A dieta e seu reflexo na saúde bucal em grupo de idosos: Relato de experiência/ Diet and its reflection on oral health in a group of elderly: Experience Report

Introdução: A dieta e condição nutricional influenciam a saúde bucal de diversas formas. As deficiências nutricionais podem resultar em defeitos nas estruturas dentais tanto durante a formação e erupção do dente, como após esse processo de surgimento. Os açúcares e ácidos provenientes dos alimentos podem causar cárie e erosão dentária, respectivamente. Além disso, alguns alimentos apresentam papel protetor para o câncer de boca, enquanto os defeitos nutricionais e dietas inadequadas, além do fumo e do álcool, podem contribuir para o risco de desenvolver a doença. A nutrição adequada também beneficia os tecidos periodontais (FREIRE et al., 2012). Relato de caso: Trata-se de um relato de experiência sobre A dieta e seu reflexo na saúde bucal com grupo de 80 idosos participantes do projeto “Envelhecimento Saudável” da Instituição de Ensino Superior Nova Esperança, em João Pessoa-PB, sendo formada por 18 alunos das áreas de medicina, odontologia, enfermagem e fisioterapia e 4 tutoras. A abordagem foi multidisciplinar e de índole lúdica. A elaboração e execução da vivência foi voltado para o entendimento do processo de alimentação saudável e deletéria para a saúde bucal dos idosos, bem como atentar para o desenvolvimento da cognição motora e o relacionamento entre os membros do grupo. A ação foi realizada em salas da instituição utilizando os recursos de multimídia, cartolinas, figuras, tesouras, colas e pincéis. O trabalho consistiu em identificar as figuras dos alimentos que contribuíam ou não para a saúde bucal. Estas foram coladas em quadros diferentes identificados como “Bom para a saúde bucal” e “Ruim para a saúde bucal”. Os recortes foram realizados pelos próprios idosos e os alunos e tutores envolvidos puderam orientar e ajudar nesta tarefa. O material informativo foi construído pelos participantes e visou não somente o conhecimento científico como a cognição motora dos idosos. Almejou-se com a ação orientar os idosos quanto a importância da alimentação saudável para a saúde bucal, o entretenimento e o fortalecimento de laços de amizade no grupo. Coclusão: Os participantes avaliaram a atividade como sendo de significativa contribuição para o seu cotidiano, bem como para a aquisição de novos conhecimentos e hábitos saudáveis

Needle visualization during ultrasound-guided puncture: image optimization

Abstract Background Obtaining an adequate image of the needle by ultrasound reduces complications resulting from punctures, increasing patient safety and reducing hospitalization costs. Objectives To verify human perception in relation to number of pixels, while also identifying the best puncture angle and which needle should be used, and to evaluate whether there is a difference if needle visualization software is used. Methods 20 images were analyzed by 103 students who classified them as being sufficient or insufficient and were compared with the quality observed using photoshop. We evaluated whether there were differences between puncture angles of less than 45º and more than 45º, between IV catheter and introducer needles, and between images obtained with and without visualization software. Results There was a higher percentage of sufficient ratings for images those that had more than 60 pixels and when the puncture angle was less than 45º, with significant associations between students’ evaluations and each of these groups (p < 0.001). The percentages of images classified as sufficient were higher for images in which a IV catheter was used and also higher for those using the needle visualization software, with significant associations between the results for students’ classifications and each of these groups (p < 0.001). Conclusions The human eye classifies an image as sufficient according to higher numbers of pixels. Images of punctures at angles smaller than 45º in relation to the surface, of punctures performed with a IV catheter, and when using specific visualization software are also better detected by the human eye

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally