Discussão sobre a viabilidade do casamento e da união estável de indivíduos incapazes: uma perspectiva das mudanças propostas pelo estatuto da pessoa com deficiência

O objeto deste trabalho de pesquisa foi uma análise de alguns impactos relevantes, decorrentes da modificação da Teoria das Incapacidades, e nos seus efeitos, realizada pelo recém instituído Estatuto da Pessoa com Deficiência. O Estatuto é a concretização da Convenção sobre Direitos da Pessoa com Deficiência, que foi internalizada no ordenamento jurídico brasileiro com força de Emenda Constitucional. Esta legislação tem o caráter garantista e visa a promoção da autonomia das pessoas com deficiência. Por essa razão abominou qualquer restrição que alijasse o indivíduo da sociedade, por isso, reafirmou que a curatela só será instituída extraordinariamente e afetará, somente, atos de natureza patrimonial e negocial, assim como não alcança o direito sobre o corpo, à sexualidade, ao matrimônio, à privacidade, à educação, à saúde, ao trabalho e ao voto. Tendo isso em vista, foram analisados, por meio de entendimento doutrinário, a teoria das incapacidades tradicional, aquela proposta pelo Estatuto e os institutos do casamento e da União Estável, juntamente com seus efeitos, para discutir a viabilidade de ter como nubente um absolutamente incapaz, que por ficção jurídica é relativamente incapaz

Análise dos aspectos físicos da qualidade de vida de receptores de rim

OBJETIVO Identificar os principais fatores do domínio físico modificados após transplante renal e analisar a influência desses aspectos na percepção de qualidade de vida (QV) geral. MÉTODO Estudo longitudinal, desenvolvido com 63 pacientes renais crônicos, avaliados antes e após transplante renal, utilizando a escala de qualidade de vida proposta pela Organização Mundial de Saúde RESULTADOS Observou-se melhora significativa nos aspectos físicos da QV depois do transplante renal. Correlações significativas foram observadas entre aspectos físicos e a QV geral CONCLUSÃO O transplante renal promoveu melhora em todos os aspectos físicos da QV. Os fatores que apresentaram correlação mais forte com a QV geral antes do transplante foram capacidade para o trabalho e dor. Depois da efetivação do transplante, a percepção sobre necessidade de tratamento foi o fator que apresentou correlação mais forte com a QV geral.OBJETIVO Identificar los principales factores de dominio físico modificados luego de trasplante renal y analizar la influencia de dichos aspectos en la percepción de la calidad de vida (CV) general. MÉTODO Estudio longitudinal, desarrollado con 63 pacientes renales crónicos, evaluados antes y después de trasplante renal, utilizando la escala de calidad de vida propuesta por la Organización Mundial de la Salud. RESULTADOS Se observó una mejora significativa en los aspectos físicos de la CV después del trasplante renal. Correlaciones significativas fueron observadas entre los aspectos físicos y la CV general. CONCLUSIÓN El trasplante renal proporcionó mejora en todos los aspectos físicos de la CV. Los factores que presentaron correlación más fuerte con la CV general antes del trasplante fueron la capacidad laboral y el dolor. Luego de la realización del trasplante, la percepción acerca de la necesidad de tratamiento fue el factor que presentó correlación más fuerte con la CV general.OBJECTIVE To identify the main factors of the physical domain modified after kidney transplantation and analyze the influence of those aspects in the perception of Overall quality of life (QOL). METHOD Longitudinal study, conducted with 63 chronic kidney patients, evaluated before and after kidney transplant, using the quality of life scale proposed by the World Health Organization. RESULTS We observed significant improvement in the physical aspects of QOL after kidney transplantation. Significant correlations were observed between physical aspects and the Overall QOL. CONCLUSION The kidney transplant generated improvement in all physical aspects of QOL. The factors that showed stronger correlation with the Overall QOL before the transplant were the capacity to work and pain. After the transplant, the perception of need for treatment was the factor that showed stronger correlation with the Overall QOL

Instrument for assessing the quality of mobile emergency pre-hospital care: content validation

OBJETIVOS Validar um instrumento de avaliação da qualidade da assistência pré-hospitalar móvel de urgência. MÉTODO Estudo metodológico, com 20 profissionais que opinaram sobre os itens do instrumento proposto. A análise foi realizada por meio do teste Kappa (K) e Índice de Validade do Conteúdo (IVC), considerando K >; 0,80 e IVC ≥ 0,80. RESULTADOS Três itens foram excluídos do instrumento: remuneração, satisfação profissional e atendimento realizado. Os itens que obtiveram índices K e IVC ótimos e permaneceram no instrumento foram: estado de conservação das ambulâncias; estrutura física; conforto da ambulância; recursos materiais; segurança do usuário/profissional; educação permanente; segurança demonstrada pela equipe; acesso; acolhimento; humanização; tempo resposta; privacidade ao usuário; orientações sobre o atendimento; relacionamento entre o profissional e usuário; oportunidade do usuário realizar reclamações e articulação multiprofissional. CONCLUSÃO O instrumento de avaliação da qualidade da assistência foi validado e poderá contribuir para a avaliação de serviços pré-hospitalares móveis de urgência.OBJETIVOS Validar un instrumento de evaluación de la calidad de la asistencia pre hospitalaria móvil de urgencia. El análisis fue llevado a cabo por medio de la prueba Kappa (K) e Índice de Validez de Contenido (IVC), considerando K >; 0,80 e IVC ≥ 0,80. RESULTADOS Tres puntos fueron excluidos del instrumento: remuneración, satisfacción profesional y atención realizada. Los puntos que obtuvieron índices K e IVC óptimos y permanecieron en el instrumento fueron: estado de conservación de las ambulancias; estructura física; confort de la ambulancia; recursos materiales; seguridad del usuario/profesional; educación permanente; seguridad demostrada por el equipo; acceso; acogida; humanización; tiempo respuesta; privacidad al usuario; orientaciones acerca de la atención; relación entre el profesional y el usuario; oportunidad del usuario de hacer quejas y articulación multiprofesional. CONCLUSIÓN El instrumento de evaluación de la calidad de la asistencia fue validado y podrá contribuir con la evaluación de los servicios pre hospitalarios móviles de urgencia.OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K) and Content Validity Index (CVI), considering K>; 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services

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

Tratamentos utilizados por portadores de DPOC no Brasil: Pesquisa Nacional de Saúde, 2013

OBJETIVO: Estimar a prevalência dos tratamentos utilizados para o manejo da doença pulmonar obstrutiva crônica (DPOC) na população adulta brasileira. MÉTODOS: Estudo transversal de base populacional com dados oriundos da Pesquisa Nacional de Saúde de 2013, incluindo indivíduos com 40 anos ou mais, com diagnóstico médico autorreferido de DPOC, bronquite crônica e/ou enfisema, os quais foram questionados sobre tratamentos utilizados para o manejo da doença. RESULTADOS: Foram entrevistados 60.202 adultos, dos quais 636 tinham 40 ou mais anos de idade e haviam referido diagnóstico médico de DPOC, enfisema ou bronquite crônica. Menos da metade (49,4%) da população diagnosticada relatou utilizar algum tipo de tratamento, havendo diferenças quanto à macrorregião do país (Sul 53,8% – Nordeste 41,2%, p = 0,007). O tratamento medicamentoso foi o mais referido e portadores de enfisema apresentaram a maior proporção de mais de um tipo de tratamento utilizado. Entre os indivíduos que declararam ter apenas bronquite crônica, 55,1% (IC95% 48,7–61,4) usavam medicamento, 4,7% (IC95% 2,6–8,3) realizavam fisioterapia e 6,0% (IC95% 3,6–9,9) oxigenoterapia. Por outro lado, entre os enfisematosos, 44,1% (IC95% 36,8–51,7) realizavam tratamento medicamentoso, 8,8% (IC95% 5,4–14,2) fisioterapia e 10,0% (IC95% 6,3–15,6) oxigenoterapia. CONCLUSÕES: As prevalências de tratamentos para o manejo da DPOC estavam aquém do ideal em 2013. O medicamentoso foi o principal tipo de tratamento, seguido de oxigenoterapia e fisioterapia.OBJECTIVE: To estimate the prevalence of treatments used for the management of chronic obstructive pulmonary disease (COPD) in the Brazilian adult population. METHODS: A population-based cross-sectional study with data from the 2013 Brazilian National Survey of Health, including individuals aged 40 years or older, with a self-reported medical diagnosis of COPD, chronic bronchitis and/or emphysema, who were asked about treatments used for disease management. RESULTS: A total of 60,202 adults were interviewed, of which 636 were 40 years of age or older and had reported a medical diagnosis of COPD, emphysema, or chronic bronchitis. Less than half (49.4%) of the diagnosed population reported using some type of treatment, with differences regarding the macro-region of the country (South 53.8% – Northeast 41.2%, p = 0.007). Pharmacological treatment was the most reported, and emphysema patients had the highest proportion of those undergoing more than one type of treatment. Among the individuals who reported having only chronic bronchitis, 55.1% (95%CI: 48.7–61.4) used medication, 4.7% (95%CI: 2.6–8.3) underwent physical therapy, and 6.0% (95%CI: 3.6–9.9) oxygen therapy. On the other hand, among the emphysema patients, 44.1% (95%CI: 36.8–51.7) underwent drug treatment, 8.8% (95%CI: 5.4–14.2) physical therapy, and 10.0% (95%CI: 6.3–15.6) oxygen therapy. CONCLUSION: The prevalence of treatments for COPD management was below ideal in 2013. The pharmacological treatment was the main type of treatment, followed by oxygen therapy and physical therapy

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<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

Factors associated with the knowledge of patients and caregivers about clean intermittent urethral catheterization: an integrative review

Objective: To identify the factors associated with the knowledge of patients and caregivers about Clean Intermittent Urethral Catheterization in the literature which hinder or facilitate the procedure. Method: An integrative review of the literature conducted in the MEDLINE/PubMed, CINAHL, Cochrane, Web of Science, SCOPUS and LILACS databases. Results: 13 primary studies were included in the sample after the peer review. A synthesis of knowledge was performed in two categories: Factors associated with the knowledge of patients and caregivers which hinder the procedure and Factors associated with the knowledge of patients and caregivers which facilitate the procedure. Factors that hinder and facilitate the procedure respectively related to the need of information and negative feelings, use of easy-to-understand language, and application of information leaflets, among others. Conclusion: There is a shortage of published articles on the subject, and those which were identified had a low level of evidence, therefore requiring greater commitment and effort on the part of health professionals and researchers to use more robust designs

Morphological analysis and immunohistochemical expression in restorations with self-adhesive resin : a randomized split-mouth design-controlled study

To evaluate the morphology and immunohistochemical expression of MMP-9, TIMP-3, COL-I, TNF-alfa and COX-2 in the dentinopulp complex of restorations with self adhesive composite (Vertise Flow/Kerr) compared with conventional resin composite with self-etc

Evaluation of therapeutic drug protocol used for control of pain after dental extractions / Avaliação do protocolo terapêutico medicamentoso utilizado para o controle da dor após exodontias

Pain control after surgery is one of the factors concern of surgical specialties. Aim of this study is to evaluate and compare the efficacy of nimesulide 100 mg and dipyrone monohydrate 500 mg used after extractions performed by a maxillofacial surgery UFPI services in order to support the drug choice appropriately, prioritizing the analgesic effect needed to patients undergoing interventions. Forty patients underwent extractions in the clinic of the UFPI, in the Health Center Poty Velho and Emergency Hospital of Promorar. Patients were divided into groups: undergoing intervention with and without ostectomy. Dipyrone monohydrate 500 mg or nimesulide 100 mg produced by compounding pharmacy, were prescribed for patients randomly, featuring a blind study. The intensity of pain after the extraction was assessed by patients using a visual analogue scale, in a postoperative period of 72 hours at 24 hour intervals. There was no statistical variation between the analgesics studied during the 3 days postoperatively evaluated, considering the presence or absence of ostectomy as a modifier of the search. Analgesia effect of nimesulide was similar to dipyrone according to the present study