3 research outputs found

    Barras transpalatinas: indicações e comparação

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    Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina DentáriaAs barras transpalatinas são dispositivos ortodônticos com grande utilidade na prática clinica, atravessam o palato presas ao 1º Molar superior e têm aplicações diversas podendo impedir ou efetuar movimento dentário. O presente trabalho teve como objetivos analisar as diversas indicações das barras transpalatinas e comparar a barra de Goshgarian com a barra de Zachrisson. Neste contexto foram considerados na revisão da literatura artigos que comparassem ambas as barras. Dentro das limitações impostas pelo tipo de revisão realizada podemos concluir que a barra transpalatina com melhores resultados a nível de momentos e forças aplicadas é a barra de Zachrisson, porém deve ser analisado o efeito pretendido e a melhor opção terapêutica deve ser escolhida.The transpalatal bars are orthodontic devices with great utility in Clinical Practice, they cross the palate and are clutch to the 1st upper Molar. The applications are very different, with them we can stop dental movement or enforce it. The present work proposes itself to analyze the indications of transpalatal bars comparing the types that are most used - Goshgarian bar and Zachrisson - through existing studies and literature. With this work the conclusion was that the Zachrisson bar shows the best results of applied forces and moments, however it must be always considered the desired effect and the best option therapy must be chosen

    Barras transpalatinas: indicações e comparação

    Get PDF
    Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina DentáriaAs barras transpalatinas são dispositivos ortodônticos com grande utilidade na prática clinica, atravessam o palato presas ao 1º Molar superior e têm aplicações diversas podendo impedir ou efetuar movimento dentário. O presente trabalho teve como objetivos analisar as diversas indicações das barras transpalatinas e comparar a barra de Goshgarian com a barra de Zachrisson. Neste contexto foram considerados na revisão da literatura artigos que comparassem ambas as barras. Dentro das limitações impostas pelo tipo de revisão realizada podemos concluir que a barra transpalatina com melhores resultados a nível de momentos e forças aplicadas é a barra de Zachrisson, porém deve ser analisado o efeito pretendido e a melhor opção terapêutica deve ser escolhida.The transpalatal bars are orthodontic devices with great utility in Clinical Practice, they cross the palate and are clutch to the 1st upper Molar. The applications are very different, with them we can stop dental movement or enforce it. The present work proposes itself to analyze the indications of transpalatal bars comparing the types that are most used - Goshgarian bar and Zachrisson - through existing studies and literature. With this work the conclusion was that the Zachrisson bar shows the best results of applied forces and moments, however it must be always considered the desired effect and the best option therapy must be chosen

    Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

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    Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status
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