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1.
Bioethics ; 38(3): 233-240, 2024 03.
Article in English | MEDLINE | ID: mdl-37776570

ABSTRACT

This article discusses an approach to translational bioethics (TB) that is concerned with the adaptation-or 'translation'-of concepts, theories and methods from bioethics to practical contexts, in order to support 'non-bioethicists', such as researchers and healthcare practitioners, in dealing with their ethical issues themselves. Specifically, it goes into the participatory development of clinical ethics support (CES) instruments that respond to the needs and wishes of healthcare practitioners and that are tailored to the specific care contexts in which they are to be used. The theoretical underpinnings of this participatory approach to TB are found in hermeneutic ethics and pragmatism. As an example, the development of CURA, a low-threshold CES instrument for healthcare professionals in palliative care, is discussed. From this example, it becomes clear that TB is a two-way street. Practice may be improved by means of CES that is effectively tailored to specific end users and care contexts. The other way around, ethical theory may be enriched by means of the insights gained from engaging with practice in developing CES in a process of co-creation. TB is also a two-way street in the sense that it requires collaboration and commitment of both bioethicists and practitioners, who engage in a process of mutual learning. However, substantial challenges remain. For instance, is there a limit to the extent to which a method of moral reasoning can be adapted in order to meet the constraints of a given healthcare setting? Who is to decide, the bioethicist or the practitioners?


Subject(s)
Bioethics , Ethics, Clinical , Humans , Ethicists , Morals , Delivery of Health Care
2.
Psicol. Estud. (Online) ; 29: e53449, 2024.
Article in Portuguese | LILACS, Index Psychology - journals | ID: biblio-1529195

ABSTRACT

RESUMO Por meio da antropologia da saúde, podemos compreender o terreiro de umbanda como parte de um sistema popular de cuidado. Este estudo teve por objetivo investigar as concepções de saúde e doença produzidas por zeladores de terreiro de umbanda. Participaram dez zeladores de terreiro da cidade de Uberaba (MG/Brasil), sendo três mulheres e sete homens, com idades entre 40 e 76 anos. O tempo médio de atuação como dirigente foi de 18,4 anos, variando de cinco a 43 anos. Os terreiros chefiados por esses participantes atendem entre 15 e 280 pessoas por dia de funcionamento. Pela análise das entrevistas, destaca-se que o cuidado em saúde oferecido pelos zeladores ultrapassa os limites rituais, nas cerimônias públicas, sendo prestado de modo contínuo nos terreiros. As posturas assumidas pelos entrevistados envolvem ações de escuta, acolhimento e proximidade física no momento da urgência. Pelas narrativas, pode-se concluir que o zelar, no sentido de gerenciar o espaço do terreiro, espiritual e materialmente, não pode ser dissociado do cuidar, significando os zeladores como importantes agentes populares de saúde.


RESUMEN A través de la antropología de la salud podemos entender el terreiro de umbanda como parte de un sistema de atención popular. Este estudio tuvo como objetivo investigar las concepciones de salud y enfermedad producidas por los cuidadores del terreiro de umbanda. Participaron diez cuidadores de terreiro de la ciudad de Uberaba (MG/Brasil), tres mujeres y siete hombres, con edades comprendidas entre 40 y 76 años. El tiempo promedio como gerente fue de 18.4 años, que van de cinco a 43 años. Los terreiros encabezados por estos participantes atienden entre 15 y 280 personas por día de operación. Del análisis de las entrevistas, se destaca que la atención médica ofrecida por los cuidadores va más allá de los límites rituales, en ceremonias públicas, que se brindan continuamente en los terreiros. Las actitudes asumidas por los entrevistados implican escuchar, acoger y proximidad física en el momento de urgencia. A través de las narrativas, se puede concluir que el cuidado, en el sentido de administrar el espacio del terreiro, espiritual y materialmente, no se puede disociar del cuidado, lo que significa que los cuidadores son importantes agentes de salud populares.


ABSTRACT Through health anthropology we can understand the umbanda terreiro (specific place for the religious ritual) as part of a popular system of care. This study aimed to investigate the conceptions of health and illness produced by saint keepers of umbanda terreiro. Ten leaders of the terreiros in the city of Uberaba (MG/Brazil) participated, being three women and seven men, between 40 and 76 years old. The average time of performance as a manager was 18.4 years, ranging from 5 to 43 years. The terreiros led by these participants attend between 15 and 280 people working day. The health care offered by saint keepers exceeds ritual limits in public ceremonies and is provided on a continuous basis in the terreiros. The postures assumed by the interviewees involve actions of listening, welcoming and physical proximity at the moment of urgency. From the narratives, it can be concluded that care, in the sense of managing the space of the terreiro, both spiritually and materially, can not be dissociated from caring, meaning saint keepers as important popular health.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Therapeutics , Mental Health/ethics , Faith Healing/ethics , Self Care/psychology , Ceremonial Behavior , Emotions/ethics , User Embracement , Ethnopsychology/ethics , Anthropology, Cultural
3.
BMC Palliat Care ; 22(1): 158, 2023 Oct 21.
Article in English | MEDLINE | ID: mdl-37865740

ABSTRACT

BACKGROUND: Healthcare professionals in palliative care are found to be confronted with moral challenges on a frequent basis. CURA is a low-threshold instrument for dialogical ethical reflection that was developed to deal with these challenges. A previous study identified the need of healthcare professionals to be trained to introduce CURA in their organization, initiate and facilitate reflections with CURA, and contribute to the implementation of CURA. The aim of this study was to develop and evaluate a training for professionals to become 'CURA-ambassadors'. METHODS: The training was developed in a participatory way in two cycles. We trained 72 healthcare professionals. The training was evaluated by means of a questionnaire and six semi-structured interviews. RESULTS: The study resulted in a blended learning training combining training sessions with an e-module and with practicing with organizing and facilitating CURA in daily healthcare practice. The main objectives of the training are to enable CURA-ambassadors to introduce CURA within their organization, initiate and facilitate ethical reflections using CURA, and contribute to the implementation of CURA. Participants were generally positive about the training program and the trainers. Technical difficulties related to the e-module were mentioned as main point of improvement. DISCUSSION: The training program can generate ownership, responsibility, and competency among CURA-ambassadors, which are essential foundations for implementing complex interventions in healthcare practice. The training program received positive evaluations shortly after completing the program. This study adds to our understanding of what is needed for healthcare professionals to use CURA, in order to support them in dealing with moral challenges and to foster their moral resilience. Further research is needed to assess whether participants experience the training as sufficient and effective when using and implementing CURA structurally in their organizations over a longer period of time.


Subject(s)
Hospice and Palliative Care Nursing , Palliative Care , Humans , Health Personnel/education , Delivery of Health Care , Learning
4.
Vive (El Alto) ; 6(17): 464-481, ago. 2023.
Article in Spanish | LILACS | ID: biblio-1515632

ABSTRACT

Los tratamientos periodontales implican cortes y sangrado de la mucosa gingival; la Morinda citrifolia, específicamente sobre los fragmentos encargados de la cicatrización (plaquetas), tiene un efecto más significativo en los procesos curativos de las lesiones. Objetivo. Identificar el potencial cicatrizante de los extractos hidroalcohólicos de Morinda citrifolia (noni peruano) en los procesos regenerativos de las incisiones periodontales al 70% a diversas concentraciones (1%; 5; y 10%) y su efecto coadyuvante acelerador en la vía oral como curación de tejidos. Materiales y Métodos. Se realizó una investigación aplicada, bajo el diseño experimental. Para ello, se llevó a cabo un estudio previo para el análisis farmacognóstico, porcentaje de humedad, pruebas de solubilidad y el análisis fitoquímico cualitativo para garantizar que el análisis farmacológico y la prueba experimental se completaran adecuadamente. Se administraron dosis a cinco ratas albinas macho Holtzman divididas en cuatro grupos a los cuales se les aplicó las concentraciones en cantidades de 0,5 ml dos veces al día en la incisión, la cual se evaluó durante siete días para obtener parámetros específicos, como infección, tono de piel gingival, cierre de heridas, reducción del tamaño de la incisión y porcentaje de curación. Resultados. Indicaron que todos los grupos que se le suministró el extracto hidroalcohólico al 70% en varias concentraciones mejoró su actividad curativa al reducir el tamaño de la incisión en la encía al séptimo día, donde resultó que la mejor concentración fue del 5% en comparación con las otras concentraciones (1% y 10%). Investigación que indica la eficacia de la Morinda citrifolia peruana como acelerador del proceso de curación en la terapia periodontal.


Periodontal treatments involve cuts and bleeding of the gingival mucosa; Morinda citrifolia, specifically on the fragments in charge of healing (platelets), has a more significant effect on the healing processes of the lesions. Objective. To identify the healing potential of hydroalcoholic extracts of Morinda citrifolia (Peruvian noni) in the regenerative processes of periodontal incisions at 70% at various concentrations (1%; 5; and 10%) and its accelerating coadjuvant effect in the oral route as tissue healing. Materials and Methods. An applied research was carried out under an experimental design. For this purpose, a previous study was carried out for pharmacognostic analysis, moisture percentage, solubility tests and qualitative phytochemical analysis to ensure that the pharmacological analysis and experimental test were properly completed. Doses were administered to five male Holtzman albino rats divided into four groups to which the concentrations were applied in 0.5 ml amounts twice daily to the incision, which was evaluated for seven days for specific parameters, such as infection, gingival skin tone, wound closure, incision size reduction and percentage healing. Results. They indicated that all groups that were given the 70% hydroalcoholic extract in various concentrations improved their healing activity by reducing the size of the gingival incision on the seventh day, where it turned out that the best concentration was 5% compared to the other concentrations (1% and 10%). Conclusion. Research indicating the efficacy of Peruvian Morinda citrifolia as an accelerator of the healing process in periodontal therapy.


Os tratamentos periodontais envolvem corte e sangramento da mucosa gengival; a Morinda citrifolia, especificamente sobre os fragmentos responsáveis pela cicatrização (plaquetas), tem um efeito mais significativo nos processos de cicatrização das lesões. Objetivo. Identificar o potencial cicatrizante de extratos hidroalcoólicos de Morinda citrifolia (noni peruano) nos processos regenerativos de incisões periodontais a 70% em diversas concentrações (1%; 5; e 10%) e seu efeito coadjuvante acelerador na via oral como cicatrizante tecidual. Materiais e métodos. Foi realizada uma pesquisa aplicada sob um desenho experimental. Para esse fim, foi realizado um pré-estudo para análise farmacognóstica, porcentagem de umidade, testes de solubilidade e análise fitoquímica qualitativa para garantir que a análise farmacológica e o teste experimental fossem adequadamente concluídos. Cinco ratos albinos Holtzman machos divididos em quatro grupos foram dosados e as concentrações foram aplicadas em quantidades de 0,5 ml duas vezes ao dia na incisão, que foi avaliada por sete dias quanto a parâmetros específicos, como infecção, tônus gengivais da pele, fechamento da ferida, redução do tamanho da incisão e porcentagem de cicatrização. Resultados. Eles indicaram que todos os grupos que receberam extrato hidroalcoólico a 70% em várias concentrações melhoraram sua atividade de cicatrização ao reduzir o tamanho da incisão gengival no sétimo dia, sendo que a melhor concentração foi de 5% em comparação com as outras concentrações (1% e 10%). Conclusão. A pesquisa indica a eficácia da Morinda citrifolia peruana como um acelerador do processo de cicatrização na terapia periodontal.

5.
Schweiz Arch Tierheilkd ; 165(5): 307-320, 2023 May.
Article in German | MEDLINE | ID: mdl-37227093

ABSTRACT

INTRODUCTION: Biosecurity in livestock farming includes all measures preventing pathogen introduction onto a farm (external biosecurity) and pathogen transmission on the farm itself (internal biosecurity). An important risk factor for the dissemination of infectious diseases are specialised external persons working on numerous farms, such as professional hoof trimmers in Switzerland. In the present study, 49 hoof trimmers, participating in the Swiss claw health programme and working as professionals, were questioned regarding their biosecurity measures and observed by two veterinarians during hoof trimming in order to assess the implementation of biosecurity measures by hoof trimmers. Data were processed using a scoring system, in which points were allocated to the different working methods taking into account their assumed transmission potential for infectious diseases such as digital dermatitis (DD) and Salmonellosis. The working method, which complied with the ideal biosecurity measure, was always given a whole point, whereas less optimal working methods were only given an intermediate value or no point. The scoring system helped identify precisely the strengths and weaknesses of the hoof trimmers in terms of biosecurity. The level of implementation of biosecurity measures by hoof trimmers was overall quite low (53 %=average of the overall biosecurity scores of the 49 hoof trimmers). Hoof trimmers which attended specialised training courses tended to have a higher level of implementation of biosecurity measures. The answers given by the hoof trimmers and the observations made by the veterinarians were compared, whereby it was found that hoof trimmers generally evaluated themselves better in regard to biosecurity than veterinarians assessed them. In summary and based on the results of this study, the dissemination of pathogens, such as DD associated treponemes and salmonella is possible during hoof trimming performed by external persons working on numerous farms. Thus, future training and continuing education courses should place emphasis on biosecurity.


INTRODUCTION: Le concept de biosécurité englobe, en lien avec la production animale, toutes les mesures empêchant l'introduction de germes dans une exploitation (biosécurité externe) et la propagation de germes à l'intérieur de l'exploitation (biosécurité interne). Un facteur de risque important pour la propagation de maladies infectieuses est le personnel spécialisé externe travaillant sur plusieurs exploitations, dont font partie les pareurs d'onglons professionnels intervenant sur les exploitations bovines suisses. Dans la présente étude, afin de donner un aperçu de la situation actuelle concernant la mise en oeuvre de mesures de biosécurité par les pareurs d'onglons, 49 pareurs d'onglons participant au programme suisse de santé des onglons, ont été questionnés à ce sujet et observés lors du parage des onglons par des vétérinaires. Le traitement des données a été effectué à l'aide d'un système de notation, attribuant des points aux différentes pratiques de travail selon leur potentiel supposé de transmission des maladies infectieuses que sont la Dermatite digitale (DD) et la Salmonellose. La pratique de travail, qui correspondait à la mesure de biosécurité idéale, obtenait toujours un point entier, alors que les pratiques de travail moins optimales ne recevaient qu'une valeur intermédiaire ou aucun point. Le système de notation a permis de désigner précisément les forces et les faiblesses des pareurs d'onglons en terme de biosécurité. Le niveau de mise en œuvre de mesures de biosécurité par les pareurs d'onglons est de manière générale relativement faible (53 % = moyenne du score de biosécurité générale des 49 pareurs). Les pareurs d'onglons ayant suivi plus fréquemment des formations spécifiques présentaient tendanciellement un niveau de mise en oeuvre de mesures de biosécurité plus élevé. De plus, les réponses des pareurs d'onglons et les observations des vétérinaires ont été comparées. Il a été constaté, que les pareurs d'onglons s'évaluaient généralement meilleurs en matière de biosécurité que les vétérinaires ne les jugeaient. En résumé et en tenant compte des résultats de cette étude, la propagation de germes pathogènes par les pareurs d'onglons dans le cadre de leur activité professionnelle, tels que les tréponèmes associés à la DD et les salmonelles, est possible. Par conséquent, la biosécurité devrait être thématisée en priorité lors des formations et formations continues futures.


Subject(s)
Digital Dermatitis , Hoof and Claw , Animals , Switzerland , Biosecurity , Farms
6.
Rev. bioét. derecho ; (57): 33-51, Mar. 2023. ilus
Article in Spanish | IBECS | ID: ibc-216057

ABSTRACT

El presente artículo analiza la responsabilidad civil médica atribuible a los profesionales de la salud que intervienen en el proceso de atención a distancia. Con este objeto, se propone un conjunto de principios de los cuales se derivan deberes de cuidado en la telemedicina exigibles a los profesionales de salud y a los prestadores. A partir de los principios de analogía con y complementariedad de la atención presencial, se desarrollan tres categorías de principios especiales para la atención a distancia: principios habilitantes, principios operativos y principios de protección al paciente. Bajo este esquema de principios se especifican deberes de cuidado, distinguiendo aquellos que responden a los riesgos causados por la distancia física de aquellos que surgen de los cambios organizacionales necesarios para este tipo de atención. La aplicación de estos deberes se analiza en tres escenarios de telemedicina: la teleconsulta, la teleinterconsulta y la teleconsultoría. Esta estructura de principios y deberes en la prestación de salud a distancia permite delimitar los alcances de la lex artis para cada escenario específico y, al mismo tiempo, elaborar estrategias regulatorias considerando criterios de necesidad, racionalidad y suficiencia, según los contenidos específicos que caracterizan cada escenario de atención de salud a distancia. (AU)


El present article analitza la responsabilitat civil mèdica atribuïble als professionals de la salut que intervenen en el procés d'atenció a distància. Amb aquest objecte, es proposa un conjunt de principis dels quals es deriven deures de cura en la telemedicina exigibles als professionals de salut i als prestadors. A partir delsprincipis d'analogia amb i complementarietat de l'atenció presencial, es desenvolupen tres categories de principis especials per a l'atenció a distància: principis habilitants, principis operatius i principis de protecció al pacient. Sota aquest esquema de principis s'especifiquen deures de cura, distingint aquells que responen als riscos causats per la distància física d'aquells que sorgeixen dels canvis organitzacionals necessaris per a aquesta mena d'atenció. L'aplicació d'aquests deures s'analitza en tres escenaris de telemedicina: la teleconsulta, la teleinterconsulta i la teleconsultoría. Aquesta estructura de principis i deures en la prestació de salut a distància permet delimitar els abastos de la lex artis per a cada escenari específic i, al mateixtemps, elaborar estratègies reguladores considerant criteris de necessitat, racionalitat i suficiència, segons els continguts específics que caracteritzen cada escenari d'atenció de salut a distància.(AU)


This article analyzes the civil medical liability imputable to health professionals involved at remote healthcare. To this end, a set of principles is proposed from which health professionals and telemedicine providers are required to perform care duties. Based on the principles of analogy with and complementarity of face-to-face healthcare, three categories of special principles for remote healthcare are developed: enabling principles, operational principles, and patient protection principles. Under this scheme of principles, duties of care are specified, distinguishing those that respond to the risks caused by physical distance from those that arise from the organizational changes necessary for this type of healthcare. The application of these duties is analyzed in three telemedicine scenarios: virtual visit, virtual consult and eConsult. This structure of principles and duties in the provision of remote healthcare allows to delimit the scope of leges artis for each specific scenario and, at the same time, to develop regulatory strategies considering criteria of necessity, rationality and sufficiency, according to the specific contents that characterize each scenario of remote healthcare.(AU)


Subject(s)
Humans , Damage Liability , Telemedicine , Health Personnel , Morals , Liability, Legal , Bioethics , Bioethical Issues
7.
Junguiana ; 41(2)2º sem. 2023.
Article in English, Portuguese | LILACS | ID: biblio-1524361

ABSTRACT

Considerando a relação psique-soma, a autora tenta compreender o fenômeno da cura e da saúde em diferentes culturas e abordagens teóricas. Procura mostrar como, através dos tempos, práticas e rituais curativos foram desenvolvidos para lidar com a doença e como as culturas têm oscilado entre o reducionismo e o holismo nas práticas médicas. Ressalta a perspectiva holística, conhecida como "sistêmica", para mostrar que a saúde envolve aspectos físicos, psicológicos e sociais. Em sintonia com a psicologia analítica, conclui que a doença deve fornecer sentido (telos) e que a cura é alcançada quando, no processo de individuação, o elemento espiritual for incluído.


Considering the psyche-soma connection, the author cries to understand the phenomena of health and healing in different cultures and theoretical approaches. The author shows how through the ages healing practices and rituals have developed to deal with illness; and, how cultures have oscillated between reductionism and holism in their medical practices. The holistic perspective, known as "systemic", is stressed to show that health implicates physical, psychological and social aspects. Based on the premises of analytical psychology the article concludes that illness must have sense (telos) and healing is reached when the spiritual element has been included in the individuation process.


Teniendo en cuenta la relación psique-soma, la autora intenta comprender el fenómeno de la cura y la salud en diferentes culturas y enfoques teóricos. Busca mostrar cómo, a través de los tiempos, se han desarrollado prácticas y rituales de curación para lidiar con las enfermedades y cómo las culturas han oscilado entre el reduccionismo y el holismo en las prácticas médicas. Hace hincapié en la perspectiva holística, conocida como "sistémica", para demostrar que la salud implica aspectos físicos, psicológicos y sociales. En línea con la psicología analítica, concluye que la enfermedad debe proporcionar sentido (telos) y que la cura se logra cuando, en el proceso de individualización, se incluye el elemento espiritual.

8.
Anat Rec (Hoboken) ; 306(6): 1548-1557, 2023 06.
Article in English | MEDLINE | ID: mdl-36114630

ABSTRACT

Previously, only one small-sized species of Testudinidae (Chelonoidis gringorum) was named from Lower-Middle Miocene of Central Patagonia. In this short article, we describe a new large Testudinidae, here named Chelonoidis meridiana sp. nov. This large new species (carapace up to 80 cm) differs from other large species of the southern South American fossil record by the absence of gibbosities on neural and costal carapacial bones, a short and wide entoplastron with a humeropectoral sulcus that was placed well behind its posterior end, and pectoral scutes that are medially longer, approximately one-third of the medial length of the hyoplastra. The discovery of this new species in the Middle Miocene increases the raw turtle diversity in Chubut, permitting to reduce the gap between the raw and phylogenetic diversity previously proposed. This occurrence is also important from both a temporal and geographic point of view. It permits fixing the presence of large-sized tortoises in the continent since ~15 million years ago (Middle Miocene). This occurrence predates all other large and giant tortoises from Argentina and South America and it is older than the giant Chelonoidis from the Langhian-Tortonian of Colombia. This is also the southernmost occurrence of a large-sized testudinid in the world.


Subject(s)
Turtles , Animals , Phylogeny , Argentina , Turtles/anatomy & histology , South America , Fossils , Ribs
9.
Cult. cuid ; 27(65): 199-216, 2023. tab, ilus
Article in Spanish | IBECS | ID: ibc-218967

ABSTRACT

Objective: the article investigates the healing practices linked to the religious frameworkin the municipality of Cehegín, focusing on the symbolic analysis of the healing rituals of the "evileye". Methodology: an ethnographic approach was used based on the performance of a participantobservation lasting thirty-three hours and fifteen interviews with healers-shamans. Results: the results show the persistence of a series of ritual procedures linked to the prayer of the "evil eye" thatserve for issues as diverse as the training of healers or the determination of the etiology, diagnosis,symptomatology or remedy of the condition. Conclusions: the set of rituals carried out in the contextof study has as a link the use of liturgical structures that include prayers to Christian deities, andwhere symbolic elements such as the cross, the three, water or oil, serve to load semantic meaningthe ritual healing process.(AU)


Objetivo: el artículo investiga las prácticas de curación ligadas al marco creencial en elmunicipio de Cehegín, centrándose en el análisis simbólico de los rituales de sanación del “mal deojo”. Metodología: se utilizó un enfoque etnográfico basado en la realización de una observaciónparticipante de treinta y tres horas de duración y quince entrevistas a sanadores-ensalmadores. Resultados: los resultados muestran la persistencia de una serie de procedimientos rituales ligados alrezo del “mal de ojo” que sirven para cuestiones tan diversas como la capacitación de los sanadoreso la determinación de la etiología, diagnóstico, sintomatología o remedio del padecimiento. Conclusiones: el conjunto de rituales realizados en el contexto de estudio tiene como nexo de unión lautilización de estructuras litúrgicas que incluyen oraciones a deidades cristianas, y donde elementossimbólicos como la cruz, el tres, el agua o el aceite, sirven para cargan de sentido semántico el proceso ritual de curación.(AU)


Objetivo: o artigo investiga as práticas de cura vinculadas ao quadro de crenças no município de Cehegín, com foco na análise simbólica dos rituais de cura do “mau-olhado”. Metodologia:utilizou-se uma abordagem etnográfica a partir da realização de trinta e três horas de observaçãoparticipante e quinze entrevistas com benzedeiras-salmistas. Resultados: os resultados mostram apersistência de uma série de procedimentos rituais ligados à oração do “mau-olhado” que servempara questões tão diversas quanto a formação de curandeiros ou a determinação da etiologia, diagnóstico, sintomas ou remédio da doença. Conclusões: O conjunto de rituais realizados no contextode estudo tem como elo o uso de estruturas litúrgicas que incluem orações a divindades cristãs, eonde elementos simbólicos como a cruz, os três, água ou óleo, servem para carregar significadosemântico ao ritual processo de cicatrização


Subject(s)
Humans , Ceremonial Behavior , Spiritual Therapies , Anthropology, Cultural , Medicine, Traditional , Folklore , Spain , Surveys and Questionnaires
10.
Article in English | LILACS-Express | LILACS, Index Psychology - journals | ID: biblio-1440764

ABSTRACT

ABSTRACT This work aims to explore the dynamics of the cure in psychoanalysis, passing through a literary perspective. We begin by locating the idea of cure in psychoanalysis as the cure of the intractable, by thinking the logic of the cure through an aesthetic dimension. Next, we advance the idea of a literary subject, with the myth as a guiding element of a literary body that sustains its own existence. We adopt Kafka's idea of minor literature to understand the fragmented subject inserted in the culture. We then propose the neologism 'vereedades', playing on the proximity of the words 'truth' and 'path' in Portuguese ('verdade' and 'veredas') to explore curative dynamics, in which the subject explores his/her own style.


RESUMO Este trabalho visa explorar a dinâmica da cura em psicanálise, passando por uma perspectiva literária. Iniciamos localizando a ideia de cura em psicanálise como a cura do intratável, pensando a lógica da cura via uma dimensão estética. Na sequência, seguimos com a noção de sujeito literário, com o mito como um norte de um corpo literário que sustenta a própria existência do sujeito. Adotamos a ideia de uma literatura menor de Kaka para compreender o sujeito fragmentado em sua inserção na cultura. Então propomos o neologismo 'veredades', brincando com a proximidade das palavras 'verdade' e 'veredas' para explorar a dinâmica da cura, em que o sujeito explora seu próprio estilo.

11.
Rev. homeopatia (São Paulo) ; 84(1): 23-30, 2023.
Article in Portuguese | LILACS, HomeoIndex Homeopathy | ID: biblio-1425549

ABSTRACT

Este artigo tem como objeto os pensamentos vitalistas de Hahnemann e Nietzsche analisados a partir dos conceitos de vida, saúde, doença e cura. Buscou-se traçar correspondências e explicitar as diferenças dos pensamentos envolvidos, tendo como objetivo avaliar as hipóteses de os vitalismos desses autores serem semelhantes e se poderia ser possível afirmar que a busca da "grande saúde" equivaleria à meta do tratamento homeopático. Conclui-se pela semelhança dos vitalismos e pela ampliação do ideal de cura homeopático através da busca da "grande saúde", pois contempla a liberdade de espírito ao mesmo tempo em que se compromete com a ampliação da normatividade vital do ser humano.


This article having as object the vitalist studies by Hahnemann and Nietzsche. It aimed analyzing the concepts life, health and disease in the thoughts of these authors, drawing connections and explaining the differences of thoughts involved. The study sought to assess the idea that Hahnemann's vitalism resembles Nietzsche's, and whether it is possible to say that the pursuit of "big health" would the goal of homeopathic treatment to address the "freedom of spirit" in achieving the expansion of the vital normativeness.


Subject(s)
History, 18th Century , Homeopathic Philosophy , Health-Disease Process , Mind-Body Relations, Metaphysical
12.
Gerokomos (Madr., Ed. impr.) ; 33(4): 263-268, dic. 2022. ilus
Article in Spanish | IBECS | ID: ibc-220317

ABSTRACT

ObjetivoEl objetivo general es establecer qué tipo de cura, la cura en ambiente húmedo o la terapia de presión negativa, es más eficiente para el tratamiento de las lesiones por presión. También, identificar los índices de coste-efectividad, contrastar los resultados obtenidos al aplicar los 2 tipos de curas en las diferentes categorías de lesiones por presión, determinar los conocimientos y percepción de enfermería en el ámbito de las lesiones por presión, y comparar las sensaciones experimentadas por los pacientes al recibir las curas. Metodología: Se realizó un estudio de coste a partir de una revisión bibliográfica en las siguientes bases de datos: SciELO, Google Académico, CUIDEN, IBECS, Elsevier, PubMed, MEDLINE, Dialnet, Scopus y CINAHL, durante los meses de septiembre a diciembre de 2020. Resultados: Se obtuvieron un total de 31 artículos que hacen referencia a la cura en ambiente húmedo y/o a la terapia de presión negativa aplicadas en lesiones por presión de diferentes categorías. Dichos documentos están comprendidos entre 2010 y 2020, ambos incluidos, muestran el texto completo y están publicados en español o inglés. El 82% de los documentos analizan el índice coste-efectividad, teniendo en cuenta el gasto final de tratamiento y los resultados de cada tipo de cura, entre otras variables. Conclusiones: El tratamiento de elección para las lesiones por presión categorías I y II es la cura en ambiente húmedo, mientras que en las lesiones por presión categorías III y IV, la evidencia científica actual muestra mejores resultados con terapia de presión negativa (AU)


Objectives: The general objective is to establish which type of cure, the moist wound healing (MWH) or the negative pressure wound therapy (NPWT), is more efficient for the treatment of pressure injuries (PI). Also, to identify the cost-effectiveness indices, to compare the results obtained by applying the two types of treatment in the different categories of PI, to determine the knowledge and perception of nursing in the field of PI and to compare the sensations experienced by patients when receiving treatment. Methodology: A cost study was made based on a literature review in the following databases: SciELO, Google Scholar, CUIDEN, IBECS, Elsevier, PubMed, MEDLINE, Dialnet, Scopus and CINAHL, during the months of September to December 2020. Results: A total of 31 articles were obtained that refer to MWH and/or NPWT applied in PI of different categories. These documents are from 2010 to 2020 both inclusive, show full text and are published in English or Spanish. 82% of the documents analyse the cost-effectiveness index, including the final cost of treatment and the results of each type of cure, among other variables. Conclusions: The treatment of choice for PI categories I and II is MWH, while in PI categories III and IV the current scientific evidence shows better results with NPWT (AU)


Subject(s)
Humans , Negative-Pressure Wound Therapy , Pressure Ulcer/nursing , Humidity , Cost-Benefit Analysis
13.
Gerokomos (Madr., Ed. impr.) ; 33(4): 274-282, dic. 2022. ilus, tab
Article in Spanish | IBECS | ID: ibc-220319

ABSTRACT

Introducción: Las úlceras venosas tienen una alta prevalencia, por lo que aumentan los costes sanitarios y empeoran la calidad de vida del paciente. La terapia de presión negativa y los injertos en sello se utilizan en la cura de heridas complejas. Objetivos: Mostrar la eficacia de la terapia de presión negativa y la de los injertos en sello en una úlcera venosa tratada desde atención primaria en el domicilio del paciente. Metodología: Valoración de la lesión, realización de un plan de cuidados personalizado y evolución durante 1 año hasta la cicatrización completa. Resultados: Este trabajo muestras efectos beneficiosos de la terapia de presión negativa, se redujo el exudado, se acortó el tiempo de cicatrización, se controló y eliminó el dolor y, por ende, la calidad de vida del paciente, como también lo hizo en la fase final la aplicación de injertos en sello. Conclusiones: Se muestra la necesidad de abordar un caso clínico desde una perspectiva holística y multidisciplinar fomentando la enfermería basada en la evidencia y empoderando al paciente (AU)


Venous ulcers are highly prevalent, increasing healthcare costs and worsening the patient’s quality of life. Negative pressure therapy (NPT) and seal grafts are used in the healing of complex wounds. Objectives: To show the efficacy of TPN and seal grafts in a venous ulcer treated by primary care at the patient’s home. Methodology: Assessment of the lesion, development of a personalized care plan and evolution during one year until complete healing. Results: This work shows beneficial effects of TPN, reducing exudate, shortening healing time, controlling and eliminating pain and therefore, the patient’s quality of life as well as in the final phase, the application of grafts in seal. Conclusions: It shows the need to approach a clinical case from a holistic and multidisciplinary perspective promoting evidence-based nursing and empowering the patient (AU)


Subject(s)
Humans , Male , Middle Aged , Negative-Pressure Wound Therapy/methods , Varicose Ulcer/therapy , Occlusive Dressings , Treatment Outcome
14.
Rev. bioét. derecho ; (56): 185-207, Nov. 2022. graf
Article in Spanish | IBECS | ID: ibc-210243

ABSTRACT

La humanización en la prestación de servicios de salud es un imperativo ético, incluso para las Unidades de Cuidado Intensivo (UCI), donde brindar atención integral centrada en pacientes y familiares, y no en lo tecnológico, es un reto. Se presenta un estudio cualitativo que utilizó entrevistas semiestructuradas en línea, observación participante y diario de campo. Participaron 10 trabajadores de UCI privadas y 10 en UCI públicas: 6 fisioterapeutas, 5 médicos, 4 sanitarios de enfermería y 5 enfermeras. Para analizar la información se realizó codificación, categorización y hermenéutica de ideas. Se descubrieron dos posturas frente a la humanización: como obligación (deontología) o como acto respeto (profesionalismo). Se comprende y practica la humanización como: 1) buen trato y cordialidad al realizar intervenciones; 2) ponerse en el lugar del paciente reconociendo que tiene familia; 3) cuidados que garantizan confort al paciente mediante acciones sobre el cuerpo;4) cumplir con objetivos terapéuticos evitando sufrimiento o daño; 5) reconocer la dignidad del paciente; 6) atención a la vulnerabilidad del paciente, especialmente oncológico. Existen barreras para la humanización: la pandemia, los insumos de la UCI, las normas institucionales rígidas, entre otras. En conclusión, los significados otorgados a la humanización en cuidado crítico están mediadas por prácticas con énfasis en aspectos biológicos e ideas relacionadas con el respeto por la dignidad humana (intimidad), el buen trato y evitar sufrimiento al paciente. La pandemia generó crisis en la atención humanizada expresada, entre otras, en ausencia de apoyo psicosocial al personal que trabaja en UCI.(AU)


La humanització en la prestació de serveis de salut és un imperatiu ètic, fins i tot per a les Unitats de Cura Intensiva (UCI), on brindar atenció integral centrada en pacients i familiars, i no en l’aspecte tecnològic, és un repte. Es presenta un estudi qualitatiu que va utilitzar entrevistes semi-estructurades en línia, observació participant i diari de camp. Van participar 10 treballadors d'UCI privades i 10 en UCI públiques: 6 fisioterapeutes, 5 metges, 4 sanitaris d'infermeria i 5 infermeres. Per a analitzar la informació es va realitzar codificació, categorització i hermenèutica d'idees. Es van descobrir dues postures enfront de la humanització: com a obligació (deontologia)o com a acte respecto (professionalisme). Es comprèn i practica la humanització com: 1) bon tracte i cordialitat en realitzar intervencions; 2) posar-se en el lloc del pacient reconeixent que té família; 3) cures que garanteixen confort al pacient mitjançant accions sobre el cos; 4) complir amb objectius terapèutics evitant sofriment o mal; 5) reconèixer la dignitat del pacient; 6) atenció a la vulnerabilitat del pacient, especialment oncològic. Existeixen barreres per a la humanització: la pandèmia, els inputs de l'UCI, les normes institucionals rígides, entre altres. En conclusió, els significats atorgats a la humanització en cura crítica estan mediades per pràctiques amb èmfasis en aspectes biològics i idees relacionades amb el respecte per la dignitat humana (intimitat), el bon tracte i evitar sofriment al pacient. La pandèmia va generar crisi en l'atenció humanitzada expressada, entre altres, en absència de suport psicosocial al personal que treballa en UCI.(AU)


Humanization in the provision of health services is an ethical imperative; even for Intensive Care Units (ICU), where achieving comprehensive care focused on patients and families and not on technology is a challenge. A qualitative study is presented that used semi-structured online interviews, participant observation, and field diary. 10 private ICU workers and 10 public ICU workers participated: 6 physiotherapists, 5 doctors, 4 nursing assistants and 5 nurses. To analyse the information, ideas were codified, categorized and hermeneutics performed. Two positions were found regarding humanization, as an obligation (deontology) or as an act of respect (professionalism). Humanization is understood and practiced as: 1) good treatment and cordiality when carrying out interventions; 2) put yourself in the patient's shoes, recognizing that you have a family; 3) care that guarantees comfort to the patient through actions on the body; 4) meet therapeutic objectives avoiding suffering or harm; 5) recognize the dignity of the patient; 6) attention to the vulnerability of the patient, especially cancer. There are barriers to humanization: the pandemic, ICU supplies, rigid institutional regulations, and others. In conclusions the meanings given to humanization in critical care are mediated by practices with an emphasis on biological aspects and ideas related to respect for human dignity (privacy), good treatment and avoiding suffering to the patient. The pandemic generated a crisis for humanized care, expressed, among others, in the absence of psychosocial support for personnel working in the ICU.(AU)


Subject(s)
Humans , Humanization of Assistance , Intensive Care Units , Health Personnel , Patient-Centered Care , Family , Quality of Health Care , Professionalism , Virtues , Psychosocial Support Systems , Colombia , Bioethics , Bioethical Issues , 25783
15.
Hist. ciênc. saúde-Manguinhos ; 29(3): 681-701, jul.-set. 2022. graf
Article in Portuguese | LILACS | ID: biblio-1405026

ABSTRACT

Resumo Em 1924, um personagem despontou na imprensa brasileira: o "Professor Mozart". Seu nome era Mozart Dias Teixeira e, durante as décadas de 1920 e 1930, ele praticou curas em diversas cidades do país, provocando controvérsias entre setores da sociedade. O artigo analisa o caso, dividindo-se em três eixos: introduz o personagem e o debate sobre os seus métodos de cura, mostra como as polêmicas inspiraram produções artísticas que transitaram no seio da população e, por fim, discute a questão do charlatanismo e o problema da liberdade profissional e de culto. O estudo pretende ser uma contribuição à historiografia do espiritismo, do ocultismo e das ciências psíquicas no Brasil.


Abstract In 1924, a new figure appeared on the pages of Brazilian newspapers: "Professor Mozart." In the 1920s and 1930s, Mozart Dias Teixeira practiced healing in several Brazilian cities, sparking controversy among certain segments of society. A threefold analysis of the case is presented: describing the man himself and the debate surrounding his healing methods; showing how the controversies inspired the production and circulation of art among the population; and discussing the issues of charlatanism and professional and religious freedom. The study intends to contribute to the historiography on spiritism, occultism, and psychic sciences in Brazil.


Subject(s)
Quackery , Spiritualism , History of Medicine , Mass Media , Occultism , Brazil , History, 20th Century
16.
Gerokomos (Madr., Ed. impr.) ; 33(3): 201-203, sept. 2022. ilus
Article in Spanish | IBECS | ID: ibc-219843

ABSTRACT

Introducción: En el proceso de una intervención quirúrgica actúa un equipo multidisciplinar, cada uno de estos miembros realiza sus funciones correspondientes y son interdependientes, pero se complementan entre sí. La seguridad del paciente no consiste en crear un dispositivo complejo y muy costoso o en un profesional excelente, sino en aplicar a nuestro trabajo diario y en nuestra práctica habitual el mejor conocimiento posible. La gestión de riesgos clínicos se basa en la identificación, el análisis y la corrección de las causas que originan o pudieran originar daño secundario al paciente tras el procedimiento o la administración de cuidados, y la iatrogenia es uno de los factores de análisis y control. Caso clínico: Paciente de 15 años, que tras ser intervenido de torsión testicular derecha presentó quemadura por bisturí eléctrico en cara interna del muslo, producida de forma iatrogénica durante el procedimiento quirúrgico. La causa de la quemadura fue el descontrol de la placa de seguridad del bisturí electrónico usado en la intervención. Plan de actuación: Se realizó cura en ambiente húmedo con apósito de alginato de Ag, que se fijó con apósito de espuma de silicona con reborde. El retroceso y estancamiento de la evolución precisó de antibioterapia sistémica tras cultivo y antibiograma, que propició la resolución del caso hasta la cicatrización total de la herida. Discusión y conclusiones: La cura en ambiente húmedo se convierte en una alternativa efectiva ante este tipo de lesiones. El abordaje integral y multidisciplinar del paciente y la posterior planificación de actuaciones se han mostrado eficaces a la hora de solucionar los problemas detectados en la valoración inicial, conllevando determinadas ventajas, así como el análisis y evaluación del proceso de seguridad del pacient (AU)


Introduction: In the process of a surgical intervention, a multidisciplinary team acts, each of these members performs their corresponding functions, and they are interdependent, but they complement each other. Patient safety does not consist in creating a complex and very expensive device or in an excellent professional, but in applying the best possible knowledge to our daily work and habitual practice. Clinical risk management is based on the identification, analysis and correction of the causes that cause or could cause secondary damage to the patient after the procedure or the administration of care, with iatrogenesis being one of the analysis and control factors. Clinical case: A 15-year-old patient who, after undergoing surgery for right testicular torsion, presented an electric scalpel burn on the inner side of the thigh, produced iatrogenically during the surgical procedure. The cause of the burn was the lack of control of the security plate of the electronic scalpel used in the intervention. Action plan: A humid environment cure was performed with an Ag alginate dressing fixed with a silicone foam dressing with a border. The setback and stagnation of the evolution required systemic antibiotic therapy, after culture and antibiogram, which led to the resolution of the case until the total healing of the wound. Discussion and conclusions: Humid environment cure becomes an effective alternative to this type of injury. The comprehensive and multidisciplinary approach to the patient and the subsequent planning of actions have been shown to be effective in solving the problems detected in the initial assessment, entailing certain advantages. as well as the analysis and evaluation of the patient safety process (AU)


Subject(s)
Humans , Male , Adolescent , Iatrogenic Disease , Electrosurgery/adverse effects , Burns, Electric , Testis/surgery
17.
Gerokomos (Madr., Ed. impr.) ; 33(2): 133-136, jun. 2022. ilus
Article in Spanish | IBECS | ID: ibc-210355

ABSTRACT

Objetivo: Exponer un abordaje terapéutico conservador para el abordaje de lesiones necróticas periféricas secundarias a la administración de fármacos vasoactivos. Metodología: A través de un caso clínico se describe el planteamiento de curas realizadas. Resultados: El caso se resolvió en 28 semanas y se evitó la amputación de todos los dedos de manos y pies, a excepción de 1 dedo de la mano y 2 dedos del pie, lo que minimizó las secuelas al paciente y se preservó su estado funcional. Conclusión: La aplicación en ambiente húmedo en este tipo de lesiones necróticas secundarias a fármacos vasoactivos, resultó efectiva en este caso clínico y evitó tratamientos más agresivos que pudieran repercutir negativamente en la calidad de vida del paciente (AU)


Objective: To present a conservative therapeutic approach for the approach of peripheral necrotic lesions secondary to the administration of vasoactive drugs. Methodology: Through a clinical case, the approach to cures carried out is described. Results: The case was resolved in 28 weeks avoiding the amputation of all fingers and toes except for 1 finger and 2 toes, minimizing the sequelae to the patient and preserving their functional status. Conclusion: The application of most environment treatment in this type of necrotic lesions secondary to vasoactive drugs was effective in this clinical case and avoided more aggressive treatments that could negatively affect the quality of life of the patient (AU)


Subject(s)
Humans , Male , Middle Aged , Vasoconstrictor Agents/adverse effects , Gangrene/chemically induced , Gangrene/therapy , Humidity , Conservative Treatment , Shock, Septic/drug therapy , Vasoconstrictor Agents/therapeutic use , Treatment Outcome
18.
Psico USF ; 27(2): 225-236, abr.-jun. 2022. tab, graf
Article in English | LILACS, Index Psychology - journals | ID: biblio-1406319

ABSTRACT

This study aimed to confirm the multifactorial structure of the Beliefs Toward Cure of Homosexuality Scale (BTCHS) - (ECCH in Portuguese) and to verify evidence of its validity based on external variables. To this end, two studies were carried out. In Study 1, there were 214 university students, with an average age of 24 years (SD = 9.15). These students answered the HCBS and demographic questions. The results indicated a satisfactory fit for multifactorial modeling. Study 2, in turn, presented 430 university students with an average age of 23 years (SD = 7.90). In addition to the HCBS, the participants responded to the measures of sexual prejudice (MSP) and attitudes towards gays and lesbians (ATGL) questionnaires. Performing correlation analyses between the variables, we found significant correlations between the HCBS and the MSP and ATGL. In conclusion, the HCBS presented an adequate data-model fit for its multifactorial structure and evidence for its validity based on external variables. (AU)


Este estudo objetivou confirmar a estrutura multifatorial da Escala de Crenças sobre a Cura da Homossexuliade (ECCH) e verificar evidências de validade baseada em variáveis externas. Para tal, foram realizados dois estudos. No Estudo 1 contou-se com 214 estudantes universtários, com uma média de idade de 24 anos (DP = 9,15). Estes responderam a ECCH e a perguntas demográficas. Os resultados indicaram um ajuste satisfatório do modelo multifatorial. O Estudo 2, por sua vez, contou com a participação de 430 estudantes universitários com uma média de idade de 23 anos (DP = 7,90). Além da ECCH, esses participantes responderam as medidas de preconceito sexual (EMPS) e atitudes frente a gays e lésbicas (EMAFGL). Mediante a realização de análises de correlação entre as variáveis foi possível constatar correlações significativas da ECCH com as dimensões da EMPS e EMAFGL. Conclui-se, que a ECCH apresenta bons indicadores de ajuste do modelo multifatorial e evidências de validade baseada em variáveis externas. (AU)


Este estudio objetivó confirmar la estructura multifactor de la Escala de Creencias sobre la Cura de la Homosexualidad (ECCH) y verificar evidencias de validez basadas en variables externas. Para ello, fueron realizados dos estudios. En el estudio 1 participaron 214 estudiantes universitarios, con una edad media de 24 años (DS = 9,15). Estos respondieron la ECCH y a las preguntas demográficas. Los resultados indicaron un ajuste satisfactorio del modelo multifactorial. El estudio 2, por su parte, contó con la participación de 430 estudiantes universitarios con una edad media de 23 años (DS = 7,90). Además de la ECCH, los participantes contestaron las medidas de prejuicio sexual (EMPS) y actitudes frente a gays y lesbianas (ATGL). Mediante la realización de análisis de correlación entre las variables fue posible constatar correlaciones significativas de la ECCH con las dimensiones de la EMPS y ATGL. Se concluye, que la ECCH presenta buenos índices de ajuste del modelo multifactorial y evidencias de validez basadas en variables externas. (AU)


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Homosexuality/psychology , Sexism/psychology , Sexual and Gender Minorities/psychology , Gender Diversity , Students/psychology , Universities , Reproducibility of Results , Factor Analysis, Statistical , Correlation of Data
19.
Junguiana ; 40(1)jan.- jun. 2022.
Article in Spanish, Portuguese | LILACS, Index Psychology - journals | ID: biblio-1434729

ABSTRACT

O mito de Tântalo como referencial primordial da conferência da outorga. Concessão de Outorga como atributo do Arquétipo do Pai. Os sofrimentos do tutelado e comprometimentos severos da psique decorrentes da negação ou da perda da outorga. Reações psíquicas, em função da perda da outorga como: vergonha, sentimento de culpa. A vergonha de se saber incompetente. E a humilhação por ser ridículo. Os fundamentos simbólicos da emergência da depressão. Pai-Narciso, aquele que não outorga. Pais com estruturas patriarcais rigidamente defensivas. Os conflitos de filhos de casais cindidos, em que um confere a outorga e o outro a nega. A possibilidade de saída resiliente com a automobilização da outorga. Correlações simbólicas entre os castigos de Tântalo e a grandiosidade da outorga.


The myth of Tantalus as a primary reference for the granting conference. Granting of Bestowal (the act of conferring an honor or presenting a gift) as an attribute of the Father Archetype. Sufferings of the ward and severe impairments of the psyche resulting from the denial or loss of the bestowal. Psychic reactions, due to the loss of the grant, such as: shame, feeling of guilt. The shame of being incompetent. And the humiliation for being ridiculous. The symbolic foundations of the emergence of depression. Father-Narcissus, the one who does not bestow. Parents with rigidly defensive patriarchal structures. The conflicts of children of split couples in which one grants and the other denies it. The possibility of a resilient exit with the automobilization of the grant. Symbolic correlations between Tantalus' punishments and the grandiosity of the bestowal.


El mito de Tántalo como referencia principal para la conferencia de concesión. Otorgamiento como un atributo del Arquetipo del Padre Los sufrimientos del pupilo y los severos impedimentos de la psique resultantes de la negación o pérdida del otorgamiento. Reacciones psíquicas, por la pérdida de la beca, tales como: vergüenza, sentimiento de culpa. La vergüenza de ser incompetente. Y la humillación por hacer el ridículo. Los fundamentos simbólicos de la aparición de la depresión. Padre-Narciso, el que no da. Padres con estructuras patriarcales rígidamente defensivas. Los conflictos de hijos de parejas escindidas en los que uno lo concede y el otro lo niega. La posibilidad de una salida resiliente con la automovilización de la subvención. Correlaciones simbólicas entre los castigos de Tántalo y la grandiosidad del otorgamiento


Subject(s)
Depression , Parenting , Guilt , Narcissism
20.
São José dos Campos; s.n; 2022. 104 p. tab, ilus, graf.
Thesis in Portuguese | LILACS, BBO - Dentistry | ID: biblio-1396533

ABSTRACT

O objetivo deste estudo foi avaliar in vitro a influência de um novo dispositivo fotopolimerização e pino de fibra de vidro nas propriedades mecânicas, físicoquímicas e adesão dos cimentos resinosos. Foram utilizados oitenta dentes bovinos, submetidos ao tratamento endodôntico, distribuídos em 5 grupos (n=16): CD (Pino fibra vidro e cimento dual); PF (Pino perfurado e cimento fotoativado); PD (Pino perfurado e cimento dual); POF (Pino perfurado iluminador de fibra óptica e cimento fotoativado); POD (Pino perfurado iluminador de fibra óptica e cimento dual). Os dentes foram preparados para colocação de um protótipo de pino em fibra de vidro que possui um canal interno de diâmetro regular e com conicidade progressiva. A perfuração permite a inserção da fibra óptica ao longo da extensão do pino a fim de possibilitar a ação da luz ao longo de todo o comprimento do conduto radicular. Após a cimentação, os espécimes foram seccionados perpendicularmente, e obtida 1 fatia de 2 mm de espessura do terço apical, médio e cervical. A avaliação mecânica foi realizada através do ensaio de push-out para determinação da resistência adesiva nos terços cervical, médio e apical seguido pela análise da fratura em estereomicroscópio. Os retentores intrarradiculares foram também submetidos ao teste de flexão de 3 pontos para análise do material preenchedor do pino de fibra (n=10). As análises físico - químicas foram realizadas através da determinação do grau de conversão dos cimentos (RAMAN) e análise em espectroscopia de energia dispersiva (EDS) dos monômeros presentes. A adesão foi analisada pela interface de cimentação pelo MEV e reconstrução 3D do novo sistema através do Micro-CT. Os dados obtidos foram analisados estatisticamente pelo ANOVA (um e dois fatores) e comparação múltipla de Tukey, (p<0,05). Os resultados de resistência adesiva evidenciaram que o terço apical obteve o maior valor de resistência adesiva em comparação ao terço médio (p<0,001), o grupo POD do terço apical foi estatisticamente significante em relação ao grupo CD do terço médio (p<0,001). Na analise individual de cada terço, não houve diferença entre os grupos experimentais e o controle (p>0,05). A falha adesiva entre cimento e dentina foi a mais predominante entre todos os grupos e terços. O pino de fibra de vidro (controle) obteve o maior valor de resistência à flexão (p<0,001), seguido do pino de fibra de vidro perfurado preenchido com cimento resinoso (p<0,001). Os maiores valores de GC foram alcançados pelo grupo POD com 82,3% (cervical) 69,9 % (médio) e 76,21% (apical) e o EDS comprovou a presença de componentes químicos adequados. A análise da adesão do novo pino de fibra de vidro comprova uma excelente adaptação no interior do canal radicular nas regiões cervical, médio e apical. Portanto o novo dispositivo com fibra óptica e pino de fibra de vidro experimental aumentaram as propriedades mecânicas, físico-químicas e adesão do cimento resinoso (AU)


The aim of this study was to evaluate in vitro the influence of a new light curing device with optical fiber and experimental glass fiber post on the physicochemical, mechanical, and adhesion properties of resin cements. Eighty bovine teeth were used, submitted to an endodontic treatment, distributed in 5 groups (n=16): CD (Glass fiber post and dual cement); PF (Perforated post and light-cured cement); PD (Perforated post and dual cement); POF (Fiber optic illuminating with a perforated post and lightcured cement); POD (Fiber optic illuminating with a perforated post and dual cement). The teeth were prepared for placement of a glass fiber post prototype, which has an internal canal of regular diameter and progressive taper. The internal perforation extension allows the insertion of the optical fiber along the entire length of the post in order to allow the action of light along the entire length of the root canal.The specimens were sectioned perpendicularly for the tests, and 1 slice approximately 2 mm thick was obtained from the apical, middle and cervical thirds. The mechanical evaluation was carried out through the push-out test to determine the adhesive bond strength, in the cervical, middle and apical thirds, followed by the fracture analysis under a stereomicroscope, the intraradicular post were also submitted to the 3-point bending test for material analys of the fiber post filler (n=10). The physicochemical analyzes were performed by determining the degree of conversion of the cements (RAMAN) of each sample and the analysis of energy dispersive spectroscopy (EDS) of the monomers present. Adhesion was analyzed by the cementation interface and 3D reconstruction of the new system through micro-CT, and finally, SEM analysis of the adhesive interface. The data obtained were analyzed for normality and statistically by ANOVA (one and two ways) and Tukey's multiple comparison (p<0.05). The adhesive bond strength results showed that the apical third had the highest value of adhesive strength compared to the middle third (p<0.001), and the POD group of the apical third was statistically significant in relation to the CD group of the middle third (p<0.001). In the individual analysis of each third, there was no difference between the experimental and control groups (p>0.05). Adhesive failure between cement and dentin was the most prevalent among all groups and thirds. The conventional post (control) had the highest flexural strength value (p<0.001), followed by the perforated fiberglass post filled with resin cement (p<0.001). The POD group achieved the highest GC values with 82.3% (cervical), 69.9% (medium), and 76.21% (apical) and EDS confirmed the presence of adequate chemical components. The analysis of the adhesion of the new fiberglass post proves an excellent adaptation inside the root canal in the cervical, middle and apical regions. Therefore, the new light curing device with optical fiber and experimental glass fiber post improved the resin cement's mechanical, phycochemical, and adhesion. (AU)


Subject(s)
Animals , Cattle , Analysis of Variance , Post and Core Technique , Resin Cements , Curing Lights, Dental , Flexural Strength , Mechanical Tests
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