Reparo de lesão periapical extensa após utilização de curativo de demora à base de hidróxido de cálcio: relato de caso

PURPOSE: The objective of this paper is to report the clinical case of a patient who presented a chronic apical periodontitis, arising from internal inflammatory resorption followed by pulp necrosis, and a long-term success of a root canal therapy using calcium hydroxide as root canal dressing. CASE DESCRIPTION: A 20-year-old male patient presented for routine dental treatment. By radiographic examination we noted an extensive radioluscent area, laterally to the permanent maxillary right lateral incisor, with possibility of communication with the lateral periodontium, suggestive of a chronic apical periodontitis. Due to external root resorption detection, we used a calcium hydroxide root canal dressing, changed every 15 days, for a period of 2 months. Root canal filling was performed using gutta-percha cones by lateral condensation technique Radiographic follow up held after 19 years of treatment indicated a periodontium in conditions of normality, with the presence of lamina dura. CONCLUSION: Calcium hydroxide is a suitable material to be used as root canal dressing in teeth with apical periodontitis. Long-term evaluation demonstrated the satisfactory clinical outcome following root canal treatment.OBJETIVO: O objetivo deste trabalho é relatar o caso clínico de um paciente que apresentava lesão periapical crônica decorrente de necrose de pulpar e o sucesso a longo prazo de uma terapia endodôntica utilizando o hidróxido de cálcio como curativo de demora. DESCRIÇÃO DO CASO: O paciente, do gênero masculino, com 20 anos de idade, compareceu à Clínica Odontológica para tratamento de rotina. Por meio de exames radiográficos observamos uma área radioluscente extensa, lateralmente ao incisivo lateral superior direito, com possibilidade de comunicação com o periodonto lateral, sugestivo de lesão periapical. Devido à presença de reabsorção radicular externa, foi utilizado um curativo de demora à base de hidróxido de cálcio (Calen®), trocado a cada 15 dias, por um período de 2 meses. A obturação do canal radicular foi realizada com cones de guta-percha pela técnica de condensação lateral ativa. O acompanhamento radiográfico realizado após 19 anos do tratamento endodôntico indicou um periodonto em condições de normalidade, com integridade da lamina dura. CONCLUSÃO: O hidróxido de cálcio é um material adequado para ser usado como curativo de demora em dentes com lesão periapical, uma vez que a avaliação a longo prazo demonstrou resultados clínicos satisfatórios após o tratamento endodôntico.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Influência da posição da retirada da amostra nos parâmetros da qualidade da carne.

Editado por Ana Rita de Araújo Nogueira, Simone Cristina Méo Niciura

Quality of Life of Patients with Type 1 Diabetes Mellitus Using Insulin Analog Glargine Compared with NPH Insulin: A Systematic Review and Policy Implications

INTRODUCTION: Insulin analogue glargine (GLA) has been available as one of the therapeutic options for patients with type 1 diabetes mellitus to enhance glycemic control. Studies have shown that a decrease in the frequency of hypoglycemia episodes improves the Quality of Life (QoL) of diabetic patients. However, there are appreciable acquisition cost differences between different insulins. Consequently, a need to assess their impact on QoL to provide future guidance to health authorities. METHOD: A Systematic review (SR) of multiple databases including Medline, LILACS, Cochrane and EMBASE databases with several combinations of agreed terms involving randomized controlled trials (RCTs) and cohorts, as well as manual searches and gray literature was undertaken. The primary outcome measure was a change in QoL. The quality of the studies and the risk of bias was also assessed. RESULTS: Eight studies were eventually included in the systematic review out of 634 publications. Eight different QoL instruments were used (2 generic, 2 mixed and 4 specific), in which the Diabetes Treatment Satisfaction Questionnaire (DTSQs) was the most used. The systematic review did not consistently show any significant difference overall in QoL scores whether as part of subsets or combined into a single score with the use of GLA versus NPH insulin. Only in patients’ satisfaction measured by DTSQ was a better result consistently seen with GLA versus NPH insulin but not using the WED scale. However, none of the cohort studies scored a maximum on the Newcastle-Ottawa scale for quality and they generally were of moderate quality with bias in the studies. CONCLUSION: There was no consistent difference in QoL or patient reported outcomes when the findings from the eight studies were collated. In view of this, we believe the current price differential between GLA and NPH insulin in Brazil cannot be justified by these findings

Can we rely on iFR for avoiding FFR? Conclusions of a 5-year experience

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017Background: Recently, the instantaneous wave free ratio (iFR), has been proposed an alternative or complementary method to fractional flow reserve (FFR). This new method does not require the use of adenosine and may expedite the speed of functional assessment. The iFR “hybrid strategy” relies on values 0,93 as definitive results which would not require the use of FFR. However, this strategy is much less consensual than FFR alone. Purpose: We aimed to assess the concordance of FFR and iFR results using the principle of the “hybrid strategy”, based on the 5-year experience of a single center. We also aimed to analyse the effect of iFR in the operator's decision to proceed to FFR, and its impact on procedure duration and radiation time/dosage. Methods: Single-center registry of all patients undergoing functional coronary lesion assessment during 5 years. FFR was used as a gold standard (with a cut-off point for intervention ≤0,80) for assessing the diagnostic accuracy of iFR in every patient who underwent measurements with both techniques. For analysis purposes, an iFR value 0,93 was considered negative (i.e. defer intervention). Values in between were deemed inconclusive. For statistical analysis we used the T student and Chi-Square tests. Results: Functional testing was undertaken in 326 patients (67±11 years, 65,6% male), encompassing 402 lesions. 154 lesions underwent assessment with both techniques, 222 by FFR only and 26 cases iFR only. The average iFR was 0,9±0,1. 60 lesions had an iFR >0,93 and 21 an iFR <0,86. An iFR value between 0,86 and 0,93 was strongly associated with the decision to proceed to FFR (χ2=30,1; p0,93 (71,4% vs 68%; p=0,792). In these cases, there was a statistically significant concordance of 87% between the iFR and FFR results (χ2=22,43; p<0,001). Notwithstanding, there were 4 out of 13 cases (30,7%) of positive iFR with negative FFR and 3 out of 42 (7,1%) cases of negative iFR and positive FFR. This difference was statistically significant (p=0,026). Regarding procedural time, radiation time and radiation dose, there were no statistically significant differences between patients who only underwent iFR, FFR only, or both techniques. Conclusions: The iFR results were inconclusive (i.e. between 0,86 and 0,93) in most cases. There was a high degree of concordance between the iFR and FFR values. However, a significant proportion of patients, particularly in cases of positive iFR (<0,86), were classified as negative by FFR. The use of iFR had no impact on procedural time, radiation time and radiation dose.info:eu-repo/semantics/publishedVersio

Fruticultura Tropical no Acre: implantação e resultados preliminares

In Rio Branco, Acre, by the convention INPA/BANACRE, was started in 1978 the installation of a project of tropical fruit culture. There were selected 10 small scale farmers with low income and were selected also the follewing fruit speciesAnnona muricata L., Rollinia mucosa (Jacq.) Baill., Matisia cordata (H.B.K.) = Quararibea cordata (Humb. & Bonpl.) Vischer, Arthocarpus incisa L., Pourouma cecropiaefolia Mart., Euterpe oleracea Mart., Bactris gasipaes H.B.K. = Guilielma gasipaes (H.B.K.) Bailey, Achras sapota L. = Manilkara zapota (L.) van Royen, Pouteria caimito (Ruiz & Pav.) Radlk and Theobroma grandiflorum (Willd & Spreng) Schum. These species were collected in several regions in the Amazon basin. There is being made a constant evaluation of several characters to form an information bank and to evaluate the adaptation of the species. In the period of November/78 to February/80, were planted 49 ha on 6 properties, and until March/81 there will be planted more 51 ha, to reach the ideal of 10 ha 10 properties (100 ha)