Efficacy of a high concentration of nano silver fluoride in preventing caries: A randomized controlled trial.

Background: To investigate the effectiveness of a novel agent containing Nano Silver Fluoride 1500 (NSF 1500) and chitosan to inactivate carious lesions in children. Material and Methods: The study included eighty children. While both groups had fluoride dentifrice applied to their teeth, only the experimental group received treatment with the NSF 1500-ppm solution. The first and sixth-month interval examinations were conducted by two calibrated dentists (k = 0.85). Results: The NSF 1500 group had 69.2% of their teeth with arrested decay, while the control group had 24.1%. The difference was statistically significant (p 0.001), with a preventive fraction of 59.4%. The number needed to treat (NNT) was approximately two. The NSF 1500 formulation was more effective than toothbrushing alone with fluoridated dentifrice in preventing dental caries. Conclusions: The effectiveness of NSF 1500 is determined by the size and depth of the dental cavity. Its ability to arrest caries lesions was comparable to previously tested products, NSF 400 and NSF 600. Key words:Preventive dentistry, dental caries, nanoparticles.

An exploratory study of children with caries and its relationship to SARS-CoV-2.

This exploratory study investigated whether children with dental decay were more likely to have COVID-19 than those without caries. The children underwent dental inspection and blood collection for detection of SARS-CoV-2 antibodies. Fifty-four children aged 6 to 9 years participated in the survey, which was conducted between March and June 2020 in the municipality of Ipojuca, Pernambuco, Brazil. The diagnosis of caries was performed using the dmft and DMFT indices. Parents reported signs and symptoms of sickness in their children during this period. The serology test aimed to verify the immune response of the children to coronavirus by detecting IgM/IgG antibodies. Statistical analyses were performed at P < 0.05. The majority of the children presented caries (68.5%). Of the nine children who tested positive for COVID-19 (16.7%), eight presented IgG antibodies to the virus, and only one had IgG and IgM antibodies to SARS-CoV2. Children who tested positive for SARS-CoV-2 had a higher percentage of caries lesions than those who tested negative for SARS-CoV-2 (77.8% vs 65.9%), but this difference was not statistically significant.

An exploratory study of children with caries and its relationship to SARS-CoV-2

Abstract This exploratory study investigated whether children with dental decay were more likely to have COVID-19 than those without caries. The children underwent dental inspection and blood collection for detection of SARS-CoV-2 antibodies. Fifty-four children aged 6 to 9 years participated in the survey, which was conducted between March and June 2020 in the municipality of Ipojuca, Pernambuco, Brazil. The diagnosis of caries was performed using the dmft and DMFT indices. Parents reported signs and symptoms of sickness in their children during this period. The serology test aimed to verify the immune response of the children to coronavirus by detecting IgM/IgG antibodies. Statistical analyses were performed at P < 0.05. The majority of the children presented caries (68.5%). Of the nine children who tested positive for COVID-19 (16.7%), eight presented IgG antibodies to the virus, and only one had IgG and IgM antibodies to SARS-CoV2. Children who tested positive for SARS-CoV-2 had a higher percentage of caries lesions than those who tested negative for SARS-CoV-2 (77.8% vs 65.9%), but this difference was not statistically significant.

Oral manifestations in hospitalized children with COVID-19.

As the pandemic progressed, the incidence of viruses among children also increased. This study investigates the presence of oral lesions in hospitalized children by analyzing data collected from medical records of infants seen at the pediatric Infectious disease unit at the General Hospital of the University of Pernambuco, Recife, Brazil, from March to August 2020. This study includes children aged 0 to 12 years diagnosed with severe symptoms of COVID-19. The data describe the frequencies and percentages of categorical variables, expressed as mean, median, and standard deviation. The chi-square test evaluated the association of oral manifestations according to the presence of comorbidities. Of 89 children, 20.2% had oral manifestations, and mucositis was the most prevalent lesion (12.4%). Of the 18 children with oral manifestations, 12 did not present comorbidities, but 7.9% had multisystem inflammatory syndrome and 5.6% had Kawasaki disease. Results show that children with oral lesions had longer hospital stays. These findings indicate the need for further studies to clarify the relationship between the oral manifestations of COVID-19 in pediatric patients for screening of the virus by dentists.

Mutagenic Evaluation of Fluoxetine and Fluoxetine-Galactomannan Complex Through the Analysis of Chromosomal Aberrations in Human Peripheral Leukocytes and Salmonella typhimurium/Microssome Assay / Avaliação Mutagênica de Fluoxetina e Complexo Fluoxetina-Galactomanana Através da Análise de Aberrações Cromossômicas em Leucócitos Periféricos Humanos e em Salmonella typhimurium / Ensaio Microssômico

Objectives: The purpose of this study was to evaluate the mutagenic potential of fluoxetine and fluoxetine-galactomannan. Methods: Chromosomal aberration test and Salmonella typhimurium/microsome mutagenicity assay. Results: The results showed that fluoxetine (250 µg/mL) can cause chromosomal breaks of treated leukocytes and increase the frequency of reversion of the tester strains of S. typhimurium / microsome assay only at the highest concentration (5 mg/mL), while fluoxetine encapsulated in galactomannan did not cause these changes (leukocytes and S. typhimuriums strains). Conclusion: In summary, fluoxetine showed a mutagenic effect detectable only at high concentrations in both eukaryotic and prokaryotic models. Furthermore, the fluoxetine/galactomannan complex, in this first moment, prevented the mutagenicity attributed to fluoxetine, emphasizing that the present encapsulation process can be an alternative in preventing these effects in vitro.

Objetivos: avaliar o potencial mutagênico da fluoxetina e da fluoxetina-galactomanana. Métodos: Teste de aberração cromossômica e ensaio de mutagenicidade de Salmonella typhimurium /microssoma. Resultados: a fluoxetina (250 µg/mL) pode causar quebras cromossômicas de leucócitos tratados e aumentar a frequência de reversão das cepas testadoras de S. typhimurium /microssoma apenas na concentração mais alta (5 mg/mL), enquanto a fluoxetina encapsulada em galactomanano não causou essas alterações (leucócitos e cepas de S. typhimurium). Conclusão: a fluoxetina mostrou um efeito mutagênico detectável apenas em altas concentrações em modelos eucarióticos e procarióticos. Além disso, o complexo fluoxetina/galactomanan, neste primeiro momento, evitou a mutagenicidade atribuída à fluoxetina, ressaltando que o presente processo de encapsulamento pode ser uma alternativa na prevenção desses efeitos in vitro.

Viral symptoms in children and SARS-COV-2: information for pediatric dentists for the control of transmission.

The new coronavi rus, which has spread worldwide, has spiraled out of control in Brazil. The number of infected children has increased, and more Infants Special Care Units are needed to prevent deaths. This study aims to report the most common signs and symptoms in children infected by seasonal respiratory viruses and those infected by COVID-19. This knowledge is essential to educate pediatric dentists, who may contribute to identifying the difference in symptoms and notify the cases, thus preventing the spread of COVID-19. This study was carried out in a Family Health Center of Ipojuca, state of Pernambuco, Brazil, and included 54 children seen for dental emergency care. The parents provided information about the signs and symptoms of their children' s health conditions during the lockdown from March to July 2020. All children had a serological test to detect any exposure to the virus. Kolmogorov-Smirnov and Mann-Whitney tests were used to assess the distribution of the data and compare the quantitative variables between the groups. Among the study participants, 16.7% tested positive for COVID-19. The most prevalent symptoms were headache (38.9%), sneezing (35.2%), and fever (20.4%); six out of nine children with a positive test had symptoms after infection of an adult in the family. Children infected with COVID-19 showed similar clinical signs to those with negative results. Pediatric dentists should acquire knowledge to report on sick children and prevent the spread of the disease.

Oral manifestations in hospitalized children with COVID-19

Abstract As the pandemic progressed, the incidence of viruses among children also increased. This study investigates the presence of oral lesions in hospitalized children by analyzing data collected from medical records of infants seen at the pediatric Infectious disease unit at the General Hospital of the University of Pernambuco, Recife, Brazil, from March to August 2020. This study includes children aged 0 to 12 years diagnosed with severe symptoms of COVID-19. The data describe the frequencies and percentages of categorical variables, expressed as mean, median, and standard deviation. The chi-square test evaluated the association of oral manifestations according to the presence of comorbidities. Of 89 children, 20.2% had oral manifestations, and mucositis was the most prevalent lesion (12.4%). Of the 18 children with oral manifestations, 12 did not present comorbidities, but 7.9% had multisystem inflammatory syndrome and 5.6% had Kawasaki disease. Results show that children with oral lesions had longer hospital stays. These findings indicate the need for further studies to clarify the relationship between the oral manifestations of COVID-19 in pediatric patients for screening of the virus by dentists.

Viral symptoms in children and SARS-COV-2: information for pediatric dentists for the control of transmission

Abstract: The new coronavi rus, which has spread worldwide, has spiraled out of control in Brazil. The number of infected children has increased, and more Infants Special Care Units are needed to prevent deaths. This study aims to report the most common signs and symptoms in children infected by seasonal respiratory viruses and those infected by COVID-19. This knowledge is essential to educate pediatric dentists, who may contribute to identifying the difference in symptoms and notify the cases, thus preventing the spread of COVID-19. This study was carried out in a Family Health Center of Ipojuca, state of Pernambuco, Brazil, and included 54 children seen for dental emergency care. The parents provided information about the signs and symptoms of their children' s health conditions during the lockdown from March to July 2020. All children had a serological test to detect any exposure to the virus. Kolmogorov-Smirnov and Mann-Whitney tests were used to assess the distribution of the data and compare the quantitative variables between the groups. Among the study participants, 16.7% tested positive for COVID-19. The most prevalent symptoms were headache (38.9%), sneezing (35.2%), and fever (20.4%); six out of nine children with a positive test had symptoms after infection of an adult in the family. Children infected with COVID-19 showed similar clinical signs to those with negative results. Pediatric dentists should acquire knowledge to report on sick children and prevent the spread of the disease.

Anxiolytic-like effect of chalcone N-{4'[(2E)-3-(3-nitrophenyl)-1-(phenyl)prop-2-en-1-one]} acetamide on adult zebrafish (Danio rerio): Involvement of the 5-HT system.

The action of anxiolytic compounds that act on selective serotonin receptors (SSRIs) have been scarcely evaluated. Serotonergic drugs have been shown to be effective in treating anxiety without presenting adverse effects as benzodiazepines. However, the anxiolytic effects take days to occur. This study aimed to evaluate the anxiolytic effect of the synthetic chalcone, 4'-[(2E) -3- (3-nitrophenyl) -1- (phenyl) prop-2-en-1-one] acetamide (PAAMNBA), and its possible mechanism of action in adult zebrafish (Danio rerio). PAAMNBA was synthesized with a yield of 51.3% and its chemical structure was determined by 1H and 13C NMR. Initially, PAAPMNBA was intraperitoneally administered to zebrafish (n = 6/group) at doses of 4, 12, or 40 mg/kg, and the animals were subsequently subjected to acute and open field toxicity tests. PAAMNBA was administered to the other groups (n = 6/group) for analyzing its effect in the light and dark test. The involvement of the serotonergic (5HT) system was also evaluated using 5-HTR 1, 5-HTR 2A/2C, and 5-HTR 3A/3B receptor antagonists, namely, pizotifeo, granizetron, and ciproeptadina, respectively. Molecular coupling was performed using the 5-HT1 receptor. PAAMNBA was found to be non-toxic, reduced the locomotor activity, and had an anxiolytic effect in adult zebrafish. The effect was reduced by pretreatment with pizotifene and was not reversed by treatment with granizetron and cyproeptadine. A previous in vivo molecular coupling study indicated that chalcones interact with the 5-HT1 receptor. The results suggested that the chalcone, PAAPMNBA, has anxiolytic activity, that is mediated by the serotonergic system via the 5-HT1 receptor. The interaction of PAAPMNBA with the 5-HT1 receptor was confirmed by molecular docking studies.

The Five Times Sit-to-Stand Test: safety and reliability with older intensive care unit patients at discharge. / Teste de Sentar-Levantar Cinco Vezes: segurança e confiabilidade em pacientes idosos na alta da unidade de terapia intensiva.

OBJECTIVE: Assess the Five Times Sit-to-Stand Test safety and clinimetric properties in older patients hospitalized in an intensive care unit. METHODS: Test safety was assessed according to the incidence of adverse events and through hemodynamic and respiratory data. Additionally, reliability properties were investigated using the intraclass correlation coefficients, standard error of measurement, standard error percentage change, Altman-Bland plot and a survival agreement plot. RESULTS: The overall suitability of the Five Times Sit-to-Stand Test was found to be low, with 29.8% meeting the inclusion criteria. Only 44% of the hospitalized patients who met the inclusion criteria performed the test, with no need for discontinuation in any patient. Heart rate (79.7 ± 10.2bpm/86.6 ± 9.7bpm; p = 0.001) and systolic blood pressure (118 ± 21.4mmHg/129 ± 21.5mmHg; p = 0.031) were the only variables that presented a significant statistical increase, with no evidence of exacerbated response to the test. Additionally, no adverse events were reported from participating and both test-retest and interrater reliability were high (intraclass correlation coefficient ≥ 0.99). CONCLUSION: The Five Times Sit-to-Stand Test was proven to be safe and to have excellent reliability. Its clinical use, however, may be restricted to high-functioning older adults in hospital settings.

OBJETIVO: Avaliar a segurança e as propriedades clinimétricas do Teste de Sentar-Levantar Cinco Vezes em pacientes mais velhos internados em unidade de terapia intensiva. MÉTODOS: A segurança do teste foi avaliada segundo a incidência de eventos adversos e pela análise dos dados hemodinâmicos e respiratórios. Além disto, a confiabilidade de suas propriedades foi investigada por meio de avaliação de coeficientes de correlação intraclasses, mensuração do erro padrão da média, porcentagem de alteração do erro padrão da média, gráficos de Altman-Bland e de concordância-sobrevivência. RESULTADOS: A adequabilidade do Teste de Sentar-Levantar Cinco Vezes foi identificada como baixa, já que apenas 29,8% dos potenciais participantes cumpriam os critérios de inclusão. Apenas 44% dos pacientes hospitalizados que cumpriam os critérios de inclusão realizaram o teste, sem necessidade de cessação para qualquer dos pacientes. A frequência cardíaca (79,7 ± 10,2bpm/86,6 ± 9,7bpm; p = 0,001) e a pressão arterial sistólica (118 ± 21,4mmHg/129 ± 21,5mmHg; p = 0,031) foram as únicas variáveis com aumento estatisticamente significante, sem evidência de resposta exacerbada ao teste. Além disto, não se relataram eventos adversos, e a confiabilidade tanto entre teste e reteste quanto entre avaliadores foi elevada (coeficiente de correlação entre classes ≥ 0,99). CONCLUSÃO: O Teste de Sentar-Levantar Cinco Vezes se comprovou seguro e com excelente confiabilidade. Seu uso clínico no ambiente hospitalar, contudo, pode ser restrito a pacientes adultos mais velhos com elevada funcionalidade.

Teste de Sentar-Levantar Cinco Vezes: segurança e confiabilidade em pacientes idosos na alta da unidade de terapia intensiva / The Five Times Sit-to-Stand Test: safety and reliability with older intensive care unit patients at discharge

RESUMO Objetivo: Avaliar a segurança e as propriedades clinimétricas do Teste de Sentar-Levantar Cinco Vezes em pacientes mais velhos internados em unidade de terapia intensiva. Métodos: A segurança do teste foi avaliada segundo a incidência de eventos adversos e pela análise dos dados hemodinâmicos e respiratórios. Além disto, a confiabilidade de suas propriedades foi investigada por meio de avaliação de coeficientes de correlação intraclasses, mensuração do erro padrão da média, porcentagem de alteração do erro padrão da média, gráficos de Altman-Bland e de concordância-sobrevivência. Resultados: A adequabilidade do Teste de Sentar-Levantar Cinco Vezes foi identificada como baixa, já que apenas 29,8% dos potenciais participantes cumpriam os critérios de inclusão. Apenas 44% dos pacientes hospitalizados que cumpriam os critérios de inclusão realizaram o teste, sem necessidade de cessação para qualquer dos pacientes. A frequência cardíaca (79,7 ± 10,2bpm/86,6 ± 9,7bpm; p = 0,001) e a pressão arterial sistólica (118 ± 21,4mmHg/129 ± 21,5mmHg; p = 0,031) foram as únicas variáveis com aumento estatisticamente significante, sem evidência de resposta exacerbada ao teste. Além disto, não se relataram eventos adversos, e a confiabilidade tanto entre teste e reteste quanto entre avaliadores foi elevada (coeficiente de correlação entre classes ≥ 0,99). Conclusão: O Teste de Sentar-Levantar Cinco Vezes se comprovou seguro e com excelente confiabilidade. Seu uso clínico no ambiente hospitalar, contudo, pode ser restrito a pacientes adultos mais velhos com elevada funcionalidade.

ABSTRACT Objective: Assess the Five Times Sit-to-Stand Test safety and clinimetric properties in older patients hospitalized in an intensive care unit. Methods: Test safety was assessed according to the incidence of adverse events and through hemodynamic and respiratory data. Additionally, reliability properties were investigated using the intraclass correlation coefficients, standard error of measurement, standard error percentage change, Altman-Bland plot and a survival agreement plot. Results: The overall suitability of the Five Times Sit-to-Stand Test was found to be low, with 29.8% meeting the inclusion criteria. Only 44% of the hospitalized patients who met the inclusion criteria performed the test, with no need for discontinuation in any patient. Heart rate (79.7 ± 10.2bpm/86.6 ± 9.7bpm; p = 0.001) and systolic blood pressure (118 ± 21.4mmHg/129 ± 21.5mmHg; p = 0.031) were the only variables that presented a significant statistical increase, with no evidence of exacerbated response to the test. Additionally, no adverse events were reported from participating and both test-retest and interrater reliability were high (intraclass correlation coefficient ≥ 0.99). Conclusion: The Five Times Sit-to-Stand Test was proven to be safe and to have excellent reliability. Its clinical use, however, may be restricted to high-functioning older adults in hospital settings.

Cashew gum and maltrodextrin particles for green tea (Camellia sinensis var Assamica) extract encapsulation.

Cashew gum and maltodextrin microcapsules containing green tea leaf extracts were made using a spray-dryer. Green tea extracts were submitted to cytotoxicity analysis and characterization of bioactive compounds. Three formulations of microcapsules were performed, which were then submitted to characterization through morphological study, particle diameter and distribution, zeta potential, Exploratory Differential Calorimetry, entrapment efficiency, dissolution test and X-ray diffraction. The extract had a high bioactive compound content and no cytotoxicity was observed. The amorphous microcapsules presented irregular shapes with a circular predominance and dentate surface, mean diameters varying from 2.50 to 3.64 µm, solubility ranging from 63% to 72.66%. Low values of microencapsulation efficiency, zeta potencial and dissolution profile were observed. The microparticles based on the dry extract of green tea present potential as a food ingredient and as a promoter of health benefits.

Conhecimento e prática de enfermeiros no cuidado a pacientes com feridas tumorais malignas / Nurses' knowledge and practices in caring for patients with malignant tumor wounds / Conocimiento y práctica de enfermeros en el cuidado a pacientes con heridas tumorales malignas

INTRODUÇÃO: As feridas tumorais malignas representam uma angústia para pacientes que enfrentam uma doença terminal, uma vez que são lesões desfigurantes, sem possibilidades de cicatrização e que desenvolvem sintomas de difícil controle. O objetivo foi verificar o conhecimento e prática de enfermeiros no cuidado a pacientes com feridas tumorais malignas. MATERIAIS E MÉTODOS: Trata-se de um estudo exploratório, descritivo, quantitativo realizado com 22 enfermeiros de um hospital da Paraíba, Brasil, durante o período de abril a junho de 2016. O instrumento foi um questionário estruturado baseado no protocolo do Ministério da Saúde. Para a análise dos dados utilizou-se estatística descritiva e literatura pertinente. RESULTADOS: Os resultados permitiram identificar que os enfermeiros apresentam lacunas no conhecimento de conteúdos e técnicas sobre avaliação e tratamento de pacientes com feridas neoplásicas. Além disso, constatou-se que os enfermeiros não executam alguns cuidados pertinentes a essa clientela. DISCUSSÃO: Acredita-se que essas fragilidades estejam relacionadas ao dimensionamento de pessoal, déficit no conhecimento, inabilidade em realizar cuidados com feridas tumorais malignas, falta de insumos que auxiliem na avaliação e tratamento da lesão, inexistência de protocolo institucional para o cuidado com essas lesões. CONCLUSÕES: Desse modo, a instituição lócus da pesquisa precisa investir em educação permanente, a fim de treinar a equipe de enfermagem para o acompanhamento de pacientes com feridas tumorais malignas, adquirir materiais necessários e implantar protocolos assistenciais que norteiem a prática de métodos avaliativos e terapêuticos para o cuidado com pessoas com essas lesões, familiares e cuidadores.

INTRODUCTION: Malignant tumor wounds represent anguish for patients confronting terminal illness, as these are disfiguring lesions, with no possibility of healing and which develop symptoms that are difficult to control. The aim of this study was to verify nurses' knowledge and practices in caring for patients with malignant tumor wounds. MATERIALS AND METHODS: This was a quantitative, descriptive exploratory study carried out with 22 nurses from a hospital in Paraíba, Brazil, during April to June 2016. The instrument was a structured questionnaire based on the protocol by the Ministry of Health. Data analysis used descriptive statistics and relevant literature. RESULTS: The results permitted identifying that nurses have gaps in content knowledge and techniques to evaluate and treat patients with neoplastic wounds. In addition, it was found that nurses do not perform some pertinent care to those patients. DISCUSSION: It is believed that these fragilities are related to personnel size, knowledge deficits, inability to perform care with malignant tumor wounds, lack of inputs that aid in the evaluation and treatment of the lesion, and lack of institutional protocol to care with these lesions. CONCLUSIONS: Thus, the institution's locus of research needs to invest in permanent education to train the nursing staff to monitor patients with malignant tumor wounds, acquire necessary materials, and implement care protocols that guide the practice of assessment and therapeutic methods for caring for people with these injuries, family members, and caregivers.

INTRODUCCIÓN: Las heridas tumorales malignas representan una angustia para los pacientes que se enfrentan a una enfermedad terminal, ya que son lesiones desfigurantes, sin posibilidades de cicatrización y que desarrollan síntomas de difícil control. El objetivo fue verificar el conocimiento y práctica de enfermeros en el cuidado a pacientes con heridas tumorales malignas. MATERIALES Y MÉTODOS: Se trata de un estudio exploratorio, descriptivo, cuantitativo realizado con 22 enfermeros de un hospital de Paraíba, Brasil, durante el período de abril a junio de 2016. El instrumento fue un cuestionario estructurado basado en el protocolo del Ministerio de Salud. Para el análisis de los datos se utilizó estadística descriptiva y literatura pertinente. RESULTADOS: Los resultados permitieron identificar que los enfermeros presentan lagunas en el conocimiento de contenidos y técnicas sobre evaluación y tratamiento de pacientes con heridas neoplásicas. Además, se constató que los enfermeros no realizan algunos cuidados pertinentes a esa clientela. DISCUSIÓN: Se cree que estas fragilidades están relacionadas al dimensionamiento de personal, déficit en el conocimiento, inhabilidad en realizar cuidados con heridas tumorales malignas, falta de insumos que auxilien en la evaluación y tratamiento de la lesión, inexistencia de protocolo institucional para el cuidado con esas lesiones. CONCLUSIONES: De este modo, la institución locus de la investigación necesita invertir en educación permanente, a fin de entrenar al equipo de enfermería para el acompañamiento de pacientes con heridas tumorales malignas, adquirir materiales necesarios e implantar protocolos asistenciales que orienten la práctica de métodos evaluativos y terapéuticos para el cuidado de personas con esas lesiones, familiares y cuidadores.

O Programa Mas Medicos em Pernambuco: promoção da saúde e da cidadania em contextos sociais de vulnerabilidade / The Mas Medicos Program in Pernambuco: promotion of health and citizenship in social contexts of vulnerability

Este trabalho traz os resultados de um estudo de casos múltiplos acerca do Programa Mais Médicos (PMM) em três municípios de Pernambuco: Vitória de Santo Antão, Águas Belas e Ouricuri. Nesses locais, entre junho e agosto de 2016, foram selecionadas Unidades de Saúde da Família (USF), onde atuam médicos e médicas cubanos da cooperação entre o governo brasileiro e a Organização Pan-Americana da Saúde/Organização Mundial de Saúde (OPAS/OMS). O objetivo do PMM é reduzir os vazios assistenciais, por meio da expansão da rede de serviços da Atenção Básica, tendo como consequência a ampliação e a melhoria da atenção à saúde aos usuários do Sistema Único de Saúde (SUS). A metodologia empregada abrangeu dados quantitativos do Ministério da Saúde e do IBGE, e dados qualitativos obtidos por meio de entrevistas semiestruturadas e grupos focais, envolvendo profissionais das Equipes de Saúde da Família (eSF) e usuários dos serviços. Financiada pela OPAS/OMS, a pesquisa que originou este estudo aponta não só uma melhoria da situação de saúde da população e a satisfação dos usuários com os serviços prestados pelas eSFs, mas também identifica as barreiras econômicas e sociais que impedem o acesso pleno às USFs como portas preferenciais de acesso ao SUS. Além disso, destaca-se que o PMM promoveu uma cultura do autocuidado entre as pessoas e o despertar de uma consciência a respeito do exercício da cidadania, que só pode ser efetivada por meio do usufruto de políticas públicas bem estruturadas.(AU)

Enxerto de tecido conjuntivo subepitelial como solução para retração gengival isolada / Subepithelial connective tissue graft as a solution for a single gingival recession

A retração gengival é comum em pacientes de ambos os sexos e de idades variadas, e é caracterizada pela migração apical da margem gengival com exposição da superfície radicular. A resolução dessa alteração tem sido considerada um dos principais objetivos da terapia cirúrgica periodontal com a intenção de atingir um completo recobrimento radicular. No presente caso clínico, o paciente possuía uma retração gengival classe II de Miller na região do elemento 41, decorrente da movimentação ortodôntica feita no mesmo. A realização de uma análise minuciosa do caso é importante para selecionar a técnica cirúrgica, que neste relato foi a de enxerto de tecido conjuntivo subepitelial. O acompanhamento pós-cirúrgico foi realizado, constatando o aumento da gengiva queratinizada, com um bom recobrimento radicular e uma melhora significativa, tanto na estética como na higiene.

Gingival recession is common in patients of both genders and various ages, being characterized by apical migration of the gingival margin exposing the root surface. The resolution of this change has been considered a major goal of periodontal surgical therapy with the intention of achieving complete root coverage. In the present clinical case reported the patient had a Miller class II gingival recession in the region of element 41, due to the orthodontic movement. A detailed analysis of this case provided the subepithelial connective tissue graft as the best solution. At the follow-up, the band of keratinized tissue increased along with a good root coverage and signifi cant improvements on esthetics and hygiene aspects.

APRIMORANDO A ESTÉTICA COM COROAS "METAL FREE": RELATO DE CASO / Improving the aesthetics with "METAL FREE": a case report

O Introdução: A busca pela estética está cada vez mais presente no dia-a-dia do cirurgião-dentista. Devido a isto a preocupação dos pacientes com as restaurações, especialmente em dentes anteriores, tem aumentado cada vez mais. A utilização de coroas livre de metal responde positivamente a essa preocupação estética. Objetivo: Este artigo tem como objetivo apresentar um relato de caso clínico que mostra a reabilitação de dois dentes com o uso de coroas puras de cerâmica IPS E-MAX. Relato de Caso: O paciente procurou atendimento odontológico se queixando da estética dos elementos 24 e 25, após constatar que os elementos haviam tratamento endodôntico adequado e já haviam núcleos metálicos fundidos (duracast) em condições satisfatórias, foi selecionado o sistema cerâmico dissilicato de lítio IPS E-max (Ivoclar Vivadent), para a confecção das coroas. Conclusão: As coroas em cerâmica metal-free, apresentam-se como uma excelente alternativa restauradora, desde que o protocolo clínico de utilização seja corretamente seguido.clínico, é imprescindível ao profissional fazer opção por parâmetros mais científicos, favorecendo a função mesmo que a estética fique comprometida.

Introduction: The search for aesthetic is becoming increasingly present on the day of the dentist. Due to this the concern of the pacients with restorations, especially in anterior teeth, is increasing more and more. The use of metal free crowns responds positively to this aesthetic concern. Objective: This article aims to present a case report showing the rehabilitation of two teeth using pure ceramic crowns IPS E-MAX. Case report: The patient sought dental care complaining of aesthetic elements 24 and 25, after noting that the elements had appropriate endodontic treatment and had already molten metallic cores (gold /duracast) in satisfactory condition, was chosen lithium disilicate ceramic system IPS E-max (Ivoclar Vivadent), for the manufacture of ceramic crown. Conclusion: Ceramic crowns metal free, are presented as an excellent alternative restoration since the clinical protocol is followed correctly.

Práticas inadequadas da alimentação complementar em lactentes, residentes em Belém-PA / Inadequate suplementary feeding practices in infants living in Belém-PA

Objetivo: avaliar práticas alimentares de lactentes de quatro meses a um ano de vida, residentes em Belém-PA. Método: Estudo realizado através de questionários com antecedentes alimentares e recordatório alimentar de 24 horas em 320 lactentes de quatro a 12 meses de idade que não estavam em aleitamento materno exclusivo. Para o cálculo do tamanho amostral foi tomado como base o número de crianças com idade entre quatro e 12 meses, atendidas no mesmo período em 2010, prefixado um erro amostral de 5% e um poder estatístico de 80%, sendo estimado número de 320 lactentes. Resultados: verificou-se introdução precoce de suco de fruta, papa de fruta e papa salgada, cujas médias em meses foram respectivamente 5.5, 5.6 e 5.6, e introdução tardia de carnes e ovos. A introdução da alimentação da família foi de 8.0 meses em média. Alimentos consumidos em 24 horas nos lactentes de quatro meses de idade foram: refrigerante 0.6%, café 0.3%, açúcar 11.3% e mingau 3.4% e aos 12 meses notou-se elevado consumo de açúcar 82.5%, refrigerante 11.9%, café 4.1%, mingau 62.2%, achocolatados 22.2%, biscoitos recheados 28.1% e bolachas 29.1%. A média da introdução do leite de vaca foi de 5.0 meses. A média da duração do aleitamento materno não exclusivo em meses foi 7.7. Conclusão: é necessário melhorar os hábitos alimentares da população estudada, pois alimentos complementares de baixo valor nutritivo são introduzidos de forma precoce e alimentos mais ricos em proteínas e micronutrientes mais tardiamente

Objective: evaluate feeding practices of infants from four months to a year old, living in Belém, PA. Method: the study was conducted through questionnaires with a history of food and 24-hour dietary anamneses in 320 infants from four to 12 months-old, who were not exclusively breast fed. Sample size was calculated from the number of children aged between four and 12 months attended in the same period in 2010, a 5% sampling error and statistical power of 80% were prefixed, estimated number was 320 infant. Results: there was an early introduction of fruit juice, fruit paps and other paps, the respectively averages in months were 5.5, 5.6 and 5.6, and late introduction of meat and eggs. The introduction of family food was 8.0 months on average. Food consumed in 24 hours in infants of four months of age were soft drinks (0.6%); coffee (0.3%); sugar (11.3%) and porridge (3.4%); by 12-months-old, a high consumption of sugar was noted (82.5%), followed by soft drinks (11.9%), coffee (4.1%), porridge (62.2%), chocolate (22.2%), sandwich cookies (28.1%) and biscuit (29.1%). The average time of cows? milk introduction was 5.0 months and the non-exclusive breast milk duration was 7.7 months. Conclusion: it is necessary to improve the dietary habits in the studied population since low nutritious value supplementary foods are introduced precociously and richer protein and micronutrients foods later.

Hemorragia perimesencefálica näo-aneurismática: uma forma benigna de hemorragia subaracnóide. Relato de caso e revisäo de literatura / Non-aneurysmal perimesencephalic hemorrhage: a benign form of subarachnoid hemorrhage. Report of a case

Hemorragia perimesencefálica não-aneurismática é uma forma distinta de hemorragia subaracnóide descrita recentemente. Essa patologia apresenta-se com padrões tomográficos e topográficos bastante sugestivos, além de possuir um curso clínico favorável. É relatado um caso no qual os critérios diagnósticos são preenchidos, ressaltando-se por outro lado a benignidade da afecção, conforme revisão da literatura.

Esquistossomose cerebelar: relato de caso / Cerebellar schistosomiasis. A case report

Os autores relatam um caso raro de granuloma esquistossomótico no cerebelo removido completamente através de técnicas microcirúrgicas e tratado ulteriormente com oxaminiquine. Alguns aspectos etiopatogênicos assim como clínicos, neuradiológicos e cirúrgicos säo comentados