A possibilidade do controle fraco de constitucionalidade e a função política da jurisdição constitucional

O presente trabalho de monografia objetiva a análise da PEC 33/2011, a qual delibera acerca da polêmica de quem será o titular para o exercício do controle de constitucionalidade. Nesse diapasão, surge como protagonista o ativismo judicial e a judicialização, os quais originaram o antagonismo e a reação do legislativo é  usurpação de sua competência definida pela Carta Magna, haja vista que o poder judiciário, pela força do povo, é coagido a decidir sobre casos concretos que afetam os direitos fundamentais e as garantias individuais. Assim, foram analisados os modelos de controle de constitucionalidade norte-americano, austríaco, alemão, francês e, especialmente, o canadense, com a análise do controle fraco de constitucionalidade. Por conseguinte, foi analisado o contexto histórico das constituições outorgadas e promulgadas no Brasil, as quais paulatinamente disciplinaram o modo de produção das leis e atos normativos e impuseram deveres de atuação ao Estado, bem como determinaram a competência do controle concentrado e difuso das normas constitucionais, consolidando-se a supremacia judicial. Assim, o relato feito é de suma importância para que seja percebida e entendida a discussão acerca da judicialização, do ativismo judicial e da reação do legislativo com a propositura da Proposta de Emenda Constitucional (PEC) 33 de 2011, que tem provocado um amplo debate ente os poderes judiciário e legislativo

Can we use the questionnaire SNOT-22 as a predictor for the indication of surgical treatment in chronic rhinosinusitis?

Introduction: Chronic rhinosinusitis is a prevalent disease that has a negative impact on the lives of sufferers. SNOT-22 is considered the most appropriate questionnaire for assessing the quality of life of these patients and a very effective method of evaluating therapeutic interventionshowever it is not used as a tool for decision -making. Objective: To test the hypothesis that the SNOT-22 score can predict the outcome of surgical treatment. Methods: A retrospective, longitudinal and analytical study. We evaluated the medical records of patients with chronic rhinosinusitis that completed the SNOT-22 at the time of diagnosis. All the patients were consecutively receiving care at an otolaryngology service in Salvador, Bahia from August 2011 to June 2012. The outcomes of the surgical treatment of these patients were obtained from their medical records. The initial score was compared to a group of patients who were not referred for surgery. All the patients completed and signed a consent form. Results: Of the 88 patients with chronic rhinosinusitis, 26 had evolved to surgery over the last 3 years. The groups were homogeneous regarding gender and respiratory and medication allergies. The patients of the surgical group were 44.8 + 13.8 years old and the patients of the clinical group were 38.2 + 12.5 years old (p = 0.517). The average SNOT-22 score of the case group was 49 + 19 and the average score of the control group was 49 + 27 (p = 0.927). Conclusion: The SNOT-22 was unable to predict the outcome of surgical patients with chronic rhinosinusitis. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.Escola Bahiana Med & Saude Publ Bahiana, Programa Posgrad, Salvador, BA, BrazilUniv Fed Bahia UFBA, Salvador, BA, BrazilInst Otorrinolaringol Otorrinos Associados INOOA, Salvador, BA, BrazilSanta Casa Sao Paulo, Otorrinolaringol, Sao Paulo, SP, BrazilUniv Porto, Bioet, Oporto, PortugalUniv Fed Sao Paulo UNIFESP, Programa Posgrad Otorrinolaringol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Programa Posgrad Otorrinolaringol, Sao Paulo, SP, BrazilWeb of Scienc

Trisomy 21 alters DNA methylation in parent-of-origin-dependent and independent manners

The supernumerary chromosome 21 in Down syndrome differentially affects the methylation statuses at CpG dinucleotide sites and creates genome-wide transcriptional dysregulation of parental alleles, ultimately causing diverse pathologies. At present, it is unknown whether those effects are dependent or independent of the parental origin of the nondis-joined chromosome 21. Linkage analysis is a standard method for the determination of the parental origin of this aneuploidy, although it is inadequate in cases with deficiency of samples from the progenitors. Here, we assessed the reliability of the epigenetic 5(m)CpG imprints resulting in the maternally (oocyte)-derived allele methylation at a differentially methylated region (DMR) of the candidate imprinted WRB gene for asserting the parental origin of chromosome 21. We developed a methylation-sensitive restriction enzyme-specific PCR assay, based on the WRB DMR, across single nucleotide polymorphisms (SNPs) to examine the methylation statuses in the parental alleles. In genomic DNA from blood cells of either disomic or trisomic subjects, the maternal alleles were consistently methylated, while the paternal alleles were unmethylated. However, the supernumerary chromosome 21 did alter the methylation patterns at the RUNX1 (chromosome 21) and TMEM131 (chromosome 2) CpG sites in a parent-of-origin-independent manner. To evaluate the 5(m)CpG imprints, we conducted a computational comparative epigenomic analysis of transcriptome RNA sequencing (RNA-Seq) and histone modification expression patterns. We found allele fractions consistent with the transcriptional biallelic expression of WRB and ten neighboring genes, despite the similarities in the confluence of both a 17-histone modification activation backbone module and a 5-histone modification repressive module between the WRB DMR and the DMRs of six imprinted genes. We concluded that the maternally inherited 5(m)CpG imprints at the WRB DMR are uncoupled from the parental allele expression of WRB and ten neighboring genes in several tissues and that trisomy 21 alters DNA methylation in parent-of-origin-dependent and -independent manners

Postural control parameters in elderly female fallers and non-fallers diagnosed or not with knee osteoarthritis

OBJECTIVES: To compare stabilometric parameters of elderly female fallers and non-fallers associated or not with knee osteoarthritis (OA). METHODS: Fifty-six elderly female fallers and non-fallers diagnosed or not with unilateral or bilateral knee OA were divided into the following groups: FOA (n = 10), elderly female fallers with knee OA; FNOA (n = 11), elderly female fallers without knee OA; NFOA (n = 14), elderly female non-fallers with knee OA; and NFNOA (n = 21), elderly female non-fallers without knee OA. For analyzing semi-static balance on a force platform with the elderly females standing, the following parameters were assessed in four conditions: center of pressure (COP), anterior-posterior and mediolateral displacements (APD and MLD, respectively); and COP anterior-posterior and mediolateral displacement velocities (APV and MLV, respectively). The following conditions were assessed: 1) standing on a firm wooden surface with eyes open (WSEO); 2) standing on a firm wooden surface with eyes closed (WSEC); 3) standing on a foam surface with eyes open (FSEO); 4) standing on a foam surface with eyes closed (FSEC). RESULTS: The elderly females with knee OA showed greater APD in all four conditions assessed (P < 0.05), while the elderly female fallers showed greater MLD (P < 0.05). No difference between the groups was observed for APV and MLV (P &gt; 0.05). CONCLUSIONS: Knee OA per se increases APD of the COP, while the history of falls, regardless of the presence of knee OA, hinders postural control in the ML direction.OBJETIVOS: Comparar parâmetros estabilométricos de mulheres idosas com ou sem histórico de quedas associadas ou não à osteoartrite (OA) de joelhos. MÉTODOS: Cinquenta e seis idosas apresentando ou não histórico de quedas (Q) e OA de joelho unilateral e bilateral foram distribuídas da seguinte maneira: grupo QOA (n = 10), idosas com histórico de queda e OA de joelho; grupo QSOA (n = 11), idosas com histórico de queda e sem OA de joelho; grupo SQOA (n = 14), idosas sem histórico de quedas (SQ) e com OA de joelho; e grupo SQSOA (n = 21), idosas sem histórico de quedas e sem OA de joelho. Para análise do equilíbrio semiestático usando uma plataforma de força, foram avaliados os deslocamentos anteroposterior (DAP) e mediolateral (DML), as velocidades de oscilação anteroposterior (VAP) e mediolateral (VML) em quatro situações na postura ereta. As situações avaliadas foram as seguintes: 1) PFOA: sobre superfície fixa e olhos abertos; 2) PFOF: sobre superfície fixa e olhos fechados; 3) PIOA: sobre superfície instável e olhos abertos; 4) PIOF: sobre superfície instável e os olhos fechados. RESULTADOS: As idosas com OA de joelho apresentaram maior DAP em todas as situações analisadas (P < 0,05), ao passo que idosas com histórico de quedas apresentaram maior DML (P < 0,05). Não houve diferenças entre os grupos para VAP e VML (P &gt; 0,05). CONCLUSÕES: A OA de joelho, por si, é um fator prejudicial no aumento de oscilação do centro de pressão (COP) na direção anteroposterior, enquanto o histórico de quedas, independente da presença de OA de joelhos, traz prejuízos ao controle postural na direção mediolateral.51251

PROJEÇÃO DA TAXA CUMULATIVA DE ÓBITOS POR COVID-19 NO BRASIL: UM ESTUDO DE MODELAGEM

Purpose: We estimated the potential number of COVID-19 deaths for Brazil for the next months. Methods: The study included all confirmed cases of COVID-19 deaths, from the first confirmed death on March 17 until May 15, 2020. These data were collected from an official Brazilian website of the Ministry of Health. The Boltzmann function was applied to a data simulation for each set of data regarding to all states of the country. Results: The model data were well-fitted, with R2 values close to 0.999. Up to May 15, 14,817 COVID-19 deaths were confirmed in the country. Amazonas has the highest rate of accumulated cases per 1,000,000 inhabitants (321.14), followed by Ceará (161.63). We estimated that Rio de Janeiro, Roraima, Amazonas, Pará, and Pernambuco will experience a substantial increase in the rate of cumulative cases until July 15. Mato Grosso do Sul, Paraná, Minas Gerais, Rio Grande do Sul, and Santa Catarina will show lower rates per 1,000,000 inhabitants. Conclusion: We estimate a substantial increase in the rate of cumulative cases in Brazil over the next months. The Boltzmann function proved to be a simple tool for epidemiological forecasting that can assist in the planning of measures to contain COVID-19.Objetivo: estimar o número potencial de mortes por COVID-19 no Brasil nos próximos meses. Métodos: O estudo incluiu todos os casos confirmados de óbitos do COVID-19, desde o primeiro óbito confirmado em 17 de março até 15 de maio de 2020. Esses dados foram coletados no site oficial do Ministério da Saúde. A função Boltzmann foi aplicada a uma simulação de dados para cada conjunto de dados referente a todos os estados do país. Resultados: Os dados do modelo foram bem ajustados, com valores de R² próximos a 0,999. Até 15 de maio, 14.817 mortes de COVID-19 foram confirmadas no país. O Amazonas possui a maior taxa de casos acumulados por 1.000.000 habitantes (321,14), seguido por Ceará (161,63). Estimou-se que o Rio de Janeiro, Roraima, Amazonas, Pará e Pernambuco sofrerão um aumento substancial na taxa de casos acumulados até 15 de julho. Mato Grosso do Sul, Paraná, Minas Gerais, Rio Grande do Sul e Santa Catarina apresentarão taxas potenciais mais baixas por 1.000.000 habitantes. Conclusão: Foi estimado um aumento substancial na taxa de casos cumulativos no Brasil nos próximos meses. A função Boltzmann provou ser uma ferramenta simples para previsão epidemiológica que pode auxiliar no planejamento de medidas para conter o COVID-19

Immediate implants placed into infected sockets: a case report with 3-year follow-up

The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persisting after failed endodontic treatment and endodontic surgery, and discusses the relationship between the procedure and periapical lesions. Surgical removal of hopeless teeth 11, 12 and 21 was performed conservatively in such a way to preserve the anatomy and gingival esthetics. A second surgical access was gained at the apical level, allowing the debridement of the surgical chamber for elimination of the periapical lesion, visual orientation for setting of the implants and filling of the surgical chamber with xenogenous bovine bone graft. After this procedure, the bone chamber was covered with an absorbent membrane and the healing screws were positioned on the implants. Later, a provisional partial removable denture was installed and the implants were inserted after 6 months. After 3 years of rehabilitation, the implants present satisfactory functional and esthetic conditions, suggesting that immediate implant placement combined with guided bone regeneration may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history in the anterior maxilla.A integridade estética/funcional do tecido periodontal pode ser comprometida pela perda do elemento dental. Os implantes imediatos tornaram-se uma opção viável na manutenção da arquitetura periodontal, desde que haja a compatibilidade com o alvéolo e a possibilidade da contaminação local ser totalmente eliminada. O objetivo deste estudo foi descrever o procedimento de instalação de implantes imediatos na região anterior de maxila usados na reposição de dentes com lesões crônicas periapicais, discutindo a relação entre o procedimento e lesões periapicais. A remoção dos dentes condenados (11, 12 e 21) foi feita de forma conservadora a fim de preservar a estética e arquitetura periodontal. Um segundo acesso cirúrgico foi obtido a nível apical, permitindo: o debridamento da loja cirúrgica, orientação visual dos implantes e o preenchimento com enxerto ósseo bovino. A loja óssea foi coberta por uma membrana absorvível e uma prótese parcial removível provisória foi instalada e após 6 meses os implantes foram reabilitados. Após 3 anos de reabilitação, os implantes se apresentam em condições satisfatórias de estética/função, sugerindo que a instalação de implantes imediatos combinados com a regeneração tecidual guiada em lesões periapicais crônicas podem ser indicados para repor dentes perdidos devido a lesões periapicais crônicas com história de insucesso endodôntico na maxila anterior

Acidose metabólica e o estado nutricional de pacientes em hemodiálise

Introduction: The prevalence of malnutrition in hemodialysis (HD) is high, being a marker of poor prognosis in chronic kidney disease. Metabolic acidosis is common on dialysis, and has been associated with mortality. Objectives: To evaluate metabolic acidosis and the nutritional status of HD patients. Methods: A cross-sectional study was carried out in a single HD center. Data were collected from medical records, and the presence of metabolic acidosis and the nutritional status of the patients were verified by anthropometric and biochemical indicators. Results: The total sample of 63 patients, 54% male and 46% female, with 58.7% between 45 and 64 years. The mean dialysis time was of 5.4 years. The mean value of the body mass index (BMI) was 24.9kg/m2, and the mean value of albumin was 3.9g/dL. The prevalence of metabolic acidosis was of 77.8%. There was a negative linear correlation between bicarbonate and creatinine, without correlation with anthropometric and albumin indicators. Patients malnourished according to the BMI corresponded to 55.5% of the total sample and gained more interdialytic weight. Out of the total sample, 14.2% of the patients were classified as malnourished by the arm circumference index, and albumin &lt; 4.0 g/dL was observed in 49.2% of the patients. Serum creatinine was higher in male patients aged between 45 and 64 years old. No difference in time on hemodialysis was observed regarding age, interdialytic weight gain, laboratory, and anthropometric measures. Conclusion: The prevalence of metabolic acidosis was high, and there was no correlation with the nutritional status. Bicarbonate &lt; 22 mEq/L was correlated with higher creatinine values, but was unrelated to the nutritional status. The nutritional assessment by BMI was in agreement with the Brazilian literature, and albumin indicated elevated malnutrition

Endodontic Treatment of Complex Dens Invaginatus Teeth with Long Term Follow-Up Periods

Dens invaginatus is characterized by invagination of enamel and dentin in the dental papilla prior to tissue calcification. This malformation commonly occurs in the maxillary lateral incisors. The present study reports two complex endodontic treatments in Oehlers’ type II and III dens invaginatus, with periapical lesion and presence of bone resorption. In the reported cases, conventional endodontic therapy was successful and sufficient enough to eliminate the infectious process, allowing periapical bone neoformation and absence of symptomatology. Dens invaginatus is a relatively easy-to-diagnose dental malformation. However, it is necessary to know its radiographic aspects. The treatment results demonstrated that, although the cases of dens invaginatus of high complexity are challenging, an accurate diagnosis accompanied with proper endodontic treatment can avoid unnecessary surgical intervention and allow great chances of favorable prognosis in long term.Keywords: Anomalies; Classification; Dens Invaginatus; Root Canal Therap

Effect of Reciprocating and Rotary Systems on Postoperative Pain: A Systematic Review and Meta-Analysis

Introduction: Our study aimed to compare the incidence and intensity of postoperative pain after endodontic instrumentation with reciprocating and rotary systems. Methods and Materials: An electronic literature search was performed with MEDLINE via PubMed, Scopus, and Web of Science databases from January 2008 to June 2020. Two high-impact endodontic journals were also hand searched. The selection criteria were: Population; patients requiring endodontic treatment, Intervention and Comparison; endodontic instrumentation with reciprocating versus rotary systems, and Outcome; postoperative pain. We extrapolated all included research data and reported them as dichotomized ordinal variables to evaluate the incidence of pain and continuous variables to assess pain intensity. Standardized mean difference (SMD) was calculated with Inverse Variance method for pain intensity; the incidence of postoperative pain was calculated using relative risk (RR) with the Mantel-Haenszel method. Random-effects model and 95% confidence interval (CI) were used for all meta-analyses. The I2 statistic was used to evaluate the statistical heterogeneity among studies (P&lt;0.05). Results: Twenty-one articles were selected and 17 of them were included in the meta-analysis for the evaluation of postoperative pain in the first 24h. The meta-analysis was performed in two steps: a) all studies were included; b) subsequently studies with preoperative pain were excluded. A significant difference was observed in the intensity of postoperative pain; with rotary system having more favorable in both steps [a) SMD: 0.27; 95% CI: 0.13 to 0.41; P=0.0002; b) SMD: 0.37; 95% CI: 0.15 to 0.58; P=0.0010]. There was no significant difference in the incidence of pain, and the incidence of mild, moderate and severe pain . Conclusion: The meta-analysis results revealed that rotary system were the instrument of choice as they had lower intensity of postoperative pain. Further controlled studies are advocated to provide clarification for intensity/incidence of postoperative pain in endodontic treatment with mechanized instruments