Prosthetic rehabilitation of an edentulous cleft palate using a denture with a palatal obturator: a clinical report

A cleft palate is a genetic disorder that occurs when an oro-nasal communication is present between the palate and the base of the nose. During pregnancy, the maxillary is not completely merged, and the defect is only seen at birth. Possible causes are hormonal imbalances, nutritional deficiencies, infections, radiation during pregnancy, alcohol or cigarette consumption, the ingestion of other teratogenic substances by the mother, and heredity. The resulting defect requires corrective surgery. In the case of a cleft palate, surgery is postponed until after the first year of life to avoid disturbing the normal development of speech and the risk of aspiration of food, which causes infections such as otitis and pneumonia. Ear infections can harm the development of speech in cases where surgery is not possible or the defect has reappeared. This article describes the prosthetic rehabilitation of a edentulous patient: a woman of 53 years old with a cleft palate who was treated surgically. In a clinical examination, a residual palatal defect was identified. The prosthetic rehabilitation involved the emplacement of a complete adapted prosthesis, using a palatal obturator, with a view to sealing the defect and allowing the patient to acquire better speech quality, and improve her nutrition and well-being

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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Experiences with perinatal loss from the health professionals’ perspective

The purpose of this paper is to know the experience of health professionals in situations of perinatal death and grief and to describe their action strategies in the management of perinatal loss. A qualitative study with a phenomenological approach was carried out through interviews conducted with 19 professionals. Three thematic categories were identified: Healthcare practice, feelings aroused by perinatal loss and meaning and beliefs about perinatal loss and grief. The results revealed that the lack of knowledge and skills to deal with perinatal loss are identified as the main reason behind unsuitable attitudes that are usually adopted in these situations. This generates anxiety, helplessness and frustration that compromise professional competency. The conclusion reached is that the promotion of training programs to acquire knowledge, skills and abilities in management of perinatal bereavement and the development of a clinical practice guideline for perinatal loss are necessary.El objetivo de este artículo es conocer la experiencia vivida por los profesionales de la salud en situaciones de muerte y duelo perinatal y describir las estrategias de actuación ante la pérdida perinatal. Se trata de un estudio cualitativo con un enfoque fenomenológico realizado a 19 profesionales a través de entrevistas. Se identificaron 3 categorías temáticas: la práctica asistencial, los sentimientos que despierta la pérdida perinatal y significado y creencias sobre la pérdida y el duelo perinatal. Los resultados ponen de manifiesto que la falta de conocimientos y de recursos para enfrentar la pérdida perinatal hace que se adopten actitudes poco adecuadas en estas situaciones, generando una sensación de ansiedad, impotencia y frustración que compromete la competencia profesional. Se concluye que es fundamental promover programas de formación para adquirir conocimientos y destrezas sobre el duelo perinatal y elaborar una guía de práctica clínica para la atención a la pérdida perinatal.O objetivo deste artigo foi conhecer a experiência dos profissionais de saúde em casos de morte perinatal e o pesar decorrente e, ainda, descrever as estratégias de ação frente à perda perinatal. Trata-se de estudo qualitativo com abordagem fenomenológica, por meio de entrevista com 19 profissionais. Três categorias temáticas foram identificadas: a prática de cuidados de saúde, os sentimentos despertados pela perda perinatal e o significado e crenças sobre perda e pesar perinatal. Os resultados mostram que a falta de conhecimento e recursos para lidar com a perda perinatal torna inadequada as atitudes nessas situações, gerando sensação de desamparo, ansiedade e frustração que compromete a competência profissional. Conclui-se que é fundamental promover programas de treinamento para adquirir conhecimentos, aptidões e habilidades em pesar perinatal e desenvolver uma diretriz de prática clínica para o cuidado da perda perinatal