RESUMO
O objetivo do presente estudo foi realizar uma revisão de literatura sobre a metodologia lean, avaliando sua aplicabilidade na odontologia. A pesquisa delineada é de natureza bibliográfica, descritiva e retrospectiva. Assim, foram selecionados artigos científicos que abordavam conceitos sobre metodologia lean e odontologia. As buscas foram realizadas nos bancos de dados virtuais: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Biblioteca Regional de Medicina (BIREME), Scientific Electronic Library Online (SciELO) e Public MEDLINE (PubMed). Foram incluídos sobretudo artigos dos últimos 35 anos (1987-2022) e que apresentaram pelo menos o resumo, em inglês ou português, com os seguintes termos: "metodologia lean"; "gestão em saúde e odontologia". A saúde mundial sofreu uma explosão no conhecimento, na inovação e na capacidade de gerenciar as condições anteriormente fatais. Contudo, ainda está longe do padrão esperado de qualidade, resultados, custo e equidade. O lean thinking, ou pensamento enxuto, tem sido implementado em clínicas, consultórios e hospitais com o objetivo de conseguir melhorias nos processos de serviços odontológicos e de saúde bucal, resultando em melhorias significativas nos processos, qualidade do atendimento e redução de custos para as organizações. A metodologia lean pode ser aplicada na odontologia visto que pode atuar na redução de desperdícios, eliminação de redundâncias de atividades e aumento da segurança da assistência.
This study aimed to carry out a literature review on the lean method, assessing its applicability in dentistry. The research has a bibliographic, descriptive, and retrospective scope. Thus, we selected scientific articles that addressed concepts on the lean method and dentistry. We researched the following databases: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Biblioteca Regional de Medicina (BIREME), Scientific Electronic Library Online (SciELO), and Public MEDLINE (PubMed). We included, essentially, articles from the last 35 years (1987-2022) with abstracts (in English or Portuguese) that presented the following terms: "Lean Methodology" and "Health Management and Dentistry." Worldwide healthcare has experienced an explosion in knowledge, innovation, and the ability to manage formerly fatal conditions. However, it is still far from the expected standard of quality, results, cost, and equity. Lean Methodology has been implemented in clinics, offices, and hospitals to attain improvements in dental and oral health service processes, resulting in significant advances in these, as well as in the quality of care and cost reduction for organizations. The Lean Method can be applied in dentistry since it can act in reducing waste, eliminating redundancies in activities, and increasing the safety of care.
RESUMO
Key measures to halt the spread of tuberculosis (TB) include early diagnosis, effective treatment, and monitoring disease management. We sought to evaluate the use of serum immunoglobulin levels against antigens present in cell envelope of Mycobacterium tuberculosis to monitor TB treatment response in children and adolescents with pulmonary (PTB) or extrapulmonary TB (EPTB). Blood samples were collected prior to and one, two, and six months following treatment initiation. Serum immunoglobulin levels against cardiolipin, sulfatide, mycolic acid and Mce1A protein were measured by ELISA. Serum from 53 TB patients and 12 healthy participants were analyzed. After six months of successful treatment, there was a significant decrease (p < 0.0001) in IgM levels against cardiolipin, sulfatide, mycolic acid and Mce1A protein and IgG levels against Mce1A protein when compared to baseline immunoglobulin levels. There was no significant variation in antibody levels during follow-up between participants with PTB and EPTB, confirmed and unconfirmed TB diagnosis, and HIV infection status. Antibody levels in control participants without TB did not decrease during follow-up. These results suggest that immunoglobulin responses to mycobacterial cell wall products may be a useful tool to monitor treatment response in children and adolescents with PTB or EPTB.