Analyse du programme de développement durable Proambiente à Juina-MT

Rapport de terrainCe texte est le rapport d'études de l'analyse du programme de développement durable Proambiente implanté dans la commune de Juina au Mato Grosso, Brésil

Mucocele com reabsorção da parede do seio maxilar: relato de caso

Mucoceles are locally-expansive, slow-growing benign lesions that are generated from obstructed seromucous glands in the sinonasal mucosa. It has a cystic aspect and leads to sinus opacification. Patients usually present non-specific opacification and, in rare cases, enlarged mucoceles can lead to bone destruction through the compression of sinus surrounding bone walls. This report shows the case of a female patient without any clinical complaints who presented an evident opacification in her left maxillary sinus eroding the sinus wall, which was noticeable by means of panoramic radiograph, aside from maxillary sinus wall thinning and destruction, demonstrated through cone beam computed tomography examinations. The main diagnosis hypothesis was mucocele, as confirmed by the patient’s otolaryngologist. As the presence of any inflammatory disease in the maxillary sinus contraindicates sinus augmentation, the patient was referred to otorhinolaryngy treatment before implant rehabilitation.As mucoceles são lesões benignas localmente expansivas, de crescimento lento, que se desenvolvem a partir de glândulas seromucosas obstruídas na mucosa nasossinusal. Os pacientes geralmente apresentam radiograficamente opacificação inespecífica de aspecto cístico e, em casos raros, mucoceles de grandes proporções podem levar à destruição óssea, por meio da compressão do seio ao redor das paredes ósseas. Neste relato, é demonstrado um caso de uma paciente do gênero feminino, sem queixas clínicas, que apresentava evidente opacificação em seu seio maxilar esquerdo, erodindo a parede sinusal, observada inicialmente em radiografia panorâmica. Por meio da tomografia computadorizada de feixe cônico, notou-se afinamento e erosão da parede do seio maxilar. A principal hipótese diagnóstica foi mucocele, confirmada posteriormente pelo otorrinolaringologista da paciente. Como a presença de qualquer doença inflamatória no seio maxilar é uma contraindicação a cirurgias em soalho de seio maxilar, a paciente foi encaminhada para tratamento otorrinolaringológico antes da reabilitação com implantes

Gonadotropin-releasing Hormone Agonists For Ovarian Function Preservation In Premenopausal Women Undergoing Chemotherapy For Early-stage Breast Cancer: A Systematic Review And Meta-analysis

Chemotherapy may result in a detrimental effect on ovarian function and fertility in premenopausal women undergoing treatment for early-stage breast cancer (EBC). To minimize risk of harm to ovarian function and fertility for patients in this setting, careful considerations should be made. Gonadotropin-releasing hormone agonists (GnRHa) have been suggested as an alternative to prevent the loss of ovarian function due to exposure to cytotoxic agents, but GnRHa use for ovarian protection in EBC patients is not fully resolved. OBJECTIVE To determine the effectiveness of GnRHa administered concurrently with chemotherapy for ovarian function preservation. DATA SOURCES PubMed, SCOPUS, and Cochrane databases were searched for studies published between January 1975 and March 2015. The abstracts of the American Society of Clinical Oncology Annual Meeting between 1995 and 2014 and the San Antonio Breast Cancer Symposium between 2009 and 2014 were searched as well. STUDY SELECTION Prospective, randomized, clinical trials addressing the role of ovarian suppression with GnRHa in preventing early ovarian dysfunction in premenopausal women undergoing treatment for EBC were selected. DATA EXTRACTION AND SYNTHESIS Data extraction was performed independently by 2 authors. The methodology and the risk of bias were assessment based on the description of randomization method, withdrawals, and blinding process. MAIN OUTCOMES AND MEASURES Rate of resumption of regular menses after a minimal follow-up period of 6 months following chemotherapy was used as a surrogate to assess the incidence of ovarian dysfunction. Additional secondary outcomes included hormone levels and number of pregnancies. Risk ratio estimates were calculated based on the number of evaluable patients. Analyses were conducted using a random effect model. RESULTS Seven studies were included in this analysis, totaling 1047 randomized patients and 856 evaluable patients. The use of GnRHa was associated with a higher rate of recovery of regular menses after 6 months (odds ratio [OR], 2.41; 95% CI, 1.40-4.15; P = .002) and at least 12 months (OR, 1.85; 95% CI, 1.33-2.59; P < .001) following the last chemotherapy cycle. The use of GnRHa was also associated with a higher number of pregnancies (OR, 1.85; 95% CI, 1.02-3.36; P = .04), although this outcome was not uniformly reported and fertility or rate of pregnancy was not the primary outcome in any of the trials. CONCLUSIONS AND RELEVANCE Gonadotropin-releasing hormone agonists given with chemotherapy was associated with increased rates of recovery of regular menses in this meta-analysis. Evidence was insufficient to assess outcomes related to GnRHa and ovarian function and fertility and needs further investigation.216573Astra-Zenec

Phosphorus Sorption and Redistribution on Soil Solid Phase in a Brazilian Haplorthox Amended with Biosolids

Land application of biosolids (SS) can cause a buildup of phosphorus (P) in the top soil. The changes in the soil P characteristics may be assessed by the sorption isotherm and the sequential fractionation techniques. Samples of Haplorthox were collected from a field experiment where maize was cultivated for two years, after two applications of SS originated from two cities of São Paulo State, Brazil. SS applications added a total of 125, 250, 500, 1000 and 2000 kg ha−1 of P in the area. To perform the sorption isotherms and obtain P maximum sorption capacity (Qmax) and the binding energy, soil samples were submitted to increasing P concentration solutions until equilibrium was reached. Sequential fractionation was done by a sequential extraction with CaCl2, NaHCO3, NaOH, HCl, and HNO3 + HClO4 (residual). Addition of biosolids from both cities to the soil decreased Qmax and the binding energy obtained by the Langmuir equation. SS additions changed the P fractions distribution in the soil by increasing the labile fractions (P-CaCl2 and P-NaHCO3) and the moderately labile fraction (P-NaOH) by 11.2% and 20.3%, respectively, in detriment of the most resistant P fraction

Analysis of acoustic frequency and wave amplitude generated by the Oscillatory Thoracic Thixotropic Device (Diottix(r)) in human chest

O Diottix(r) foi calibrado a 25 Hz para atingir a frequência indicada na literatura como eficaz a fim de mobilizar secreções de vias aéreas. A amplitude e a frequência das ondas geradas pelo equipamento nas diferentes regiões do tórax ainda precisam ser investigadas. O objetivo de estudo foi analisar a frequência e a amplitude das ondas geradas pelo Diottix(r) no tórax de indivíduos saudáveis. A aplicação do Diottix(r) foi realizada nas regiões anterior e posterior do tórax. As ondas mecânicas foram captadas utilizando estetoscópios conectados a microfones de eletreto, os quais estavam ligados a um osciloscópio digital. Os dados de frequência e amplitude foram captados pelo estetoscópio, posicionado em seis pontos na região anterior e seis na posterior do tórax, seguindo as posições comumente utilizadas na ausculta pulmonar. Os sinais foram registrados e transferidos para um computador por meio de um software para análise deles. A frequência das ondas não apresentou variação significativa (24,9 a 26,4 Hz). A amplitude de onda na região anterior versus posterior em cada segmento do pulmão, terço superior, médio e inferior, apresentou diferença. O Diottix(r) produz frequências no tórax de acordo com o calibrado; desta forma, pode ser um recurso complementar às manobras de higiene brônquica. As amplitudes de ondas parecem ser afetadas por outras estruturas, que incluem as partes ósseas e o coração.Diottix(r) fue calibrado en 25 Hz para alcanzar la frecuencia indicada en la literatura como eficaz para movilizar secreciones de las vías aéreas. La amplitud y frecuencia de ondas generadas por el equipamiento en las diferentes regiones del tórax aun necesitan de más investigaciones. El objetivo de eso estudio fue analizar la frecuencia y amplitud de ondas generadas por el Diottix(r) en el tórax de sujetos saludables. La aplicación del Diottix(r) fue realizada en las regiones anterior y posterior del tórax. Las ondas mecánicas fueron captadas utilizándose estetoscopios ligados a micrófonos de electret, los cuales estaban ligados a uno osciloscopio digital. Los datos de frecuencia y amplitud fueron captados por lo estetoscopio posicionado en seis puntos en la región anterior y seis en la posterior del tórax, siguiendo las posiciones comúnmente utilizadas en la ausculta pulmonar. Los sígnales fueron registrados y transferidos para una computadora a través de un programa para su análisis de datos. La frecuencia de ondas no presentó variación significativa (del 24,9 al 26,4 Hz). La amplitud de onda en la región anterior versus posterior en cada segmento del pulmón, tercio superior, medio e inferior, presentó diferencia. Lo Diottix(r) produce frecuencias en el tórax según el calibrado. Por lo tanto, puede ser uno recurso complementar a las manobras de higiene de los bronquios. Las amplitudes de ondas parecen ser afectadas por otras estructuras, las cuales incluyen partes óseas y el corazón.Diottix(r) was calibrated at 25 Hz to achieve the frequency indicated in literature as being effective to mobilize the airways secretions. However, the amplitude and frequency of the waves generated by the equipment in different regions of the chest still need to be investigated. The objective of this study was to analyze the frequency and amplitude of waves generated by Diottix(r) in chests of healthy subjects. Diottix(r) was used in the anterior and posterior regions of the chest. The mechanical waves were captured using stethoscopes connected to electret microphones, which were connected to a digital oscilloscope. Frequency and amplitude data were recorded by the stethoscope, positioned in six points in the anterior region and six in the posterior region of the chest, following the positions commonly used in pulmonary auscultation. Signals were recorded and transferred to a computer with software for their analysis. The frequency of waves did not present a significant change (from 24.9 to 26.4 Hz). The wave amplitude in the anterior versus the posterior region in each area of the lung, the upper, middle and lower, had differences. Diottix(r) produces frequencies in the chest according to the calibrated; thus, it can be a complementary resource to bronchial hygiene maneuvers. The amplitudes of waves seem to be affected by other structures like bone parts and heart

Correlation between MCI/Sapori screening tools and DXA results and between MCI/Sapori and Frax tool for estimating fracture risk

Background: Peripheral Dual-energy X-ray absorptiometry (DXA) can be applied to identify low bone mineral density (BMD) patients, however, DXA is not sufficiently available in many countries. Thus, the use of simpler and cheaper screening tools than DXA to detect low BMD become indispensable. Objectives: The objective of this study was to correlate São Paulo osteoporosis risk index (Sapori) and mandibular cortical index (MCI) screening tools with the femur DXA results of patients in our sample of Brazilian women. A secondary objective was to assess which of these screening tools better correlates with the results of the Frax tool. Material and Methods: Exams of women who had undergone panoramic radiographic examination at the beginning of dental treatment and peripheral DXA for screening osteoporosis from 2010 to 2014 were included. The MCI was evaluated, and Sapori and Frax were calculated with their available online software tools. Spearman correlation was performed to analyse the level of correlation between femur T-scores (and MCI and Sapori values, as well to perform the level of correlation between Frax and MCI and Sapori values. Results: The spearman correlation comparing the numerical T-score values and the categorical values of MCI (rs=-0.274), and of Sapori (rs=-0.470), showed a statistically significant inverse correlation for both equations (p&lt;0.01). The Spearman equation comparing the values obtained with Frax and MCI did not show a statistically signifcant correlation (p&gt;0.01). But the equation comparing the values obtained with Frax and Sapori showed a positive, moderate and statistically significant correlation between them (rs=0.460). Conclusion: MCI is not a reliable screening tool to identify women with low BMD or Osteoporosis, whereas more optimistic results were observed for the Sapori.A Absorciometria bifotónica de raios X (Dexa) pode ser aplicada para identificar uma baixa densidade mineral óssea (DMO) em pacientes. No entanto, o exame de Dexa não está disponível em muitos países. Assim, o uso de ferramentas de triagem mais simples e mais baratas para detectar uma baixa DMO torna-se indispensável. Objetivos: O objetivo deste estudo foi correlacionar o índice de triagem de osteoporose de São Paulo (Sapori) e o índice cortical mandibular (MCI) com os resultados obtidos pelo Dexa de fêmur de pacientes em uma amostra de mulheres brasileiras. Como objetivo secundário, avaliar qual dessas ferramentas de triagem se correlaciona melhor com os resultados obtidos pela ferramenta Frax. Material e Métodos: Foram incluídos exames de mulheres que foram submetidas a exames radiográficos do tipo panorâmico no início de seus tratamentos odontológicos, e a exames de Dexa periférica para rastreamento de osteoporose entre 2010 a 2014. O ICM foi avaliado e o Sapori e o Frax foram calculados através de suas ferramentas de software disponíveis. A Correlação de Spearman foi realizada para analisar o nível de correlação entre os valores de T-score obtidos do fêmur com os valores de ICM e Sapori, bem como para a correlação entre Frax e ICM e Sapori. Resultados: A Correlação de Spearman comparando os valores numéricos de T e os valores categóricos de ICM (rs=-0,274) e de Sapori (rs=-0,470) mostraram uma correlação inversa e estatisticamente significante para ambas as equações (p&lt;0,01) e a equação de Spearman comparando os valores obtidos com Frax e ICM não apresentaram correlação estatisticamente significante (p&gt;0,01), mas a equação comparando os valores obtidos com Frax e Sapori mostrou uma correlação positiva, moderada e estatisticamente significante (rs=0,460). Conclusão: O ICM não é uma ferramenta confiável para identificar mulheres com baixa DMO ou Osteoporose; resultados mais otimistas foram observados para a ferramenta Sapori

Clinical and epidemiological differences between septic arthritis of the knee and hip caused by oxacillin-sensitive and -resistant s. aureus

OBJECTIVE: To establish the risk factors for joint infection by oxacillin-resistant Staphylococcus aureus (MRSA) using clinical and epidemiological data. METHODS: All septic arthritis cases of the knee and hip diagnosed and treated in our institution from 2006 to 2012 were evaluated retrospectively. Only patients with cultures identified as microbial agents were included in the study. The clinical and epidemiological characteristics of the patients were analyzed, seeking the differences between populations affected by MRSA and oxacillin-sensitive Staphylococcus aureus (MSSA). RESULTS: S. aureus was isolated in thirty-five patients (46.0%) in our total sample, 25 in the knee and 10 in the hip. Of these 35 patients, 22 presented with MSSA and 13 presented with MRSA. Provenance from a health service-related environment, as described by the Centers for Disease Control and Prevention, was the only variable associated with oxacillin-resistant strains of this bacterium (p = 0.001). CONCLUSION: Provenance from a health service-related environment was associated with a higher incidence of MRSA-related septic arthritis, suggesting that this agent should be considered in the initial choice of antibiotic treatment. Previous surgeries of the knee or affected limb and the absence of leukocytes might also be related to infection with this agent

Reciprocating and rotatory NiTi instruments used for root canal preparation of primary teeth: a systematic review and meta-analysis

Objective: To compare the root canal preparation of primary teeth with reciprocating and rotary NiTi instruments. Material and Methods: Electronic databases (PubMed/MEDLINE, Web of Science, TRIP, Lilacs, Embase, and Scopus) were systematically searched until October 2020. In vitro studies comparing the cleaning ability, debris extrusion, file deformation, or working time of rotary and reciprocating NiTi instruments in primary teeth were evaluated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Meta-analyses were conducted using a random-effects model to calculate pooled mean differences between reciprocating and rotary NiTi instruments considering the outcomes: working time (minutes) and debris extrusion (milligrams). Statistical analyses were performed using RevMan 5.3 at a significance level of 5%. Results: From 4,417 potentially relevant studies, 10 were included in the systematic review, and 8 considered in the meta-analyses. There was no significant difference between reciprocating and rotary NiTi instruments considering debris extrusion [3 data sets; effect size: -0.11 (-0.25-0.04); p=0.15] and working time [6 data sets; effect size: -0.37 (-0.98-0.24); p=0.24]. The heterogeneity found was moderate to high. The risk of bias was low in most studies (50.0% of all items across studies). Conclusion: There is no scientific evidence showing superiority of reciprocating or rotary NiTi instruments used for root canal preparation in primary teeth

Reciprocating and Rotatory NiTi Instruments Used for Root Canal Preparation of Primary Teeth: A Systematic Review and Meta-Analysis

Objective: To compare the root canal preparation of primary teeth with reciprocating and rotary NiTi instruments. Material and Methods: Electronic databases (PubMed/MEDLINE, Web of Science, TRIP, Lilacs, Embase, and Scopus) were systematically searched until October 2020. In vitro studies comparing the cleaning ability, debris extrusion, file deformation, or working time of rotary and reciprocating NiTi instruments in primary teeth were evaluated. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Meta-analyses were conducted using a random-effects model to calculate pooled mean differences between reciprocating and rotary NiTi instruments considering the outcomes: working time (minutes) and debris extrusion (milligrams). Statistical analyses were performed using RevMan 5.3 at a significance level of 5%. Results: From 4,417 potentially relevant studies, 10 were included in the systematic review, and 8 considered in the meta-analyses. There was no significant difference between reciprocating and rotary NiTi instruments considering debris extrusion [3 data sets; effect size: -0.11 (-0.25–0.04); p=0.15] and working time [6 data sets; effect size: -0.37 (-0.98–0.24); p=0.24]. The heterogeneity found was moderate to high. The risk of bias was low in most studies (50.0% of all items across studies). Conclusion: There is no scientific evidence showing superiority of reciprocating or rotary NiTi instruments used for root canal preparation in primary teeth