In Vivo Detection of External Apical Root Resorption Induced by Apical Periodontitis Using Periapical Radiography and Cone-Beam Computed Tomography

Objective: To compare the accuracy of periapical radiography (PR) and cone-beam computed tomography (CBCT) for the detection of external apical root resorption (EARR) due to root canal contamination. Material and Methods: Dog’s teeth with experimentally induced root resorption due to root canal contamination underwent or not root canal treatment (n=62). True positives (TP), false positives (FP), true negatives (TN), and false negatives (FN) in PR and CBCT diagnoses were determined using histopathologic findings as the gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (TP + TN) in the diagnosis of EARR were calculated. Data were compared using chi-squared test (⍺=0.05). Results: EARR was detected in 35% of roots by PR, in 47% by CBCT, and in 50% of the roots by microscopy (p=0.03 PR versus microscopy; p=0.67 CBCT versusmicroscopy). Overall, CBCT produced more accurate diagnoses than PR (p=0.008). PR and CBCT allowed the identification of large resorption in 100% of the cases and showed the same accuracy. However, for small resorptions, PR showed an accuracy of 0.83, whereas CBCT showed an accuracy of 0.96 (p=0.003). Conclusion: Cone-beam computed tomography showed higher accuracy in detecting external apical root resorption of endodontic origin

Masticatory Function and Nutritional Status in Brazilian Institutionalized Elders: Influence of Denture Use

Objective: To evaluate the influence of tooth loss and the use of removable dentures on chewing function and nutritional status of institutionalized elders. Material and Methods: Cross-sectional study with 155 elders from seven long-stay institutions in João Pessoa, Brazil. The participants were classified according to the presence of reminiscent teeth and use of dentures in four levels: toothless, without denture (1); toothless with a complete denture (2); partial toothless without denture (3) and partial toothless with a partial denture (4). Nutritional status was assessed using the Mini-Nutritional Assessment (MNA) instrument and the Body Mass Index (BMI). Swallowing threshold was used for the assessment of masticatory function, using a portion of roasted peanuts (3.7 g). Comparisons among groups were performed using Kruskal-Wallis test with Bonferroni adjustment, considering p<0.05. Results: MNA (p=0.702) and BMI (p=0.884) were not modified in relation to the presence of teeth and denture use. Toothless individuals without dentures had a lower swallowing threshold (p<0.001), whilst partial toothless with dentures had better masticatory function (p>0.05). Conclusion: The presence of reminiscent teeth and the use of dentures do not influence the nutritional status of the elders but interfere with the masticatory function. Prosthetic rehabilitation is desirable for complete toothless individuals

Sociodemographic Profile of Elderly People with Temporomandibular Disorder and Depression in Combination with Parkinson's Disease

Objective: To describe the sociodemographic profile of elderly people with temporomandibular disorder and depression in Parkinson's disease cases. Material and Methods: It is a cross-sectional cohort cut study, which used secondary data from 124 elderly people with Parkinson’s disease (PD). To diagnose temporomandibular disorder (TMD), the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire was used, and the variables studied were: age, sex, race, education, marital status, family income, stage of the disease, and depression. The statistical analysis performed was descriptive and used absolute numbers and a frequency count. Results: After the application of the eligibility criteria, the patient records of 81 elderly people with Parkinson’s disease were selected; 15 presented associated TMD and depression. The average age was 69 years old; 66.67% were male; 46.67% had more than 9 years of schooling; 60% were married or had a partner; 53.33% received between 1 and 2 minimum wages; 33.33% stated they were brown; 80% were in the moderate stage of the disease; 46.66% were in group II according to the RDC/TMD, presenting disk displacement; and 53.33% presented severe depression. Conclusion: It was verified that the elderly people with Parkinson’s and associated TMD and depression were male, married or with a partner, on a low income, with nine or more years of schooling, and were in the moderate stage of the disease

Sociodemographic Profile of Elderly People with Temporomandibular Disorder and Depression in Combination with Parkinson's Disease

Objective: To describe the sociodemographic profile of elderly people with temporomandibular disorder and depression in Parkinson's disease cases. Material and Methods: It is a cross-sectional cohort cut study, which used secondary data from 124 elderly people with Parkinson’s disease (PD). To diagnose temporomandibular disorder (TMD), the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire was used, and the variables studied were: age, sex, race, education, marital status, family income, stage of the disease, and depression. The statistical analysis performed was descriptive and used absolute numbers and a frequency count. Results: After the application of the eligibility criteria, the patient records of 81 elderly people with Parkinson’s disease were selected; 15 presented associated TMD and depression. The average age was 69 years old; 66.67% were male; 46.67% had more than 9 years of schooling; 60% were married or had a partner; 53.33% received between 1 and 2 minimum wages; 33.33% stated they were brown; 80% were in the moderate stage of the disease; 46.66% were in group II according to the RDC/TMD, presenting disk displacement; and 53.33% presented severe depression. Conclusion: It was verified that the elderly people with Parkinson’s and associated TMD and depression were male, married or with a partner, on a low income, with nine or more years of schooling, and were in the moderate stage of the disease

Síndrome pré-menstrual: possibilidades de cuidados para atenuação dos sintomas

Introdução: A Síndrome Pré-menstrual (SPM), com início de uma a duas semanas antes da menstruação, engloba um padrão recorrente de sintomas físicos, afetivos e comportamentais, podendo ser agravados por fatores externos, como hábitos de vida e condição socioeconômica, afetando negativamente as atividades diárias. Objetivo: Analisar a relação entre a síndrome pré-menstrual e a possibilidade de reabilitação. Método: Revisão integrativa da literatura realizada através da leitura de portais oficiais de órgãos públicos e da busca eletrônica na Biblioteca Virtual em Saúde (BVS), no PubMed e na Scientific Electronic Library Online (SciELO). Resultados: Nessa revisão integrativa foram selecionados 41 estudos primários publicados nos últimos 5 anos, disponíveis gratuitamente e nos idiomas inglês e português. Discussão: Com relação às técnicas não farmacológicas, observou-se que os métodos de exercício físico, dieta, medicina tradicional iraniana, suplementação de vitamina D e terapia cognitivo-comportamental obtiveram boa eficácia na atenuação dos sintomas da SPM, como dismenorreia e alterações de humor; o tratamento com auriculoterapia mostrou resultados semelhantes ao uso de placebo; outros como acupuntura e acupressão não trouxeram resultados conclusivos.  Entre os métodos farmacológicos, o tratamento padrão preconizado é por meio de anticoncepcionais orais combinados. Além disso, o uso de inibidores seletivos da recaptação da serotonina (ISRSs) pode aumentar a quantidade de serotonina para neurotransmissão e consequentemente melhorar os sintomas da SPM. Os moduladores seletivos do receptor de estrogênio oferecem uma estratégia segura para manejo de sintomas, inclusive os de menopausa. O uso de moduladores do receptor de progesterona, por outro lado, mostrou maior controle de comportamentos agressivos. Por fim, um estudo multicêntrico realizado na Suécia mostrou resultado promissor do neuroesteroide endógeno em comparação ao uso de anticoncepcionais orais combinados. Conclusão: Há fortes indícios de melhora dos sintomas da SPM diante das diversas possibilidades para sua reabilitação, sejam elas farmacológicas ou não-farmacológicas.Introduction: Premenstrual syndrome (PMS), with beggining in one or two weeks before menstruation, includes a recurring pattern of physical, affective and behavioral symptoms that can be exarcebated by external factors as life habits and socialeconomic conditions, affecting negatively the daily activities.  Objective: Analyze the relationship between premenstrual syndrome and the possibility of rehabilitation. Method: Integrative literature review performed through reading of official portals of public agencies and the eletronic search in Biblioteca Virtual em Saúde (BVS), PubMed and Scientific Electronic Library Online (SciELO). Results: In this integrative review, it was selected 41 primary studies published within the last 5 years, available for free and in english and portuguese languages. Discussion: In regard of the non-pharmacological techniques, it was observed that physical exercise, diet, traditional iranian medicine, vitamine D supplementation and cognitive behavioral therapy had good efficiency in the attenuation of the PMS symptoms, as dysmenorrhea and mood changes; the treatment with auriculotherapy has shown similar results as the use of placebo; others as acupuncture and acupressure didn’t bring conclusive results. Between the pharmacological methods, the standard treatment is with combined oral contraceptives. Furthermore, the use of selective serotonin reuptake inhibitors (SSRIs) can increase the amount of serotonin for neurotransmission and consequently improve PMS symptoms. The selective estrogen receptor modulator offers a safe strategy to handle the symptoms, including menopauses. The use of selective progesterone receptor modulator, on the other hand, has shown better control of aggressive behaviors. At last, a multicentric study made in Sweden has shown promising results of endogenous neurosteroid when compared to the use of combined oral contraceptives. Conclusion: There are strong evidence of improvement of PMS symptoms in front of the many rehabilitation possibilities, whether they are pharmacological or non-pharmacological

Trabalho Infantil: De gente pequena à gente grande!

O presente artigo analisa como as famílias percebem a saúde/doença da criança/adolescente trabalhadora. Considerando que o trabalho precoce acarreta riscos à saúde afetando diretamente seu desenvolvimento físico, psicológico e social, pois é notório que a maturidade de sistemas (fisiológico, imunológico, neurológico, psicológico) difere entre adultos e crianças. Busca ainda: traçar o perfil das famílias de crianças/adolescentes trabalhadoras; identificar a partir dos relatos dos responsáveis, as principais doenças que acometem as crianças/adolescentes trabalhadoras e mostrar a relação que os mesmos fazem entre os riscos, as doenças e o trabalho. O enfoque foi dado às crianças/adolescentes assistidas pelo Programa de Erradicação ao Trabalho Infantil de Mossoró/RN. O trabalho consiste em uma pesquisa bibliográfica e de campo, atendendo as nuances quantitativas e qualitativas. As reflexões foram construídas através de questionários realizados com as famílias, bem como com a literatura e legislação vigente. Foi identificado como o trabalho precoce pode prejudicar a formação intelectual, já que eles deixam de brincar, ir à escola e realizar atividades compatíveis com sua idade. Isso, de certa forma, é prejudicial ao seu desenvolvimento psíquico, intelectual e afetivo, acarretando perda de etapas fundamentais da sua vida. Além disso, compromete a formação escolar, uma vez que a falta de tempo e condições físicas e mentais de pelo trabalho e estudo ao mesmo tempo proporcionam um aumento na evasão escolar e índices de baixa escolaridade. Desta forma, foi identificado que o trabalho infantil desenvolve diversos problemas de saúde, como: asma, problemas cardíacos, respiratórios, intestinais, de coluna, garganta e ouvido, alergia, hepatite, epilepsia, dores de cabeça e nas pernas, anemia e hipertireoidismo. Sendo que o trabalho infantil ainda é uma realidade presente na vida dessas famílias

Heparan sulfates and heparins: similar compounds performing the same functions in vertebrates and invertebrates?

The distribution and structure of heparan sulfate and heparin are briefly reviewed. Heparan sulfate is a ubiquitous compound of animal cells whose structure has been maintained throughout evolution, showing an enormous variability regarding the relative amounts of its disaccharide units. Heparin, on the other hand, is present only in a few tissues and species of the animal kingdom and in the form of granules inside organelles in the cytoplasm of special cells. Thus, the distribution as well as the main structural features of the molecule, including its main disaccharide unit, have been maintained through evolution. These and other studies led to the proposal that heparan sulfate may be involved in the cell-cell recognition phenomena and control of cell growth, whereas heparin may be involved in defense mechanisms against bacteria and other foreign materials. All indications obtained thus far suggest that these molecules perform the same functions in vertebrates and invertebrates.Universidade Federal de São Paulo (UNIFESP)A02Universidade Federal do Rio Grande do NorteUniversidade de Mogi das CruzesUNIFESPSciEL

Displasia Cemento-Óssea Florida, acompanhamento clínico e radiográfico de 1 ano: relato de caso / Florid cemento-osseous dysplasia 1-year clinical and radiographic follow-up: case report

A displasia cemento óssea florida (DCOF) faz parte de um grupo de lesões benignas, no qual mostra predileção por mulheres negras de meia idade. Presente na maioria das vezes no ápice dos incisivos ânteroinferiores bilateralmente em mandíbula, e normalmente são diagnosticadas em radiografias de rotina. O objetivo do presente trabalho trata-se do relato de caso de uma paciente com displasia óssea florida, suas características clínicas e radiográficas, acompanhados por um período de 1 ano. Relata-se o caso de uma paciente do gênero feminino, melanoderma, 52 anos, que procurou atendimento para consulta de rotina, e então diagnosticada com DCOF nos exames complementares, no entanto como a paciente era assintomática, optou-se pelo acompanhamento clínico e radiográfico da lesão. Diante do exposto, o conhecimento sobre a classificação das displasias é relevante, evitando dessa forma diagnósticos errôneos e, por conseguinte, tratamentos invasivos desnecessários

Síndrome do manguito rotador: reabilitação

Iniciamos a elaboraçao desta diretriz com a capacitaçao dos autores por meio da metodologia empregada pelo Oxford Centre for Evidence Based Medicine, para elaboraçao de diretrizes clínicas pelo Programa Diretrizes da Associaçao Médica Brasileira (AMB). Foram revisados artigos nas bases de dados do MedLine (PubMed) e outras fontes de pesquisa, sem limite de tempo. A estratégia de busca utilizada baseou-se em perguntas estruturadas na forma P.I.C.O. (das iniciais "Paciente", "Intervençao", "Controle", "Outcome").We began the preparation of this guideline with the training of the authors using the methodology employed by the Oxford Centre for Evidence-Based Medicine, for the development of clinical guidelines for the Programa Diretrizes da Associaçao Médica Brasileira-AMB (Brazilian Medical Association's Guideline Program-BMA). Articles were reviewed from the MEDLINE (PubMed) database and other research sources, on an open-ended basis. The search strategy used was based on structured questions in the P.I.C.O. form (from the initials of "Patient", "Intervention", "Control", and "Outcome")