Evaluation Of Three Radiographic Methods For Detecting Occlusal Caries Lesions

Aim: To compare, in vitro, the performance of three radiographic methods for the detection of occlusal caries in permanent teeth. Methods: A total of 96 extracted molars with no apparent occlusal cavitation were selected, they were photographed and radiographed under standardized conditions using conventional E-plus films and two digital systems, CDR and Sidexis. Two examiners analyzed all films and images, recording the presence and lesion depth. One quarter of the teeth were re-examined for intra- and interexaminer agreements. The teeth were subsequently bisected and examined under a stereomicroscope. The intra and interexaminer agreements and the diagnostic performance (sensitivity, specificity, accuracy and the area under receiver operating characteristic, ROC curve) of each method were evaluated. Results: Out of 96 occlusal surfaces, 41 were sound, 31 had lesions in enamel, and 24 had dentin lesions. Weighted Kappa values for intraexaminer agreement varied widely, depending on both the observer and method. The interexaminer agreement was higher for the digital images than for the conventional films. The area under the ROC curve for enamel and dentin caries (at D1 diagnostic threshold) was 0.55 for films, 0.60 for Schick and 0.54 for Sirona, which were not significantly different from each other. Conclusions: Digital images presented better results of interexaminer agreement; however, no additional effect in the diagnostic performance could be observed in comparison to conventional films.8267-7

El Pensamiento Constitucional de Álvaro D’Ors

Es sabido que don Álvaro D’Ors produjo una teoría política —él mismo tituló uno de sus libros Ensayos de Teoría Política—, pero no puede decirse con seguridad lo mismo de una teoría constitucional, a pesar de sus no escasos pronunciamientos sobre diversos problemas de naturaleza constitucional. El propósito de este trabajo es, primero, identificar los principales trabajos orsianos que tratan de los temas constitucionales importantes, y, segundo, disponerlos ordenadamente en el marco de una teoría constitucional general.It is widely known that the late Prof. Álvaro D’Ors produced a full bodied political theory —he himself labelled one of his books Ensayos de Teoría Política—, yet the same cannot be safely said as regards constitutional theory, notwithstanding the fact of his not so scarce writings on a variety of problems of a constitutional nature. The aim of this contribution is twofold: on the one hand, to spot the main orsian pieces dealing with salient constitutional topics; on the other hand, disposing them in the shelves of a frame provided by the general constitutional theory

Association between social conditions and oral health in school failure

OBJECTIVE: To evaluate the association of school failure among Brazilian adolescents with social conditions and aspects of oral health through hierarchical analysis. METHODS: A state-wide survey of 5,558 adolescents from the state of São Paulo, Brazil, inquired about the sociodemographic and social capital of participants by using a structured questionnaire. Trained and calibrated professionals performed intraoral examinations and interviews in the households. Questions about the access to dentist, reason for and frequency of using dental services, toothache episodes and impact of oral conditions on daily activities (OIDP) were applied. Oral examinations evaluated caries experience, tooth losses, periodontal problems, presence of open bite, and maxillary and mandibular overjet. School failure was estimated according to the teenagers’ years of schooling. The independent variables were grouped into three blocks: sociodemographic and economic characteristics, social capital and oral health aspects. The multiple hierarchical logistic regression model was used to identify the factors associated with school failure. RESULTS: Of the total sample, information about schooling of 5,162 adolescents was obtained, of whom 29.6% presented school failure. We found that adolescents over the age of 16 years who did not declare themselves as white, female, with feelings of insecurity, unhappiness, with toothache, caries, tooth losses, affected by dentofacial and/or periodontal changes, were more likely to fail at school. CONCLUSION: Oral disorders and social factors were associated with school failure in adolescents. A successful school trajectory was a strong determinant of health, therefore actions between the educational and health sectors must be developed for adolescents, especially those with this profile

Molecular characterization of carbapenem-resistant and metallo-β-lactamase-producing Pseudomonas aeruginosa isolated from blood cultures from children and teenagers with cancer

INTRODUCTION: The objective of this study was to evaluate the prevalence and dissemination of carbapenem-resistant and metallo-β-lactamase-producing Pseudomonas aeruginosa isolated from blood-stream samples (2000-2005) that were collected from patients admitted to the Institute of Pediatric Oncology, UNIFESP (IOP-GRAACC). METHODS AND RESULTS: Fifty-six P. aeruginosa samples were isolated from 49 patients. Thirty-two of these samples were classified as carbapenem-resistant using the disc diffusion method and were subjected to the PCR reaction in order to detect MBL genes. Eighteen of these 32 isolates showed the blaSPM-1 gene. Eight samples selected in different years over the study period presented the same genetic profile according to pulsed-field gel electrophoresis. The antimicrobial therapy was considered adequate for only 23.5% of the patients with bacteremia due to P. aeruginosa carrying the blaSPM-1 gene, and a high lethality rate of 70.6% was observed during the 30-day period after bacteremia and an inadequate initial antibiotic regimen. CONCLUSIONS: We detected the presence of a clone of carbapenem-resistant P. aeruginosa carrying blaSPM-1 that persisted in blood culture samples over a six-year period at the institution, with high lethality, thus justifying rigorous epidemiological surveillance and a rearrangement of the antimicrobial therapy regimens at the institution.INTRODUCÃO: O objetivo do estudo foi avaliar a prevalência e a disseminação de amostras de Pseudomonas aeruginosa resistente aos carbapenêmicos e produtoras de metalo-β-lactamases isoladas de hemoculturas (2000-2005) de pacientes do Instituto de Oncologia Pediátrica da UNIFESP (IOP-GRAACC). MÉTODOS E RESULTADOS: Cinquenta e seis amostras de Pseudomonas aeruginosa foram isoladas de 49 pacientes. Trinta e duas dessas amostras foram classificadas como resistentes aos carbapenêmicos pela técnica de disco difusão e submetidas a reação de PCR para detecção de genes de MBL. Dezoitos dessas 32 amostras evidenciaram o gene blaSPM-1. Oito amostras selecionadas em diferentes anos no período de estudo apresentaram o mesmo perfil genético por pulsed-field gel electrophoresis. A terapêutica antimicrobiana foi considerada adequada em apenas 23,5% dos pacientes com bacteremia por P. aeruginosa carreando blaSPM-1 e letalidade de 70,6% no período de até 30 dias após a bacteremia e uma inadequação inicial dos esquemas antibióticos utilizados CONCLUSÕES: Evidenciamos a presença de um clone de P. aeruginosa resistente aos carbapenêmicos carreando blaSPM-1 que persistiu em amostras de hemocultura pelo período de 6 anos na instituição, com alta letalidade, justificando uma vigilância epidemiológica rigorosa e uma readequação dos esquemas de terapia antimicrobianos na instituição.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Laboratório Especial em Microbiologia ClínicaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Instituto de Oncologia Pediátrica-Grupo de Apoio ao Adolescente e à Criança com CâncerUNIFESP, EPM, Laboratório Especial em Microbiologia ClínicaUNIFESP, EPM, Instituto de Oncologia Pediátrica-Grupo de Apoio ao Adolescente e à Criança com CâncerSciEL

Nuclear Plants and Emergency Virtual Simulations Based on a Low-Cost Engine Reuse

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La percepción española de la ONU (1945 - 1962)

Sin resume

Orthogonally additive polynomials on C*-Algebras

We show that for every orthogonally additive scalar n-homogeneous polynomial P on a C*-algebra A there exists phi in A* satisfying P(x) = phi(x(n)), for each element x in A. The vector-valued analogue follows as a corollary