Assistência Multidisciplinar à Saúde - vol 3

O módulo 4, denominado Atenção Integral à Saúde do Idoso, é parte integrante da Unidade IV, aborda a saúde do idoso. Como será discutido no módulo, a proporção de idosos vem aumentando, o serviço de saúde e os profi ssionais que nele atuam precisam estar sensibilizados para fazer a atenção a esta faixa etária. Para isto precisa ter competências para prestar atenção qualifi cada focada para esta faixa etária. O conteúdo traz os conceitos de envelhecimento saudável, as políticas de atenção específi cas para tal ciclo de vida, além dos cuidados que as equipes precisam desenvolver para promover a saúde dos idosos. Vale ressaltar que são ações que independem do núcleo de competência dos profi ssionais, ou seja, é de responsabilidade de todos os membros da equipe, médico, odontólogo e enfermeiro. O módulo 5, denominado Atenção Integral à Saúde Mental, faz a abordagem dos principais problemas na área de saúde mental. Ele pretende clarifi car o que os profi ssionais da atenção primária precisam saber para suspeitar de problemas de saúde mental. O tema vai ser tratado separadamente, pois se entende que a abordagem dos problemas relacionados á saúde mental do indivíduo são fundamentais para a manutenção de uma comunidade saudável. Reconhecer os sinais de distúrbios mentais é de competência de todos os integrantes da equipe de saúde da família, esta ação não deve ser atribuída somente ao profi ssional da área de saúde mental.3.0MINISTÉRIO DA SAÚDEUna-SU

Clinical evaluation of dental alignment and leveling with three different

INTRODUCTION: A wide variety of orthodontic wires made of different alloys is available to be used in orthodontic practice and may produce different clinical responses during tooth movement. OBJECTIVE: This research evaluated the alignment and leveling of lower dental arches after the use of three types of orthodontic wires. METHODS: A sample of 36 patients was randomly divided into 3 groups: stainless steel, multistranded steel and superelastic nickel-titanium, according to the first leveling arches used. In order to observe differences in tooth position and axial inclination of the lower incisors, all patients had lateral cephalometric radiographs taken before the insertion of the first arches and 2 months later. The irregularity index and the curve of Spee were measured, compared between groups and considered influential on the proclination of incisors during the initial phase of alignment and leveling. The Reflex microscope was used to measure the irregularity index, whereas the ANOVA analysis of variance was used to verify differences between groups with regard to the degree of dental alignment and leveling. RESULTS: There were significant differences between groups only at T2 for the irregularity index. CONCLUSION: The NiTi and multistranded steel wires showed greater aligning capacity when compared with stainless steel wires.INTRODUÇÃO: uma grande variedade de fios ortodônticos, compostos por diferentes ligas, está disponível para utilização ortodôntica, podendo gerar respostas clínicas diversas, durante a movimentação dentária. OBJETIVO: este trabalho visa a avaliar o alinhamento e nivelamento das arcadas dentárias inferiores, após a utilização de três tipos de fios ortodônticos. MÉTODOS: uma amostra de 36 pacientes foi aleatoriamente dividida em três grupos, de acordo com os primeiros arcos utilizados para o alinhamento e nivelamento: aço inoxidável convencional, aço multifilamentado e de níquel-titânio superelástico. Para se avaliar as diferenças relacionadas ao posicionamento dentário e inclinação axial dos incisivos inferiores, foram obtidas radiografias cefalométricas de perfil, de todos os pacientes, em duas fases do tratamento: antes da inserção dos primeiros arcos e dois meses após a inserção dos mesmos. O índice de irregularidade dentária (IID) e a profundidade inicial de curva de Spee, fatores influentes sobre a projeção de incisivos durante a fase inicial de alinhamento e nivelamento, foram avaliados e comparados intra- e intergrupos. Para a medição do IID, foi utilizado o Reflex Microscope, possibilitando a mensuração do grau de alinhamento e nivelamento dentário em terceira dimensão. A análise de variância (ANOVA) foi utilizada para se avaliar as diferenças intergrupos em relação ao grau de alinhamento e nivelamento dentário. RESULTADOS: diferenças estatisticamente significativas intergrupos somente foram encontradas em T2, em relação ao índice de irregularidade dentária, já que os fios de NiTi e aço multifilamentado apresentaram maior capacidade de alinhamento do que os fios de aço inoxidável convencionais

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Editoria

Multi-wavelength emission from 3C 66A: clues on its redshift and gamma-ray emission location

The quasi-simultaneous multi-wavelength emission of TeV blazar 3C 66A is studied by using a one-zone multi-component leptonic jet model. It is found that the quasi-simultaneous spectral energy distribution (SED) of 3C 66A can be well reproduced, especially its {\it Fermi}-LAT first 3 months average spectrum can be well reproduced by the synchrotron-self Compton (SSC) component plus external Compton (EC) component of the broad line region (BLR). Clues on its redshift and gamma-ray emission location are obtained. The results indicate the following. (i) On the redshift; The theoretical intrinsic TeV spectra can be predicted by extrapolating the reproduced GeV spectra. Through comparing this extrapolated TeV spectra with the extragalactic background light (EBL) corrected observed TeV spectra, it is suggested that the redshift of 3C 66A could be between 0.1 and 0.3, the most likely value is $\sim$ 0.2. (ii) On the gamma-ray emission location; To well reproduce the GeV emission of 3C 66A under different assumptions on BLR, the gamma-ray emission region is always required to be beyond the inner zone of BLR. The BLR absorption effect on gamma-ray emission confirms this point.Comment: accepted for publication in Research in Astronomy and Astrophysics (RAA

Ovarian adenosarcoma simulating a simple cyst in a young patient

Müllerian adenosarcoma is a rare, mixed tumor that can occur throughout the female genital tract, but is most commonly found in the uterus. Ovarian adenosarcoma is rarer and has a poorer prognosis than uterine adenosarcoma. Data on the clinicopathological features of ovarian adenosarcoma are limited, and, due to its rarity, the management is controversial. The authors report a case of a 25-year-old patient who presented with recurrent abdominal pain. Sonography and laparotomy showed an ovarian cyst, and pathologic examination confirmed the diagnosis of cystic low-grade adenosarcoma. The patient remains free of recurrence 6 months after diagnosis. The authors call attention to the differential diagnosis of ovarian masses, especially in young patients, and to the lack of evidence on the management of this neoplasm in the literature

Prototype of a new tip developed to be coupled to dental light-curing units for optimizing bonding of orthodontic brackets and accessories

OBJECTIVE: development of a new device to be coupled to light-curing units for bonding orthodontic brackets and accessories, and test its efficacy in an in vitro mechanical trial. The inner surface of the device is mirrored and is based on physical concepts of light refraction and reflection. The main advantage of such device is the reduced clinical time needed for bonding and the low possibility of contamination during the process. METHODS: One hundred and twenty specimens were used for testing the shear bond strength of brackets bonded with the device. The Adhesive Remnant Index (ARI) was also determined. The sample was divided into 2 groups. In group 1 a halogen light-curing unit was used while in group 2 a led light-curing unit was used. Each group was then subdivided. In subgroups H1 and L1, a conventional light guide rod was used while in subgroups H2 and L2 bonding was performed with the mirrored device coupled to the tip of the guide light rod. RESULTS: The values obtained for the shear bond strength and the ARI in the subgroups were compared. Results showed that there was no statistically significant difference for the shear strength (p > 0.05) and the ARI (p > 0.05) between the subgroups. CONCLUSION: The tests of mechanical trials and the ARI analysis showed that the new device fulfilled the requirements for bonding orthodontic accessories, and that the time for bonding was reduced to half, being necessary only one light exposure.OBJETIVO: desenvolver uma nova ponteira para ser acoplada aos aparelhos fotopolimerizadores utilizados para colagem de braquetes e acessórios ortodônticos, e testar sua da efetividade em ensaio mecânico in vitro. A ponteira é espelhada na superfície interna e baseia-se em conceitos físicos de refração e reflexão de luz. Apresenta como principal vantagem o menor tempo clínico durante o procedimento de colagem, reduzindo a possibilidade de contaminação durante o processo. MÉTODOS: por meio de ensaio de resistência ao cisalhamento e determinação do índice remanescente de adesivo (IRA), testou-se a ponteira desenvolvida em 120 corpos de prova. A amostra foi dividia em dois grupos. No grupo 1, foi utilizado aparelho fotopolimerizador de fonte de luz halógena e, no grupo 2, fonte de LED. Cada grupo foi subdividido. Nos subgrupos H1 e L1, utilizou-se a ponteira convencional. Nos subgrupos H2 e L2 a colagem foi feita utilizando a ponteira desenvolvida para a polimerização do material de colagem. RESULTADOS: os valores dos testes de cisalhamento e IRA para os subgrupos foram comparados entre si. Os resultados mostraram que não houve diferença estatisticamente significativa para o ensaio de resistência ao cisalhamento (p > 0,05) nem para o IRA (p > 0,05) entre os subgrupos. CONCLUSÃO: os testes de ensaio mecânico, assim como a análise do IRA, mostraram que a nova ponteira desenvolvida cumpriu os requisitos necessários à colagem dos acessórios ortodônticos, e que o tempo de colagem foi reduzido pela metade, sendo necessária uma só incidência

Loop-induced photon spectral lines from neutralino annihilation in the NMSSM

We have computed the loop-induced processes of neutralino annihilation into two photons and, for the first time, into a photon and a Z boson in the framework of the NMSSM. The photons produced from these radiative modes are monochromatic and possess a clear "smoking gun" experimental signature. This numerical analysis has been done with the help of the SloopS code, initially developed for automatic one-loop calculation in the MSSM. We have computed the rates for different benchmark points coming from SUGRA and GMSB soft SUSY breaking scenarios and compared them with the MSSM. We comment on how this signal can be enhanced, with respect to the MSSM, especially in the low mass region of the neutralino. We also discuss the possibility of this observable to constrain the NMSSM parameter space, taking into account the latest limits from the FERMI collaboration on these two modes.Comment: 18 pages, 3 figures. Minor clarifications added in the text. Typing mistakes and references corrected. Matches published versio

Evaluation of marginal microleakage and depth of penetration of glass ionomer cements used as occlusal sealants

OBJETIVE: the aim of this study was to conduct an in vitro comparison of marginal microleakage (MM) and the depth of penetration (DP) of glass ionomer cements (GIC) and a resin sealant (RS) into occlusal pit and fissures. METHODS: for that purpose, 60 intact third molars were equally distributed to 5 groups: G1 - 37% phosphoric acid / Delton; G2 - 40% polyacrylic acid / Ketac-Molar / nail varnish; G3 - Fuji Plus conditioner / Fuji Plus/ nail varnish; G4 -37% phosphoric acid / Vitremer / Finishing gloss; G5 -37% phosphoric acid / Vitremer prepared with a 1:4 ratio of powder / Finishing gloss. The teeth were submitted to a thermal treatment corresponding to 300 cycles (15 sec, 5/55(0)C), followed by complete coating with nail varnish, except for 1mm beyond the contour of the sealant. Afterwards, the teeth were immersed in 0.5% basic fuchsine for 24 hours. Thereafter, the teeth were sectioned in buccolingual direction and microscopically analyzed (150x magnification) by means of predetermined scores. The results were subject to the Kruskal-Wallis test. RESULTS: there was no statistical difference between the materials tested in relation to the DP, being that all groups displayed nearly complete filling of the fissures. No sealant material was able to prevent dye penetration; however, the GICs provided better results of MM, with significant difference when compared to the RS. CONCLUSION: all materials investigated presented a satisfactory degree of penetration into the fissures; however, the glass ionomer cements displayed better performance in the marginal microleakage test compared to the resin sealant.OBJETIVO: o objetivo deste estudo foi comparar in vitro a microinfiltração marginal (MM) e o grau de profundidade de penetração (DP) de cimentos de ionômero de vidro (CIV) e um selante resinoso (SR) em fossas e fissuras oclusais. MATERIAIS E MÉTODOS: para tanto, 60 terceiros molares hígidos foram igualmente distribuídos em 5 grupos: G1- ácido fosfórico 37%/Delton; G2- ácido poliacrílico 40%/Ketac-Molar/esmalte cosmético; G3- Fuji Plus conditioner/Fuji Plus/ esmalte de cosmético; G4 - ácido fosfórico 37%/Vitremer/Finishing gloss; G5- ácido fosfórico 37%/Vitremer diluído na proporção de 1/4 de pó/Finishing gloss. Os dentes foram submetidos a um tratamento térmico correspondente a 300 ciclos (15 seg, 5/ 55(0)C), seguindo da total cobertura com esmalte cosmético, exceto 1mm além do contorno do material selador, sendo então imersos em solução de fucsina básica 0,5%, por 24 horas. Posteriormente, os dentes foram seccionados vestíbulo-lingualmente, e avaliados microscopicamente (aumento 150X), por meio de escores pré-determinados. Os resultados foram submetidos ao Teste de Kruskal Wallis. RESULTADOS: não houve diferença estatística entre os materiais testados em relação à DP, sendo que todos os grupos apresentaram um preenchimento quase total das fissuras. Nenhum material selador foi apto em impedir a penetração da solução corante, entretanto, os CIVs promoveram os melhores resultados de MM, distinguindo-se significantemente em relação ao SR. CONCLUSÃO: Todos os materiais testados apresentaram um grau de penetração satisfatório no interior das fissuras, no entanto, os cimentos de ionômero de vidro demonstraram melhor comportamento no teste de microinfiltração marginal, quando comparado ao selante resinoso

Effect of Vitamin B Deprivation during Pregnancy and Lactation on Homocysteine Metabolism and Related Metabolites in Brain and Plasma of Mice Offspring

Epidemiological and experimental studies indicate that the altered fetal and neonatal environment influences physiological functions and may increase the risk of developing chronic diseases in adulthood. Because homocysteine (Hcy) metabolic imbalance is considered a risk factor for neurodegenerative diseases, we investigated whether maternal Vitamin B deficiency during early development alters the offspring's methionine-homocysteine metabolism in their brain. To this end, the dams were submitted to experimental diet one month before and during pregnancy or pregnancy/lactation. After birth, the offspring were organized into the following groups: control (CT), deficient diet during pregnancy and lactation (DPL) and deficient diet during pregnancy (DP). the mice were euthanized at various stages of development. Hcy, cysteine, glutathione (GSH), S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH), folate and cobalamin concentrations were measured in the plasma and/or brain. At postnatal day (PND) 0, total brain of female and male offspring exhibited decreased SAM/SAH ratios. Moreover, at PND 28, we observed decreased GSH/GSSG ratios in both females and males in the DPL group. Exposure to a Vitamin B-deficient diet during the ontogenic plasticity period had a negative impact on plasma folate and brain cortex SAM concentrations in aged DPL males. We also observed decreased plasma GSH concentrations in both DP and DPL males (PND 210). Additionally, this manipulation seemed to affect the female and male offspring differently. the decreased plasma GSH concentration may reflect redox changes in tissues and the decreased brain cortex SAM may be involved in changes of gene expression, which could contribute to neurodegenerative diseases over the long term.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)AFIPUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilUniv São Paulo, Sch Pharmaceut Sci, São Paulo, BrazilUniv Pernambuco, Pediat Hematol & Oncol Ctr, Inst Biol Sci, Recife, PE, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychobiol, São Paulo, BrazilFAPESP: 2010/00075-2Web of Scienc

Tonsillolith : a report of three clinical cases

Tonsillolith is a rare dystrophic calcification as a result of chronic inflammation of the tonsils. Three asymptomatic cases of tonsillolith are reported, incidentally discovered through panoramic radiographs, which showed different sizes of radiopaque images, varying from 2 to 5mm; cases I and III images did not overlap the mandible ramus, which led to a probable diagnosis of soft tissue calcification. Case II had radiopaque unilateral images, with osseous tissue density, overlapping the mandibular ramus, leading to a benign intra-osseous lesion, which was considered as differential diagnosis. No symptoms were reported in any case. Only case I had clinical characteristics, showing highly consistent white plaques partially visible through the mucosa. Computed tomography of the maxillofacial region/head and neck were requested to find out the exact location of these images, since most of the overlapping radiopaque images in the mandibular ramus were very similar to intra-osseous abnormalities. The computed tomography showed hyperdense images in the palatine tonsils, confirming the diagnosis of tonsillolith. The patients are currently under follow-up. No treatment is required if there is no symptom. In conclusion, tonsillolith might show images on panoramic radiographs similar to intra osseous abnormalities. The diagnosis is relatively easy when computed tomography is requested, although the images are not pathognomonic. Therefore, clinicians should consider other pathologies as differential diagnosis