Locoregional Anesthesia for Dental Treatment in Cardiac Patients: A Comparative Study of 2% Plain Lidocaine and 2% Lidocaine with Epinephrine (1:100,000)

OBJECTIVES: This study analyzes hemodynamic changes in patients with cardiac valvular diseases submitted to dental treatment under local anesthesia containing epinephrine. METHODS: This randomized clinical trial was performed at the Dental Division of the Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Brazil). Patients were separated into two groups with the help of an aleatory number table: 2% plain lidocaine (PL, n= 31) and 2% lidocaine with epinephrine (1:100,000) (LE, n= 28). Blood pressure, heart rate, oxygenation and electrocardiogram data were all recorded throughout the procedure. State and trait anxiety levels were measured. RESULTS: Fifty-nine patients were selected for the LE group (n=28), with an average age of 40.3 ± 10.9, or for the PL group (n=31), age 42.2 ± 10.3. No differences were shown in blood pressure, heart rate and pulse oximetry values before, during and after local anesthesia injection between the two groups. State and trait anxiety levels were not different. Arrhythmias observed before dental anesthesia did not change in shape or magnitude after treatment. Complaints of pain during the dental procedure were more frequent within the PL group, which received a higher amount of local anesthesia. CONCLUSION: Lidocaine with epinephrine (1:100,000) provided effective local anesthesia. This treatment did not cause an increase in heart rate or blood pressure and did not cause any arrhythmic changes in patients with cardiac valvular diseases

Local anesthesia with epinephrine is safe and effective for oral surgery in patients with type 2 diabetes mellitus and coronary disease: a prospective randomized study

OBJECTIVE: To investigate the variations in blood glucose levels, hemodynamic effects and patient anxiety scores during tooth extraction in patients with type 2 diabetes mellitus T2DM and coronary disease under local anesthesia with 2% lidocaine with or without epinephrine. STUDY DESIGN: This is a prospective randomized study of 70 patients with T2DM with coronary disease who underwent oral surgery. The study was double blind with respect to the glycemia measurements. Blood glucose levels were continuously monitored for 24 hours using the MiniMed Continuous Glucose Monitoring System. Patients were randomized into two groups: 35 patients received 5.4 mL of 2% lidocaine, and 35 patients received 5.4 mL of 2% lidocaine with 1:100,000 epinephrine. Hemodynamic parameters (blood pressure and heart rate) and anxiety levels were also evaluated. RESULTS: There was no difference in blood glucose levels between the groups at each time point evaluated. Surprisingly, both groups demonstrated a significant decrease in blood glucose levels over time. The groups showed no significant differences in hemodynamic and anxiety status parameters. CONCLUSION: The administration of 5.4 mL of 2% lidocaine with epinephrine neither caused hyperglycemia nor had any significant impact on hemodynamic or anxiety parameters. However, lower blood glucose levels were observed. This is the first report using continuous blood glucose monitoring to show the benefits and lack of side effects of local anesthesia with epinephrine in patients with type 2 diabetes mellitus and coronary disease

Peripheral oxygen saturation, heart rate, and blood pressure during dental treatment of children with cyanotic congenital heart disease

OBJECTIVES: In this observational study, we evaluated the peripheral oxygen saturation (SpO2), heart rate, and blood pressure of children with cyanotic congenital heart disease who were undergoing dental extraction. METHODS: Forty-four patients between the ages of 6 and 12 years who underwent upper primary tooth extraction were included in the study. Of these, 20 patients were in the cyanotic congenital heart disease group and 24 were in the control group. RESULTS: Peripheral oxygen saturation, heart rate, and systolic blood pressure in the cyanotic congenital heart disease group varied quite significantly during the treatment protocol (

Uso do código SWAT na previsão de vazão dos rios da bacia hidrográfica Tocantins-Araguaia

A bacia hidrográfica Tocantins-Araguaia é caracterizada por apresentar singularidade na ocorrência de enchentes e deslizamentos de massa em função de seus altos valores de vazão. Desse modo, o objetivo foi aplicar o simulador Soil and Water Assessment Tool (SWAT) para promover a previsão de vazão dos rios da bacia hidrográfica Tocantins-Araguaiae criar cenários para avaliação do papel da dinâmica da taxa de fluxo em função das altas precipitações e desmatamento. O modelo apresentou valores aceitáveis na calibração e validação e posteriormente, cenários de 0 a 100% da mudança do uso da terra foram simulados. Os resultados mostram que com perda de 10% da vegetação na bacia durante períodos de alto escoamento pluviométrico, o escoamento superficial e a erosão aumentam, causando problemas de sedimentação e inundação. Assim, o modelo possibilitou uma compreensão abrangente do sistema para o desenvolvimento da melhor política de manejo e tomada de decisão

Sedação com benzodiazepínicos orais na prática odontológica em pacientes cardíacos: uma revisão de literatura

Existem diferentes tipos de sedação utilizados para a realização de procedimentos médicos e odontológicos. As medicações mais comumente usadas para este fim são os benzodiazepínicos, considerados seguros e efetivos na prática odontológica hospitalar ou ambulatorial. No entanto, na prática clínica odontológica, eles são subutilizados, especialmente em pacientes com doenças cardiovasculares. O objetivo deste estudo foi abordar o uso de benzodiazepínicos como sedativos orais, suas indicações, contraindicações e peculiaridades, bem como sua correlação com pacientes cardíacos, através de uma revisão da literatura. Sedação, ou ansiólise mínima, é um estado induzido por medicamentos, durante o qual os pacientes respondem normalmente a comandos verbais e reflexos das vias aéreas, enquanto a função respiratória e cardiovascular não é afetada. Os efeitos benéficos de benzodiazepínicos incluem redução da ansiedade, indução e manutenção do sono, relaxamento muscular e tratamento e prevenção de convulsões epiléticas. Benzodiazepínicos são indicados para pacientes com ansiedade, mas devem ser usados com cautela em pacientes com doenças graves, gravidez ou que utilizem outros depressores do sistema nervoso central. É importante que o dentista conheça e use esta classe de medicamentos, melhorando a qualidade de atendimento para o paciente cardíaco.There are different types of sedation used for performing medical and dental procedures. The medications most commonly used for this purpose are benzodiazepines, which are considered safe and effective in the hospital or outpatient dental practice. However, in dental clinical practice, they are underutilized, especially in patients with cardiovascular disease. The aim of this study was to address the use of benzodiazepines as oral sedatives, their indications, contraindications, and peculiarities, as well as their correlation with cardiac patients, through a literature review. Sedation or minimum anxiolysis is a drug-induced state during which patients respond normally to verbal commands and airway reflexes, while respiratory and cardiovascular functions are unaffected. The beneficial effects of benzodiazepines include reduced anxiety, sleep induction and maintenance, muscle relaxation, and treatment and prevention of epileptic seizures. Benzodiazepines are indicated for patients with anxiety but should be used with caution in patients with serious illnesses, pregnancy or using other central nervous system depressants. Its use in cardiac patients is safe and effective because it reduces the hemodynamic function. It is important for the dentist to know and use this class of medications, improving the quality of care for the cardiac patient

Thought on Food: A Systematic Review of Current Approaches and Challenges for Food Intake Detection

Nowadays, individuals have very stressful lifestyles, affecting their nutritional habits. In the early stages of life, teenagers begin to exhibit bad habits and inadequate nutrition. Likewise, other people with dementia, Alzheimer’s disease, or other conditions may not take food or medicine regularly. Therefore, the ability to monitor could be beneficial for them and for the doctors that can analyze the patterns of eating habits and their correlation with overall health. Many sensors help accurately detect food intake episodes, including electrogastrography, cameras, microphones, and inertial sensors. Accurate detection may provide better control to enable healthy nutrition habits. This paper presents a systematic review of the use of technology for food intake detection, focusing on the different sensors and methodologies used. The search was performed with a Natural Language Processing (NLP) framework that helps screen irrelevant studies while following the PRISMA methodology. It automatically searched and filtered the research studies in different databases, including PubMed, Springer, ACM, IEEE Xplore, MDPI, and Elsevier. Then, the manual analysis selected 30 papers based on the results of the framework for further analysis, which support the interest in using sensors for food intake detection and nutrition assessment. The mainly used sensors are cameras, inertial, and acoustic sensors that handle the recognition of food intake episodes with artificial intelligence techniques. This research identifies the most used sensors and data processing methodologies to detect food intake.info:eu-repo/semantics/publishedVersio

When the fever will not stop, stop the pills! A case report

ABSTRACT Neuroleptic malignant syndrome (NMS) is a neurologic emergency potentially fatal. This rare side effect is most commonly associated with first-generation antipsychotics and less frequently with atypical or second-generation antipsychotics. The diagnosis relies on both clinical and laboratory criteria, with other organic and psychiatric conditions being ruled out. CASE REPORT: A 39-year-old female patient, who is institutionalized and completely dependent, has a medical history of recurrent urinary infections and colonization by carbapenem-resistant Klebsiella pneumoniae. Her regular medication regimen included sertraline, valproic acid, quetiapine, risperidone, lorazepam, diazepam, haloperidol, baclofen, and fentanyl. The patient began experiencing dyspnea. Upon physical examination, she exhibited hypotension and a diminished vesicular murmur at the right base during pulmonary auscultation. Initially, after hospitalization, she developed high febrile peaks associated with hemodynamic instability, prompting the initiation of antibiotic treatment. Despite this, her fever persisted without an increase in blood inflammatory parameters, and she developed purulent sputum, necessitating antibiotherapy escalation. The seventh day of hospitalization showed no improvement in symptoms, suggesting NNMS as a differential diagnosis. All antipsychotic and sedative drugs, as well as antibiotherapy, were discontinued, after which the patient showed significant clinical improvement. CONCLUSION: Antipsychotic agents are commonly employed to manage behavioral changes linked to various disorders. However, their severe side effects necessitate a high degree of vigilance, the cessation of all medications, and the implementation of supportive care measures. A prompt and accurate diagnosis of NMS is crucial to alleviating the severe, prolonged morbidity and potential mortality associated with this syndrome

INGESTIVE BEHAVIOR OF BUFFALOES FED INCREASING LEVELS OF CONCENTRATE IN SUGARCANE BASED DIETS

The experiment was conducted to evaluate the ingestive behavior of buffalo fed sugarcane with different levels of concentrate. Twenty four Murrah buffaloes with body weight of 219±23 kg and nine months old were assigned to completely randomized design. Animals were placed in individual pens where they received diets ad libitum, twice a day. The experimental period has divided into 30 d for adaptation and 84 d for observations and samples collection. Four treatments were used: 1) 80% sugarcane (SC) + 20% concentrate (C); 2) 60% SC + 40% C; 3) 40% SC + 60% C; 4) 20% SC + 80% C. The diets were isoproteics and urea/ammonium sulfate was used at 9:1 ratio to correct the protein level of sugarcane. The evaluated variables were time spent feeding (TSF), ruminating (TSR), idle (TSI), dry matter intake (DMI), feeding efficiency of dry matter (FEDM), rumination efficiency of dry matter (REDM), number of meals, duration of meal and duration of breaks between meal. A regression analysis was performed using the MIXED procedure. DMI was positively affected (P0.05) on TSF. However, the TSR and number of meals decreased linearly (

PERFIL SOCIOECONÔMICO DOS BENEFICIÁRIOS RURAIS DO PROGRAMA BOLSA FAMÍLIA NA REGIÃO SUL DO BRASIL

The Bolsa Família Conditional Cash Transfer Program (PBF) has been the subject of studies and inspired anti-poverty programs, within and outside Brazil. Nevertheless, in rural areas, where there is the most part of the poor and extremely poor population and there are many PBF’s beneficiaries, there are few studies to understand its impact and its contribution to rural development. This article presents and analyzes the profile of rural PBF’s beneficiaries in southern Brazil in 2014. Using official data from the Cadastro Único para Programas Sociais (CadÚnico) of the Ministério do Desenvolvimento Social e Combate à Fome (MDS) the article indicates that there is similarity between the studied states and low availability of resources that the PBF’s beneficiaries may convert into work and income, maintaining them with a high level of poverty. Thus, the income transfer policy alone has been insufficient to overcome poverty, which requires that their implementation be associated with other activities and programs guided by the rural territorial development perspective.O Programa de Transferência de Renda Condicionada Bolsa Família (PBF) tem sido alvo de estudos e inspirado programas de combate à pobreza, dentro e fora do Brasil. Apesar disso, há poucos estudos para se compreender seus impactos e sua contribuição para o desenvolvimento rural, região onde se concentra grande parte da população pobre e extremamente pobre e onde há grande quantidade de beneficiários do PBF. Este artigo apresenta e analisa o perfil dos beneficiários rurais do PBF na região Sul do Brasil, em 2014. Utilizando dados oficiais do Cadastro Único para Programas Sociais (CadÚnico) do Ministério do Desenvolvimento Social e Combate à Fome, o estudo indica que há similaridade entre os estados estudados e baixa disponibilidade de recursos para os beneficiários do PBF converterem em trabalho e renda, contribuindo para a continuidade do elevado nível de pobreza. Assim, a política de transferência de renda, isoladamente, tem sido insuficiente para a superação da pobreza, o que requer que sua execução esteja associada a outras ações e programas pautados pela perspectiva do desenvolvimento territorial rural