Horner's Syndrome as a Complication of Ultrasound-Guided Central Cannulation: A Case Report.

Cannulation of the internal jugular vein is often necessary for the management of critically ill patients. Despite being a very common procedure and performed more and more safely, several complications still occur. Horner's Syndrome (HS) is one of those complications described before the use of ultrasound as a method of guidance. HS is caused by functional interruption of sympathetic nerve supply to the eye, leading to a classic triad of ipsilateral ptosis, miosis, and anhidrosis. We present the case of a patient, in need of emergent surgery to control the hemorrhagic focus after delivery, with a transient HS secondary to internal jugular vein cannulation under real-time ultrasound guidance.

Technical feasibility of conventional and nonconventional vegetables' intercropping under organic fertilization / Viabilidade técnica do cultivo consorciado de hortaliças convencionais e não convencionais sob fertilização orgânica

This work aimed to evaluate the technical feasibility of lettuce, Indian spinach and taro intercropping under organic fertilizer. The experiment was performed at Água Limpa Farm, belonging to the University of Brasília, located in Brasília - DF, from October 2014 to June 2015. A completely randomized block design with seven treatments and four replications was used. Each experimental plot had 18 m2 (4.5 m x 4.0 m), totaling 28 plots. The following treatments were assessed: lettuce monoculture, Indian spinach monoculture, taro monoculture, lettuce/Indian spinach intercropping, lettuce/taro intercropping, Indian spinach/taro intercropping, and lettuce/Indian spinach/taro intercropping. In all treatments, the following spacings were used: 0.25 x 0.25 m (lettuce), 1.0 x 0.6 m (Indian spinach), and 1.0 x 0.3 m (taro). Crop production was evaluated from sample plants taken from the central part of each plot. Two harvests of lettuce, two of Indian spinach and one of taro were carried out during intercropping. In the first cycle, lettuce highest mean yield values were observed in the lettuce monoculture (3.5 kg m-2) and lettuce/Indian spinach intercropping (3.4 kg m-2). The crop reached the commercial size in both production cycles, except when intercropped with Indian spinach in the second cycle. The highest Indian spinach mean fresh mass was recorded in the lettuce/Indian spinach intercropping (974.7 g plant-1; first harvest) and monoculture (327.5 g plant-1; second harvest). The yield of taro rhizomes was significantly higher when intercropped with lettuce, showing a mean value of 16.8 kg m-2. The intercropping arrangements with lettuce increased yield of nonconventional vegetables. The conventional and nonconventional vegetables' intercropping technique increased species diversity in the area without interfering in the agronomic performance and quality of the crops.

Análise de casos de hanseníase notificados em Curitiba - Paraná / Case analysis of Leprosy notified in Curitiba - Paraná

Esse trabalho tem como objetivo analisar o perfil epidemiológico dos pacientes notificados com hanseníase em Curitiba de 2001 a 2015. Foram analisadas 1.725 Fichas de Notificação Compulsória, acessadas pelo banco de dados do Centro de Epidemiologia da Secretaria Municipal de Saúde. Resultados mostraram diminuição de casos em 80% no período. Predominou homem branco, média de 46,7 anos, ensino fundamental incompleto, formas virchowiana (42,3%) e classificação operacional multibacilar (73,2%). Em 62,8% das fichas a baciloscopia não foi preenchida ou não realizada. Tempo médio entre diagnóstico e tratamento foi de 15,4 dias, sendo que 69,2% receberam tratamento no mesmo dia do diagnóstico. Das fichas preenchidas 82,3% obtiveram cura. Tempo médio do tratamento foi 11,7 meses com poliquimioterapia 12 doses e taxa de abandono de 3,6%. Mesmo com a diminuição no número de casos Curitiba persiste com problemas quanto ao diagnóstico precoce, preenchimento correto das fichas de notificação e busca ativa de contatos.

The goal of this paper is to analyze the health profile of patients notified with leprosy in Curitiba from 2001 to 2015. It were assessed 1.725 obligatory notification forms from the Epidimological Health Center. The results revealed drop of cases in the period. Prevalence white male, average of 46,7 years old, primary school not completed, subtype Virchowiana (42,3%) and multibacillary (73,2%). In 62,8% of the cases the skin smear was unfilled or not fulfilled. The average time between diagnosis and treatment was 15,4 days, part of which 69,2% received treatment in the same day of the diagnosis. Out of the filled forms 82,3% patients were cured. The average time of treatment was 11,7 months with polychemotherapy 12 shots and dropout rate of 3,6%. Even with the decrease of the number of cases in Curitiba remains challenges of early diagnosis, correct filled of the obligatory forms and active pursuits of contacts

Treatment of postmenopausal osteoporosis: a literature-based algorithm for use in the public health care system.

Bisphosphonates are considered first-line agents in the treatment of postmenopausal osteoporosis based on extensive experience of use, safety, and proven efficacy in reducing vertebral, non-vertebral and femur fractures. However, post-marketing reports based on the treatment of millions of patients/year over lengthy periods of time have revealed the occurrence of initially unexpected adverse effects, such as osteonecrosis of the jaw and atypical femoral fracture, leading to the restriction of treatment duration with bisphosphonates by global regulatory agencies. However, despite the association between these effects and bisphosphonates, this risk should be analyzed in the context of osteoporosis treatment, alongside the benefit of preventing osteoporotic fractures and their clinical consequences. Therefore, we consider it plausible to discuss the restriction to the use of bisphosphonates, possible indications for prolonged treatment and alternative therapies following the suspension of this drug class for patients with persistent high risk of fracture after initial treatment, especially considering the problems of public health funding in Brazil and the shortage of drugs provided by the government. Thus, to standardize the treatment of osteoporosis in the public health care system, we aim to develop a proposal for a scientifically-based pharmacological treatment for postmenopausal osteoporosis, establishing criteria for indication and allowing the rational use of each pharmacological agent. We discuss the duration of the initial bisphosphonate treatment, the therapeutic options for refractory patients and potential indications of other classes of drugs as first-choice treatment in the sphere of public health, in which assessing risk and cost effectiveness is a priority.

Treatment of postmenopausal osteoporosis: a literature-based algorithm for use in the public health care system / Tratamento da osteoporose pós-menopáusica: um algoritmo baseado na literatura para uso no sistema público de saúde

ABSTRACT Bisphosphonates are considered first-line agents in the treatment of postmenopausal osteoporosis based on extensive experience of use, safety, and proven efficacy in reducing vertebral, non-vertebral and femur fractures. However, post-marketing reports based on the treatment of millions of patients/year over lengthy periods of time have revealed the occurrence of initially unexpected adverse effects, such as osteonecrosis of the jaw and atypical femoral fracture, leading to the restriction of treatment duration with bisphosphonates by global regulatory agencies. However, despite the association between these effects and bisphosphonates, this risk should be analyzed in the context of osteoporosis treatment, alongside the benefit of preventing osteoporotic fractures and their clinical consequences. Therefore, we consider it plausible to discuss the restriction to the use of bisphosphonates, possible indications for prolonged treatment and alternative therapies following the suspension of this drug class for patients with persistent high risk of fracture after initial treatment, especially considering the problems of public health funding in Brazil and the shortage of drugs provided by the government. Thus, to standardize the treatment of osteoporosis in the public health care system, we aim to develop a proposal for a scientifically-based pharmacological treatment for postmenopausal osteoporosis, establishing criteria for indication and allowing the rational use of each pharmacological agent. We discuss the duration of the initial bisphosphonate treatment, the therapeutic options for refractory patients and potential indications of other classes of drugs as first-choice treatment in the sphere of public health, in which assessing risk and cost effectiveness is a priority.

RESUMO Com base na vasta experiência de uso, segurança e eficácia comprovada na redução de fraturas vertebrais, não vertebrais e femorais, os bisfosfonatos são considerados agentes de primeira linha no tratamento da osteoporose pós-menopáusica. No entanto, os relatos pós-venda baseados no tratamento de milhões de pacientes/ano durante períodos prolongados de tempo revelaram a ocorrência de efeitos adversos inicialmente inesperados, como osteonecrose da mandíbula e fratura atípica do fêmur. Isso levou as agências reguladoras globais a restringirem a duração do tratamento com bisfosfonatos. No entanto, apesar da associação entre esses efeitos e os bisfosfonatos, esse risco deve ser analisado no contexto do tratamento da osteoporose, paralelamente ao benefício na prevenção de fraturas osteoporóticas e suas consequências clínicas. Portanto, considera-se plausível discutir a restrição ao uso dos bisfosfonatos, possíveis indicações para o tratamento prolongado e terapias opcionais após a suspensão dessa classe de fármaco para pacientes com alto risco persistente de fratura após o tratamento inicial, especialmente se considerarmos os problemas financeiros de saúde pública no Brasil e a escassez de fármacos fornecidos pelo governo. Assim, para padronizar o tratamento da osteoporose no sistema público de saúde pretende-se desenvolver uma proposta de tratamento farmacológico cientificamente fundamentada para a osteoporose pós-menopáusica, estabelecer critérios de indicação e permitir o uso racional de cada agente farmacológico. Discutem-se a duração do tratamento inicial com bisfosfonatos, as opções terapêuticas para pacientes refratários e potenciais indicações de outras classes de medicamentos como tratamento de primeira linha na esfera da saúde pública, em que a avaliação do risco e custo-efetividade é uma prioridade.

Conhecimento em saúde sexual e reprodutiva: estudo transversal com adolescentes / Sexual and reproductive health knowledge: a cross-sectional study with adolescents

Objetivou investigar e comparar o conhecimento sobre saúde sexual e reprodutiva, e fontes de informação, entre adolescentes de escolas públicas de Goiânia-Goiás. Estudo de corte transversal realizado com 2449 escolares. Os dados do questionário auto aplicável foram analisados pelo Statistical Package Social Science, versão 13.0. As diferenças entre as proporções foram analisadas pelos testes de c2 e nível de significância (p<0,05). Observou-se diferença estatística entre os sexos considerando o conhecimento sobre Infecções Sexualmente Transmissíveis e métodos de prevenção às IST e contracepção (p<0,000), também, adolescentes do sexo masculino apresentaram maior risco de exposição a relações sexuais sem preservativo (p<0,000). Em relação à aquisição de métodos preventivos para IST e contracepção, mulheres demonstraram mais conhecimento de locais de acesso aos dispositivos, bem como buscavam em variadas fontes, informações acerca de conteúdos relacianados à saúde sexual e reprodutiva. Conclui-se que adolescentes do sexo masculino apresentaram maior perfil de vulnerabilidade social e individual.

The objective was to investigate and compare sexual and reproductive knowledge and sources of information, between public school adolescents from Goiânia-Goiás. A cross-sectional study conducted with 2,449 students. We analyzed data from the self-reported questionnaire using the Statistical Package for Social Sciences, version 13.0. We investigated the differences between proportions using c2 tests and a significance level (p<0.05). We observed a statistical difference between sex considering the knowledge about Sexually Transmitted Infections and, STI and contraception prevention (p<0.000). Additionally, male adolescents presented higher exposure risk to sexual relations without preservative (p<0.000). About the acquisition of preventive methods for STIs and contraception, women were more knowledgeable about access to devices, as well as; they searched different sources and content information about sexual and reproductive health. We concluded that male adolescents presented higher social and individual vulnerability profiles.

Concepções de pais de adolescentes escolares sobre a sexualidade de seus filhos / Conceptions of parents of adolescent students about the sexuality of their children

Conhecer a concepção de pais de adolescentes escolares sobre a sexualidade dos seus filhos.Métodos: pesquisa qualitativa, modalidade Pesquisa Estratégica, utilizando grupos focais norteados porinstrumento semiestruturado, com 15 pais de adolescentes escolares. Os dados foram analisados por Análisede Conteúdo, em que emergiram as categorias “Compreendendo aspectos relacionados à sexualidade”;“Dificuldades para o diálogo”; “Facilidades para o diálogo”; e “As atribuições da família e da escola no apoio atemática”. Resultados: os pais apresentaram conhecimento superficial e conceitos errôneos sobre o tema. Foiidentificada uma grande dificuldade de diálogo entre pais e filhos, justificada pelo desconhecimento e timidezdos pais e falta de abertura do adolescente, ainda assim, houve reconhecimento da responsabilização da famílianeste contexto. Conclusão: há necessidade de ampliação do trabalho intersetorial envolvendo segmentos daeducação, saúde e instituições de ensino superior a fim de apoiar as famílias com informações sobre sexualidadeno contexto escolar...

Large-scale mitogenomics enables insights into Schizophora (Diptera) radiation and population diversity.

True flies are insects of the order Diptera and encompass one of the most diverse groups of animals on Earth. Within dipterans, Schizophora represents a recent radiation of insects that was used as a model to develop a pipeline for generating complete mitogenomes using various sequencing platforms and strategies. 91 mitogenomes from 32 different species were sequenced and assembled with high fidelity, using amplicon, whole genome shotgun or single molecule sequencing approaches. Based on the novel mitogenomes, we estimate the origin of Schizophora within the Cretaceous-Paleogene (K-Pg) boundary, about 68.3 Ma. Detailed analyses of the blowfly family (Calliphoridae) place its origin at 22 Ma, concomitant with the radiation of grazing mammals. The emergence of ectoparasitism within calliphorids was dated 6.95 Ma for the screwworm fly and 2.3 Ma for the Australian sheep blowfly. Varying population histories were observed for the blowfly Chrysomya megacephala and the housefly Musca domestica samples in our dataset. Whereas blowflies (n = 50) appear to have undergone selective sweeps and/or severe bottlenecks in the New World, houseflies (n = 14) display variation among populations from different zoogeographical zones and low levels of gene flow. The reported high-throughput mitogenomics approach for insects enables new insights into schizophoran diversity and population history of flies.

Fibrocalculous pancreatic diabetes.

The aim of this paper is to review the relevant literature related to the epidemiology, pathophysiology, natural history, clinical features and treatment of fibrocalculous pancreatic diabetes (FCPD). We review the English-language literature on this topic published between 1956 and 2014. FCPD is a form of diabetes usually associated with chronic calcific pancreatitis. It has been predominantly, though not exclusively, described in lean, young adults living in tropical developing countries. Historically linked to malnutrition, the etiology of this phenotype has not been clearly elucidated, nor has there been a clear consensus on specific diagnostic criteria or clinical features. Affected individuals usually present with a long-standing history of abdominal pain, which may begin as early as childhood. Progressive pancreatic endocrine and exocrine dysfunction, consistent with chronic pancreatitis is expected. Common causes of chronic pancreatitis, such as alcohol abuse, are usually absent. Typical radiographic and pathological features include coarse pancreatic calcifications, main pancreatic duct dilation, pancreatic fibrosis and atrophy. Progressive microvascular complications are common, but diabetic ketoacidosis is remarkably unusual. Pancreatic carcinoma is an infrequently described long term complication. FCPD is an uncommon diabetes phenotype characterized by early onset non-alcoholic chronic pancreatitis with hyperglycemia, insulin deficiency and a striking resistance to ketosis.

Ensaio clínico controlado randomizado: região ventro glútea, local alternativo para aplicação da benzilpenicilina benzatina G / Ventrogluteal region, an alternative location to apply benzathine penicillin

O objetivo deste estudo foi comparar o nível de dor relacionada à administração da Benzilpenicilina Benzatina G nas regiões ventro glútea (VG) e dorso glútea (DG). Ensaio clínico controlado randomizado. Participaram do estudo 61 pessoas, 31 do grupo de intervenção (região VG) e 30 do grupo controle (região DG). O teste de qui-quadrado e Mann­ Whitney foram utilizados para testar diferenças entre proporções e comparar tendências centrais entre os grupos, respectivamente. Valores de p ˂ 0,05 foram considerados estatisticamente significantes. Nos três momentos avaliados, a média do escore de dor foi maior quando a aplicação do fármaco ocorreu na região VG vs. DG. No primeiro e terceiro minuto a diferença foi estatisticamente significativa. Estes resultados ratificam a região VG como local alternativo com menor reação local para aplicação de injeções intramusculares.

The objective of this study was to compare the pain level related to the administration of benzathine penicillin on the ventrogluteal (VG) and dorsogluteal (DG) region. A randomized controlled trial. Sixty-one people participated in the study, 31 on the intervention group (VG region), and 30 on the control (DG region). The Chi-Squared and Mann-Whitney tests were used to test differences of proportions and to compare central tendencies between groups, respectively. Values of p <0.05 were considered statistically significant. At the three assessed moments, the mean score of pain was higher when the application of the drug was on the VG region vs. DG. At the first and third minute, the difference was statistically significant. These results confirm the VG region as alternative place with less local reaction to apply intra- muscular injections.

Cutaneous metastasis from gastrointestinal adenocarcinoma of unknown primary origin.

Cutaneous metastasis is a rare manifestation of visceral malignancies that indicates primarily advanced disease. Due to its low incidence and similarity to other cutaneous lesions, it is not uncommon to have a delayed diagnosis and a shortened prognosis. We describe the case of a patient who presented with a cutaneous nodule in the sternal region as a first sign of malignancy.

Cutaneous metastasis from gastrointestinal adenocarcinoma of unknown primary origin

AbstractCutaneous metastasis is a rare manifestation of visceral malignancies that indicates primarily advanced disease. Due to its low incidence and similarity to other cutaneous lesions, it is not uncommon to have a delayed diagnosis and a shortened prognosis. We describe the case of a patient who presented with a cutaneous nodule in the sternal region as a first sign of malignancy.

Alopecia areata update.

There is neither a cure for alopecia areata (AA) nor any universally proven therapy that induces and sustains remission in patients afflicted with this autoimmune disease. AA is characterized as a nonscarring alopecia which affects children and adults. It can be relatively easy to treat when the disease is patchy and limited; but when children and adults present with long standing extensive scalp and body hair loss, successful management can be challenging. Of the treatment choices available, physicians and midlevel providers usually select a cost-effective treatment approach based on disease duration, disease activity, age of the patient, and disease extent. In this manuscript, the clinical presentation, epidemiology, pathophysiology, plus current and evolving treatments for AA will be reviewed.

Use of participative methodology in oral health education for adolescents / Utilização de metodologia participativa na educação em saúde bucal para adolescentes

Objective: This paper describes a model of participative methodology used in the oral health education for teenagers. Methods: 16 teenagers aged between 10 and 14 years old participated. Focus groups were used to evaluate the topics of interest. The methodology evaluation was performed by the analysis of the material developed by the teenagers and an objective questionnaire, applied after the project completion. Results: By means of the focus group it was identified the following issues: problems due to bad breath in their relationships and the relationshipbetween lack of access to employment and precarious oral health. Ten meetings were held to discuss these issues and evaluate their relationshipwith oral health basics. The participation of adolescents was encouraged via movies and music available on the Internet. At the end of the meetings the group produced some educational materials and a comic book, which was analyzed and considered as a category 3: very rich design in content, objective concepts and clear goals. The questionnaire revealed that the right answers concentrated on the subjects which they have developed educational materials, such as self-care. 88% of the teenagers evaluated the project as very important, and an influencing factor in their improvement of oral health care. Conclusion: The use of a participative methodology for oral health education can, in fact, positively impact on changing teenagers behaviors. Third sector institutions that perform a well-planned and committed work can contribute to the promotion of oral health in Brazil.

Objetivo: Descrever um modelo de metodologia participativa utilizado na educação em saúde bucal de adolescentes. Métodos: Participaram 16 adolescentes com idades entre 10 e 14 anos. Para o conhecimento de temas de interesse foi utilizado o grupo focal. A avaliação da metodologia empregada foi realizada através da análise do material desenvolvido pelos adolescentes e de um questionário objetivo, aplicado após o término do projeto. Resultados: Através do grupo focal foi possível identificar os seguintes temas: problemas trazidos pelo mau-hálito em uma relação afetiva e a relação entre dificuldade de acesso ao emprego e recariedade da saúde bucal. Foram realizados 10 encontros para a discussão e relacionamento desses temas com conceitos básicos de saúde bucal. A participação dos adolescentes foi incentivada através de filmes disponíveis na Internet e músicas. Ao final dos encontros o grupo produziu alguns materiais educativos e um gibi, que foi analisado e considerado como categoria 3: desenho muito rico em conteúdo; conceitos objetivos e claros. O questionário demonstrou que as respostas certas se concentraram nos temas para os quais eles desenvolveram material didático,como o auto-cuidado. O projeto foi avaliado por 88% dos adolescentes como muito importante e como um fator que os influenciou na melhora do cuidado com a saúde bucal. Conclusão: A utilização de uma metodologia participativa de educação em saúde bucal pode, de fato, impactar positivamente na mudança de atitude dos adolescentes. Instituições do terceiro setor que realizem um trabalho comprometido e bem planejado podem contribuir para a promoção de saúde bucal no Brasil.

Fulminant gastrointestinal hemorrhage due to Strongyloides stercoralis hyperinfection in an AIDS patient.

Strongyloides stercoralis is an endemic nematode to tropical and subtropical regions of the globe. The parasite is capable of autoinfection, which is limited by an intact immune response. In immunocompromised hosts, hyperinfection and dissemination can occur and have a high index of mortality. A hyperinfection syndrome with dissemination is frequently associated with corticosteroid administration and other conditions (malignancies and organ transplantation). Interestingly, although strongyloidiasis is common among AIDS patients in endemic areas, the hyperinfection syndrome is rarely noted. We report here on a rare manifestation of fulminant gastrointestinal hemorrhage due to hyperinfection of strongyloidiasis in a female drug-abusing, alcoholic HIV/AIDS patient.

Fulminant gastrointestinal hemorrhage due to Strongyloides stercoralis hyperinfection in an AIDS patient

Strongyloides stercoralis is an endemic nematode to tropical and subtropical regions of the globe. The parasite is capable of autoinfection, which is limited by an intact immune response. In immunocompromised hosts, hyperinfection and dissemination can occur and have a high index of mortality. A hyperinfection syndrome with dissemination is frequently associated with corticosteroid administration and other conditions (malignancies and organ transplantation). Interestingly, although strongyloidiasis is common among AIDS patients in endemic areas, the hyperinfection syndrome is rarely noted. We report here on a rare manifestation of fulminant gastrointestinal hemorrhage due to hyperinfection of strongyloidiasis in a female drug-abusing, alcoholic HIV/AIDS patient.

Relevance of the Surgical Care Improvement Project on glycemic control in patients undergoing cardiac surgery who receive continuous insulin infusions.

OBJECTIVE: The Surgical Care Improvement Project (SCIP) has benchmarked 6:00 am blood glucose levels of less than 200 mg/dL on postoperative day (POD) 1 and 2 as quality measures of glycemic control in cardiac surgery. This study was undertaken to (1) determine the incidence of SCIP outliers in patients receiving a continuous insulin infusion (CII) targeted to maintain perioperative serum glucose levels less than 180 mg/dL after cardiac surgery, (2) identify the profile of patients who are SCIP outliers, (3) determine whether SCIP outliers have increased morbidity and mortality, and (4) identify more relevant benchmarks for glycemic control in patients having cardiac surgery. METHODS: Between January 1, 2008, and April 30, 2011, a total of 832 patients underwent cardiac surgery and received CII to maintain serum blood glucose levels of less than 180 mg/dL. Patients were divided into 2 groups: patients compliant with SCIP and SCIP outliers. RESULTS: The incidence of SCIP outliers was 6.6% (55/832). Patients more likely to be SCIP outliers had diabetes mellitus (38, 69% vs 250, 32%; P < .0001), a higher hemoglobin A1c (8.74 ± 2.25 vs 7.59 ± 2.90; P < .0009), and a higher body mass index (31.1 ± 6.5 vs 29.2 ± 5.7; P = .03). However, SCIP outliers had no increase in morbidity, mortality, or hospital length of stay. CONCLUSIONS: Patients undergoing cardiac surgery may still be SCIP outliers despite CII targeted to maintain serum glucose levels below 180 mg/dL; however, SCIP outliers had no increase in morbidity, mortality, or length of stay.

Perfil epidemiológico dos pacientes atendidos em um Centro de Atenção Psicossocial / Epidemiological profile of patients treated in a Center for Psychosocial Care

Estudo transversal com o objetivo de delinear o perfil dos pacientes atendidos no Centro de Atenção Psicossocial de Barbacena. Foram avaliados 583 prontuários de um total de 4.000 usuários atendidos no período de 2003 a 2008. A idade média dos participantes foi de 38,7±3,6 anos; a maioria dos pacientes era do sexo masculino (56,6%), casados ou em união estável (48,8%), com baixa escolaridade (60%), com passado de tratamento psiquiátrico (64,7%); 28,8% eram portadores de quadros psicóticos, 22% de transtornos afetivos e 20% de transtornos decorrentes do uso de substâncias. Mais da metade dos pacientes não estava em crise quando procurou o atendimento indicando a necessidade de maior investimento e capacitação nos níveis primário e secundário de atenção à saúde.

Cross-sectional study aimed to delineate the profile of patients treated at the Center for Psychosocial Care of Barbacena. There were assessed 583 medical records of a total of four thousand users attended from 2003 to 2008. The average age of participants was 38.7±3.6 years and the majority of patients were male (56.6%), married or in stable (48.8%), low education (60%) and with past psychiatric treatment (64.7%); 28.8% suffered from a psychotic condition, 22% of affective disorders and 20% of problems caused by substance use. More than half of the patients was not in crisis when he sought care indicates a need for increased investment and capacity at primary and secondary health care.

Glucose control in diabetes type 2 after oral minor surgery procedures

The aims of this study were to investigate if surgical removal of oral infections foci has effect on metabolic glucose level control 30 days postoperatively, to evaluate post extraction healing and to validate the use of a capillary glucose monitor for glucose level assessment in oral surgery type 2 diabetic outpatients. Material and methods: Twenty type 2 diabetic patients under wetn minor oral surgeries. Capillary and plasma glucose exams were taken from subjects in fasting and 2h post-prandial condition, before aand after oral surgery, in four different clinical recorded. A commercial sel-monitor was used for capillary tests. Data were submitted to statistical analysis (level of significance igual ou menor do que 0.05). Results: Differences in capillary and plasma glucose level between the first visit and 30 days afeter oral surgery were statistically significant (p = 0.014 and p = 0.005). differences between capillary and plasma glucose rate were between 4.48 and 6.5 per cent. wound healing was delayed in eight cases (40 per cent). Conclusion: Infections de3ntal foci removal diminished blood glucose levels in type 2 diabetic patients. The capillary monitor showed to be adequate to acess immediate glucose level in oral surgery ourpatients