RESUMO
PURPOSE: The structural similarity index measure (SSIM) has become a popular quality metric to evaluate QSM in a way that is closer to human perception than RMS error (RMSE). However, SSIM may overpenalize errors in diamagnetic tissues and underpenalize them in paramagnetic tissues, resulting in biasing. In addition, extreme artifacts may compress the dynamic range, resulting in unrealistically high SSIM scores (hacking). To overcome biasing and hacking, we propose XSIM: SSIM implemented in the native QSM range, and with internal parameters optimized for QSM. METHODS: We used forward simulations from a COSMOS ground-truth brain susceptibility map included in the 2016 QSM Reconstruction Challenge to investigate the effect of QSM reconstruction errors on the SSIM, XSIM, and RMSE metrics. We also used these metrics to optimize QSM reconstructions of the in vivo challenge data set. We repeated this experiment with the QSM abdominal phantom. To validate the use of XSIM instead of SSIM for QSM quality assessment across a range of different reconstruction techniques/algorithms, we analyzed the reconstructions submitted to the 2019 QSM Reconstruction Challenge 2.0. RESULTS: Our experiments confirmed the biasing and hacking effects on the SSIM metric applied to QSM. The XSIM metric was robust to those effects, penalizing the presence of streaking artifacts and reconstruction errors. Using XSIM to optimize QSM reconstruction regularization weights returned less overregularization than SSIM and RMSE. CONCLUSION: XSIM is recommended over traditional SSIM to evaluate QSM reconstructions against a known ground truth, as it avoids biasing and hacking effects and provides a larger dynamic range of scores.
RESUMO
Although women with schizophrenia face significant lifelong challenges due to their diagnosis and sex-related issues, those challenges are seldom taken into consideration in their medical treatment and general care. In order to report the needs and desires of a group of women with schizophrenia, we conducted a series of semistructured interviews with nine women diagnosed with schizophrenia and attending outpatient clinics at the Hospital Del Salvador in Valparaíso. Our qualitative study followed a phenomenological design. Using ATLAS.ti software, we performed a content analysis of the interview transcripts, developed a coding frame for each major topic addressed in the interviews, and triangulated the results. Despite presenting with psychotic symptoms, some women received different diagnoses. Although acknowledging the benefits of medication, women also reported concerns about weight gain and body image. All women reported experiences with stigma and self-stigma related to the diagnosis of schizophrenia, and most had experienced childhood trauma, including sexual abuse, parental violence, and/or bullying. Young women with schizophrenia also feared that if they become mothers, then their children might also have schizophrenia and/or that they would be unable to adequately care for them. Women with schizophrenia have different experiences and play different roles in society beyond their psychoses, an understanding that should integrated into more personalized treatments for schizophrenia that consider individual characteristics and needs.
RESUMO
BACKGROUND: At the beginning of the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) of unprecedented scope and duration were implemented to limit community spread of COVID-19. There remains limited evidence about how these measures impacted the lived experience of affected communities. This study captured the early impacts and coping strategies implemented in King County, Washington, one of the first U.S. communities impacted by COVID-19. METHODS: We conducted a cross-sectional web-based survey of 793 English- and Spanish-speaking adult King County residents from March 18, 2020 -May 30, 2020, using voluntary response sampling. The survey included close- and open-ended questions on participant demographics, wellbeing, protective actions, and COVID-19-related concerns, including a freeform narrative response to describe the pandemic's individual-, family- and community-level impacts and associated coping strategies. Descriptive statistics were used to analyze close-ended questions, and qualitative content analysis methods were used to analyze free-form narrative responses. RESULTS: The median age of participants was 45 years old, and 74% were female, 82% were White, and 6% were Hispanic/Latinx; 474 (60%) provided a qualitative narrative. Quantitative findings demonstrated that higher percentages of participants engaged in most types of COVID-19 protective behaviors after the stay-at-home order was implemented and schools and community spaces were closed, relative to before, and that participants tended to report greater concern about the pandemic's physical health or healthcare access impacts than the financial or social impacts. Qualitative data analysis described employment or financial impacts (56%) and vitality coping strategies (65%), intended to support health or positive functioning. CONCLUSIONS: This study documented early impacts of the COVID-19 pandemic and the NPIs implemented in response, as well as strategies employed to cope with those impacts, which can inform early-stage policy formation and intervention strategies to mitigate the negative impacts. Future research should explore the endurance and evolution of the early impacts and coping strategies throughout the multiyear pandemic.
Assuntos
COVID-19 , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Pandemias/prevenção & controle , Quarentena , Washington/epidemiologiaRESUMO
ABSTRACT Objective: In traumatic injuries of the thoracic spine, three variables are analyzed to make decisions: morphology of the injury, posterior ligamentous complex and neurological status; currently the fourth column is not evaluated; our objective was to determine the biomechanical behavior of the spine with a fracture of the fifth thoracic vertebral body when accompanied by a short oblique fracture of the sternum. Methods: An anonymous model of a healthy 25-year-old male was used, from which the thoracic spine and rib cage were obtained; in addition to the ligaments of the posterior complex and the intervertebral discs, four models were simulated. An axial section was made, a load of 400 N was applied, and the biomechanical behavior of each model was determined. Results: The area that suffered the most stress at the vertebral level was the posterior column of T4-T5 (tensile strength of 747 MPa), which exceeded the plastic limit, the load through the ribs was distributed from the first to the sixth (100 MPa), in the sternum the stress increased (200 MPa), the deformity increased to 45 mm. Conclusions: The sternum was a fundamental part of the spine's stability; the combined injury severely increased the stress (8 MPa to 747 MPa) in the spine and exceeded the plastic limit, which generated an instability that is represented by the global deformity acquired (1 mm to 45 mm). Level of evidence II; Prospective comparative study.
RESUMO Objetivo: Nas lesões traumáticas da coluna torácica, três variáveis são analisadas para tomada de decisão: morfologia da lesão, complexo ligamentar posterior e estado neurológico; atualmente a quarta coluna não é avaliada, nosso objetivo foi determinar o comportamento biomecânico da coluna com fratura do quinto corpo vertebral torácico quando acompanhada de fratura oblíqua curta do esterno. Métodos: Obteve-se um modelo anônimo de um homem saudável de 25 anos, do qual foram obtidas a coluna torácica e caixa torácica, além dos ligamentos do complexo posterior e dos discos intervertebrais, foram simulados 4 modelos, foi feito o corte, e foi aplicada uma carga de 400 N e o comportamento biomecânico de cada modelo foi estendido. Resultados: A área que mais sofreu estresse ao nível vertebral foi a coluna posterior de T4-T5 (resistência à tração de 747 MPa), que ultrapassou o limite plástico, a carga pelas costelas foi distribuída da primeira à sexta (100 MPa), no esterno a maior tensão (200 MPa), a deformidade maior que 45 mm. Conclusões: O esterno foi a peça fundamental na estabilidade da coluna, a lesão combinada aumentou severamente o estresse (8 MPa a 747 MPa) na coluna e ultrapassou o limite plástico, o que mantém uma instabilidade que é representada pela deformidade global adquirida (1 mm a 45 mm). Nível de evidência II; Estudo prospectivo comparativo.
RESUMEN Objetivo: En las lesiones traumáticas de la columna torácica se analizan tres variables para tomar decisiones: morfología de la lesión, complejo ligamentoso posterior y estado neurológico; actualmente no se evalúa la cuarta columna, nuestro objetivo fue determinar el comportamiento biomecánico de la columna con una fractura del quinto cuerpo vertebral torácico cuando se acompaña de una fractura oblicua corta del esternón. Métodos: Se utilizó un modelo anónimo de sexo masculino sano de 25 años de edad, del cual se obtuvo la columna torácica, y la caja torácica, además se le agregaron los ligamentos del complejo posterior y los discos intervertebrales, se simularon 4 modelos a los cuales se les realizó un corte axial, se aplicó una carga de 400 N y se determinó el comportamiento biomecánico de cada modelo. Resultados: La zona que más estrés sufrió a nivel vertebral fue la columna posterior de T4-T5 (resistencia a la tracción de 747 MPa), la cual superó el límite plástico, la carga a través de las costillas se distribuyó de la primera a la sexta (100 MPa), en el esternón el estrés aumentó (200 MPa), la deformidad aumentó a 45 mm. Conclusiones: El esternón fue parte fundamental en la estabilidad de la columna, la lesión combinada incrementó severamente el estrés (8 MPa a 747 MPa) en la columna y este superó el límite plástico, lo que generó una inestabilidad que se representa por la deformidad global adquirida (1 mm a 45 mm). Nivel de evidencia II; Estudio prospectivo comparativo.
Assuntos
Fraturas da Coluna VertebralRESUMO
INTRODUCCIÓN. La epidemia de influenza y sus complicaciones profundizaron el estudio de las neumonías virales en cuidados intensivos. En nuestro país hay pocos datos sobre este tema. OBJETIVOS. Realizar una caracterización demográfica y clínica de pacientes críticos con neumonía por Influenza A H1N1 en un hospital de tercer nivel de complejidad. MATERIALES Y MÉTODOS. Estudio observacional, analítico, retrospectivo, con análisis univariante y multivariante. Población de 293 y muestra de 44 datos de historias clínicas electrónicas de pacientes diagnosticados con A H1N1 ingresados a la Unidad de cuidados intensivos del Hospital de Especialidades Carlos Andrade Marín en el período enero 2016 a diciembre de 2018. Como criterios de inclusión se consideró a todos los pacientes adultos mayores de 18 años que ingresaron a la UCI, con el diagnóstico de neumonía comunitaria grave con confirmación por reacción de cadena de polimerasa en tiempo real para influenza A H1N1 en hisopado nasal o aspirado traqueal. Se excluyó a pacientes embarazadas con diagnóstico de influenza A H1N1, pacientes con más de 48 horas de ingreso hospitalario previo a su ingreso a UCI, pacientes con datos insuficientes en los registros. Los datos se obtuvieron del sistema AS-400. El análisis estadístico se realizó en el programa Statistical Package for Social Sciences, versión 22. El nivel de significación fue una p<0.05. RESULTADOS. La prevalencia en pacientes críticos de neumonía por influenza A H1N1 durante 2016-2018 fue de 16,72%, la mediana de edad fue de 55 años, 25% masculinos, 34% obesos, 34% con hipertensión arterial. Escala "Acute Physiology and Chronic Health Evaluation II" 23,50, "Simplified Acute Physiologic Score III" 54, "Sepsis related Organ Failure Assessment" 11,50, Lactato deshidrogenasa 99,50, Procalcitonina 0,99; 9 días de ventilación mecánica invasiva, 10,50 días de estancia en la unidad. El 91% presentó shock séptico, 59% lesión renal aguda. El 89% tuvo Síndrome de Distrés Respiratorio del Adultos, 69% fue grave, 87% usó ventilación mecánica, 38,50% corticoides, 36% posición prona, Presión parcial de oxígeno/Fracción inspirada de oxígeno 74, volumen tidal/kilogramo de 7 mililitros, presión plateau de 27,50 centímetros de agua. La mortalidad general en la Unidad de Cuidados Intensivos fue de 38,63% y a los 28 días de 63,60%, en shock séptico fue 42,50% y en Síndrome de Distrés Respiratorio del Adultos del 41,02%. El análisis de regresión logística multivariable identificó como factores independientes asociados a mortalidad el incremento de Lactato deshidrogenasa (OR 2,69, 9% IC 1,090-6,642) y Procalcitonina (OR 2,51, IC 1,005-6,272). CONCLUSIONES. Las características, frecuencia y mortalidad de este grupo de pacientes críticos con neumonía por influenza A H1N1 son similares a lo reportado en la literatura mundial.
INTRODUCTION. The influenza epidemic and its complications deepened the study of viral pneumonias in intensive care. In our country there is little data on this subject. OBJECTIVES. To perform a demographic and clinical characterization of critical patients with pneumonia due to pneumonia due to Influenza A H1N1 in a third level hospital. MATERIALS AND METHODS. Observational, analytical, retrospective study, with univariate and multivariate analysis. We compared the groups of dead patients and survivors. The significance level was p<0,05. RESULTS. The prevalence in critically ill patients of influenza A H1N1 pneumonia during 2016-2018 was 16,72%, 44 cases were collected, median age 55 years, 25% male, 34% obese, 34% with arterial hypertension. APACHE II 23,50, SAPS III 54, SOFA 11,50, LDH 99,50, PCT 0,99, 9 days of invasive mechanical ventilation, 10,50 days of unit stay. 91% presented septic shock, 59% with acute kidney injury 89% had ARDS, 69% were severe, 87% used mechanical ventilation, 38,50% corticosteroids, 36% prone position, PaO2/FiO2 74, tidal volume/kg of 7 ml, plateau pressure of 27,50 cmH2O. Overall mortality in the ICU was 38,63% and at 28 days was 63,60%, in septic shock it was 42,50% and in Adult Respiratory Distress Syndrome it was 42,50%. was 42,50% and 41,02% in Adult Respiratory Distress Syndrome. The ultivariate logistic regression analysis identified as independent factors associated with mortality, the increase in LDH (OR 2,69, 9% CI 1,090-6,642) and PCT (OR 2,51, CI 1,005-6,272). CONCLUSIONS. The characteristics, frequency and mortality of this group of critical patients with pneumonia due to influenza A H1N1 are similar to those reported in the world literature.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pneumonia , Pneumonia Viral , Síndrome do Desconforto Respiratório do Recém-Nascido , Infecções Comunitárias Adquiridas , Sepse , Vírus da Influenza A Subtipo H1N1 , Respiração Artificial , Choque Séptico , Comorbidade , Mortalidade , Lavagem Broncoalveolar , Diagnóstico , Equador , Conduta do Tratamento Medicamentoso , Unidades de Terapia IntensivaRESUMO
Resumen El síndrome de Austrian es una tríada que engloba neumonía, meningitis y endocarditis causadas por Staphylococcus pneumoniae. Dado el aumento en el uso de antibióticos, cada vez vemos esta enfermedad de forma menos frecuente en la práctica clínica diaria. No obstante, se debe recordar su existencia ya que el conocimiento de esta entidad puede ser crucial en el pronóstico de estos enfermos. Desconocer algunos síndromes por presentar una frecuencia menor en los tiempos actuales no exime de mantener la buena práctica clínica ya que de ello puede depender el devenir del paciente. Se presenta un caso de síndrome de Austrian en un paciente joven, quien tuvo evolución tórpida los primeros días de ingreso; finalmente, tras la realización de varias pruebas, se solicitó un ecocardiograma que fue la clave para el diagnóstico. Se trata de un caso de interés para reflexionar en que, a pesar de poseer nuevas tecnologías a nuestro alcance en la actualidad, es preciso recordar la importancia de una buena exploración física.
Abstract Austrian syndrome is a triad that includes pneumonia, meningitis, and endocarditis caused by Staphylococcus pneumoniae. Given the increase in the use of antibiotics, it is becoming less common to see this disease in daily clinical practice. However, it should be remembered that it exists since knowledge of this condition could be crucial in the prognosis of these patients. To not recognise some syndromes due to currently having a lower frequency does not exempt maintaining good clinical practice, since the outcome of the patient may depend on this. A case of Austrian syndrome is presented in a young patient, who had a slow response in the first days of admission. Finally, after performing several tests, a cardiac ultrasound was requested, which was key for the diagnosis. It is an interesting case to reflect that, despite currently having new technologies within our reach, it is essential to remember the importance of a good physical examination.
Assuntos
Humanos , Pessoa de Meia-Idade , Endocardite , Pneumonia , Ecocardiografia , MeningiteRESUMO
Objetivo: Determinar si los cambios de temperatura afectan a la resistencia flexural de los acrílicos de termocurado para la base de dentaduras con y sin insertos metálicos Materiales y métodos: Se elaboraron 80 muestras de acrílico de termocurado marca Veracril® según la especificación Nº12 de la American Dental Association (ADA) (10×65×25 mm); se conformaron cuatro gru-pos de 20 probetas, organizándolas de la siguiente manera Grupo 1: muestras sin realizar termociclado y sin inserto metálico. Grupo 2: muestras sometidas a termociclado y sin inserto metálico. Grupo 3: muestras sin realizar termociclado y con inserto metálico. Grupo 4 muestras sometidas a termociclado y con inserto metálico. Se realizaron 1000 ciclos termales mediante un procedimiento manual de 2 minutos por cada ciclo térmico, correspondiendo 1 minuto en temperatura de 5 ± 2 oC y 1 minuto a 55 ± 2 oC a un ciclo. La resistencia flexural se evaluó con una prueba de tres puntos a una velocidad de 1mm/min. El análisis estadístico fue a través de la prueba t de Student para muestras relacionadas con un nivel de significancia del 5%. Resultados: La media de resistencia flexural fue de 73.51, 65.65, 71.14 y 73.08 Megapascales (MPa)., para los grupos 1,2,3 y 4 respectivamente. Se observó que el G1 fue mayor que el G2 (p=0.002) y el G3 con el G4 no obtuvo valores con diferencia estadística significativa (p=0.554). Conclusión: Los cambios térmicos como procesos de envejecimiento del material influyen de forma negativa en la resistencia flexural de las muestras que en su estructura no presentaban inserto metálico, mientras que las muestras que poseían los insertos mejoraron la resistencia del material siendo esto estadísticamente comprobable.
Objective: The aim of this study was to determine if the different temperature changes affect in the flexural strength of the heat-cured acrylic for the base of dentures with and without metallic inserts by means of thermal cycling and flexion tests.Ma-terials and Methods: Eightysamples were prepared of a heat-cure acrylic Veracril® marque according to the specification no. Nº12 de la American Dental Association (ADA) (10×65×25 mm); Four groups of 20 buretteswere formed, each being Group 1: samples without realizing thermo cycling and without metallic insert. Group 2 for samples submitted to thermo cycling and wi-thout metallic insert. Group 3 for samples without thermo cycling and metallic insert in this structure. Group 4 samples submitted to thermo cycling and with metallic insert.1000 thermal cycles were realized by means of a manual procedure of 2 minutes by every thermal cycle, corresponding 1 minute in temperature of 5 ± 2 oC and 1 minute to 55 ± 2 oC to a cycle. The flexural resis-tance was evaluated by a test of three points at a speed of 1mm/min.The statistical analysis was through the Student t-test with a level of significance of 5%.Results: The mean flexural resistance was 73.51, 65.65, 71.14 and 73.08 MPa. For the groups 1,2,3 and 4 respectively. It was observed that G1 was greater than G2 (p = 0.002) and G3 with G4 did not obtain values with significant statistical difference (p = 0.554). Conclusion: The thermal changes as aging processes of the material negatively influence the flexural resistance of the samples which in their structure did not have a metallic insert improving the resistance of the material.
Objetivo: Determinar se a mudança de temperatura afeta, à resistência de flexão dos acrílicos de termo curvos para a base de den-taduras com e sem inserções metálicas. Materiais e métodos: elaboraram 80 amostras de acrílico curvo marca Veracril® segundo a especificação Nº12 da American Dental Association (ADA) (10×65×25 mm); conformaram-se quatro grupos de 20 provetas, organizando da seguinte maneira Grupo 1: amostras sem realizar termo ciclagem e sem inserção metálica. Grupo 2: amostras submetidas a termo ciclagem e sem inserção metálica. Grupo 3: amostras sem realizar termo ciclagem e com inserção metálica. Grupo 4 amostras submetidas a termo ciclagem e com inserção metálica. Realizaram-se 1000 ciclos termais mediante um procedi-mento manual de 2 minutos em cada ciclo térmico, correspondendo 1 minuto em temperatura de 5 ± 2 C e 1 minuto a 55 ± 2 C a um ciclo. A resistência de flexão se avaliou com uma prova de três pontos a uma velocidade de 1mm/min. A análise estadística foi através da prova t de Student para amostras relacionadas com um nível de significância de 5%. Resultados: A média de resistência de flexão foi de 73.51, 65.65, 71.14 e 73.08 Megapascales (MPa)., para os grupos 1,2,3 e 4 respetivamente. Observou-se que o G1 foi maior que e o G2 (p=0.002) e o G3 com o G4 não teve valores com diferença estadística significante (p=0.554). Conclusão: As mudanças térmicas como processos de envelhecimento do material influência de forma negativa na resistência de flexão das amostras que na sua estrutura não apresentavam inserção metálica, enquanto que as amostras que possuíam as inserções melho-raram a resistência do material sendo isto estatisticamente comprovável.
Assuntos
Prostodontia , Manejo de Espécimes , Resinas Acrílicas , Planejamento de Prótese Dentária , Prótese Dentária , Polimetil Metacrilato , Falha de Prótese , Ajuste de Prótese , Análise Diferencial Térmica , Má Oclusão , BocaRESUMO
Las prótesis totales pueden presentar problemas biomecánicos relacionados con la retención y estabilidad, que pueden originarse a partir de errores del profesional durante la toma de impresión funcional de los tejidos, diseño y confección de las prótesis; además de errores durante la fase de laboratorio a cargo de los técnicos o simplemente a cambios biológicos que experimentan los tejidos subyacentes como la reabsorción ósea, atrofia de los maxilares y disminución del flujo salival. Esta última circunstancia es de principal preocupación, ya que la saliva tiene un papel importante en la retención de las prótesis como adhesivo natural, por lo que durante años se han propuesto diversos métodos alternativos de retención, especialmente sistemas adhesivos complementarios cuyas propiedades se han perfeccionado con la inclusión de otros compuestos como algunos polímeros sintéticos, agentes antimicrobianos, colorantes, aditivitos y preservativos; además se encuentran disponibles en diferentes presentaciones comerciales. El objetivo de esta revisión es exaltar las propiedades de la saliva como adhesivo natural y la posibilidad de mejorar la retención de las prótesis, cuando estas no poseen la capacidad de asegurar resultados deseados mediante sistemas adhesivos complementarios, que son una alternativa segura y efectiva, siempre que el odontólogo asuma la responsabilidad y la competencia de prescribir el tipo de adhesivo en relación con condiciones específicas del paciente para evitar situaciones indeseables como efectos sistémicos por la ingesta excesiva y prolongada de sales de zinc incluidas en algunas presentaciones comerciales de adhesivos para prótesis.
Complete dentures may show biomechanical problems related to retention and stability, which can arise from professional errors during functional tissue impression, as well as during prostheses design and manufacturing, in addition to errors during the laboratory phase by technicians or simply by biological changes of adjacent tissues, such as bone resorption, maxillaries atrophy, and decreased salivary flow. The latter is a circumstance of major concern because saliva plays an important role in prosthesis retention as a natural adhesive; therefore, various alternative retention methods have been suggested over time, especially in terms of complementary adhesive systems whose properties have been improved by including other compounds such as synthetic polymers, antimicrobial agents, colorants, additives, and preservatives, which are available in different commercial presentations. The goal of this review is to highlight the properties of saliva as a natural adhesive and the possibility of improving denture retention when it lacks the ability to guarantee the desired results by additional adhesive systems, which are a safe and effective alternative, provided that the dentist is responsible and competent enough to prescribe the right adhesive in relation to specific patient conditions to avoid undesirable situations such as systemic effects due to prolonged and excessive intake of zinc salts included in some commercial presentations of denture adhesives.
Assuntos
Humanos , Prótese Dentária , Retenção de Dentadura , Saliva , Carboximetilcelulose SódicaRESUMO
Background: The behaviour of two biotrickling filters connected in serie (BTF) inoculated with Acidithiobacillus thiooxidans and Thiobacillus thioparus, biodegrading hydrogen sulphide (H2S) and dimethyl sulphide (DMS) simultaneously were studied. A model which considers gas to liquid mass transfer and biooxidation in the biofilm attached to the support is developed. Additionally, a fixed bed biotrickling filter where the microorganism is immobilized in a biofilm which degrades a mixture of H2S and DMS is implemented. Validation of the model was carried out using experimental data obtained at different H2S and DMS loads. Results: The inhibitory effect caused by the presence of H2S on the DMS is observed, which is evidenced by the decrease of the DMS removal efficiency from 80 to 27 percent, due to the preference that T. thioparus has by simple metabolism. H2S is not affected by the DMS, with removal efficiencies of 95 to 97 percent, but it decreases at high concentrations of the compound, due to the inhibition of metabolism by high H2S input loads. The model which describes the BFT fits successfully with the experimental results and it has a high sensitivity to inhibition parameters. Conclusion: It is shown that the microorganism has a high affinity for H2S, producing substrate inhibition when the concentration is high. The H2S is able to inhibit the DMS biooxidation, whereas the DMS does not affect the H2S biooxidation.
Assuntos
Filtração , Sulfeto de Hidrogênio , Modelos Teóricos , Sulfetos , Thiobacillus , Acidithiobacillus thiooxidansRESUMO
Las incrustaciones en resina compuesta son una alternativa de bajo costo ante los métodos de obturación directos, frente a las dificultades de la adaptación marginal y la ubicación de contactos proximales, porque permiten otorgar una mejor anatomía dental a la restauración y superar el fenómeno de contracción al polimerizar grandes capas de material por fuera de la cavidad dental. El objetivo del presente artículo fue exponer el uso de la resina compuesta bajo técnica indirecta como una alternativa de fácil manipulación y resultados clínicos considerables ante la afectación estructural de molares. Se presentaron dos casos clínicos de incrustaciones con resina compuesta de tipo inlay onlay en dos molares permanentes afectados estructuralmente, uno de ellos fue tratado endodónticamente. Para la obtención de un troquel de trabajo sobre el que se confecciona la incrustación bajo técnica incremental se obtienen modelos al impresionar con alginato la arcada de los dientes seleccionados, se realiza vaciado en silicona liviana del diente preparado y el resto en yeso piedra tipo III. El proceso de cementación en la cavidad bucal se lleva a cabo con cemento resinoso de doble curado. Las incrustaciones fueron sometidas a un control a los seis meses para evaluar los signos de filtración o desadaptación marginal mediante el secado con aire de la jeringa triple, explorador y radiografías periapicales, que mostraron ausencia de desadaptación o pigmentación marginal. Se concluyó que ante la afectación estructural de molares, las incrustaciones con resina compuesta bajo técnica indirecta fueron de fácil manipulación y se obtuvieron satisfactorios resultados clínicos(AU)
The composite resin inlays are a low cost alternative which seeks improvements to the direct filling methods meet the challenges of the marginal adaptation, location of proximal contacts, allows us to improve the restoration dental anatomy and overcome the phenomenon of contraction at large sections of material polymerized outside the dental cavity. The objective of this article was to show the use of the composite with indirect technique how an alternative to easy handle and significant clinical results with the structural involvement of molars. The article reports two cases of composite resin inlay onlay in two permanent molars structurally affected, one endodontically treated. The collection of models is performed by the arch alginate impression of the teeth selected, making silicone light casting the prepared tooth and the rest in type III dental stone to obtain a die of work on drawing up the inlay in incremental technique. The cementation process oral cavity is carried out with dual cure resin cement. To control at six months for signs of a leak or marginal jet we used air-dried syringe, explorer and periapical X-Ray. The clinical examination and radiographic analysis revealed a good performance of the restorations in the absence of mismatch or marginal pigmentation. In conclusions the use of the composite inlays in molars with structural involvement with indirect technique is an alternative to easy handle and significant clinical results(AU)
Assuntos
Humanos , Feminino , Adulto , Resinas Compostas/uso terapêutico , Dente não Vital/terapia , Infiltração Dentária/terapia , Restaurações Intracoronárias/métodosRESUMO
Infection recurrence rates among hepatitis B virus infected liver allograft recipients, may be as high as 80%. Immunoprophylaxis with anti HBVgammaglobulin may reduce these rates and improve survival. The dose of anti HBV gammaglobulin that must be used is not clearly defined. The most commonly accepted protocol uses 10,000 units during the anhepatic phase and 10,000 units daily during one week, followed by weekly doses of 10,000 units during one month and maintenance with 10,000 units monthly, without measuring anti hepatitis B surface antigen antibodies (antiHBs). Some reports recommend the use of immunoglobulin on demand, to maintain antiHBs titers between 100 and 250 U/l. The infection recurrence rates among patients treated with immunoglobulin and Lamivudine fluctuates between 0 and 10%, during follow up periods of 13 to 30 months. We report three liver allograft recipients that received immunoglobulin on demand, using a mean of41,000 units, maintaining adequate antiHBs titers.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatite B/cirurgia , Imunoglobulinas/administração & dosagem , Cirrose Hepática/prevenção & controle , Transplante de Fígado/métodos , Vírus da Hepatite B/imunologia , Hepatite B/complicações , Cirrose Hepática/cirurgia , Cirrose Hepática/virologia , Recidiva/prevenção & controleRESUMO
El trastorno obsesivo-compulsivo (TOC) es una patología frecuente. Como sucede en medicina, sino se explora su presencia no va ha encontrarse. La naturaleza del cuadro es tan intensamente perturbadora y los hallazgos terapéuticos tan prometedores, que indagar por su presencia pueden ser de gran beneficio para quien lo padece. A propósito de la descripción de un caso clínico se revisan los antecedentes hitóricos, epidemiología, criterios de diagnóstico diferencial y tratamiento de este tipo de desórdenes psiquiátricos.