An old and current orthodontic treatment. Rapid maxillary expansion

Las anomalías transversales se presentan frecuentemente desde edades tempranas. Generalmente son causadas por problemas funcionales como deglución atípica y respiración bucal. Las alteraciones de la oclusión sobre el plano transversal son conocidas como mordidas cruzadas posteriores, pudiendo ser de origen dentario o esqueletal. Si el diagnóstico de nuestro paciente es una compresión maxilar de origen esqueletal, el tratamiento indicado será la expansión rápida del maxilar (ERM). La corrección de la deficiencia transversal del maxilar superior con el uso del disyuntor, constituye un recurso terapéutico capaz de cambiar las relaciones dentarias y esqueléticas en una primera fase del tratamiento, utilizando al máximo los cambios dinámicos asociados con el crecimiento y preparando un mejor entorno orofacial para la erupción de la dentición permanente. En este trabajo se desarrollan tres casos clínicos que modificaron notoriamente su morfología luego del tratamiento con ERM mediante el uso de diferentes tipos de disyuntores.Transverse anomalies are frequently seen from an early age. They are usually caused by functional problems such as incorrect swallowing and mouth breathing. Alterations of occlusion on the transverse plane are known as posterior cross-bites, having skeletal or dental origin. If the diagnosis of the patient is a skeletal maxillary constriction, the prescribed treatment will be rapid maxillary expansion (RME). The correction of transverse maxillary deficiency using expanders is a therapeutic resource capable of changing the dental and skeletal relations in the first phase of treatment, making the most out of the patient’s dynamic growth changes and preparing a better orofacial environment for the eruption of permanent dentition. This article analyses three clinical cases of patients that significantly changed their morphology after treatment with RME by using different types of appliances.Facultad de Odontologí

Understanding the digital flow in orthodontics: from digital systems to artificial intelligence

Esta publicación tiene como objetivo analizar el aporte de la tecnología digital a la Odontología general y en particular a la Ortodoncia, sumado a la llegada de una nueva herramienta: la inteligencia artificial (I.A.), cuyas aplicaciones están entrando en el ámbito clínico a gran velocidad resultando cada vez más relevantes y funcionales para los odontólogos. En este trabajo expresaremos cómo funciona el Flujo Digital junto a la Inteligencia Artificial, cuáles son sus campos de aplicación, los retos que enfrenta la odontología en la actualidad y su futuro próximo.This publication aims to analyze the contribution of digital technology to general dentistry and to orthodontics, added to the arrival of a new tool: artificial intelligence (A.I.), whose applications are entering the clinical field at great speed becoming increasingly relevant and functional for dentists. In this project we will express how the digital flow works together with Artificial Intelligence, what are its fields of application, the challenges facing dentistry today and in the near future.Facultad de Odontologí

Analysis of the effects of body weight-supported gait training on the electromyographic activity of the lower limbs and motor irradiation to the upper limbs in spinal cord injured patients

Rehabilitation on the treadmill with partial body weight support (PBWS) in individuals with spinal cord injuries can passively reproduce gait, helping them with weight bearing on the lower limbs (LL) and orthostatic posture. The objective of the study was to assess motor irradiation from the lower limbs to the upper limbs during gait training with PBWS. The participants were three male individuals diagnosed with low spinal cord injury (T10 and L1), classified as ASIA A, with partial preservation of nerve roots. Subjects were submitted to gait training with PBWS and electromyographic assessment of the muscles Biceps brachii (BB), Rectus femoris (RF) and Lateral Gastrocnemius (LG) on both sides. Statistical analysis included Shapiro-Wilk and de Levene tests, One way ANOVA test and Tukey’s HSD post-hoc test. In the resting state, there was less activity of BB muscles on both sides when compared to the RF and LG, which can be explained by the secondary impairments arising from the individuals’ injury. The gait cycle (GC) was repeated three times; in GC1 there was greater electromyographic activity in the right LG muscle and lower activity of the right BB muscle and, statistically, right LG and left BB showed higher mean activity (statistically significant results). In GC2, the same pattern of activity of GC1 was observed, but the right RF muscle reduced its activation threshold. In GC3, the activity levels of the previous cycles were maintained, but the left RF muscle showed an increase in the thresholds of electromyographic activation when compared to the other muscles. Based on these results, the BB muscle presented quantitative variations in electromyographic activation, demonstrating the presence of motor irradiation from LL to upper limbs during the GC. The qualitative analysis showed “peaks” of activity in this muscle mainly during the support phases of the gait training.A reabilitação na esteira com suporte parcial de peso (ESPP) nos indivíduos lesados medulares pode reproduzir de modo passivo a marcha, proporcionando-lhes a descarga de peso em membros inferiores (MMII) e a manutenção da postura ortostática. O objetivo do estudo foi analisar se, durante a marcha passiva na ESPP, existe irradiação motora de MMII aos membros superiores. Foram selecionados três indivíduos do gênero masculino, com diagnóstico de Traumatismo Raquimedular baixo (T10 e L1), classificados como ASIA A com preservação parcial de raízes nervosas. Os indivíduos foram submetidos a uma avaliação passiva da marcha na ESSP, utilizando a avaliação eletromiográfica dos músculos: bíceps braquial (BB), reto femoral (RF) e gastrocnêmio lateral (GL) bilateralmente e a uma análise estatística, incluindo testes de Shapiro-Wilk e de Levene, One way ANOVA, post-hoc Tukey HSD. Na condição clínica de repouso, observou-se menor ativação dos músculos BB bilateralmente, quando comparado aos músculos RF e GL, fato justificado pelos comprometimentos secundários advindos da lesão dos indivíduos. As condições clínicas do ciclo da marcha (CM) repetiram-se três vezes; no CM1 observou-se uma maior ativação eletromiográfica do músculo GL direito e uma menor ativação do músculo BB direito, e estatisticamente, GL direito e BB esquerdo demonstraram maior atividade média (resultados estatisticamente significantes). No CM2 o mesmo padrão de ativação do CM1 foi observado, no entanto o músculo RF direito reduziu seu limiar de ativação. No CM3 os níveis de ativação das condições anteriores mantiveram-se, no entanto, o músculo RF esquerdo apresentou aumento nos limiares de ativação eletromiográfica, quando comparado aos demais músculos. Com base nestes resultados, o músculo BB apresentou variações quantitativas na ativação eletromiográfica, determinando a presença de irradiação motora de MMII para superiores durante o CM. Em uma análise qualitativa, foi observado que durante as fases de apoio da marcha houve “picos” de ativação deste músculo

Produção e caracterização de biossurfactantes metabolizados por Pleurotus sajor-caju a partir de óleo de soja

Este estudo teve como objetivo avaliar a produção de biossurfactantes pelo fungo basidiomiceto Pleurotussajor-caju CCB 019. A formação de biossurfactantes foi definida pela diminuição, ou seja, redução da tensãosuperficial (RT%) do meio de cultivo no tempo inicial e do caldo após o cultivo. Para acompanhar o crescimentomicelial e a variação da tensão superficial (ΔT) do caldo de cultivo com o tempo, um biorreator debancada (4 L) foi usado e as menores tensões superficiais ocorreram em seis dias de cultivo (144 h) (43,4mN/m) no experimento B1 (T = 34 ° C, pH inicial de 3, agitação de 300 min-1, aeração de 0,25 L. min-1 eutilizando óleo de soja comercial) e 192 horas (8 dias) (40,7 mN/m) no ensaio B2 (as mesmas condições deB1, mas usando óleo de soja residual de fritura). O índice de emulsificação para o experimento B1, em 6 dias,foi de 66,6% e para o experimento B2, em 8 dias, foi de 65,8%. Os biosurfactantes extraídos a partir dos experimentosB1 e B2 mostraram 12,0% À 0,5 e 10,6 À 0,6% de carboidratos, 7,4À 0,5% e 7,7 À 1,0% de proteína,respectivamente. Na análise do espectro de FTIR, para ambos os experimentos, podem ser identificadasbandas confirmando a presença de carboidratos e de proteínas, também sugerindo a presença de lipídeos

Diagnósticos de enfermagem relacionados ao politraumatismo em atendimento pré-hospitalar móvel

The aim was to identify the most frequent nursing diagnoses in occurrences of multiple trauma, since this activity, exclusive to nurses, is recognized for its work of excellence in pre-hospital care. The results help nurses to act in the context of trauma emergencies and highlight the potential of nursing diagnoses in prioritizing care for patients who are victims of multiple traumas. It was evidenced that the Acute Pain diagnosis was more prevalent, even though pain is subjective and the target of lived experiences in relation to sensory perception. Then, the diagnosis of Impaired Physical Mobility, which involves the ability to move and the immobilizations performed during care, and then the diagnoses related to oxygenation and breathing, such as Ineffective Breathing Pattern and Impaired Gas Exchange. Specific nursing interventions for the diagnoses found were presented.Objetivou-se identificar os diagnósticos de enfermagem mais frequentes em ocorrências de politraumatismo, uma vez que essa atividade, privativa do enfermeiro, é reconhecida pelo seu trabalho de excelência no atendimento pré-hospitalar. Os resultados auxiliam na atuação do enfermeiro no cenário das emergências em trauma e salientam o potencial dos diagnósticos de enfermagem na priorização da assistência às pacientes vítimas de múltiplos traumas. Evidenciou-se que o diagnóstico Dor Aguda teve mais prevalência, mesmo a dor sendo subjetiva e alvo de experiências vividas em relação a percepção sensorial. Em seguida, o diagnóstico de Mobilidade Física Prejudicada, que envolve a capacidade de mover-se e as imobilizações feitas no atendimento, e então os diagnósticos relacionados à oxigenação e respiração, como Padrão Respiratório Ineficaz e Troca de Gases Prejudicada. Intervenções de enfermagem específicas para os diagnósticos encontrados foram apresentadas

Diagnósticos de enfermagem relacionados ao politraumatismo em atendimento pré-hospitalar móvel

The aim was to identify the most frequent nursing diagnoses in occurrences of multiple trauma, since this activity, exclusive to nurses, is recognized for its work of excellence in pre-hospital care. The results help nurses to act in the context of trauma emergencies and highlight the potential of nursing diagnoses in prioritizing care for patients who are victims of multiple traumas. It was evidenced that the Acute Pain diagnosis was more prevalent, even though pain is subjective and the target of lived experiences in relation to sensory perception. Then, the diagnosis of Impaired Physical Mobility, which involves the ability to move and the immobilizations performed during care, and then the diagnoses related to oxygenation and breathing, such as Ineffective Breathing Pattern and Impaired Gas Exchange. Specific nursing interventions for the diagnoses found were presented.Objetivou-se identificar os diagnósticos de enfermagem mais frequentes em ocorrências de politraumatismo, uma vez que essa atividade, privativa do enfermeiro, é reconhecida pelo seu trabalho de excelência no atendimento pré-hospitalar. Os resultados auxiliam na atuação do enfermeiro no cenário das emergências em trauma e salientam o potencial dos diagnósticos de enfermagem na priorização da assistência às pacientes vítimas de múltiplos traumas. Evidenciou-se que o diagnóstico Dor Aguda teve mais prevalência, mesmo a dor sendo subjetiva e alvo de experiências vividas em relação a percepção sensorial. Em seguida, o diagnóstico de Mobilidade Física Prejudicada, que envolve a capacidade de mover-se e as imobilizações feitas no atendimento, e então os diagnósticos relacionados à oxigenação e respiração, como Padrão Respiratório Ineficaz e Troca de Gases Prejudicada. Intervenções de enfermagem específicas para os diagnósticos encontrados foram apresentadas

COVID-19 Severity in Multiple Sclerosis: Putting Data Into Context

Background and objectives: It is unclear how multiple sclerosis (MS) affects the severity of COVID-19. The aim of this study is to compare COVID-19-related outcomes collected in an Italian cohort of patients with MS with the outcomes expected in the age- and sex-matched Italian population. Methods: Hospitalization, intensive care unit (ICU) admission, and death after COVID-19 diagnosis of 1,362 patients with MS were compared with the age- and sex-matched Italian population in a retrospective observational case-cohort study with population-based control. The observed vs the expected events were compared in the whole MS cohort and in different subgroups (higher risk: Expanded Disability Status Scale [EDSS] score > 3 or at least 1 comorbidity, lower risk: EDSS score ≤ 3 and no comorbidities) by the χ2 test, and the risk excess was quantified by risk ratios (RRs). Results: The risk of severe events was about twice the risk in the age- and sex-matched Italian population: RR = 2.12 for hospitalization (p < 0.001), RR = 2.19 for ICU admission (p < 0.001), and RR = 2.43 for death (p < 0.001). The excess of risk was confined to the higher-risk group (n = 553). In lower-risk patients (n = 809), the rate of events was close to that of the Italian age- and sex-matched population (RR = 1.12 for hospitalization, RR = 1.52 for ICU admission, and RR = 1.19 for death). In the lower-risk group, an increased hospitalization risk was detected in patients on anti-CD20 (RR = 3.03, p = 0.005), whereas a decrease was detected in patients on interferon (0 observed vs 4 expected events, p = 0.04). Discussion: Overall, the MS cohort had a risk of severe events that is twice the risk than the age- and sex-matched Italian population. This excess of risk is mainly explained by the EDSS score and comorbidities, whereas a residual increase of hospitalization risk was observed in patients on anti-CD20 therapies and a decrease in people on interferon

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection