Alveolite seca - Revisão Bibliográfica

No âmbito deste relatório final de estágio, apresenta-se uma revisão bibliográfica sobre a alveolite seca, para conhecer o melhor possível uma complicação frequente no consultório dentário, que causa dor ao paciente, obrigando o médico dentista a ter consultas de urgência, alterando a agenda, para além do incómodo para o paciente. Deste modo, o principal objetivo é conhecer as causas desta doença, assim como os diferentes tipos de tratamento e protocolos de atuação. Assim, foram selecionados 19 artigos de 40 consultados, publicados na Pubmed e Scielo e de bibliografia em formato de papel, publicados nos últimos 15 anos. Foram excluídos todos os que não eram de acesso gratuito e os artigos que não respeitavam as normas de publicação científica ou que não iam de encontro com o tema em questão. Apesar de nesta revisão se verificar que existem novos tratamentos da alveolite seca que estão a ser referidos, tais como o laser e plasma rico em fatores de crescimento, essas novas técnicas requerem material caro que não está acessível em todos os consultórios dentários, contudo existem tratamentos mais económicos como a lavagem do alvéolo com clorhexidina e a colocação de medicamentos intraalveolares que também apresentam resultados satisfatórios

Prognostic Value of Treadmill Exercise Echocardiography

[Abstract] Introduction and objectives. Exercise echocardiography (EE) is useful for diagnosing coronary disease, but little is known about its value for risk stratification. We aimed to determine: a) whether data from EE supplemented clinical data and data from exercise testing and resting echocardiography in predicting cardiac events; and b) whether the number and location of abnormal regions and their responses to exercise influenced risk stratification. Patients and method. The 2,436 patients referred for EE were followed up for 2.1 ±1.5 years. Some 120 serious cardiovascular events (i.e., non-fatal myocardial infarction or cardiovascular death) occurred before revascularization. Results. In 1203 patients (49%), EE gave abnormal results. There were 89 events in patients with an abnormal result (7.3%) and 31 in those with a normal result (2.5%; P <.0001). Multivariate analysis of clinical data, and data from exercise testing, resting echocardiography, and EE showed that male sex (RR=1.7; 95% CI, 1.1–2.8; P = .02), metabolic equivalents or METs (RR=0.9; 95% CI, 0.86–0.98; P=.01), peak heart rate × blood pressure (RR= 0.9; 95% CI, 0.9; P=.002), resting wall motion score index (RR=2.5; 95% CI, 1.5–4.1; P <.0001), and number of abnormal regions at peak exercise (RR=1.4; 95% CI, 1.2–1.7; P<.0001) were independently associated with the risk of a serious event (final model χ2, 170; incremental P <.0001). The same variables, excluding sex, were independently associated with cardiovascular death (final model χ2, 169; incremental P = .01). Conclusions. Exercise echocardiography supplements clinical data and data from exercise testing and resting echocardiography in patients with known or suspected coronary artery disease.[Resumen] Introducción y objetivos. Aunque la ecocardiografía de ejercicio es útil para el diagnóstico de la enfermedad coronaria, hay menos datos referentes a su valor pronós-tico. El objetivo de este estudio fue esclarecer: a) si hay un valor incremental de la ecocardiografía en el pico del ejercicio respecto a las variables clínicas, la prueba de esfuerzo y la ecocardiografía en reposo, y b) si el número y la localización de los territorios afectados, así como el tipo de respuesta al ejercicio, influyen en la estratificación. Pacientes y método. En 2.436 pacientes referidos para ecocardiografía de ejercicio se realizó un seguimien-to de 2,1 ± 1,5 años. Hubo 120 eventos (infarto no fatal o muerte cardiovascular) antes de la revascularización. Resultados. La ecocardiografía fue anormal en 1.203 pacientes (49%). Hubo 89 eventos en pacientes con resul-tado anormal (7,3%) frente a 31 con resultado normal (2,5%; p < 0,001). Mediante un análisis multivariable de variables clínicas, de la prueba de esfuerzo y de la ecocardiografía en reposo y ejercicio encontramos que las variables asociadas de manera independiente con el riesgo de eventos eran: ser varón (riesgo relativo [RR] = 1,7; interva-lo de confianza [IC] del 95%, 1,1–2,8; p = 0,02), los equiva-lentes metabólicos o MET (RR = 0,9; IC del 95%, 0,9–1,0; p = 0,01), el producto frecuencia cardíaca × presión arterial (RR = 0,9; IC del 95%, 0,9–1,0; p = 0,02), el índice de moti-lidad segmentaria basal (RR = 2,5; IC del 95%, 1,5–4,1; p < 0,0001) y el número de territorios afectados (RR = 1,4; IC del 95%, 1,2-1,7; p < 0,0001) (χ2 final = 170, valor incremental de la ecocardiografía en el máximo esfuerzo; p < 0,0001). Las mismas variables, excepto el sexo, estaban asociadas con la muerte (χ2 final = 169, valor incremental de la ecocardiografía de ejercicio; p = 0,01). Conclusiones. La ecocardiografía en el máximo ejercicio incrementa el valor pronóstico de las variables clínicas, la prueba de esfuerzo y la ecocardiografía de reposo

Differences between the sexes of persons admitted for suicidal ideation/attempt at high risk in the health area of Ferrol, Spain

[Resumen] Para obtener un perfil tipo de ingreso por conducta o ideación suicida de alto riesgo, analizamos diferencias entre sexos de personas que ingresaron en la Unidad de Hospitalización Breve de Psiquiatría de Ferrol. Utilizamos una metodología cuantitativa, con diseño transeccional descriptivo. Tuvimos en cuenta variables: sociodemográficas, clínicas y asistenciales de 2012-2014 recogidas mediante MONSUE en 139 sujetos y 185 episodios. Utilizamos chi-cuadrado y ANOVA (SPSS.18.0©) para analizar los datos. La significación estadística (p<0,05) estuvo presente en situación y actividad laboral, convivencia y letalidad del intento, personalidad patológica y consumo de tóxicos, y asistencia y tentativas previas. Las tentativas de suicidio fueron escalonadas y al alza, predominando el sexo femenino en entornos urbanos.[Abstract] Our aim was to obtain a profile of inpatients with high risk suicidal behaviour. In a Spanish psychiatric ward, we analyze aforementioned inpatients using quantitative methods, with a cross-sectional descriptive design. We take into account several variables (socio-demographic, clinical and healthcare variables) from 2012 until 2014, collected by MONSUE in 139 indviduals through 185 episodes. We employ chi-square and ANOVA (SPSS.18.0 (C)) for statistical analysis. Some variables reach conventional levels of statistical significance: women, urban, labour situation and job category, usual household composition, attempt lethality, presence of pathological personality, drug use, previous suicide attempts and healthcare assistance related to. During this time the attempeted suicides were growing

Tratamiento de la madera arqueológica saturada de humedad por el método denominado plastinación

El artículo analiza los antecedentes históricos en la elaboración y aplicación de técnicas para la preservación de materiales diversos, hasta llegar a la creación de la técnica de la plastinación en 1978. Este método de preservación de material orgánico se ha adoptado como herramienta de trabajo en el tratamiento de materiales arqueológicos de procedencia subacuática, a cargo del Centro de Arqueología Subacuática del IAPH. A lo largo de 2006 y 2007 se ha utilizado dicha técnica en la conservación de unas maderas de época romana aparecidas en la ciudad de Huelv

Prediction of Mortality and Major Cardiac Events by Exercise Echocardiography in Patients With Normal Exercise Electrocardiographic Testing

ObjectivesWe sought to assess the value of exercise echocardiography (EE) for predicting outcome in patients with known or suspected coronary artery disease and normal exercise electrocardiogram (ECG) testing.BackgroundThe prognostic value of EE in patients with normal exercise ECG testing has not been characterized.MethodsWe studied 4,004 consecutive patients (2,358 men, mean age [± SD] 59.6 ± 12.5 years) with interpretable ECG who underwent treadmill EE and did not develop chest pain or ischemic ECG abnormalities during the tests. Wall motion score index (WMSI) was evaluated at rest and with exercise, and the difference (ΔWMSI) was calculated. Ischemia was defined as the development of new or worsening wall motion abnormalities with exercise. End points were all-cause mortality and major cardiac events (MACE).ResultsOverall, 669 patients (16.7%) developed ischemia with exercise. During a mean follow-up of 4.5 ± 3.4 years, 313 patients died, and 183 patients had a MACE before any revascularization procedure. The 5-year mortality and MACE rates were 6.4% and 4.2% in patients without ischemia versus 12.1% and 10.1% in those with ischemia, respectively (p < 0.001). In the multivariate analysis, ΔWMSI remained an independent predictor of mortality (hazard ratio [HR]: 2.73, 95% confidence interval [CI]: 1.40 to 5.32, p = 0.003) and MACE (HR: 3.59, 95% CI: 1.42 to 9.07, p = 0.007). The addition of the EE results to the clinical, resting echocardiographic and exercise hemodynamic data significantly increased the global chi-square of the models for the prediction of mortality (p = 0.005) and MACE (p = 0.009).ConclusionsThe use of EE provides significant prognostic information for predicting mortality and MACE in patients with interpretable ECG and normal exercise ECG testing