 times higher, respectively. CONCLUSIONS: Patients investigated in this study presented a high incidence of yeasts in the oral cavity, with those with oral lesions and dental prostheses being more likely to carry yeasts. When oral lesions are detected in patients undergoing hemodialysis treatment, particularly in those who are prosthesis users, early diagnosis and treatment of this type of lesion, in association with systemic investigations, should be performed to mitigate possible unfavorable prognoses.

Color stability over time of three resin-based restorative materials stored dry and in artificial saliva.

OBJECTIVE: To evaluate the color match of different composite resins relative to Vitapan Classical shade guide tab and their respective manufacturers' shade guide tabs as a function of time and storage. MATERIALS AND METHODS: Three enamel shade A2 composite resins were used to fabricate 36 disk-shaped polymerized specimens (12 each), allocated into 2 groups of 6 and stored dry (GD) and in artificial saliva (GS). CIELAB coordinates from shade tabs and resin specimens immediately after polymerization (t0), and 24 hours (t1), 7 (t7), 14 (t14) and 21 (t21) days after polymerization were captured using a colorimeter. Color difference (ΔE00 ) between composite specimens and the reference tabs was calculated using the CIEDE2000 formula. The results were analyzed with repeated measures ANOVA, Tukey's HDS post-hoc test, and Student t test (p ≤ 0.05). RESULTS: Color of the three tested composites relative to Vita and their respective tabs significantly changed as a function of time until t14; however, between t14 and t21, no significant differences were found. No differences in color were found relative to storage at t14 and t21. ΔE00 values of specimens at t14 were significantly higher relative to their respective tabs than to Vitapan tab. CONCLUSIONS: For all brands color changed up to day 14, when it stabilized, regardless of whether composite specimens had been stored in artificial saliva or simply in a box. Vitapan tab presented a better color match than the manufacturers' tabs. CLINICAL SIGNIFICANCE: The results found in this study demonstrated that the Vitapan Classical shade guide tab A2 provided a better color match than the respective shade guide tabs A2 supplied by the composite manufacturers. If custom shade tabs are to be made, however, they could be kept in a box and used as shade references from 14 days after being fabricated, when color stabilizes.

Adequabilidade da assistência ao pré-natal em duas Unidades de Saúde em Curitiba, Paraná / Adequacy of prenatal care at two health units in Curitiba, Paraná

Este estudo objetivou avaliar a adequabilidade do pré-natal, conforme Protocolo Mãe Curitibana em uma Unidade Básica de Saúde com Programa Saúde da Família (PSF) e outra unidade de saúde tradicional (UBS), com estudo transversal, retrospectivo com dados dos prontuários cadastrados entre fevereiro de 2010 a janeiro de 2011. Foram excluídas as gestantes que apresentaram abortamento e abandono do pré-natal, totalizando 158 gestantes, sendo 79 da unidade PSF e o restante da UBS. A média do início do pré-natal foi de 11±6,26 semanas, e a análise das médias dos registros no pré-natal para o PSF e UBS foi de 10,39 e 8,82 nas consultas, 9,87 e 8,57 para pressão arterial, 1,04 e 1,22 no tipo sanguíneo, 2,17 e 1,86 para glicemia, 1,32 e 1,05 para HbsAg, 2,35 e 1,89 para parcial de urina e 2,64 e 2,22 para cultura de urina com diferenças estatisticamente significativas (p<0,05) entre as unidades. Observaram-se diferenças na adequabilidade da assistência pré-natal entre as unidades PSF e UBS, com melhor desempenho no PSF. Alguns procedimentos como a verificação de altura uterina, batimentos cardiofetais, exames de urina e VDRL estão aquém dos percentuais esperados, necessitando rever e aperfeiçoar as práticas dos profissionais de saúde na atenção pré-natal.

This study aimed to evaluate the adequacy of prenatal care according to Protocol Mother Curitibana in a primary care unit with the Family Health Program (PSF) and other traditional health unit (UBS). Cross-sectional study with retrospective data from medical records registered between February 2010 and January 2011. We excludedwomen who had abortions and abandonment of prenatal care, totaling 158 pregnant women, 79 unit PSF and the rest of UBS. The average onset of prenatal care was 11± 6.26 weeks, and mean analysis of prenatal records for PSF and UBS for pregnant women were 10.39 and 8.82 for consultations, 9.87 and 8.57 for blood pressure, 1.04 and 1.22 for blood type, 2.17 and 1.86 for glucose, 1.32 and 1.05 for HBsAg, 2.35 and 1.89 for Partial Urine and 2.64 and 2.22 for Urine Culture with statistically significant differences (p <0.05) between the units. This study found differences in the adequacy of prenatal care between PSF and traditional models UBS highlighting the best performance of the model PSF. It also identified some procedures like verification of uterine height growth, beats fetal cardiac and urine analysis and VDRL short of the expected percentage, requiring review and improve practices of health professionals in prenatal care

Validation of an instrument for investigating knowledge on the initial assistance to burns victims / Validación de un instrumento de investigación de conocimiento sobre la atención inicial al quemado / Validação de um instrumento de investigação de conhecimento sobre o atendimento inicial ao queimado

This study featured a methodological quantitative approach and its objective was to validate an instrument on the initial assistance given to burns victims, on medical and nursing knowledge, using the theoretical stage of Pasquali's model. The data were collected in June - August 2008, in two parts: analysis of face validity and content validity by 18 judges; and analysis of internal consistency, undertaken through Item Response Theory, by 42 doctors and nurses from a teaching hospital in the North-West region of the Brazilian state of Paraná. Following the judges' analysis, 35 questions regarding general, medical and nursing knowledge showed agreement above 80% for the concepts. Through the internal consistency analysis applied to the general knowledge questions, three were discarded due to not being correlated with the construct. The remaining seven questions (70%) presented low discrimination of the respondents, varying levels of difficulty, and similar probabilities of correct random guesses. The final instrument contains 32 questions and is available for use.

Investigación de desarrollo metodológico de abordaje cuantitativo, cuyo objetivo fue validar un instrumento sobre atención inicial al quemado dirigido al conocimiento de médicos y enfermeros, utilizando la etapa teórica de Pasquali. Los datos fueron recolectados en junio-agosto de 2008, en dos momentos: análisis aparente y de contenido por 18 jueces; y análisis de la consistencia interna, por la Teoría de Respuesta al Ítem, por 42 profesionales médicos y enfermeros de un hospital escuela. Después del análisis, 35 cuestiones sobre conocimiento general, médico y enfermería presentaron concordancia por encima de 80% en los conceptos. A través del análisis de la consistencia interna, aplicada a las cuestiones de conocimiento general, fueron desechadas tres por no estar correlacionadas al constructo. Las otras siete (70%) presentaron baja discriminación de los participantes, grado de dificultad variado y probabilidad de acierto al acaso similares. El instrumento final contiene 32 cuestiones y se encuentra disponible para utilización.

Pesquisa de desenvolvimento metodológico de abordagem quantitativa, cujo objetivo foi validar um instrumento sobre atendimento inicial ao queimado voltado para o conhecimento de médicos e enfermeiros, utilizando a etapa teórica de Pasquali. Os dados foram coletados em junho-agosto de 2008, em dois momentos: análise aparente e de conteúdo por 18 juízes; e análise da consistência interna, através da Teoria de Resposta ao Item, por 42 profissionais médicos e enfermeiros de um hospital-ensino da Região Noroeste do Paraná. Após análise dos juízes, 35 questões sobre conhecimento geral, médico e enfermagem apresentaram concordância nos conceitos, superior a 80%. Através da análise da consistência interna aplicada às questões de conhecimento geral, foram descartadas três questões, por não estarem correlacionadas com o construto. As demais sete (70%) apresentaram baixa discriminação dos respondentes, graus de dificuldade variados e probabilidades similares de acerto ao acaso. O instrumento final contém 32 questões e encontra-se disponível para utilização.

Risk factors for cervical HPV infection and genotypes distribution in HIV-infected South Brazilian women.

BACKGROUND: Human Papillomavirus (HPV) infection is particularly burdensome for women infected with human immunodeficiency virus (HIV), which increases their risk of developing cervical lesions and cancer (CC). We conducted a molecular study of the distribution of cervical HPV genotypes and the risk factors for this infection in HIV-infected Brazilian women. FINDINGS: Cervical and endocervical samples for Papanicolaou screening and HPV detection were collected from 178 HIV-infected women using highly active antiretroviral therapy (HAART) of Maringá city/Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding to HIV infection from medical records. HPV was detected by polymerase chain reaction (PCR), and genotyping using PCR-restriction fragment length polymorphism analysis. HIV infection was well controlled, but women with a current CD4+ T lymphocyte count between 200-350 cells/mm3 (37.6%) had a two-fold greater risk of HPV infection than those with > 350 cells/mm3 (26.4%). HPV was associated with parity ≥3, hormonal contraceptive use and current smoker. HPV infection occurred with high frequency (46.6%) but a low frequency of cervical abnormalities was detected (7.30%), mainly low-grade squamous intraephitelial cervical lesions (LSIL) (84.6%). A high frequency of multiple HPV infections was detected (23.0%), and the most frequent HPV genotype was HPV-72 (6.7%), followed by -16, -31 and -51 (6.14% each). CONCLUSIONS: We showed that HAART use does not protect HIV-infected women from HPV, but appear to exert some protection against cervical lesions development. This study provides other important information about risk factors and cervical HPV in HIV-infected women, which can contribute to planning protocols.