Trends in vasectomy and sexually transmitted diseases in Chile: findings from robust national databases.

A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic.

Trends in vasectomy and sexually transmitted diseases in Chile: findings from robust national databases / Tendencias de la vasectomía y las enfermedades de transmisión sexual en Chile: resultados de bases de datos robustas / Tendências em vasectomia e doenças sexualmente transmissíveis no Chile: resultados de bases de dados robustas

Abstract: A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic.

Resumen: Se viene surgiendo una controversia sobre el aumento o la disminución de la vasectomía; sin embargo, la evidencia aún es escasa en América Latina. Este estudio ecológico analizó las tendencias de la vasectomía y las enfermedades de transmisión sexual (ETS) durante un período de 10 años en Chile y determinó si existe alguna relación entre ellas. Este es un estudio ecológico mixto que utiliza datos secundarios representativos sobre el número de vasectomías y casos de ETS de 2008 a 2017. Las tasas de vasectomía se calcularon por grupos de edad teniendo en cuenta a hombres entre 20-59 años de edad y ETS específicas (VIH, clamidia, gonorrea, tricomoniasis y sífilis) para el mismo período. Los modelos de regresión binomial negativa multivariante se ajustaron para evaluar las tendencias y las relaciones entre las tasas. La edad media de la vasectomía fue de 40,3 años, sin diferencias significativas entre el período del estudio (p = 0,058). La tasa general de vasectomía tuvo un incremento significativo para el período de 2008 a 2017 (p < 0,001), con diferencias entre los grupos de edad (p < 0,001). El incremento más significativo se observó en hombres de entre 30-49 años (p < 0,001). Las tasas de ETS tuvieron una alza significativa (p < 0,05) durante el período de estudio. Hubo una correlación positiva significativa entre las tasas de vasectomía y las tasas de incidencia de gonorrea (p = 0,008) y una correlación inversa con las tasas de incidencia de hepatitis B (p = 0,002). Se concluye que las tendencias de la vasectomía y las tasas de ETS presentaron un incremento significativo en período de 2008 a 2017 en Chile, especialmente entre los hombres de entre 30-49 años. La relación entre la vasectomía y el incremento de las ETS puede ser un nuevo factor de riesgo para las políticas de salud sexual y reproductiva que puede ayudar a controlar la epidemia del VIH y las ETS.

Resumo: Uma controvérsia sobre o aumento ou declínio da vasectomia está surgindo; no entanto, as evidências ainda são escassas na América Latina. Este estudo ecológico analisou as tendências de vasectomia e doenças sexualmente transmissíveis (DST) em um período de dez anos no Chile e determinou se há alguma relação entre elas. Este é um estudo ecológico misto utilizando dados secundários e representativos sobre o número de vasectomias e casos de DSTs de 2008 a 2017. As taxas de vasectomia foram calculadas por grupos etários, considerando homens de 20-59 anos de idade e DSTs específicas (HIV, clamídia, gonorreia, tricomoníase e sífilis) para o mesmo período. Modelos de regressão binomial negativa multivariada foram ajustados para avaliar tendências e relações entre taxas. A média de idade da vasectomia foi de 40,3 anos, sem diferenças significativas entre os anos do estudo (p = 0,058). A taxa geral de vasectomia aumentou significativamente de 2008 a 2017 (p < 0,001), com diferenças entre grupos etários (p < 0,001). O aumento mais significativo foi observado em homens de 30-49 anos (p < 0,001). As taxas de DST aumentaram significativamente (p < 0,05) durante o período de estudo. Houve correlação positiva significativa entre as taxas de vasectomia e as taxas de incidência de gonorreia (p = 0,008) e uma correlação inversa com as taxas de incidência de hepatite B (p = 0,002). As tendências de vasectomia e as taxas de DST aumentaram significativamente de 2008 para 2017 no Chile, especialmente entre homens de 30-49 anos. A relação entre vasectomia e incrementos de DST sugere um novo fator de risco para políticas de saúde sexual e reprodutiva para auxiliar no controle da epidemia de HIV e DST.

Ligand-Independent Activation of Aryl Hydrocarbon Receptor and Attenuation of Glutamine Levels by Natural Deep Eutectic Solvent.

Natural deep eutectic solvents (NADESs) are emerging sustainable alternatives to conventional organic solvents. Beyond their role as laboratory solvents, NADESs are increasingly explored in drug delivery and as therapeutics. Their increasing applications notwithstanding, our understanding of how they interact with biomolecules at multiple levels - metabolome, proteome, and transcriptome - within human cell remain poor. Here, we deploy integrated metabolomics, proteomics, and transcriptomics to probe how NADESs perturb the molecular landscape of human cells. In a human cell line model, we found that an archetypal NADES derived from choline and geranic acid (CAGE) significantly altered the metabolome, proteome, and transcriptome. CAGE upregulated indole-3-lactic acid and 4-hydroxyphenyllactic acid levels, resulting in ligand-independent activation of aryl hydrocarbon receptor to signal the transcription of genes with implications for inflammation, immunomodulation, cell development, and chemical detoxification. Further, treating the cell line with CAGE downregulated glutamine biosynthesis, a nutrient rapidly proliferating cancer cells require. CAGE's ability to attenuate glutamine levels is potentially relevant for cancer treatment. These findings suggest that NADESs, even when derived from natural components like choline, can indirectly modulate cell biology at multiple levels, expanding their applications beyond chemistry to biomedicine and biotechnology.

Specific plasticity of the anemone Anthopleura hermaphroditica to intertidal and subtidal environmental conditions of the Quempillén estuary.

The cellular capacity of marine organisms to address rapid fluctuations in environmental conditions is decisive, especially when their bathymetric distribution encompasses intertidal and subtidal zones of estuarine systems. To understand how the bathymetric distribution determines the oxidative damage and antioxidant response of the estuarine anemone Anthopleura hermaphroditica, individuals were collected from upper intertidal and shallow subtidal zones of Quempillén River estuary (Chile), and their response analysed in a fully orthogonal, multifactorial laboratory experiment. The organisms were exposed to the effects of temperature (10°C and 30°C), salinity (10 ppt and 30 ppt) and radiation (PAR, > 400-700 nm; PAR+UV-A, > 320-700 nm; PAR+UV-A+UV-B, > 280-700 nm), and their levels of lipid peroxidation, protein carbonyl and total antioxidant capacity were determined. The results indicated that the intertidal individuals of A. hermaphroditica presented higher levels of tolerance to the stressful ranges of temperature, salinity, and radiation than individuals from the subtidal zone, which was evident from their lower levels of oxidative damage to lipids and proteins. These results were consistent with increased levels of total antioxidant capacity observed in subtidal organisms. Thus intertidal individuals could have greater plasticity to environmental variations than subtidal individuals. Future studies are needed to understand the mechanisms underlying stress adaptation in individuals from this estuarine anemone subjected to different environmental stressors during their life cycles.

An insight into embryogenesis interruption by carbon nitride dots: can they be nucleobase analogs?

The carbon nitride dot (CND) is an emerging carbon-based nanomaterial. It possesses rich surface functional moieties and a carbon nitride core. Spectroscopic data have demonstrated the analogy between CNDs and cytosine/uracil. Recently, it was found that CNDs could interrupt the normal embryogenesis of zebrafish. Modifying CNDs with various nucleobases, especially cytosine, further decreased embryo viability and increased deformities. Physicochemical property characterization demonstrated that adenine- and cytosine-incorporated CNDs are similar but different from guanine-, thymine- and uracil-incorporated CNDs in many properties, morphology, and structure. To investigate the embryogenesis interruption at the cellular level, bare and different nucleobase-incorporated CNDs were applied to normal and cancerous cell lines. A dose-dependent decline was observed in the viability of normal and cancerous cells incubated with cytosine-incorporated CNDs, which matched results from the zebrafish embryogenesis experiment. In addition, nucleobase-incorporated CNDs were observed to enter cell nuclei, demonstrating a possibility of CND-DNA interactions. CNDs modified by complementary nucleobases could bind each other via hydrogen bonds, which suggests nucleobase-incorporated CNDs can potentially bind the complementary nucleobases in a DNA double helix. Nonetheless, neither bare nor nucleobase-incorporated CNDs were observed to intervene in the amplification of the zebrafish polymerase-alpha 1 gene in quantitative polymerase chain reactions. Thus, in conclusion, the embryogenesis interruption by bare and nucleobase-incorporated CNDs might not be a consequence of CND-DNA interactions during DNA replication. Instead, CND-Ca2+ interactions offer a plausible mechanism that hindered cell proliferation and zebrafish embryogenesis originating from disturbed Ca2+ homeostasis by CNDs. Eventually, the hypothesis that raw or nucleobase-incorporated CNDs can be nucleobase analogs proved to be invalid.

How pervasive are post-translational and -transcriptional modifications?

Cells use post-translational and post-transcription modifications as crucial mechanisms to maintain homeostasis and regulate gene transcription. Recent discoveries demonstrate that these modifications are more pervasive and important than scientists previously posited. Here, we discuss their importance and provide insight to stimulate new research into these modifications.

Hydroxy acids for adhesion to enamel and dentin: Long-term bonding performance and effect on dentin biostability.

OBJECTIVES: To test the demineralization potential, bonding performance, and dentin biostability when using hydroxy acids for etching enamel and dentin. METHODS: Surface microhardness, roughness and depth of demineralization were investigated after etching enamel and dentin with 35 % glycolic acid (Gly), tartaric acid (Ta), gluconic acid (Glu), gluconolactone (Gln), or phosphoric acid (Pa) (n = 5/group). Dentin microtensile bond strength (µTBS) after 24 h or 1 year of bonding (n = 8 teeth/group) and enamel shear bond strength (SBS) after 24 h (n = 10 teeth/group) were obtained. In dentin, failure mode was classified as adhesive, cohesive in dentin/resin, or mixed. Dentin biostability was assessed by loss of dry weight and collagen degradation after 30-day incubation (n = 10 beams/group). Statistical analysis consisted of ANOVA with post-hoc Tukey's HSD, Tukey-Kramer test, Bonferroni correction, and Fisher's exact tests (α = 0.05). RESULTS: Gly showed better or similar results than Pa for enamel microhardness and dentin roughness, while no significant differences were observed among Ta, Glu, and Gln (p > .05). Hydroxy acids produced significantly shallower demineralization than Pa (p < .05). Gln resulted in the lowest SBS and µTBS, while Gly, Glu, Ta, and Pa showed no significant difference. There was no significant difference in µTBS between 24 h and 1 year of storage. The association between failure mode and etchant was statistically significant after 24 h only (p < .001). Hydroxy acids resulted in higher dentin biostability than Pa (p < .05). CONCLUSIONS: Gly, Glu and Ta resulted in adequate bonding performance and reduced dentin degradation and are potential alternative etchants to improve long-term stability of adhesive restorations. CLINICAL SIGNIFICANCE: This study supports the potential use of hydroxy acids as alternative etchants when bonding to enamel and dentin and demonstrates that specific acids are more suitable to be used in adhesion since they result in appropriate bond strength and less dentin degradation.

Anestesia general con máscara laríngea para radioterapia infantil: técnica y complicaciones / General anesthesia with laryngeal mask airway management for radiotherapy in children: anesthetic technique and complications

Objetivo: El objetivo de este estudio es describir la técnica de anestesia general con máscara laríngea y la presencia de complicaciones anestésica en niños sometidos a radioterapia entre el 2014 y el 2016 en el Instituto Nacional del Cáncer. Secundariamente, se describirán las características demográficas y clínicas de la población estudiada. Material y Método: Estudio descriptivo, retrospectivo. Se extrajeron datos clínicos y demográficos de radioterapia bajo anestesia general realizados entre 2014 y el 2016 en niños menores de 15 años. Los datos recopilados fueron: edad, sexo, número de radioterapias con anestesia general, diagnóstico, tipo de anestesia, dispositivo de la vía aérea utilizado, complicaciones (náuseas, vómitos, laringoespasmo, aspiración broncopulmonar). El análisis estadístico fue descriptivo. Resultados: Se registraron 1.285 radioterapias en 65 niños. Todas con anestesia general. Del total de sesiones, en 85 (7%) fue necesario instalar una vía venosa periférica o el paciente contaba con una. Con respecto a los dispositivos de vía aérea, en 1.139 (94%) se utilizó máscara laríngea, en 64 (5%) presentaba traqueostomía y en 8 (0,66%) fue necesario la intubación orotraqueal. Dentro de las complicaciones encontramos náuseas y/o vómitos en 71 sesiones, correspondientes al 5,53%. Espasmo laríngeo ocurrió en 9 (0,7%) de las sesiones. Conclusiones: La anestesia general con máscara laríngea es una técnica útil y con pocas complicaciones para el manejo de niños que requieren radioterapia, donde parece no ser indispensable contar con una vía venosa periférica o central de rutina.

Objective: Describe the use of general anesthesia with laryngeal mask airway management, and the presence of complications in children who require anesthesia for radiotherapy. The demographic and clinical characteristics of the children studied will also be described. Material and Methods: This is a descriptive, retrospective study. Clinical and demographic data were obtained from radiotherapy procedures with general anesthesia in children under 15 years of age completed between 2014 and 2016. The data collected included: sex, age, number of radiotherapies with general anesthesia, diagnosis, type of anesthesia, airway management device, complications (nausea and vomiting, laryngospasm and bronchopulmonary aspiration). The data were analyzed through descriptive statistics. Results: 1,285 radiotherapies where analyzed in 65 children. All patients received general anesthesia. Of the total sessions, only in 85 (7%). Was required to install a peripheral intravenous line or the patient had one. In 1,139 (94%) of the cases, the preferred airway management device was laryngeal mask, 64 (5%) presented with tracheostomy, and in 8 (0.66%) patients it was necessary to use an orotracheal tube. Nausea and vomiting occurred in 71 cases (5.53%), and laryngospasm in only 9 (0.7%) patients. Conclusion: General anesthesia with laryngeal mask airway management is a useful technique associated with low complications when caring for children requiring anesthesia for radiotherapy. Also, in this context, it seems unnecessary to routine install a peripheral intravenous line.

Growing Safe: Acute Size Escape from Desiccation in Juvenile Crepipatella peruviana (Mollusca: Gastropoda).

Desiccation is an important limiting factor in the intertidal zone. Generally decreasing seaward, desiccation stress can also be alleviated in wet microhabitats. Juvenile snails are generally more susceptible to desiccation than adults, and, for some species, juveniles must therefore hide in microhabitats to survive emersion. The transition from hiding in safe microhabitats to being able to survive fully exposed for the duration of low tide is not well documented. In this study, we investigated the influence of size on desiccation tolerance in juveniles of the calyptraeid gastropod Crepipatella peruviana to determine the size at which they can first survive exposure to air. Juveniles 2-13 mm long were exposed to 75% or 100% relative humidity for 0.5-6.5 hours. Juveniles smaller than 5 mm in shell length did not survive emersion at 75% relative humidity for even 0.5 hours; surprisingly, most also perished after short exposures to air at 100% relative humidity, suggesting that something other than desiccation stress may also be at play. In marked contrast, 82% of juveniles larger than 6 mm in shell length survived exposure to 75% relative humidity for the full 6.5 hours. In a field survey, no juveniles smaller than 9 mm were found on exposed rock but rather were found only in wet microhabitats. We suggest that the clearly defined size escape from desiccation may reflect a change in gill functioning or a newfound ability to retain water more effectively within the mantle cavity at low tide.

Role of the Substrate in Feeding and Growth of the Marine Suspension-Feeding Gastropods Crepidula fornicata and Crepipatella peruviana.

Unlike lamellibranch bivalves, suspension-feeding calyptraeid gastropods lack siphons and paired shell valves to regulate water inflow. This study was designed to determine if calyptraeid gastropods use the solid surface to which they attach to facilitate food particle capture. Juveniles of both Crepidula fornicata and Crepipatella peruviana were maintained with phytoplankton for 3 to 6 wk in the laboratory, either attached to solid substrate or without solid substrate. Individuals of C. fornicata and C. peruviana that were reared on solid substrate grew about five to ten times more, or two times more, respectively, than those deprived of solid substrate. Final tissue weights were also significantly greater for individuals of both species that had been reared on solid substrate. For the two species, phytoplankton clearance rates were about two to three times higher for individuals attached to solid substrate than for those without solid substrate; rates of food cord production from the gills were also significantly higher. About 50% of C. peruviana that were deprived of solid substrate died during the first 3 wk of observation, and about 60% were dead by 6 wk. In contrast, most individuals of C. peruviana that were attached to solid substrate survived for the entire 6-wk study period, and all of the C. fornicata survived whether or not they were attached to solid substrate. The solid substrate to which calyptraeid gastropods attach clearly plays an important role in their feeding biology, although the precise role remains to be explored.

Brooding in the Chilean oyster Ostrea chilensis: unexpected complexity in the movements of brooded offspring within the mantle cavity.

Brooding in invertebrates serves to protect embryos from stressful external conditions by retaining progeny inside the female body, effectively reducing the risk of pelagic stages being exposed to predation or other environmental stressors, but with accompanying changes in pallial fluid characteristics, including reduced oxygen availability. Brooded embryos are usually immobile and often encapsulated, but in some Ostrea species the embryos move freely inside the female pallial cavity in close association with the mother's gills for as long as eight weeks. We used endoscopic techniques to characterize the circulation pattern of embryos brooded by females of the oyster, Ostrea chilensis. Progeny at embryonic and veliger stages typically circulated in established patterns that included the use of dorsal and ventral food grooves (DFG, VFG) to move anteriorly on the gills. Both embryos and veligers accumulated around the mother's palps, and remained there until an active maternal countercurrent moved them to the gill inhalant area. Both food grooves were able to move embryos, veligers, and food-particle aggregates anteriorly, but the DFG was more important in progeny transport; early embryos were moved more rapidly than veligers in the DFG. A microcirculation pattern of embryos was apparent when they were moved by gill lamellae: when they were close to the VFG, most embryos lost gill contact and "fell" down to the DFG. Those that actually reached the DFG moved anteriorly, but others came into contact with the base of the lamellae and again moved towards the VFG. The circulation pattern of the progeny appears well-suited for both cleaning them and directing them posteriorly to an area where there is more oxygen and food than in the palp region. This process for actively circulating progeny involves the feeding structures (gill and palps) and appears to be energetically costly for the female. It also interferes with feeding, which could explain the poor energy balance previously documented for brooding females of this species.

Anestesia y priapismo / Anesthesia and priapism

Priapismo se define como la erección persistente del pene que no está asociado con la estimulación o deseo sexual. Su ocurrencia en el intraoperatorio durante anestesia general o neuroaxial (espinal, epidural) es poco frecuente, sin embargo, éste puede provocar complicaciones, como sangrado excesivo o trauma uretral, demoras, e incluso la cancelación del procedimiento quirúrgico. La literatura existente con respecto a este tema es escasa y en muchos casos contradictoria, sobre todo cuando se trata de definir la técnica anestésica (general o neuroaxial) responsable o capaz de resolver el caso. En la siguiente revisión analizaremos los agente farmacológicos y no farmacológicos, junto con las técnicas anestésicas capaces de producir y resolver el priapismo intraoperatorio.

Priapism is defined as a persistent penile erection that is not associated with stimulation or sexual desire. Its occurrence during general or neuraxial anesthesia (spinal, epidural) is rare, however, it can cause complications such as excessive bleeding or urethral trauma, delays and even cancellation of the surgical procedure. The literature on this subject is scarce and contradictory in many cases, especially when it comes to defining the anesthetic technique (general or neuraxial) responsible or able to resolve the case. The following review will discuss the pharmacological and non-pharmacological agents, along with anesthetic techniques capable of producing and resolve intraoperative priapism.

Physical therapy treatment in incontinent women provided by a Public Health Service / Fisioterapia em mulheres incontinentes atendidas em um serviço público de saúde

Introduction: Urinary incontinence affects more than 50 million people worldwide, it has a great impact on quality of life by affecting social, domestic, occupational and sex life, regardless of age. Objective: Theobjective of this study was to analyze the effectiveness of physical therapy treatment in women attending the Urogynecology service of Hospital and Maternity Leonor Mendes de Barros. Method: We retrospectively assessed 65 records of patients with diagnosis of urinary incontinence treated between November 2005 and November 2006. In order to have their data analyzed, patients were divided into two groups; group MF, which underwent medical treatment and physiotherapy, and group M, which had only medical treatment.In order to compare both groups’ quantitative data, the analysis was performed in Statistica® software usingMann Whitney’s non-parametric test. The analysis of association between the quantitative variables was performed through the Chi-Square test at 5% (p ≥ 0.05) significance level. Results: We observed that 60.6% of patients who underwent physical therapy treatment and medical treatment had the urinary incontinence symptoms decreased or completely cured, while 80% of women belonging to the medical treatment only-group underwent surgery. Conclusion: Thus, we conclude that physical therapy is essential in treatment protocols of urinary incontinence outpatient clinics and to prevent surgery.

Planificación educativa en cuatro municipios chilenos / Education planing in four chilean municipalities

El artículo presenta una experiencia inédita de planificación educativa municipal participativa y deliberativa en cuatro municipios chilenos de la Región de Los Ríos y Los Lagos. Lo que presentamos es una práctica diferente a la centralizada, no inclusiva y tradicional, que hace hincapié en tres ámbitos, por lo general controvertidos y olvidados en la planificación local: la inclusión de otros actores (aparte de los municipales), la corresponsabilidad en las tareas propuestas y el monitoreo y evaluación compartidos de lo planificado; pilares para la generación de confianzas, una planificación aterrizada y la conformación compartida de un horizonte educacional comunal. Queremos, de fondo, enfatizar que en la toma de decisiones locales "muchos es mejor que pocos" y que estos espacios potencian una planificación austera, pero no menos compleja, de acuerdos colaborativos, que pueda permanecer en el tiempo y generar inclusión y decisiones compartidas en la educación municipal.(AU)

The article presents a new experience of participative and deliberative municipal education planning in four Chilean municipalities of the Región de los Ríos and de los Lagos. What we presented is a different practice from the centralized one, non inclusive and traditional, that insists on three scopes, generally controverted and forgotten in the local planning: the inclusion of other actors (besides the municipal ones), the joint responsibility in the proposed tasks and the shared monitoring and evaluation of the planned things; pillars for the generation of confidences, for a landed planning and for the shared conformation of a communal educational horizon. We want, basically, to emphasize that in the local decision making "many are better than few" and that these spaces harness an austere planning, but not less complex, in collaborative agreements, that can remain in the long term and generate the inclusion and shared decisions in the municipal education.(AU)

Proteção indireta do complexo dentina-polpa: mitos e realidades / Indirect protection of the pulp-dentin complex: myths and reality

A evolução da Odontologia Restauradora leva a reavaliação da real necessidade do uso de materiais para a proteção do complexo dentina-polpa. No século passado havia grande preocupação relacionada à condutibilidade térmica de restaurações metálicas e, desta forma, o emprego da proteção pulpar se fazia necessário. A necessidade do uso de algum material protetor também se relaciona à toxicidade dos materiais odontológicos, à permeabilidade dentinária e à capacidade de se obter efetivo selamento marginal. A melhoria dos procedimentos adesivos no que diz respeito à infiltração marginal fez reduzir o uso de bases e forramentos. Este artigo busca analisar o estágio atual das técnicas e materiais empregados na proteção do complexo dentina-polpa além de discutir questões polêmicas envolvidas neste assunto