RESUMO
Introduction As general practitioners/family physicians, it is our duty to promote health and prevent disease by providing cure, care, or palliation. Palliative care (PC) plays a crucial role in integrated and patient-centered health services. In the Autonomous Region of Madeira (RAM), Portugal, the PC Unit (PCU) was established in 2012. According to data from 2010, 41.2% of individuals who passed away in this region had a requirement for PC. Our objective is to determine the potential needs for PC in our population in the year 2019, prior to the pandemic. Additionally, we aim to determine the main indications for PC and the number of emergency department admissions/hospitalizations and compare these needs with data from 2010. Methods We conducted an observational, cross-sectional, and descriptive, analytical study, in which the target population consisted of all individuals who passed away in RAM in the year 2019. From this population, a representative sample of deceased individuals was obtained. The gender, age, disease with a potential indication for palliative care, admissions to emergency care and hospitalizations in the preceding 12 months, and county of residence were obtained from the RAM Health Services and analyzed using Microsoft Excel (Microsoft Corp., Redmond, WA, USA) and the Statistical Package for the Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY, USA) software. Results From the total number of individuals who passed away in RAM in the year 2019 (N=2,840), a representative sample of 339 deceased individuals was obtained. Of the deceased individuals, 56% presented with potential indications for palliative care, compared to the 41.2% result recorded in 2010 (p<0.0001). Among these individuals, 51.9% were female, and the average age was 79.7±12.2 years. Neoplasms were the primary indication for palliative care, accounting for 22.7%. Individuals with potential indications for PC, when compared to those without indications, had a higher number of hospitalizations and emergency episodes in the preceding 12 months (p=0.0005 and p=0.008, respectively). Conclusion We conclude that over half of the patients who passed away in RAM had potential indications for palliative care. These individuals experienced a higher number of hospitalizations and emergency episodes in the preceding 12 months. In this study, we also observed a significant increase in the need for palliative care compared to the year 2010.
RESUMO
As mordidas abertas anteriores associadas aos hábitos deletérios de sucção provocam desequilíbrios no crescimento craniofacial quando não são corrigidas no momento oportuno. Este artigo apresenta um caso clínico tratado durante afase de crescimento, no qual se procurou avaliar os fatores etiológicos presentes neste tipo de má-oclusão, as terapêuticas aplicadas e discutir algumas grandezas cefalométricas nos resultados alcançados. A estabilidade do resultado está diretamente relacionada ao equilíbrio dos tecidos periorais. Ao final do tratamento, se o paciente não apresentar vedamento labial normal e respiração predominantemente nasal, a estabilidade poderá estar comprometida.
The anterior open bites associated with deleterious sucking habits promotes unbalance on the craniofacial growth when not corrected at an opportune moment. This article presents a clinical case treated during the growth period where etiological factors present in this type of malocclusion and applied therapeutics were evaluated, alongside with discussion regarding cephalometric magnitudes in the obtained results. The stability of the result is directly related to the perioral tissues equilibrium. At the end of the treatment, q a competent lip posture and a prevailing nasal breathing is not presented by the patient, the stability may be compromised.
