A importância do cuidador no contexto da saúde do idoso La importancia del cuidador en el contexto de la salud del anciano The importance of the caregiver in the elderly health context

Trata-se de um estudo bibliográfico que busca discutir a temática "idoso dependente de cuidados e a capacitação do cuidador no contexto domiciliar". A análise foi realizada a partir de autores que desenvolveram estudos sobre envelhecimento com dependência, cuidado familiar e ações direcionadas ao cuidador informal. Os temas destacados para esta análise foram: o papel do cuidador informal no cuidado do idoso dependente; a vivência de ser um cuidador familiar; e os modelos de atenção e suporte direcionados ao cuidador informal. O estudo demonstra a importância da ampliação de estratégias que tenham o cuidador como sujeito principal, cabendo ao profissional de saúde e às políticas públicas valorizarem a rede de suporte ao idoso dependente. Esta rede é importante como base do processo de cuidar com qualidade.<br>Se trata de un estudio bibliográfico que busca discutir la tematica del anciano dependiente y la capacitación del cuidador en el contexto domiciliar. La análisis fue realizada a partir de autores que desarollaron estudios sobre envejecimiento con dependencia, cuidado familiar y acciones direccionadas al cuidador informal. Los temas destacados para esta análisis fueron: el papel del cuidador informal en el cuidado al idoso dependiente; la vivencia de ser un cuidador familiar; y los modelos de atención y suporte dirigidos para el cuidador informal. El estudio muestra la importancia de la ampliación de estrategias que tengan el cuidador como sujeto principal, siendo de competencia del profesional de salud y de las políticas públicas valoraren la red de soporte al idoso dependiente y tenerla como aliada en el proceso de cuidar con calidad.<br>The present study is a bibliographic research that aims to discuss the theme "the dependent elderly and caregiver's skills in domiciliary context". The authors who developed studies on dependent elderly, familiar care and non-professional care actions were consulted. The themes emphasized were: the role of non-professional caregivers; the experience of caring a relative, and models of assistance and support for non-professional caregivers. The study shows the importance of establishing strategies of support for the community Care. It is up to the health professionals and to the public policies to value a support system to the dependent aged cared in community. This system should be the base for a qualified process of care

The secretory immunoglobulin A response to Mycobacterium tuberculosis in a childhood population Resposta da imunoglobulina A secretória ao Mycobacterium tuberculosis em população infantil

We report on the measurement of saliva anti-Purified Protein Derivative sIgA and 38kDa antibodies from 127 children, of whom 31 were strong tuberculosis suspects and 96 were healthy contact children. The results concerning the percentage of children with antibody reactivity to PPD and 38kDa antigens showed that, of these 2 antigens, 38kDa induced higher reactivity in patients positive and negative for the Tuberculin Skin Test (28% and 16.6%, respectively) in comparison to controls positive and negative for the TST (11.7% and 7.1%, respectively). There was a statistically significant difference between patients positive and controls negative for the TST. In relation to the Purified Protein Derivative antigen, while 14.2% of patients positive for the TST showed antibody reactivity to the PPD antigen, no patients negative for the TST had reactivity to this antigen. The findings suggest that these two antigens seem be associated with a different development of the mucosal defence mechanisms mediated by sIgA against Mycobacterium tuberculosis.<br>Foram dosados anticorpos sIgA anti-Purified Protein Derivative e 38kDa da saliva de 127 crianças, das quais 31 eram de pacientes altamente suspeitos de tuberculose e 96 eram provenientes de crianças saudáveis, que tiveram contato com pacientes. Os resultados referentes à porcentagem de crianças, reativas ao PPD e ao antígeno 38kDa, mostraram que destes dois antígenos, o 38kDa induziu maior reatividade em pacientes positivos e negativos ao Tuberculin Skin Test (28% e 16,6%, respectivamente), em comparação aos controles positivos e negativos ao TST (11,7% e 7,1%, respectivamente). Houve diferença estatisticamente significativa entre pacientes positivos e controles negativos ao Tuberculin Skin Test. Em relação ao antígeno PPD, enquanto 14,2% de pacientes positivos ao TST mostraram anticorpos reativos ao antígeno Purified Protein Derivative, nenhum paciente negativo ao TST foi reativo ao antígeno. Os achados sugerem que, aparentemente, estes dois antígenos estão associados a desenvolvimento distinto dos mecanismos de defesa da mucosa mediados por sIgA contra Mycobacterium tuberculosis

Micro‐computed tomography analysis of enamel structure after different bleaching treatments

The aim of this investigation is to assess effect of three different bleaching techniques on structural integrity, mineral density and volume of enamel via micro-computed tomography (micro-CT) and examine color changes by CIELAB and CIEDE2000 formulas. Twenty-four upper premolar teeth were randomly separated into three different groups (n = 8) (group 1, 35% hydrogen peroxide (HP) gel with Er,Cr:YSGG laser activation; group 2, 35% HP gel with diode laser activation; group 3, 35% HP gel with chemically activation). High-resolution micro-CT system (Bruker Skyscan 1275, Kontich, Belgium) was carried out to scan samples. Each tooth was scanned twice before-after application of bleaching with same scanning parameters. Structural thickness, structural separation, fragmentation index, mineral density, and mineral volume of enamel were calculated for each region of interest (ROI). Color changes were measured with spectrophotometer and calculated with CIELAB and CIEDE2000 formulas. Data analysis was made with one-way ANOVA with post-hoc LSD. Micro-CT analysis indicated that statistically significant differences were found in structural thickness, and separation, mineral density, and mineral volume of enamel for different ROIs before and after whitening for whole groups (P .05). All bleaching applications exhibited similar efficiency on the enamel surface. Nevertheless, bleaching process with Er,Cr:YSGG laser had less negative effects on enamel as it showed less change in enamel compared to other bleaching treatments. Micro-CT analysis of histomorphometric parameters can be useful for further mineralization studies of dental hard tissues