Oral myiasis in a patient with neurological deficit - Case report / Miíase oral em paciente com déficit neurológico - Relato de caso

The term "myiasis" refers to human and animal parasites caused by fly larvae. The clinical manifestations of myiasis are not specific, they vary according to the area of the body involved and the species of fly. It is strongly associated with poor oral hygiene and is seen in people with predisposing conditions, such as lack of lip sealing due to malocclusion, tooth extraction, decreased body resistance, malnutrition, open-mouth breathing (especially during sleep), alcoholism, senility, neurological disorder, hemiplegia and facial trauma. The present work describes the particularities of diagnosis and treatment of a case of oral myiasis. A 17-year-old male patient with neurological deficit, totally dependent on his daily life activities. Oral examination revealed poor oral hygiene, presence of periodontitis and lesions in the palate and gingival regions, with swelling and presence of large numbers of larvae. Surgery under local anaesthesia was performed. After exposure of the affected region, the larvae were removed. Sixty-two larvae of various sizes were observed. Early and correct diagnosis of oral myiasis can be easily treated by the dentist by mechanical removal of the larvae with or without the use of local chemicals, with a favourable prognosis

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

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

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Manchamento por tetraciclina: como tratar?

Dental discolorations caused by drugs like tetracycline usually result in a unpleasant smi¬le. Such change causes embarrassment and even some kind of discomfort to patients; it also worries dentists which are always sear¬ching for more conservative and inexpensive treatments, in order to supply the expectations of patients that wish to have a healthy and bri¬ght smile. Non-invasive tecniques, like blea¬ching with chemical agents and invasive tecni¬ques like restorative procedures are some al-ternative. The purpose of this study is to revi¬ew the literature about the tetracycline me¬chanism and its side-effects in teeth, as well as to discuss the possibilities of color reverse in tetracycline-stained teeth using case report.O escurecimento dental de origem medicamentosa pela ingestão da tetraciclina repercute negativamente na aparência do sorriso. Tal alteração causa constrangimento e incômodo ao paciente e preocupa o Cirurgião-Dentista na busca de tratamentos mais conservadores e de menor custo que atendam aos anseios do paciente em possuir um sorriso com harmonia de cor. Para essas situações clínicas são propostas alternativas de tratamento não-invasivas, como o clareamento dental por substâncias químicas, e invasivas, como procedimentos restauradores adesivos. O objetivo deste trabalho é revisar a literatura sobre o mecanismo de ação das tetraciclinas e seus efeitos colaterais nos dentes, bem como discutir as possibilidades de reversão cromática de dentes manchados por tetraciclina através de relato clínico