INTERVENÇÕES CIRÚRGICAS EM DISFUNÇÃO TEMPOROMANDIBULAR: UMA REVISÃO DE LITERATURA

A Desordem temporomandibular (DTM) é uma condição em que há um comprometimento da articulação temporomandibular e/ou das estruturas adjacentes. Na maioria dos casos, seus sintomas são discretos e cíclicos, podendo ter variações no grau da limitação de abertura da boca e da dor, mas esta disfunção, pode também proporcionar um grande desconforto tornando-se uma doença gravemente incapacitante.  Para a solução de problemas de desordem na articulação temporomandibular existem várias opções cirúrgicas, dentre elas a artroscopia. Considerada como uma técnica segura, ela alivia a dor severa de pacientes e restabelece a amplitude dos movimentos mandibulares. A artroscopia não é considerada uma técnica invasiva, portanto os pacientes possuem uma rápida recuperação. Nos últimos anos, muito se evoluiu nessa técnica, principalmente devido à melhor qualidade das imagens de ressonância magnética (IRM), possibilitando um melhor diagnostico e tratamento mais rápido

A influência da suplementação de coenzima Q10 sobre o esquema de tratamento medicamentoso de Hipertensão Arterial Sistêmica

Objetivo: Avaliar, através de revisão de literatura, qual o efeito do uso de CoQ10 sobre a dose dos medicamentos hipotensores, quando usados em conjunto. Método: Trata-se de um estudo de revisão da literatura. A busca de artigos foi realizada na base de dados Medline entre os meses de janeiro a março de 2023. Foram utilizados na pesquisa os descritores “hypertension” e “coenzyme Q10”. Resultados: Foram encontrados 17 estudos, mas atenderam aos critérios da pesquisa apenas 2 estudos; em uma publicação os autores descreveram o resultado da administração de CoQ10 a pacientes hipertensos e em outra compilou várias intervenções feitas com o uso de CoQ10 em diferentes cardiopatias. Conclusão: Os estudos que avaliaram a influência da CoQ10 na dose de anti-hipertensivos quando associada ao tratamento padrão mostraram necessidade de menor dose ou de menos medicamentos para controle pressórico

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Ultrastructural Aspects of Female Aging Wistar Rat Epithelium Tongue: A HRSEM and TEM Study

Background: There is general consensus that the effects of intrinsic aging on the oral mucosa are relatively small, though potentially important to understanding the pathologies present in the aged animals. Objective: In this paper, the development of dorsal surface of rat tongue was examined using transmission electron microscopy (TEM) and high-resolution scanning electron microscopy (HRSEM) in order to understand the age-related structural and ultrastructural changes experimentally. Methods: In this study, we used female rats 75 and 720 days old (adult and aging). Tissues of rat tongue were prepared and the specimens submitted to HRSEM and TEM techniques. Results: The analysis of HRSEM and TEM demonstrated that the same characteristic keratinous epithelium was found in aging animals, however with some modifications. Conclusion: We agree that there are obvious changes in the oral mucosa with aging and these modifications can be observed starting from the ultrastructural aspects. Copyright (C) 2009 S. Karger AG, Base

Ultrastructure of motor nerve terminals in the anterior third of wistar rat tongue

The nerve terminals of intrinsic muscular fibers of the tongue of adult wistar rats was studied by using silver impregnation techniques, transmission electron microscopy (TEM), and high resolution scanning electron microscopy (HRSEM) to observe the nerve fibers and their terminals. Silver impregnation was done according to Winkelman and Schmit, [1957]. For TEM, small blocks were fixed in modified Karnovsky solution, postfixed in 1% buffered osmium tetroxide solution, and embedded in Spurr resin. For HRSEM, the parts were fixed in 2% osmium tetroxide solution with 1/15 M sodium phosphate buffer (pH 7.4) at 4°C for 2 h, according to the technique described by Tanaka, [1989]. Thick myelinated nerve bundles were histologically observed among the muscular fibers. The intrafusal nerve fiber presented a tortuous pathway with punctiform terminal axons in clusters contacting the surface of sarcolemma. Several myelinated nerve fibers involved by collagen fibers of the endoneurium were observed in HRSEM in three-dimensional aspects. The concentric lamellae of the myelin sheath and the axoplasm containing neurofilaments interspersed among the mitochondria were also noted. In TEM, myofibrils, mitochondria, rough endoplasmic reticulum, Golgi's apparatus, and glycogen granules were observed in sarcoplasm. It is also noted that the sarcomeres constituted by myofilaments with their A, I, and H bands and the electron dense Z lines. In areas adjacent to muscular fibers, there were myelinated and unmyelinated nerve fibers involved by endoneurium and perineurium. In the region of the neuromuscular junction, the contact with the sarcolemma of the muscular cell occurs forming several terminal buttons and showing numerous evaginations of the cell membrane. In the terminal button, mitochondria and numerous synaptic vesicles were observe

FALANDO SOBRE ABORTO COM ADOLESCENTES: A CONTRIBUIÇÃO DA ABORDAGEM MULTIPROFISSIONAL EM SAÚDE DA MULHER

O projeto de extensão “Saúde Reprodutiva e Sexual do adolescente: aconselhamento em planejamento familiar e DST em comunidades escolares do Município do Rio de Janeiro” vem sendo desenvolvido desde 2006 pela Escola de Enfermagem Anna Nery (EEAN/UFRJ), tendo como instituição colaboradora o Instituto de Atenção à Saúde São Francisco de Assis (HESFA/UFRJ). Dessa forma, as atividades de extensão contam com a participação dos residentes da Residência Multiprofissional em Saúde da Mulher (HESFA), além de graduandos, mestrandos e doutorandos da EEAN. Objetivos: O presente estudo tem por objetivo apresentar um relato da experiência das “Oficinas Sobre o Aborto” realizadas pela equipe multidisciplinar dos residentes, em um colégio estadual de ensino médio, localizado na região central do Rio de Janeiro, em Maio de 2015. Metodologia: A metodologia utilizada nas oficinas foi a problematização da questão do aborto e suas implicações para a saúde sexual e reprodutiva do adolescente, utilizando-se de dinâmicas com debates posteriores a execução da mesma. Foram trabalhadas as vivências e experiências em relação ao aborto de forma interativa com o grupo de adolescentes. Dividiu-se a turma em grupos de 4 e 5 pessoas, distribuiu-se situações e questões problemas que os mesmo deveriam debater e construir uma reposta para tais. Durante a exposição foram sistematizadas algumas falas no quatro sendo utilizadas no fechamento a partir da problematização de indicadores de saúde, fatores culturais e políticos. Resultados: Como resultados, percebeu-se que os alunos demonstraram resistência ao debate, apresentando opiniões confusas sobre o assunto e com dificuldade de diálogo entre os pares. Ao pontuar os argumentos dos adolescentes no quadro, ao final da atividade pode-se desmistifica-los e esclarecê-los com informações referentes à Saúde Pública. Alguns pontos chaves debatidos foram a autonomia do corpo feminino, as questões de gênero que envolvem a temática, os resultados da escolha e recusa ao aborto frente a condição legislativa da prática abortiva no Brasil e em outros países e suas implicações para a saúde sexual e reprodutiva do adolescente. Explicitou-se a necessidade do debate sobre a temática na população adolescente de forma a criar novas estratégias de ações educacionais no que se refere ao aborto. Acreditamos que o processo de educação permanente, que possibilita aos profissionais de saúde romper com os muros institucionais, possa ser um instrumento potencializador para as práticas do cuidado em saúde e na efetivação e garantia dos direitos sexuais e reprodutivos dos adolescentes

Resumos concluídos - Nutrição

Resumos concluídos - Nutriçã

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author