Biological and social aspects of Coronavirus Disease 2019 (COVID-19) related to oral health

The expansion of coronavirus disease 2019 (COVID-19) throughout the world has alarmed all health professionals. Especially in dentistry, there is a growing concern due to it’s high virulence and routes of transmission through saliva aerosols. The virus keeps viable on air for at least 3 hours and on plastic and stainless-steel surfaces up to 72 hours. In this sense, dental offices, both in the public and private sectors, are high-risk settings of cross infection among patients, dentists and health professionals in the clinical environment (including hospital’s intensive dental care facilities). This manuscript aims to compile current available evidence on prevention strategies for dental professionals. Besides, we briefly describe promising treatment strategies recognized until this moment. The purpose is to clarify dental practitioners about the virus history and microbiology, besides guiding on how to proceed during emergency consultations based on international documents. Dentists should consider that a substantial number of individuals (including children) who do not show any signs and symptoms of COVID-19 may be infected and can disseminate the virus. Currently, there is no effective treatment and fast diagnosis is still a challenge. All elective dental treatments and non-essential procedures should be postponed, keeping only urgent and emergency visits to the dental office. The use of teledentistry (phone calls, text messages) is a very promising tool to keep contact with the patient without being at risk of infection

Inferior alveolar nerve transposition with involvement of the mental foramen for implant placement

Inferior Alveolar Nerve (IAN) transposition is an option for prosthetic rehabilitation in cases of moderate or even severe bone reabsorption for patients that do not tolerate removable dentures. The aim of the present report is to describe an inferior alveolar nerve transposition with involvement of the mental foramen for implant placement. The surgical procedure was performed under local anesthesia, by the inferior alveolar, lingual and buccal nerve blocking technique. Centripetal osteotomy was performed, and bone tissue was removed, leaving the nerve tissue free in the foramen area. After that, transsection of the incisor nerve was performed, and lateral osteotomy was started from the buccal direction, toward the trajectory of the IAN. The procedure was concluded, by making use of a delicate resin spatula to manipulate the vascular-nervous bundle. The drilling sequence for placing the dental implants was performed, and autogenous bone was harvested using a bone collector attached to the surgical suction appliance. After the implants were placed, the bone tissue previously collected during the osteotomies and drilling processes was placed in order to protect the IAN from contact with the implants. The surgical protocol for inferior alveolar nerve transposition, followed by implant placement presented excellent results, with complete recovery of the sensitivity, seven months after the surgical procedure

Mastication and swallowing: influence of fluid addition to foods

INTRODUCTION: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. OBJECTIVES: The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume). Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p;0.05). Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake), but did not influence the chewing of fatty (cheese) and wet products (carrot). This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation

Mastication and swallowing: influence of fluid addition to foods

INTRODUCTION: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. OBJECTIVES: The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume). Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p;0.05). Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake), but did not influence the chewing of fatty (cheese) and wet products (carrot). This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation

Necessity of immediate cardiopulmonary resuscitation in trauma emergency

The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent in the emergency life-saving procedure of cardiopulmonary resuscitation. The objective of the current study was to evaluate the types of trauma and survival of patients that require immediate cardiopulmonary resuscitation in trauma emergencies. A total of 13301 patients treated as accident victims between July 2004 and December 2006 were evaluated in a prospective study. Patients requiring immediate cardiopulmonary resuscitation at admission were identified. The type of injury and the survival of these patients were evaluated

Rupture of vesicourethral anastomosis following radical retropubic prostatectomy

OBJECTIVE: Rupture of vesicourethral anastomosis following radical retropubic prostatectomy is a complication that requires immediate management. We evaluated the morbidity of this rare complication. MATERIALS AND METHODS: We analyzed retrospectively 5 cases of disruption of vesicourethral anastomosis during post-operative period in a consecutive series of 1,600 radical retropubic prostatectomies, performed by a single surgeon. RESULTS: It occurred in a ratio of 1:320 prostatectomies (0,3%). Management was conservative in all the cases with an average catheter permanence time of 28 days, being its removal preceded by cystography. Two cases were secondary to bleeding, 1 followed the change of vesical catheter and 2 by unknown causes after removing the Foley catheter. Only one patient evolved with urethral stenosis, in the period ranging from 6 to 120 months. CONCLUSION: Rupture of vesicourethral anastomosis is not related to the surgeon's experience, and conservative treatment has shown to be effective.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Department of UrologyUNIFESP, EPM, Department of UrologySciEL

Avaliação de desempenho aplicada a empresas enxutas

O objetivo deste trabalho é propor um sistema de avaliação de desempenho que utilize indicadores próprios à Produção Enxuta e os relacione aos objetivos estratégicos de uma empresa. Há a necessidade de se avaliar o alinhamento entre o sistema produtivo enxuto e a estratégia adotada por uma empresa. O sistema de avaliação de desempenho proposto neste trabalho permite uma análise mais precisa dos benefícios trazidos por este sistema produtivo, assim como seu alinhamento ao foco estratégico da empresa. Desta forma, ações que envolvam melhorias de processos, treinamento e motivação do pessoal e adoção de novas tecnologias podem ser mais bem planejadas e implementadas. Trata-se de uma pesquisa aplicada quanto à natureza, por se propor a gerar conhecimentos dirigidos à solução de problemas específicos, qualitativa quanto à abordagem, por lidar com dados qualitativos, análises de textos, comparações e abordagens não numéricas

Community-intersubjectivity and liberating education: conscientization in the critical-symmetric community

This article deals with the ethical-critical development of the new socio-historical subjects in relation to the exercise of critical discursive rationality. It constitutes, in its origin, part of the Doctoral Thesis in Education and Contemporaneity, a study of a theoretical nature, with a qualitative approach and bibliographic procedure, developed from the hermeneutic perspective of Enrique Dussel's transmodern pedagogy. Thus, in relation to its partial aspect (in relation to the totality of the research from which it proceeds), it takes Dusselian ethics and Freirean pedagogy as a theoretical reference, from which it seeks, in the Freirean paradigm of liberating education, a practical reference for the ethical-critical rational development, as an intersubjective-community experience of ethical-subjects denied as oppressed/victims. To this end, it works with the key concepts of “ethical-critical process” and “conscientization”; “critical discursive rationality” and “dialogicity”; “community intersubjectivity”; and “critical-symmetric community”.Este artículo aborda el desarrollo ético-crítico de dos nuevos sujetos sociohistóricos con el ejercicio de la racionalidad discursiva crítica. Se ha constituido, en su origen, como parte de la Tesis Doctoral en Educación y Contemporaneidad, un estudio de carácter teórico, con enfoque cualitativo y procedimiento bibliográfico, desarrollado desde la perspectiva hermenéutica de la pedagogía transmoderna de Enrique Dussel. Así, en relación a su aspecto parcial (la totalidad de la investigación de la que procede), toma como referente teórico la ética de Dussel y la pedagogía de Freire, a partir de las cuales busca, en el paradigma freireano de la educación liberadora, un referente basado en las prácticas para el desarrollo racional ético-crítico, como experiencia intersubjetiva en comunidad con sujetos éticos denegados como oprimidos/víctimas. De esta forma, opera con los conceptos clave de “proceso ético-crítico” y “concienciación”; “racionalidad discursiva crítica” y “dialogicidad”; “intersubjetividad comunitaria”; y “comunidad crítico-simétrica.O presente artigo trata do desenvolvimento ético-crítico dos novos sujeitos sócio-históricos em relação com o exercício da racionalidade discursiva crítica. Constitui, em sua origem, parte da Tese de doutoramento em Educação e Contemporaneidade, um estudo de natureza teórica, com abordagem qualitativa e procedimento bibliográfico, desenvolvido a partir da perspectiva hermenêutica da pedagógica transmoderna de Enrique Dussel. Assim, com relação ao seu aspecto parcial (em relação à totalidade da pesquisa da qual procede), toma a ética dusseliana e a pedagogia freiriana como referencial teórico, a partir do qual busca, no paradigma freiriano da educação libertadora, um referencial práxico para o desenvolvimento racional ético-crítico, como experiência intersubjetivo-comunitária dos sujeitos-éticos negados como oprimidos/vítimas. Neste intuito, opera com os conceitos-chave de “processo ético-crítico” e “conscientização”; “racionalidade discursiva crítica” e “dialogicidade”; “intersubjetividade comunitária”; e “comunidade crítico-simétrica”

Durability of CFRP-concrete bond and corresponding involved materials under different natural environmental exposures for a period of four years

Ageing of interfaces between Carbon Fibre Reinforced Polymer (CFRP) laminates and concrete, applied according to externally bonded reinforcement (EBR) and near-surface mounted (NSM) techniques, and their constitutive materials was investigated. That is, experimental tests on the ageing of concrete, epoxy adhesive, CFRP laminate, and the CFRP-concrete interface were performed for specimens after being exposed to different natural outdoor environments to promote degradation due to carbonation, chlorides, freeze-thaw attacks, and high temperatures. Besides, tests of the reference specimens, kept under a control environment of 20 °C and 55% RH, and of specimens continuously immersed in water with a controlled temperature of 20 °C were also included for comparison purposes. The characterization of physical and mechanical properties of the involved materials, and the degradation of CFRP-concrete interface for the specimens strengthened according to EBR and NSM techniques were assessed for a study period of up to four years. The results generally showed significant variations in the properties of the concrete and adhesive while the ageing of CFRP was found insignificant in all the studied environments. Besides, slight variations of the bond strength were observed, probably as a result of changes in the constitutive materials’ mechanical properties with time and environmental exposure