Retratamento endodôntico com o uso de insertos ultrassónicos associados a instrumentos reciprocantes: Um relato de caso / Endodontic treatment using ultrasonic inserts associated with reciprocating instruments: A case report

Retratamentos endodônticos necessitam de estratégias precisas e eficientes, nas suas principais etapas, a desobturação e no controle da infecção. Esse trabalho apresenta os conceitos contemporâneos das técnicas utilizadas em retratamentos. Dente 44 com sintomatologia indicativa de insucesso endodôntico. Após a anamnese e exames radiográficos o dente foi acessado, o pino de fibra de vidro foi removido com o inserto E6D e a desobturação foi realizada com o inserto Clearsonic Black, limas R25 Classic e R40 Blue também foram usadas nessa etapa. O canal foi irrigado com NaClO a 2,5% associado a PUI usando Irrisonic e agitando com Easy Clean. A medicação intracanal pasta H.P.P (Hidroxido de Calcio, PMCC e Propilenoglicol) foi utilizada após o período de escolha baseada na metodologia do trabalho o dente foi obturado com cone FM Odous calibrado e cimento biocerâmico Bio-C sealer. Radiograficamente a obturação apresentou-se satisfatória e a sintomatologia regrediu, um tempo maior de proservação é necessário para que os achados radiográficos regridam e seja confirmado o sucesso do tratamento

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity . Here we use 2,009\ua0population-based studies, with measurements of height and weight in more than 112\ua0million adults, to report national, regional and global trends in mean\ua0BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in\ua0some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities\ua0in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Hydnopolyporus fimbriatus (Fr.) D.A. Cogumelo Reid: análise fitoquímica, atividade antioxidante, flavonóides totais e compostos fenólicos totais

Hydnopolyporus fimbriatus is a species of mushroom of the Meripilaceae Jülich family found in some regions of Central and South America. This study aimed to evaluate the qualitative phytochemical composition, the antioxidant activity in the reduction of DPPH and hydroxyl free radicals and to determine the flavonoid contents and total phenolics in the ethanolic extract of the mushroom H. fimbriatus. The ethanolic extract was prepared and lyophilized. Qualitative phytochemical prospection assays were performed for different groups of organic compounds. The antioxidant assay was carried out in the reduction of the 2,2-diphenyl-1-picrylhy-drazyl free radical and in the reduction of the hydroxyl free radical by colorimetric methods. The ethanolic extract of H. fimbriatus positively exhibited several phytochemical groups, moderate antioxidant activity in reducing free radical DPPH 101.09 µ mL-1, high hydroxyl radical reducing activity 87.51% and potential total phenolic content 20.15 mg GAE 100 g-1 of dry extract. Flavonoids content was not observed possibly due to the colorimetric method using aluminum chloride. With these results, it was possible to characterize the ethanolic extract of the vegetative part of Hydnopolyporus fimbriatus. New studies should be carried out in an attempt to develop a quantitative method of total flavonoids as well as test the extract in other biological models, thus being able to develop new drugs or products for agricultural use.Hydnopolyporus fimbriatus es una especie de champiñón de la familia Meripilaceae Jülich que se encuentra en algunas regiones de América Central y del Sur. Este estudio tuvo como objetivo evaluar la composición fitoquímica cualitativa, la actividad antioxidante en la reducción de radicales libres DPPH e hidroxilo y determinar el contenido de flavonoides y fenoles totales en el extracto etanólico del champiñón H. fimbriatus. El extracto etanólico fue preparado y liofilizado. Se realizaron ensayos cualitativos de prospección fitoquímica para diferentes grupos de compuestos orgánicos. El ensayo antioxidante se realizó en la reducción del radical libre 2,2-difenil-1-picrilhidrazilo y en la reducción del radical libre hidroxilo por métodos colorimétricos. El extracto etanólico de H. fimbriatus exhibió positivamente varios grupos fitoquímicos, moderada actividad antioxidante en la reducción del radical libre DPPH 101,09 µmL-1, alta actividad reductora de radicales hidroxilo 87,51 % y potencial contenido fenólico total 20,15 mg EAG 100 g-1 de extracto seco. No se observó contenido de flavonoides posiblemente debido al método colorimétrico con cloruro de aluminio. Con estos resultados se logró caracterizar el extracto etanólico de la parte vegetativa de Hydnopolyporus fimbriatus. Se deberían realizar nuevos estudios en un intento de desarrollar un método cuantitativo de flavonoides totales así como probar el extracto en otros modelos biológicos, pudiendo así desarrollar nuevos fármacos o productos para uso agrícola.Hydnopolyporus fimbriatus é uma espécie de cogumelo da família Meripilaceae Jülich encontrada em algumas regiões da América Central e do Sul. Este estudo teve por objetivo avaliar a composição fitoquímica qualitativa, a atividade antioxidante na redução dos radicais livres DPPH e hidroxila e determinar os conteúdos de flavonoides e fenólicos totais no extrato etanólico do cogumelho H. fimbriatus. O extrato etanólico foi preparado e liofilizado. Os ensaios qualitativos de prospecção fitoquímica foram realizados para diferentes grupos de compostos orgânicos. O ensaio antioxidante foi realizado na redução do radical livre 2,2-difenil-1-picril-hidrazila e na redução do radical livre hidroxila por métodos colorimétricos. O extrato etanólico de H. fimbriatus exibiu positivamente diversos grupos fitoquímicos, moderada atividade antioxidante na redução do radical livre DPPH 101.09 µ mL-1, alta atividade de redução do radical hidroxila 87,51% e potencial conteúdo de fenólicos totais 20.15 mg EAG 100 g-1 de extrato seco. Não foi observado conteúdo de flavonoides, possivelmente devido ao método colorimétrico utilizando cloreto de alumínio. Com esses resultados, foi possível caracterizar o extrato etanólico da parte vegetative de Hydnopolyporus fimbriatus. Novos estudos deveram ser realizados na tentativa de desenvolver um método quantitativ de flavonoids totais bem como, testar o extrato em outros modelos biológicos podendo assim, desenvolver novos fármacos ou produtos de uso agrícola.    &nbsp