Slurry preparation methods affect dental porcelain reliability

One-step and incremental mixing procedures are currently used to produce dental ceramic pastes. In the ceramic industry, high quality is obtained using one-step mixing, but in dentistry, the best method has not been yet determined. The purpose of this study is to evaluate the effects of 2 mixing techniques on the biaxial flexural strength and microstructure of dental porcelain. Feldspathic porcelain discs (2 × 15 mm in diameter) were produced and divided according to the ceramic paste preparation method, powder-liquid incremental mixing group (n=50) or one-step mixing, as a control group (n=50). Specimens were tested for biaxial flexural strength and characterized using porosimetry, relative humidity, SEM/EDS, XRD, and FT-IR analyses. Statistical analysis was conducted using Weibull statistics. The Weibull modulus, characteristic strength and relative humidity were compared between groups, using Student's t-test and Mann-Whitney U test (a=.05). The powder-liquid incremental mixing group showed significantly higher values (SD) of Weibull modulus (6.74 (0.70), P<.001) and characteristic strength (79.87 (2.01) MPa, P<.001) when compared to the one-step mixing group (4.94 (0.94) and 75.95 (2.61) MPa). Significantly lower mean (SD) relative humidity values (P=.009) were found for powder-liquid incremental mixing group (20% (0.5%)) compared to one-step mixing group (22% (1%)). XRD spectra showed that the one-step mixing group produced higher amounts of the amorphous phase. Specimens produced by the incremental mixing technique showed higher biaxial flexural strength than one-step mixing

Modelo teórico e lógico para avaliação da capacidade de gestão do componente especializado da assistência farmacêutica

O Componente Especializado da Assistência Farmacêutica (CEAF) tem como objetivo a garantia da integralidade do tratamento medicamentoso em nível ambulatorial. Dada sua recente implementação, é necessário analisar se os estados possuem condições de executar as ações, atingir e sustentar os resultados esperados. Com este objetivo, é necessária uma avaliação da capacidade de gestão do CEAF no âmbito estadual. Uma das fases da avaliação é o desenvolvimento de um modelo teórico e um modelo lógico, apresentados neste artigo. Com os modelos apresentados, fica clara a complexidade e os diversos fatores que influenciam a capacidade de gestão do CEAF.&nbsp; Observou-se que há forte dependência do CEAF em relação à outras ações estruturantes na própria política de saúde, nas políticas econômicas, em relação à indústria farmacêutica, entre outros. Somado a isso, os conceitos de gestão e de capacidade de gestão adotados refletem a necessidade de superar a fragmentação e a redução tecnicista imposta à área. Por fim, a construção dos modelos de forma contextualizada auxilia de forma singular no processo de avaliação e auxiliará na análise das condições de estruturação do Componente nos estados, assim como das condições para execução e o alcance dos resultados. Palavras-chaves:&nbsp;Avaliação em Saúde; Gestão em Saúde; Modelos Lógicos; Assistência Farmacêutica; Componente Especializado da Assistência Farmacêutica. &nbsp

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks