Cohort study protocol of the Brazilian collaborative research network on COVID-19: strengthening WHO global data.

INTRODUCTION: With the COVID-19 pandemic, hospitals in low-income countries were faced with a triple challenge. First, a large number of patients required hospitalisation because of the infection's more severe symptoms. Second, there was a lack of systematic and broad testing policies for early identification of cases. Third, there were weaknesses in the integration of information systems, which led to the need to search for available information from the hospital information systems. Accordingly, it is also important to state that relevant aspects of COVID-19's natural history had not yet been fully clarified. The aim of this research protocol is to present the strategies of a Brazilian network of hospitals to perform systematised data collection on COVID-19 through the WHO platform. METHODS AND ANALYSIS: This is a multicentre project among Brazilian hospitals to provide data on COVID-19 through the WHO global platform, which integrates patient care information from different countries. From October 2020 to March 2021, a committee worked on defining a flowchart for this platform, specifying the variables of interest, data extraction standardisation and analysis. ETHICS AND DISSEMINATION: This protocol was approved by the Research Ethics Committee (CEP) of the Research Coordinating Center of Brazil (CEP of the Hospital Nossa Senhora da Conceicao), on 29 January 2021, under approval No. 4.515.519 and by the National Research Ethics Commission (CONEP), on 5 February 2021, under approval No. 4.526.456. The project results will be explained in WHO reports and published in international peer-reviewed journals, and summaries will be provided to the funders of the study.

Analysis of the impact of coronavirus disease 19 on hospitalization rates for chronic non-communicable diseases in Brazil.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has impacted health services and healthcare systems worldwide. Studies have shown that hospital admissions for causes related to chronic non-communicable diseases (NCDs) have decreased significantly during peak pandemic periods. An analysis of the impact of the COVID-19 pandemic on hospital admissions for NCDs is essential to implement disability and mortality mitigation strategies for these groups. Therefore, this study aimed to analyze the impact of the COVID-19 pandemic on hospital admissions for NCDs in Brazil according to the type of NCD, sex, age group, and region of Brazil. METHODS: This is an ecological study conducted in Brazil. Data on hospital admissions from January 1, 2017 to May 31, 2021 were extracted from the Unified Health System's Hospital Admissions Information System. The hospital admission rates per 100,000 thousand inhabitants were calculated monthly according to the type of NCD, sex, age group, and region of Brazil. Poisson regression models were used to analyze the impact of the COVID-19 pandemic on the number of hospital admissions. In this study, the pre-pandemic period was set from January 1, 2017 to February 29, 2020 and the during-pandemic from March 1, 2020 to May 31, 2021. RESULTS: There was a 27.0% (95.0%CI: -29.0; -25.0%) decrease in hospital admissions for NCDs after the onset of the pandemic compared to that during the pre-pandemic period. Decreases were found for all types of NCDs-cancer (-23.0%; 95.0%CI: -26.0; -21.0%), diabetes mellitus (-24.0%; 95.0%CI: -25.0%; -22.0%), cardiovascular diseases (-30.0%; 95.0%CI: -31.0%; -28.0%), and chronic respiratory diseases (-29.0%; 95.0%CI: -30.0%; -27.0%). In addition, there was a decrease in the number of admissions, regardless of the age group, sex, and region of Brazil. The Northern and Southern regions demonstrated the largest decrease in the percentage of hospital admissions during the pandemic period. CONCLUSIONS: There was a decrease in the hospitalization rate for NCDs in Brazil during the COVID-19 pandemic in a scenario of social distancing measures and overload of health services.

Age and experience with dental operating microscope: Do these factors influence on the post space preparation and adhesion of glass fiber posts?

This study evaluated the influence of operator's age and experience with dental operating microscope (DOM) on the cleaning of post space walls and on bond strength of glass fiber posts associated with self-adhesive resin cement. Sixty bovine roots were selected. Root canal preparation was performed and roots were filled using gutta-percha/AH Plus. For post space preparation, specimens were divided into four groups (n = 15), according to operator's age and the use of DOM: (1) ≥40 years; (2) ≥40 years with magnification; (3) <40 years; (4) <40 years with magnification. Next, a high-speed bur of the post system and torque-controlled round burs were used for cleaning of post space. Five roots in each group were evaluated for the degree of cleanliness under a stereo microscope using a scoring system. In the remaining 10 specimens from each group, glass fiber posts were cemented with RelyX U200. Two slices (1 ± 0.1 mm) prepared on each root third of all specimens were evaluated by push-out analysis. The scoring system was analyzed using Kruskal-Wallis and push-out data using ANOVA. Significance level was set at 5%. No significant difference was observed in cleaning scores among groups (p > .05). There was no significant difference when comparing the groups and the root thirds (p > .05). The adhesive failure between dentin, cement, and post predominated in all groups. Operator's age and experience with DOM did not influence the cleanliness of root canal walls or the bond strength of glass fiber posts associated with self-adhesive resin cement for post space preparation. RESEARCH HIGHLIGHTS: Although magnification is considered part of Endodontics, little is known about the variables associated. Operator's age and experience with microscope on cleaning of canals and on push-out of posts with self-adhesive resin cement were evaluated.

Eversão da cartilagem da terceira pálpebra em um gato / Eversion of the third eyelid cartilage in a cat

Background: Eversion of the cartilage of the third eyelid is a rare congenital disease in cats. It is caused by the anterioreversion of the cartilage edge of the third eyelid. Clinical signs may be associated with secondary keratoconjunctivitis,third eyelid gland protrusion, and ocular surface irritation. The diagnosis is made by ophthalmic examination, and treatment consists of surgical resection of the everted cartilage portion. The goal of the present study was to report a case ofeversion of third eyelid cartilage in a cat, given that it is an unusual abnormality in this animal species, and an importantdifferential diagnosis to be considered in the disorders of the third eyelid.Case: A 6-year-old neutered female Persian cat was presented with a presumptive diagnosis of protrusion of the thirdeyelid gland, history of ocular irritation, and epiphora in the left eye. The disorder had been intermittently present sincethe animal was 1-year-old, with spontaneous disappearance after approximately 15 days. The owner related the reappearance of the disorder to stressful situations, with no previous history of trauma or other ocular alteration. During theophthalmic examination, suspended solute was observed through biomiscroscopic examination in both eyes, as well asan increase in volume of the third eyelid in the left eye, without other changes. A thorough examination, under generalanesthesia, indicated the protruding volume of the cartilage of the everted third eyelid. The third eyelid was pleated inits upper portion, demonstrating that the cartilage of the third eyelid was folded instead of following the curvature of theocular surface. Under general anesthesia, the cartilage was partially removed through two parallel incisions on the bulbarconjunctival surface, divulsioning 5 mm in length in the vertical portion of the cartilage in a ‘T shape, and separating the...(AU)

Eversão da cartilagem da terceira pálpebra em um gato / Eversion of the third eyelid cartilage in a cat

Background: Eversion of the cartilage of the third eyelid is a rare congenital disease in cats. It is caused by the anterioreversion of the cartilage edge of the third eyelid. Clinical signs may be associated with secondary keratoconjunctivitis,third eyelid gland protrusion, and ocular surface irritation. The diagnosis is made by ophthalmic examination, and treatment consists of surgical resection of the everted cartilage portion. The goal of the present study was to report a case ofeversion of third eyelid cartilage in a cat, given that it is an unusual abnormality in this animal species, and an importantdifferential diagnosis to be considered in the disorders of the third eyelid.Case: A 6-year-old neutered female Persian cat was presented with a presumptive diagnosis of protrusion of the thirdeyelid gland, history of ocular irritation, and epiphora in the left eye. The disorder had been intermittently present sincethe animal was 1-year-old, with spontaneous disappearance after approximately 15 days. The owner related the reappearance of the disorder to stressful situations, with no previous history of trauma or other ocular alteration. During theophthalmic examination, suspended solute was observed through biomiscroscopic examination in both eyes, as well asan increase in volume of the third eyelid in the left eye, without other changes. A thorough examination, under generalanesthesia, indicated the protruding volume of the cartilage of the everted third eyelid. The third eyelid was pleated inits upper portion, demonstrating that the cartilage of the third eyelid was folded instead of following the curvature of theocular surface. Under general anesthesia, the cartilage was partially removed through two parallel incisions on the bulbarconjunctival surface, divulsioning 5 mm in length in the vertical portion of the cartilage in a ‘T’ shape, and separating the...

Fake news colocam a vida em risco: a polêmica da campanha de vacinação contra a febre amarela no Brasil / Fake News put human life at risk: the controversy of the yellow fever vaccination campaign in Brazil / Fake News ponen en riesgo la vida: la controversia de la campaña de vacunación contra la fiebre amarilla en Brasil

Este artigo faz a leitura das notícias falsas que circulam conteúdo sobre saúde pública em redes digitais e aplicativos de troca de mensagens. Para enumerar os argumentos utilizados pelos divulgadores de fake news na disputa pela enunciação da verdade, no campo do discurso, os autores escolheram a campanha de vacinação contra a febre amarela, lançada em um surto da doença no Brasil, no final de 2016. Selecionamos os textos de posts e áudios que se multiplicaram no WhatsApp, especificamente no ano de 2018, para a análise ancorada nas teses sobre produção de verdade e poder de Michel Foucault e de Nikolas Rose. Iniciamos, assim, uma reflexão sobre a ação das fake news em defesa da vida e que, ao mesmo tempo, colocam a vida em risco. A Organização Mundial da Saúde já aponta as fake news como uma das responsáveis pela baixa nos níveis internacionais de imunização.

This article analyses the fake news that spread contents of public health using digital networks and crossplatform messaging applications. To list the arguments used by those people whom spread fake news to dispute the utterance of the truth, in the discourse field, the authors have chosen the yellow fever vaccination campaign, launched in the outbreak of the disease in Brazil, in late 2016. We selected the texts of posts and audios that multiplied via WhatsApp, specifically in 2018, for analysis based on the theses on the production of truth and power by Michel Foucault and Nikolas Rose. Thus, we started a reflection on the action of fake news in defense of life while themselves put many lives at risk. The World Health Organization already points out fake news as one of the factors responsible for the drop in international levels of immunization.

Este artículo hace un análisis de las fake news que difunden contenido sobre salud pública por medio de redes digitales y aplicaciones de mensajería. Para enumerar los argumentos utilizados por las personas que hacen la divulgación de las fake news en la disputa por la expresión de la verdad, en el campo del discurso, los autores eligieron la campaña de vacunación contra la fiebre amarilla, lanzada en el brote de la enfermedad en Brasil, a fines de 2016. Seleccionamos los textos de publicaciones y audios que se multiplicaron en el WhatsApp, especialmente en 2018, para el análisis basado en las tesis sobre la producción de verdad y poder de Michel Foucault y de Nikolas Rose. Comenzamos así a reflexionar sobre la acción de las fake news en defensa de la vida y que al mismo tiempo la ponen en riesgo. La Organización Mundial de la Salud ya señala las fake news como uno de los factores responsables de la bajada de los niveles internacionales de inmunización.

An update on the epigenetics of glioblastomas.

Glioblastomas, also known as glioblastoma multiforme (GBM), are the most aggressive and malignant type of primary brain tumor in adults, exhibiting notable variability at the histopathological, genetic and epigenetic levels. Recently, epigenetic alterations have emerged as a common hallmark of many tumors, including GBM. Considering that a deeper understanding of the epigenetic modifications that occur in GBM may increase the knowledge regarding the tumorigenesis, progression and recurrence of this disease, in this review we discuss the recent major advances in GBM epigenetics research involving histone modification, glioblastoma stem cells, DNA methylation, noncoding RNAs expression, including their main alterations and the use of epigenetic therapy as a valid option for GBM treatment.

Nutritional screening in hospitalized pediatric patients: a systematic review / Triagem nutricional em pacientes pediátricos hospitalizados: uma revisão sistemática

Abstract Objective: This systematic review aimed to verify the available scientific evidence on the clinical performance and diagnostic accuracy of nutritional screening tools in hospitalized pediatric patients. Data source: A search was performed in the Medline (National Library of Medicine United States), LILACS (Latin American and Caribbean Health Sciences), PubMed (US National Library of Medicine National Institutes of Health), in the SCIELO (Scientific Electronic Library Online), through CAPES portal (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), bases Scopus e Web of Science. The descriptors used in accordance with the Descriptors in Health Sciences (DeCS)/Medical Subject Headings (MeSH) list were “malnutrition”, “screening”, and “pediatrics”, as well as the equivalent words in Portuguese. Summary of the findings: The authors identified 270 articles published between 2004 and 2014. After applying the selection criteria, 35 were analyzed in full and eight articles were included in the systematic review. We evaluated the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Five nutritional screening tools in pediatrics were identified. Among these, the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) showed high sensitivity, almost perfect inter-rater agreement and between the screening and the reference standard; the Screening Tool Risk on Nutritional Status and Growth (STRONGkids) showed high sensitivity, lower percentage of specificity, substantial intra-rater agreement, and ease of use in clinical practice. Conclusions: The studies included in this systematic review showed good performance of the nutritional screening tools in pediatrics, especially STRONGkids and STAMP. The authors emphasize the need to perform for more studies in this area. Only one tool was translated and adapted to the Brazilian pediatric population, and it is essential to carry out studies of tool adaptation and validation for this population.

Resumo Objetivo: Esta revisão sistemática tem por objetivo verificar as evidências científicas disponíveis sobre o desempenho clínico e acurácia diagnóstica dos instrumentos de triagem nutricional em pacientes pediátricos hospitalizados. Fonte de dados: Realizou-se busca nas bases de dados Medline (National Library of Medicine United States), LILACS (Latin American and Caribbean Health Sciences), PubMed (US National Library of Medicine National Institutes of Health), na biblioteca eletrônica SCIELO (Scientific Electronic Library Online), através do portal de periódicos da CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), bases Scopus e Web of Science. Os descritores utilizados conforme lista do DeCS (Descritores em Ciências da Saúde)/MeSH (Medical Subject Headings) foram “desnutrição”, “triagem” e “pediatria”, bem como, “malnutrition”, “screening” e “pediatrics”, respectivamente. Síntese dos dados: Identificou-se 270 artigos, publicados entre 2004 e 2014. Após aplicação dos critérios de seleção, 35 foram analisados na íntegra, sendo incluídos 8 artigos na revisão sistemática. Avaliou-se a qualidade metodológica dos estudos utilizando-se o QUADAS (Quality Assessment of Diagnostic Accuracy Studies). Verificou-se 05 instrumentos de triagem nutricional em pediatria. Dentre estes, o STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) apresentou sensibilidade elevada, concordância quase perfeita inter-avaliador e entre a triagem e padrão de referência; o STRONGkids (Screening Tool Risk on Nutritional Status and Growth) evidenciou sensibilidade elevada, menor percentual de especificidade, concordância intra-avaliador substancial e facilidade de uso na prática clínica. Conclusões: Os estudos incluídos nesta revisão sistemática demonstraram um bom desempenho dos instrumentos de triagem nutricional em pediatria, principalmente STRONGkids e STAMP. Evidencia-se a necessidade de mais pesquisas nessa área. Apenas um instrumento foi traduzido e adaptado para a população pediátrica brasileira, sendo imprescindível a realização de estudos de adaptação e validação de instrumentos para essa população.

Nutritional screening in hospitalized pediatric patients: a systematic review.

OBJECTIVE: This systematic review aimed to verify the available scientific evidence on the clinical performance and diagnostic accuracy of nutritional screening tools in hospitalized pediatric patients. DATA SOURCE: A search was performed in the Medline (National Library of Medicine United States), LILACS (Latin American and Caribbean Health Sciences), PubMed (US National Library of Medicine National Institutes of Health), in the SCIELO (Scientific Electronic Library Online), through CAPES portal (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), bases Scopus e Web of Science. The descriptors used in accordance with the Descriptors in Health Sciences (DeCS)/Medical Subject Headings (MeSH) list were "malnutrition", "screening", and "pediatrics", as well as the equivalent words in Portuguese. SUMMARY OF THE FINDINGS: The authors identified 270 articles published between 2004 and 2014. After applying the selection criteria, 35 were analyzed in full and eight articles were included in the systematic review. We evaluated the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Five nutritional screening tools in pediatrics were identified. Among these, the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) showed high sensitivity, almost perfect inter-rater agreement and between the screening and the reference standard; the Screening Tool Risk on Nutritional Status and Growth (STRONGkids) showed high sensitivity, lower percentage of specificity, substantial intra-rater agreement, and ease of use in clinical practice. CONCLUSIONS: The studies included in this systematic review showed good performance of the nutritional screening tools in pediatrics, especially STRONGkids and STAMP. The authors emphasize the need to perform for more studies in this area. Only one tool was translated and adapted to the Brazilian pediatric population, and it is essential to carry out studies of tool adaptation and validation for this population.

Resina composta indireta polimerizada adicionalmente como alternativa restauradora posterior û relato de caso / Composite resin indirect polymerized addition as an alternative restorative rear û case report

Restaurações diretas extensas em dentes posteriores utilizando resina composta são frequentes na prática clínica diária. A tensão gerada pela contração de polimerização pode acarretar fadiga na linha de união dente/restauração, predispondo a sensibilidade pós-operatória, infiltração marginal e redução da vida útil funcional da restauração. Na tentativa de minimizar os problemas supracitados, as restaurações posteriores em resina composta podem ser confeccionadas de forma indireta, ou seja, extraoralmente. Tal técnica, além de minimizar os efeitos deletérios da contração de polimerização, geram restaurações com maior grau de conversão polimérica, quando polimerizados adicionalmente, facilitam a excelência do contorno anatômico, dos contatos proximais e melhoram o polimento final. Este trabalho objetiva relatar através de um caso clínico a técnica de confecção de uma restauração indireta posterior empregando resina composta e autoclave como método de polimerização adicional.

Extensive direct restorations on posterior teeth using composite resin are common in clinical practice. The tension generated by the shrinkage polymerization can cause fatigue on the tooth/restoration union line, predisposing to postoperative sensitivity, microleakage and reduction of the restoration`s life. In an attempt to minimize the problems described above, the composite resin posterior restorations can be made indirectly. This technique, while minimizing the deleterious effects of shrinkage polymerization restorations, generates higher degree of polymer conversion when polymerized additionally, facilitates the anatomical contour, proximal contacts, and improve the final polishing. This study reports a case through the technique of making a posterior indirect restoration using composite resin and autocle as adiditional polymerization method.

Características clínicas da fase aguda da infecção experimental de felinos pelo vírus da imunodeficiência felina / Clinical characteristics of the acute phase of feline immunodeficiency virus experimental infection

A infecção dos felinos pelo Vírus da Imunodeficiência Felina (FIV) resulta no desenvolvimento da síndrome de imunodeficiência dos felinos. Gengivite, perda de peso, linfadenomegalia generalizada, anemia, insuficiência renal crônica, complicações neurológicas, diarréia crônica e infecções bacterianas são encontradas frequentemente. A fase aguda da infecção pode ser assintomática, retardando o estabelecimento do diagnóstico e a implantação de medidas profiláticas para restringir o contágio e a transmissão do agente aos felinos suscetíveis. Com a finalidade de estudar as características clínicas da fase aguda da infecção, dez felinos jovens, sem definição racial, com oito meses de idade foram inoculados por via endovenosa com 1mL de sangue venoso de um gato portador do FIV subtipo B. A confirmação da infecção foi obtida através de teste sorológico em quatro e oito semanas pós-inoculação (p.i.) e por nested-PCR. Foram realizados hemogramas semanais, exame ultrassonográfico do abdômen quinzenais e exame oftalmológico mensal, durante doze semanas p.i. Discreta tendência a linfopenia na segunda semana p.i. e a neutropenia entre a quinta e sétima semana p.i., febre intermitente em alguns gatos, linfadenomegalia e hepato-esplenomegalia entre a quarta e a 12ª semana p.i. foram as alterações clínicas observadas. Apenas um gato apresentou uveíte unilateral direita. A fase aguda da infecção transcorreu com alterações clínicas inespecíficas. A linfadenomegalia e a hepato-esplenomegalia observadas no decorrer da infecção, refletindo hiperplasia linfóide, sugerem a necessidade de se realizar o teste sorológico para o FIV, em todos os gatos que se apresentarem com essas alterações, o que permitirá o diagnóstico precoce da infecção e a adoção de medidas profiláticas no sentido de minimizar a propagação da infecção.

As a result of FIV infection of cats, feline immunodeficiency syndrome might be seen in the latter phase of infection. Gengivitis, weight loss, spread enlargement lymph nodes, anemia, chronic renal failure, neurological disturbances, chronic diarrhea, and oportunistic bacterial infections are commonly found. The acute phase of the infection might be unnoticed, making the diagnosis difficult and delaying the adoption of profilatic measures, in order to reduce FIV transmission for other susceptible cats. Aiming to study the clinical characteristics of the acute phase of FIV infection, ten young eight month old cats mixed breed were succesfully inoculated by intravenous route with one mL of blood obtained from one FIV-B positive cat. The infection was confirmed by ELISA test four and eight weeks p.i and nested-PCR. CBC counting, abdominal ultrasonography and ophtalmologic exams were done weekly, fortnightly and monthly during twelve weeks p.i. Mild tendency to lymphopenia at second week and neutropenia between fifth and seventh weeks p.i., fever in a few cats and lymph nodes, spleen and hepatic enlargements were the main clinical alterations found. The latters became evident starting on fourth week and remained throughout the twelve weeks observation period. Only one cat showed unilateral rigt uveitis. The acute phase of FIV infection elapsed with inespecific clinical manifestations. Lymph node, hepatic and spleen enlargements seen, though, suggest the needs for indication of tests for the diagnosis of FIV infection in all cats presenting those signs, thus allowing early diagnosis of FIV infection and the adoption of prophylatic measures.

Correlações entre diferentes frênulos linguais e alterações na fala / Correlations between different lingual frenulum and speech disorders

Objetivo: realizar revisão bibliográfica sobre o tipo do frênulo lingual e as alterações de fala associadas. Métodos: foi realizado levantamento bibliográfico sobre o tema nas bases de dados Medline, Lilacs e Scielo, de 2000 a 2010. Conclusão: de acordo com a literatura revisada, concluiu-se que asalterações do frênulo lingual contribuem para a existência de distúrbios de fala, de origem fonética. Não há evidências de que as diferentes alterações de frênulo causem alterações em diferentes fones, pois independentemente da alteração do frênulo, os fones que se alteram em diferentes graus são: oflape alveolar, os grupos consonantais compostos com [r] e ou [l] e as fricativas alveolares [s] e [z].

Purpose: to review the literature about the different lingual frenulum alterations and correlated speech disorders. Methods: literature review about the theme was made from Medline, Lilacs and Scielo databases, from 2000 to 2010. Conclusion: according to the reviewed literature, it can be concluded that alterations on the lingual frenulum contribute to speech disorders, which have phonetic origin. There are not evidences that different frenulum alterations cause alterations in different phones. Independently from the frenulum alteration, the phones that are altered by the frenulum, in different levels are: alveolar flap, consonantal clusters and alveolar fricatives [s] and [z].

Objetivo: realizar revisión bibliográfica sobre el tipo de frenillo lingual y trastornos del habla asociados. Método: se llevó a cabo levantamiento bibliográfico sobre el tema en las bases de datos Medline, Lilacs y Scielo en el período de 2000 a 2010. Conclusión: con base en la literatura revisadas e concluyo que las alteraciones del frenillo lingual contribuyen para los trastornos del habla denaturaleza fonética. No se encontró evidencias de que distintos trastornos del frenillo sean causa de alteraciones en distintos fones, porque independientemente del trastorno del frenillo los fones que se alteran, en distintos grados, son el “flape” alveolar, los grupos consonántales compuestos por [r] y/u[l] y las fricativas alveolares [s] y [z].

Correlações entre diferentes frênulos linguais e alterações na fala / Correlations between different lingual frenulum and speech disorders

Objetivo: realizar revisão bibliográfica sobre o tipo do frênulo lingual e as alterações de fala associadas. Métodos: foi realizado levantamento bibliográfico sobre o tema nas bases de dados Medline,Lilacs e Scielo, de 2000 a 2010. Conclusão: de acordo com a literatura revisada, concluiu-se que as alterações do frênulo lingual contribuem para a existência de distúrbios de fala, de origem fonética. Não há evidências de que as diferentes alterações de frênulo causem alterações em diferentes fones, pois independentemente da alteração do frênulo, os fones que se alteram em diferentes graus são: oflape alveolar, os grupos consonantais compostos com [r] e ou [l] e as fricativas alveolares [s] e [z].AU

Purpose: to review the literature about the different lingual frenulum alterations and correlated speech disorders. Methods: literature review about the theme was made from Medline, Lilacs and Scielo databases, from 2000 to 2010. Conclusion: according to the reviewed literature, it can be concluded that alterations on the lingual frenulum contribute to speech disorders, which have phonetic origin. There are not evidences that different frenulum alterations cause alterations in different phones. Independently from the frenulum alteration, the phones that are altered by the frenulum, in different levels are: alveolar flap, consonantal clusters and alveolar fricatives [s] and [z].AU

Objetivo: realizar revisión bibliográfica sobre el tipo de frenillo lingual y trastornos del habla asociados. Método: se llevó a cabo levantamiento bibliográfico sobre el tema en las bases de datos Medline, Lilacs y Scielo en el período de 2000 a 2010. Conclusión: con base en la literatura revisadas e concluyo que las alteraciones del frenillo lingual contribuyen para los trastornos del habla de naturaleza fonética. No se encontró evidencias de que distintos trastornos del frenillo sean causa de alteraciones en distintos fones, porque independientemente del trastorno del frenillo los fones que se alteran, en distintos grados, son el “flape” alveolar, los grupos consonántales compuestos por [r] y/u [l] y las fricativas alveolares [s] y [z].AU

Intervenção da Terapia Ocupacional com idosos que apresentam queixas de memória da Liga de Saúde do Idoso da Faculdade de Medicina do ABC / Occupational Therapy intervention in elderly patients who present memory complaints of the Elderly Health League of the Faculdade de Medicina do ABC

Introdução: A Terapia Ocupacional foi incorporada à Liga de Saúde do Idoso (LSI) da Faculdade de Medicina do ABC (FMABC), juntamente com profissionais de Medicina, Enfermagem e Fisioterapia, para realizar assistência integral ao idoso, possibilitando àqueles com queixas de memória a realização de atividades com significado para descobrir seus interesses, habilidades e capacidades na construção e resgate dos afazeres cotidianos. Objetivo: Incentivar a independência e autonomia dos idosos, bem como estimular o desenvolvimento da memória, facilitando a produção da história de vida de cada indivíduo. Material e método: Foram realizados 15 encontros semanais de 60 minutos cada, com 8 idosos, no Ambulatório de Especialidades da FMABC. Resultados: Constatou-se que a assistência integral destinada a essa população auxiliou na promoção da saúde e qualidade de vida. Com relação à memória, durante os encontros, os idosos disseram perceber sua melhora, uma vez que iniciaram seu treino no grupo e em suas casas. Também verificou-se que, para além das queixas de memória, o grupo teve papel importante na ampliação das redes sociais dos idosos e alguns demonstraram motivação para pensar e executar outros projetos de vida para o futuro. Conclusões: Houve diminuição de queixa da memória, promoção da participação social, autonomia e criação de projetos de vida frente a essa etapa, que nem sempre é permeada somente por perdas.

Introduction: The Occupational Therapy was incorporated to the Elderly Health League of Faculdade de Medicina do ABC (FMABC) jointly to medical, nursery and physiotherapy professionals to integrally assist the elderly, thus enabling those with memory complaints to do significant activities to find their interests, abilities, and capabilities in the construction and recovery of daily activities. Objective: To enhance elderly independence and autonomy, as well as to stimulate memory development, facilitating life history production of each individual. Material and method: We carried out 15 weekly meetings of 60 minutes each, with 8 elderly, in the Specialty Outpatient Clinic of FMABC. Results: Our data ascertained that integral assistance assigned to this population improved health promotion and quality of life. Regarding memory, the elderly reported they have noticed their improvement during the meetings, as they started the training activities within the group and also at home. We also verified that, beside the complaints related to memory problems, the group had an important role in enlarging the elderly social networks, and some of them became motivated to think about and to execute other future life projects. Conclusions: The memory problems diminished, social participation increased, and also occurred the development of autonomy and creation of life projects in this life stage, which is not always permeated only by losses.

Multicentricity in the thyroid differentiated carcinoma.

UNLABELLED: The treatment of choice for the well differentiated thyroid carcinoma has always been controversial. AIM: to analyze tumor invasion of the thyroid gland's contralateral lobe in cases of differentiated carcinoma, correlating risk/benefit with the complications of a second surgical approach. MATERIALS AND METHODS: Retrospective study, from 1998 to 2006, of 27 patients undergoing less than total thyroidectomy: lobectomy (21), subtotal thyroidectomy (5) or isthmusectomy (1). Gender, age, type of surgery, complications, histopathological analysis and invasion of the contralateral lobe were analyzed. Patients' ages varied from 17 to 89; the most frequent histopathological pattern was the classical papillary carcinoma (18 cases), followed by follicular carcinoma (6); the follicular variant of the papillary carcinoma (2) and the Hürthle cell carcinoma (1). Twenty-one patients underwent full thyroidectomies, from 15 to 30 days after the first intervention. RESULTS: the contralateral lobe analysis was negative for carcinoma in 16 (76.5%) and positive in the other 5 (23.8%) patients. The complications observed were temporary dysphonia (3 cases) and hypoparathyroidism (2 cases, one permanent). CONCLUSIONS: total thyroidectomy is important in the treatment of differentiated thyroid carcinomas, because there is a high contralateral spread rate (23.8%). It is a procedure without mortality, which bears few complications.

Multicentricidade no carcinoma diferenciado da tireóide / Multicentricity in the thyroid differentiated carcinoma

O tratamento cirúrgico de escolha no carcinoma diferenciado da tireóide sempre foi controverso. Objetivo: Analisar o acometimento tumoral do lobo contralateral da tireóide no carcinoma diferenciado, correlacionando risco e benefício com as complicações decorrentes da segunda intervenção. Casuística e Método: Estudo retrospectivo, de 1998 a 2006, com 27 pacientes submetidos à tireoidectomia menos que total, sendo 21 lobectomias, cinco tireoidectomias subtotais e uma istmectomia. Foram analisados: gênero, idade, tipo de cirurgia, complicações, histopatológico do espécime cirúrgico e invasão do lobo contralateral. As idades variaram de 17 a 89 anos; o tipo histopatológico mais freqüente foi o carcinoma papilífero clássico (18 casos), seguido do carcinoma folicular (seis casos), do carcinoma papilífero variante folicular (dois casos) e do carcinoma de células Hürthle (um caso). Vinte e um pacientes foram submetidos à totalização da tireoidectomia, 15 a 30 dias depois. Resultados: A análise do lobo contralateral foi negativa para carcinoma em 16 (76,5%) e positiva nos cinco restantes (23,8%). As complicações observadas foram: disfonia temporária (três casos) e hipoparatireoidismo (dois casos, sendo um permanente). Conclusão: A totalização da tireoidectomia é um procedimento importante no tratamento do carcinoma bem diferenciado da tireóide pelo elevado acometimento contralateral (23,8%). A incidência de complicações é pequena.

The treatment of choice for the well differentiated thyroid carcinoma has always been controversial. Aim: to analyze tumor invasion of the thyroid gland’s contralateral lobe in cases of differentiated carcinoma, correlating risk/benefit with the complications of a second surgical approach. Materials and methods: Retrospective study, from 1998 to 2006, of 27 patients undergoing less than total thyroidectomy: lobectomy (21), subtotal thyroidectomy (5) or isthmusectomy (1). Gender, age, type of surgery, complications, histopathological analysis and invasion of the contralateral lobe were analyzed. Patients’ ages varied from 17 to 89; the most frequent histopathological pattern was the classical papillary carcinoma (18 cases), followed by follicular carcinoma (6); the follicular variant of the papillary carcinoma (2) and the Hürthle cell carcinoma (1). Twenty-one patients underwent full thyroidectomies, from 15 to 30 days after the first intervention. Results: the contralateral lobe analysis was negative for carcinoma in 16 (76.5%) and positive in the other 5 (23.8%) patients. The complications observed were temporary dysphonia (3 cases) and hypoparathyroidism (2 cases, one permanent). Conclusions: total thyroidectomy is important in the treatment of differentiated thyroid carcinomas, because there is a high contralateral spread rate (23.8%). It is a procedure without mortality, which bears few complications.

Streptococcus mutans-induced secondary caries adjacent to glass ionomer cement, composite resin and amalgam restorations in vitro.

The aim of this study was to define, in vitro, the potential to inhibit secondary caries of restorative materials currently used in dental practice. Standard cavities were prepared on the buccal and lingual surfaces of fifty extracted human third molars. The teeth were randomly divided into five groups, each one restored with one of the following materials: glass ionomer cement (GIC); amalgam; light-cured composite resin; ion-releasing composite; and light-cured, fluoride-containing composite resin. The teeth were thermocycled, sterilized with gamma irradiation, exposed to a cariogenic challenge using a bacterial system using Streptococcus mutans, and then prepared for microscopic observation. The following parameters were measured in each lesion formed: extension, depth, and caries inhibition area. The outer lesions developed showed an intact surface layer and had a rectangular shape. Wall lesions were not observed inside the cavities. After Analysis of Variance and Component of Variance Models Analysis, it was observed that the GIC group had the smallest lesions and the greatest number of caries inhibition areas. The lesions developed around Amalgam and Ariston pHc restorations had an intermediate size and the largest lesions were observed around Z-100 and Heliomolar restorations. It may be concluded that the restorative materials GIC, amalgam and ion-releasing composites may reduce secondary caries formation.

Streptococcus mutans-induced secondary caries adjacent to glass ionomer cement, composite resin and amalgam restorations in vitro

The aim of this study was to define, in vitro, the potential to inhibit secondary caries of restorative materials currently used in dental practice. Standard cavities were prepared on the buccal and lingual surfaces of fifty extracted human third molars. The teeth were randomly divided into five groups, each one restored with one of the following materials: glass ionomer cement (GIC); amalgam; light-cured composite resin; ion-releasing composite; and light-cured, fluoride-containing composite resin. The teeth were thermocycled, sterilized with gamma irradiation, exposed to a cariogenic challenge using a bacterial system using Streptococcus mutans, and then prepared for microscopic observation. The following parameters were measured in each lesion formed: extension, depth, and caries inhibition area. The outer lesions developed showed an intact surface layer and had a rectangular shape. Wall lesions were not observed inside the cavities. After Analysis of Variance and Component of Variance Models Analysis, it was observed that the GIC group had the smallest lesions and the greatest number of caries inhibition areas. The lesions developed around Amalgam and Ariston pHc restorations had an intermediate size and the largest lesions were observed around Z-100 and Heliomolar restorations. It may be concluded that the restorative materials GIC, amalgam and ion-releasing composites may reduce secondary caries formation.

O objetivo deste estudo foi definir, in vitro, o potencial de materiais restauradores, usados rotineiramente na prática clínica, na inibição da cárie secundária. Cavidades padronizadas foram preparadas nas faces vestibulares e linguais de 50 terceiros molares humanos extraídos. Os dentes foram divididos aleatoriamente em 5 grupos, cada um restaurado com um dos seguintes materiais: cimento de ionômero de vidro (CIV); amálgama; resina composta fotopolimerizável; compósito que libera íons, e resina composta fotopolimerizável contendo flúor. Os dentes foram termociclados, esterilizados com radiação gama, expostos a um desafio cariogênico utilizando um sistema bacteriano com Streptococcus mutans e preparados para observação microscópica. Os parâmetros medidos em cada lesão formada foram: extensão, profundidade e área de inibição de cárie. As lesões externas formadas apresentaram camada superficial intacta e formato retangular. Não foram vistas lesões de parede no interior das cavidades. Após Análise de Variância e Análise de Componentes de Variância, foi observado que o grupo CIV apresentou as menores lesões e o maior número de áreas de inibição de cárie. As lesões formadas ao redor das restaurações de amálgama e Ariston pHc apresentaram tamanho intermediário e as maiores lesões foram observadas ao redor das restaurações dos grupos Z-100 e Heliomolar. Pode ser concluído que os materiais restauradores CIV, amálgama e compósitos que liberam íons podem reduzir a formação de cáries secundárias.

Cerebellar thiol status and motor deficit after lactational exposure to methylmercury.

This study examined the exclusive contribution of methylmercury (MeHg) exposure through maternal milk on biochemical parameters related to the thiol status (glutathione (GSH) levels, glutathione peroxidase (GPx) and glutathione reductase (GR) activities) in the cerebellums of suckling mice. The same biochemical parameters were also evaluated in the cerebellums of mothers, which were submitted to a direct oral exposure to MeHg (10 mg/L in drinking water). With regard to the relationship between cerebellar function and motor activity, the presence of signs of motor impairment was also evaluated in the offspring exposed to MeHg during lactation. After the treatment (at weaning period), the pups lactationally exposed to MeHg showed increased levels of mercury in the cerebellum compared to pups in the control group and a significant impairment in the motor performance in the rotarod apparatus. In addition, these pups showed decreased levels of GSH in the cerebellum compared to pups in the control group. In dams, MeHg significantly increased the levels of cerebellar GSH and the activities of cerebellar GR. However, this was not observed in pups. This study indicates that (1) the exposure of lactating mice to MeHg causes significant impairments in motor performance in the offspring which may be related to a decrease in the cerebellar thiol status and (2) the increased GSH levels and GR activity, observed only in the cerebellums of MeHg-exposed dams, could represent compensatory pathophysiologic responses to the oxidative effects of MeHg toward endogenous GSH.