Dicionário médico para leigos: Neonatologia

Apresenta informação sobre dentina, estrutura e permeabilidade dentinária, reação pulpar à penetração de substâncias, sensibilidade e condições da dentina, e mecanismos passivos e ativos da diminuição da sensibilidade dentinária.

Primary schoolteachers' knowledge of asthma: the impact of pharmacist intervention.

The Newcastle Asthma Knowledge questionnaire was used to determine primary schoolteachers' knowledge of asthma. The mean score achieved (20.71 +/- 3.20), was representative of a reasonable degree of knowledge. However, knowledge of symptoms associated with asthma and of medications used to manage the condition was poor. Teachers who had contact with an asthmatic individual or who had received previous training on asthma had a significantly greater knowledge of asthma. An asthma training session, delivered by a pharmacist, was found to significantly improve primary schoolteachers' knowledge of the condition, however, the extent of the improvement was low.

Shared governance and teamwork--myth or reality.

Taking time to develop key strategies and implement our model enabled team members to deliver excellent patient care through shared governance and team empowerment. The benefits of using this model are medical and nursing staff members working together and having ownership in what they do. A sense of accomplishment will be evident, and team members likely will achieve the team's goals and those of the organization. Nurses frequently practice traditional shared governance. To achieve our goals, however, we must take the opportunity that working with medical team members offers. Ensuring that we remain interested and committed to our team model is the next major challenge the team members face. We must continue to be vibrant and open to change. Educational programs, seminars, journal clubs, social activities, and challenging team members for ideas help maintain interest and focus. As managers, we must allow the team to grow and develop by promoting a climate in which learning and mastery is valued, making it clear that there is no failure, only mistakes that provide feedback. We can facilitate this by trusting, believing in, and supporting team members to provide excellent patient care while achieving their goals and those of the organization.

A self-reported work sampling study in community pharmacy practice.

Lack of time to implement pharmaceutical care has been cited as a barrier to the routine provision of this extended patient-care service. Using self-reported work sampling methodology, this study investigated how community pharmacists utilise their time. Pharmacists working in community pharmacies in the Greater Belfast area were found to spend approximately 49% of their time engaged in professional activities, 29% in semi-professional activities and 22% involved in non-professional activities. The activity to which pharmacists devoted the majority of their time was product assembly and labelling, this being a task which can be performed by trained technical staff. Only 9.5% of community pharmacists' time was devoted to counselling patients on their prescription medicines. Wide variation in the amount of time apportioned to each activity was observed between the participating community pharmacists (n = 30). Staffing levels within the community pharmacy were found to significantly influence pharmacists' involvement in a number of activities, with pharmacists who worked in pharmacies employing multiple pharmacists devoting more time to the assembly and labelling of products and less time to administrative tasks, non-professional encounters and to miscellaneous professional activities. Pharmacists working in pharmacies with a high prescription turnover were found to devote significantly less time to counselling patients regarding OTC products and in responding to patient symptoms.

Changing profile in the use of anti-asthma drugs.

Data regarding the total number of anti-asthma drugs dispensed via community pharmacies within Northern Ireland from 1980 to 1997 were collected and analysed. The use of anti-asthma drugs within this population increased markedly over the study period from 19.84 DDDs/1000/day to 84.07 DDDs/1000/day. With the exception of the non-selective beta-agonists, there has been an overall increasing trend in the utilization of all of the anti-asthma drugs during the study period. Most of the increase is attributable to the increase in prescribing of the selective beta(2)-agonists and the glucocorticoids. This increase in the utilization of anti-asthma drugs may be explained by an increasing prevalence of the condition, increased adherence to asthma management protocols or to the prescribing of more intensive drug therapies. During the study period, a wider range of anti-asthma drugs and drug delivery devices have become available and hence have been prescribed. For example, in 1980, beclomethasone was the only inhaled steroid available, whilst in 1997, of all inhaled glucocorticoid products dispensed, 55.0% were beclomethasone-containing products, with budesonide (40.1%) and fluticasone (4.9%) products also being prescribed. With regard to drug delivery devices, there has been a move towards the use of dry powder inhalers in recent years. Prescribing of generic salbutamol products has also increased.

Supracondylar osteotomy of the humerus for correction of cubitus varus.

Reports of corrective procedures for cubitus varus (gunstock deformity) have emphasized the frequency of loss of position and significant complication. Modifications that have been made to the standard supracondylar osteotomy protocol include correction of the angular deformity only, without correction of rotation; an incomplete wedge osteotomy leaving the medial cortex intact by hinging the osteotomy shut on the intact cortex; and immobilization of the elbow in full extension with the forearm supinated. In a review of 16 patients following this protocol, 11 patients had excellent results, three had good results, and two had unsatisfactory results.

Monostotic fibrous dysplasia of the hand.

A case of monostotic fibrous dysplasia of a long bone of the hand is reported. There has been only one similar case recorded, though it is not uncommon in other long bones. The diagnosis was proved by histology, and the tumour treated by subperiosteal excision. There has been no recurrence after 31 months, though in similar cases excision including the periosteum has been advised to reduce the likelihood of recurrence.

Fracture of the lumbar vertebral apophysis.

Three cases of vertebral apophyseal fracture and displacement presenting with back pain are reported. Literature review revealed 11 other such cases, and these are compared. Computed tomography scan was found to be an excellent tool to confirm this diagnosis.

A review of the morphology of Perthes' disease.

There are differences of opinion about the pathogenesis of Perthes' disease. All are agreed that it is due to ischaemia, but the cause of this and the size and number of infarctions are in dispute. Through the generosity of the contributors six whole femoral heads and core biopsies of five other cases have been studied radiographically and histologically. The findings ranged from an ischaemic arrest of ossification in the capital articular cartilage without infarction to multiple complete infarctions of the epiphysial bone. The ensuing reparative process contributes to the pathology, which is of a range to warrant grading or grouping.

Efficacy of neonatal hip examination.

An examination of the ongoing neonatal hip screening program at the Vancouver General and Grace Hospitals in Vancouver, British Columbia, over a 9 1/2 year period revealed that of the 32,480 newborns examined, 321 (9.8 per 1,000 live births) had unstable hips. Treated immediately with abduction splintage, five of these children came to percutaneous adductor tenotomy and hip spica casts. There was one false-negative screening, and there were five children with unidentified acetabular dysplasia who presented within the first year of life. No child came to open reduction of the hip or innominate or femoral osteotomy. A standardized neonatal hip screening program would seem to significantly alter the natural history of the classic congenital dislocation of the hip but also seems unable to effectively screen out acetabular dysplasia.