Influência da Anquiloglossia neonatal na amamentação exclusiva nos seis primeiros meses de vida: estudo de coorte

RESUMO Objetivo Analisar a influência da anquiloglossia na prevalência e no tempo de exclusividade do aleitamento materno de lactentes a termo até o sexto mês de vida. Métodos Estudo de coorte prospectivo, realizado com 225 díades mãe-bebê que foram acompanhadas nos seis primeiros meses de vida em centro especializado em amamentação em um hospital terciário. Lactentes a termo com anquiloglossia do tipo assintomática (sem necessidade de cirurgia) foram comparados com lactentes sem alteração em um acompanhamento mensal. O diagnóstico de anquiloglossia foi realizado através do Bristol Tongue Assessment Tool, sendo considerados com diagnóstico positivo aqueles com escore menores ou iguais a 5 considerando os aspectos funcionais e anatômicos. As análises estatísticas foram realizadas através de estatística descritiva, regressão logística (determinantes do desmame), risco relativo e curvas de sobrevivência (para analisar o tempo de aleitamento entre os grupos com e sem anquiloglossia). Resultados A anquiloglossia esteve associada com o desmame (considerado ainda que parcial) antes do sexto mês de vida. Após análise ajustada, foi detectado maior risco de desmame nos lactentes com a alteração presente, com risco presente a partir do segundo mês de vida. Na análise de sobrevida, o tempo de aleitamento nos lactentes com anquiloglossia foi menor quando comparadas às crianças sem alteração. Conclusão Em comparação com lactentes com freio lingual normal, os bebês com anquiloglossia apresentaram tempo menor de aleitamento exclusivo, porém bem acima da média observada na população geral. O risco de desmame para este grupo também foi maior

Exclusive Breastfeeding in Infants with Ankyloglossia: Does the Tongue–Tie Interfere with Growth Patterns?

The effect of ankyloglossia on breastfeeding remains unclear. Most studies focus on surgical procedures to correct aspects of breastfeeding, and few studies have focused on follow-up patients through. This chapter aims to analyze the influence of ankyloglossia on exclusive breastfeeding and the growth of infants up to the sixth month of life. A prospective cohort study was carried out with 225 mother–infant dyads who were followed up for the first six months of life. Full-term babies with and without ankyloglossia were followed up at a specialized breastfeeding center. Weight and length were measured and adjustments for age were calculated using the Body Mass Index and Z scores. Statistical analyzes were performed using descriptive statistics, and ANOVA for repeated measures. No significant differences were found in the growth measures of the following babies who remained exclusively breastfed (p > 0.05). Thus, compared with infants with the normal lingual frenulum, infants with ankyloglossia had no significant changes were observed in the growth measurements of babies with and without ankyloglossia. Infants should be followed and supported in initial difficulties to avoid unnecessary surgical procedures since the idea that tongue-tied babies could have a different milk flow rate is not supported

Is it Possible to Perform Tooth Whitening During Orthodontic Treatment? / É possível realizar o clareamento dental durante o tratamento ortodôntico?

Aims: Analyzed the use of H2O2 at 35% in teeth after orthodontic brackets placement in some respects: change the color, the bond resistance of the bracket to the enamel (BS) and the adhesive remnant index (ARI).  Methods: Ninety bovine incisors with metal brackets were used, divided into 2 groups: (1) with whitening around orthodontic brackets and (2) without whitening. The color evaluation was performed with a portable spectrophotometer, in the incisal area and under the bracket, in two stages: before the placement of the brackets and after the adhesive strength test. During the experiment the samples were immersed in artificial saliva for 24 hours, 8 and 21 days for BS and ARI analysis. Results: No significant difference in color (under the brackets and incisal area) and in BS between areas and groups assessed. Regarding the ARI, the experimental group showed a significant difference in 24-hour period. Conclusion: there was uniform whitening throughout the enamel surface with orthodontics brackets bonded. The H2O2 at 35% did not show a negative effect on the BS and the ARI, however the 24 hours group showed a higher number of teeth without cement adhered to the surface of the enamel after whitening

Heteronormatividade, Masculinidade e Preconceito em Aplicativos de Celular: O Caso do Grindr em uma Cidade Brasileira

In this study our goal was to examine the masculinity associated to heteronormativity in a gay app from the users’ point of view, which was made through an inductive study based on semistructured interviews with app users. Main results suggest that Grindr is used as a contemporary form of sociability, mainly because it provides comfort and distance from segregated spaces. At the same time, it allows discretion in sexual encounters, which only happen between “equals”: white, young, athletic, handsome, and not effeminate men, and all those who differ from this profile are repelled. Heteronormativity imposes a pattern of masculinity that has overwhelmed everyone indiscriminately. Those who do not fit this profile can only be resigned to a secondary role at virtual community. Thus, technologies like this can aggravate marginalization of those already on the society fringes if forms of sociability continue to reproduce the oppression of prevailing heteronormativity.Neste estudo nosso intuito foi o de examinar a masculinidade associada à heteronormatividade em um aplicativo gay a partir dos discursos dos próprios usuários, o que foi feito por meio de um estudo indutivo baseado em entrevistas semiestruturadas com usuários do aplicativo. Os principais resultados sugerem que o Grindr é usado como uma forma contemporânea de sociabilidade, principalmente por proporcionar conforto e afastamento de espaços segregados. Ao mesmo tempo, possibilita sigilo em encontros sexuais, que só se concretizam entre “iguais”: homens brancos, jovens, atléticos, bonitos, e não afeminados, sendo repelidos todos os que diferem desse perfil. A heteronormatividade impõe um padrão de masculinidade que tem oprimido a todos indiscriminadamente. Aos que não se encaixam nesse perfil só resta se resignar a um papel secundário também na comunidade virtual. Tecnologias como essa, assim, podem agravar a marginalização de quem já se encontra à margem da sociedade se as formas de sociabilidade continuam a reproduzir a opressão da heteronormatividade vigente

Degree of risk related to procedures performed in conjunction with surgical myocardial revascularization in octogenarians

INTRODUCTION/OBJECTIVES: We determined the degree of risk produced by the association of other surgical procedures with surgical myocardial revascularization in octogenarian patients and identified the risk factors that best explain hospital mortality. METHODS: This study was an observational analytical historical cohort study involving octogenarians operated on at our institution between January 1, 2000 and January 1, 2005. We stratified the objective population as follows: Group 1 comprised octogenarians revascularized without associated procedures, and Group 2 comprised octogenarians revascularized with associated procedures. Statistical analyses included the t test for independent samples and multiple logistic regression analysis. Significance was accepted with an alpha error of 5%. RESULTS: Univariate analyses revealed the following clinical and statistically significant variables: hospital mortality (P=0.002), diabetes mellitus (P=0.017), preoperative endocarditis (P=0.001), cardiogenic shock (P=0.019), use of an intra-aortic balloon pump (P=0.026), preoperative risk score (Parsonnet), P<0.001, procedure associated with revascularization (P<0.001), medium number of affected coronary arteries (P<0.001), use of extracorporeal circulation (P<0.001), time of extracorporeal circulation (P<0.001), number of distal anastomoses (P=0.002), graft type (P<0.001), postoperative breathing support (P<0.001), stroke (P<0.001), infection (P=0.002), creatinine level (P=0.018), and quality of life score (P=0.050). DISCUSSION/CONCLUSIONS: In octogenarian patients, the need for a procedure associated with surgical myocardial revascularization produces an absolute increase in hospital mortality risk of 45%. The variables that contributed to hospital mortality were preoperative endocarditis, preoperative cardiogenic shock, the use of extracorporeal circulation, the length of time of extracorporeal circulation, postoperative creatinine level, and postoperative need for prolonged respiratory support

Degree of risk related to procedures performed in conjunction with surgical myocardial revascularization in octogenarians

INTRODUCTION/OBJECTIVES: We determined the degree of risk produced by the association of other surgical procedures with surgical myocardial revascularization in octogenarian patients and identified the risk factors that best explain hospital mortality. METHODS: This study was an observational analytical historical cohort study involving octogenarians operated on at our institution between January 1, 2000 and January 1, 2005. We stratified the objective population as follows: Group 1 comprised octogenarians revascularized without associated procedures, and Group 2 comprised octogenarians revascularized with associated procedures. Statistical analyses included the t test for independent samples and multiple logistic regression analysis. Significance was accepted with an alpha error of 5%. RESULTS: Univariate analyses revealed the following clinical and statistically significant variables: hospital mortality (P=0.002), diabetes mellitus (P=0.017), preoperative endocarditis (P=0.001), cardiogenic shock (P=0.019), use of an intra-aortic balloon pump (P=0.026), preoperative risk score (Parsonnet),

Comparing the Efficiency of Single versus Dual Ultrasonic Devices for Metallic Post Removal in Endodontic Retreatment: A Clinical Study

Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used. Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer. Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P&lt;0.001). Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device

Bioceramic Cements: Supporting in Remineralization of Osteolytic Lesions in Endodontic-periodontal Diseases: A Report of Two Cases

Bioceramic cements used for filling root canals in cases of endo-perio lesion of endodontic origin seem to be promising due to having the potential of promoting faster and more predictable healing of the periapical lesion as they stimulate osteogenesis. An effective treatment plan depends on the precise diagnosis of endo-perio lesions. The origin of an infection, being exclusive to the root canal, from the periodontium, or both, is extremely important for devising the treatment plan. In both cases, no clinical evidence of periodontal disease (bleeding, calculus, etc.) was found; however, primary endodontic lesions with the possibility of drainage through the gingival crevice were present. In addition to the disinfection strategies used during the root canal treatments, the bioceramics Bio C Sealer, Bio C Repair and Bio Root RCS were used to fill in the root canals. Both cases presented an impressive bone gain within 8 months for case 1 and 5 months for case 2. Regarding case 1, in the palatal root canal an apical plug with a bioceramic repair cement was used. Based on the literature studied, it can be concluded that after adequate disinfection of the root canals, using bioceramic cements in filling the root canals shows the potential of supporting capabilities in remineralization of osteolytic lesions in endo-perio diseases.

Orthodontic Movement of Central Incisor with Previously-healed Root Fracture associated with Unerupted Canines

Teeth with root fracture may need orthodontic treatment. This case report presents the management of unerupted canines in a patient with previously-healed/untreated horizontal root fracture in the maxillary left central incisor. The malocclusion was treated maintaining pulp vitality considering the principles to improve the eruption path of maxillary canines and move short-rooted teeth. The root-fractured tooth remained symptomless after orthodontic treatment without significant adverse effects, and stayed stable following 2-year follow-up

Literatura e argumentação: a escrita da redação do Enem sob um olhar interdisciplinar

The development of writing involves skills that permeate school education, from language acquisition to the writing itself, by different genres. At the end of high school, the student is asked to write an argumentative essay in prose, in standard Portuguese, based on a theme of social relevance (this is one of the tests of the National High School Exam, known by its Portuguese acronym, Enem). Teachers are therefore faced with the need to improve the students’ rhetorical skills in argumentation through a written text that involves an adequate selection of the sociocultural repertoire. This work presents the experience of a project that aims to find out how literary literacy can help in the writing of the Enem essay. Through participation in a book club and writing workshops, students experience the writing process mediated by literary reading.A elaboração da escrita envolve habilidades que perpassam a formação escolar, da aquisição da linguagem à materialização da palavra escrita pelos diferentes gêneros textuais. Ao final do Ensino Médio, o estudante é demandado à escrita de um texto dissertativo-argumentativo em prosa, na modalidade culta do português, a partir de uma temática de relevância social (essa é uma das provas do Exame Nacional do Ensino Médio, o Enem). Os professores se deparam, assim, com a necessidade de aperfeiçoar a capacidade argumentativa dos discentes por meio de uma enunciação escrita que envolva uma seleção adequada do repertório sociocultural. Este trabalho apresenta a experiência de um projeto que visa saber de que maneira o letramento literário pode auxiliar na escrita da redação do Enem. Por meio da participação em um clube de leitura e em oficinas de redação, os estudantes vivenciam o processo de escrita mediado pela leitura literária