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Objetivos:Identificar o custo direto de um serviço especializado com o uso de equipamentos coletores e adjuvantes e compará-lo com o custo simulado da autoirrigação intestinal em pessoas com colostomia definitiva. Método: Estudo descritivo-exploratório conduzido por meio da abordagem quantitativa nos moldes de estudo de casos múltiplos. A amostra por conveniência foi composta de 22 participantes cadastrados em um serviço especializado do norte de Minas Gerais. A coleta de dados foi realizada em prontuários do período de janeiro de 2019 a janeiro de 2020. Resultados: Dos participantes, 59,1% apresentaram complicações relacionadas à estomia e pele periestomia. Em relação aos equipamentos coletores/adjuvantes, o custo variou de 2.340,00 a R$ 5.535,00, custo médio de R$ 4.050,01 e desvio padrão amostral de R$ 770,31. O custo direto médio com autoirrigação de colostomia foi de R$ 3.793,44. Conclusão: O custo direto médio dos equipamentos coletores/adjuvantes foi superior ao da autoirrigação de colostomia, impactado pela presença de complicações e pelo valor do protetor de colostomia.
Objectives:To identify the direct cost of a specialized service with the use of collection equipment and adjuvants and to compare it with the simulated cost of intestinal self-irrigation in people with permanent colostomy. Method: Descriptive-exploratory study conducted through a quantitative approach in the form of multiple-case studies. The convenience sample consisted of 22 participants registered in a specialized service in the north of Minas Gerais, Brazil. Data collection was carried out in medical records from January 2019 to January 2020. Results: Among the participants, 59.1% had complications related to the ostomy and peristomal skin. Regarding collector/adjuvant equipment, the cost ranged from R$ 2,340.00 to R$ 5,535.00, average cost of R$ 4,050.01, and sample standard deviation of R$ 770.31. The average direct cost with colostomy self-irrigation was R$ 3,793.44. Conclusion: The average direct cost of collection/adjuvant equipment was higher than that of colostomy self-irrigation, impacted by the presence of complications and the value of the colostomy protector.
Objetivos:Identificar o custo direto de um serviço especializado com o uso de equipamentos coletores e adjuvantes e compará-lo com o custo simulado da autoirrigação intestinal em pessoas com colostomia definitiva. Método: Estudo descritivo-exploratório conduzido por meio da abordagem quantitativa nos moldes de estudo de casos múltiplos. A amostra por conveniência foi composta de 22 participantes cadastrados em um serviço especializado do norte de Minas Gerais. A coleta de dados foi realizada em prontuários do período de janeiro de 2019 a janeiro de 2020. Resultados: Dos participantes, 59,1% apresentaram complicações relacionadas à estomia e pele periestomia. Em relação aos equipamentos coletores/adjuvantes, o custo variou de 2.340,00 a R$ 5.535,00, custo médio de R$ 4.050,01 e desvio padrão amostral de R$ 770,31. O custo direto médio com autoirrigação de colostomia foi de R$ 3.793,44. Conclusão: O custo direto médio dos equipamentos coletores/adjuvantes foi superior ao da autoirrigação de colostomia, impactado pela presença de complicações e pelo valor do protetor de colostomia.
Subject(s)
Ostomy , Colostomy , Health Care Costs , Enterostomal Therapy , Therapeutic IrrigationABSTRACT
Aim: This study evaluated the irrigation penetration during root canal instrumentation and the clinical step in which the irrigation solution can be detected in the apical region. Materials and Methods: Twenty necrotic molars were divided according to the irrigation protocol, saline solution with manual active pressure, and 2.5% sodium hypochlorite with dripping delivery. Solution penetration assessment used a radiopaque component added to each irrigant solely before a periapical radiograph. Instrumentation sequence was: #10, and #15 K-files (step 1), cervical flaring using WaveOne Small (step 2), WaveOne Small at working length (step 3), Hero-642 #35/.02 (step 4), and Hero-642 #40/.02 (step 5). The step each contrasted-irrigant reached the 2-mm-apical region was registered. Shapiro-Wilk and Fisher's exact tests were used for comparisons. Results: In step 3, both contrasted-irrigants started to be detected in the apical region, and after step 5, contrasted-irrigants penetrated in 100% of the cases, without significant difference. Conclusion: Considering distal molar roots, the apical enlargement up to an instrument #40.02 favors the irrigation to reach the 2-mm apical region.
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Objetivo: Identificar los patrones de distribución vascular del ángulo esplénico del colon (AEC) en la población chilena para su comparación con la literatura oriental (Fukuoka). Materiales y Métodos: Estudio descriptivo, transversal. Se caracterizó la irrigación del AEC de imágenes con protocolo Urotac realizadas en Clínica INDISA entre el año 2020 y 2021 (n = 127), clasificándolas dentro de 6 tipos descritos por Fukuoka. Se evaluaron características demográficas y comorbilidades. Las variables fueron analizadas utilizando estadística descriptiva y la significancia mediante la prueba Chi2. Resultados: Existen diferencias en los tipos irrigación del AEC entre la serie local y Fukuoka, la irrigación tipo 3 fue la que presentó mayor variación (p < 0,05). El tipo 1 es la más frecuente (34,7%), sin casos del Tipo 4. No se identificó diferencia entre los distintos tipos de irrigación con relación a las variables demográficas y comorbilidades. Discusión: Al comparar nuestra serie con la oriental se evidenció similar frecuencia en tipos 1 y 6, mayor en tipos 3 y 5, y tipos 2 y 4 con menor representación. Se identificó un mayor aporte en la irrigación del AEC por la arteria cólica izquierda (ACI) en la población estudiada (64,6%). Conclusión: Nuestra población tiene mayor participación de ACI en irrigación del AEC que orientales (64,6% vs 49,6%), los tipos más frecuentes son 1, 3 y 6, el Tipo 1 es la forma más frecuente de irrigación, similar a Fukuoka (34,7% vs 39,7%), Tipo 3 tiene mayor representación en nuestra población que en la oriental (29,9% vs 9,9%).
Objective: To identify the vascular distribution patterns of the splenic flexure of the colon (AEC) in the Chilean population for comparison with the oriental literature (Fukuoka). Methods: Descriptive, cross-sectional study. The irrigation of the AEC of images with the Urotac protocol performed at the INDISA Clinic between 2020 and 2021 (n = 127) was characterized, classifying them into 6 types described by Fukuoka. Demographic characteristics and comorbidities were evaluated. Variables were analyzed using descriptive statistics and significance using the Chi2 test. Results: There are differences in the types of irrigation of the AEC between the local series and Fukuoka, irrigation type 3 was the one that presented the greatest variation (p < 0.05). Type 1 is the most frequent (34.7%), with no cases of Type 4. No difference was identified between the different types of irrigation in relation to demographic variables and comorbidities. Discussion: When comparing our series with the eastern one, a similar frequency was found in types 1 and 6, higher in types 3 and 5, and types 2 and 4 with less representation. A greater contribution was identified in the irrigation of the AEC by the left colic artery (ICA) in the population studied (64.6%). Conclusion: Our population has a greater participation of ICA in AEC irrigation than Orientals (64.6% vs 49.6%), the most frequent types are 1, 3 and 6, Type 1 is the most frequent form of irrigation, similar to Fukuoka (34.7% vs 39.7%), Type 3 is more represented in our population than in the eastern one (29.9% vs 9.9%).
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This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) - Bio-C Temp and Ultracal - after different activation protocols in teeth with simulated internal root resorption. Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05). There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05). Due to this, it can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption.
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Aims: This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) -Bio-C Temp and Ultracal -after different activation protocols in teeth with simulated internal root resorption.Materials and methods: Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05).Results:There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05).Conclusion:It can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption.
ABSTRACT
Aims: This study aims to evaluate, by micro-computed tomography, the filling capacity of two root canal dressings (RCD) -Bio-C Temp and Ultracal -after different activation protocols in teeth with simulated internal root resorption.Materials and methods: Eighty single-rooted bovine teeth were sectioned in the cervical portion, standardizing the roots at 16 mm. Then, the canals were prepared by the apex-crown technique until instrument #80 using 2mL of 2.5% sodium hypochlorite solution at each instrument change. Afterward, the roots were sectioned longitudinally, and internal root resorptions were simulated using a diamond bur 1016 at 5 mm from the root apex. Hemiroots were joined and fixed with cyanoacrylate, scanned in micro-computed tomography (micro-CT) to assess total canal volume and simulated internal resorption, and then divided by stratified randomization into experimental groups according to RCD and method of activation (n = 10): Ultracal/Syringe; Ultracal/PUI, Ultracal/XP Endo Finisher, Ultracal Easy Clean, Bio-C Temp/Syringe, Bio-C Temp/PUI, Bio-C Temp/XP Endo Finisher and Bio-C/Easy Clean. Another scanning was performed to assess the volume of voids after RCD activation methods. The ANOVA and Tukey tests compared the activation methods. Student's T-test compared the RCDs within each activation method. Initial root canal volume values were similar for all groups (P > 0.05).Results:There was no difference between activation protocols (P > 0.05). Higher volumes of void spaces were observed for Bio-C Temp compared to Ultracal after all activation methods (P < 0.05), except for Easy Clean (P > 0.05).Conclusion:It can be concluded that the agitation methods tested for the Bio-C Temp and Ultracal pastes did not improve the filling of bovine teeth with simulated internal root resorption
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A successful endodontic treatment requires a combination of satisfactory mechanical instrumentation, adequate irrigation protocols, and three-dimensional obturation of the canal system. Irrigation is considered the most critical procedure to ensure cleaning and disinfection. To date, a large variety of irrigants has been proposed. However, sodium hypochlorite (NaOCl) remains the gold standard. In order to achieve complete cleaning and disinfection, final irrigation with EDTA and ultrasonic devices has been used as an ideal protocol. Most endodontic research focuses on the cleaning and antibacterial properties of the irrigant solutions. Recent evidence demonstrated that the irrigation protocols cause erosion, affecting the radicular dentin ultrastructure. This article aims to describe the clinical features of the present knowledge concerning the effect of irrigation protocols on radicular dentin.
Un tratamiento de endodoncia exitoso requiere de una satisfactoria instrumentación mecánica, protocolos de irrigación adecuados y obturación tridimensional del sistema de conductos radiculares. La irrigación se considera el procedimiento más crítico para garantizar la limpieza y desinfección. Hasta la fecha, se ha propuesto una gran variedad de irrigantes. Sin embargo, el hipoclorito de sodio (NaOCl) sigue siendo el estándar de oro. Para lograr una limpieza y desinfección completa, se ha utilizado como protocolo ideal la irrigación final con EDTA y dispositivos ultrasónicos. La mayor parte de la investigación en endodoncia se enfoca en las propiedades antibacterianas y de limpieza de las soluciones de irrigación. Reciente evidencia demostró que los protocolos de irrigación provocan erosión, afectando la ultraestructura de la dentina radicular. Este artículo tiene como objetivo describir algunas consideraciones clínicas del conocimiento actual sobre el efecto de los protocolos de irrigación en la dentina radicular.
Subject(s)
Sodium Hypochlorite/therapeutic use , Dental Pulp Cavity , Therapeutic Irrigation/instrumentationABSTRACT
El objetivo de este trabajo fue evaluar el efecto de soluciones de irrigación endodónticas solas y combinadas sobre iones calcio y fosfato de la dentina radicular ex vivo. Se emplearon 56 discos de dentina obtenidos del tercio medio radicular de premolares inferiores unirradiculares extraídos por razones ortodóncicas. Los discos se dividieron al azar en 8 grupos (n=7). Grupo I: agua destilada (AD), Grupo II: hipoclorito de sodio (NaClO) 1 %, Grupo III: EDTA 17 %, Grupo IV: ácido maleico (AM) 5 %, Grupo V: ácido acético (AA) 5 %, Grupo VI: EDTA 17 % + NaClO 1 %, Grupo VII: AM 5 % + NaClO 1 %, Grupo VIII: AA 5 % + NaClO 1 %. Los segmentos de dentina permanecieron en contacto a 37° C durante 5 min y 2,5 minutos en cada solución cuando se usaron en forma sucesiva. Se determinó la concentración de iones calcio de las soluciones mediante espectrometría de absorción atómica y la concentración de iones fosfatos mediante colorimetría (Wienner Lab.). Los resultados se expresaron en mg/ml/gr de tejido. Para el análisis estadístico se utilizó ANOVA y Test de Tukey. AA 5 % y EDTA 17 % se comportaron de manera similar utilizados solos durante 5 minutos, NaClO 1 % no mostró diferencias con el AD. AM 5 % eliminó significativamente más calcio y fosfato que todos los grupos. Todas las soluciones desmineralizaron la dentina, pero AM 5 % durante 5 min fue la solución que más afectó el componente inorgánico de la dentina.
The aim of the present study was to evaluate ex vivo irrigating solutions effect under calcium and phosphates dentin ions, using them alone and combined. In this study 56 dentin discs where used. They were obtained from middle third of mandibular single-root premolars extracted for orthodontics reasons. Discs were randomly divided into 8 groups (n:7). Group I: Distilled water (DW), Group II: 1 % sodium hypochlorite (NaOCl), Group III: 17 % EDTA, Group IV: 5 % maleic acid (MA), Group V: 5 % acetic acid (AA), Group VI: 17 % EDTA + 1 % NaOCl, Group VII: 5 % MA + 1 % NaOCl, Group VIII: 5 % AA + 1 % NaOCl. Dentin segments were kept in contact with irrigating solutions at 37°C for 5 minutes, when used alone, or for 2.5 minutes when used combined. After that, calcium ions (using absorption atomic spectrometry) and phosphorus ions (by colorimetry Wienner Lab.) were determined. Results were expressed in mg/ml/g tissue. Statistical analysis was performed by ANOVA and Tukey test. 5 % AA and 17 % EDTA eliminated similar concentrations of calcium and phosphates ions from dentin at 5 minutes exposure time, while 1 % NaOCl did not present statistical differences with control. 5 % MA eliminated significantly more calcium and phosphates ions than the rest of analyzed groups. Every tested solutions demineralized human dentin, but 5 % MA used for 5 minutes did it the most.
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Objective@#This ex vivo study evaluated the effect of ultrasound and Er:YAG laser irrigation activation techniques on the penetration of sodium hypochlorite solution into infected human root canal dentin, providing a reference for clinical infection control of infected root canals.@*Methods @#Thirty-six cases of infected root canals were collected and randomly divided into three groups according to the irrigation technique: 12 cases in the conventional syringe irrigation (CSI) group, 12 cases in the passive ultrasonic irrigation (PUI) group, 12 cases in the Er:YAG laser and photon-induced photoacoustic streaming (PIPS) group and 36 cases of clean root canals (12 cases in the CSI group, 12 cases in the PUI group, 12 cases in the PIPS group). All of the selected root canals were straight root canals of posterior teeth. After standardizing the root length, all canals were subjected to instrumentation and dynamic irrigation. 2% methylene blue solution was used to visualize the penetration of the irrigant. EXAKT cutting and grinding equipment was used to take transverse sections of 100-150 μm at the coronal, middle and apical thirds of the root canals. The data (maximum penetration depth, average penetration depth, and penetration percentage) were observed under a light microscope to evaluate the effect of dye penetration. @*Results @# With the three irrigation techniques, the maximum penetration depth, average penetration depth and penetration percentage of the infected root canals were significantly lower than those of clean root canals in the full length of the root canal (P<0.05). The penetration percentage, average penetration depth and maximum penetration depth of the PIPS group were significantly higher than those of the CSI group in the coronal, middle and apical thirds of the infected root canal, respectively (P<0.05). There was no significant difference in the maximum penetration depth, average penetration depth or penetration percentage between the PUI and CSI groups (P>0.05). There was also no significant difference in the maximum penetration depth, average penetration depth or penetration percentage between the PIPS and PUI groups (P>0.05). @*Conclusion @# The dentine permeability of infected root canals was weaker than that of clean root canals. Er:YAG laser-assisted irrigation activation technology could significantly improve the penetration of sodium hypochlorite solution into infected dentin, but passive ultrasonic irrigation did not significantly improve the penetration.
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Objective@# To compare the efficiency of four methods that remove calcium hydroxide in root canals and to guide clinical practice. @* Methods @# Sixty-five isolated mandibular single root canal premolars were collected. After crown cutting and root canal preparation, a tooth was randomly selected as the blank control group, and the remaining 64 teeth were equally divided into Groups A and B (n = 32). Group A was injected with water-soluble calcium hydroxide, and Group B was injected with oil-soluble calcium hydroxide. After 2 weeks of drug sealing, Groups A and B were randomly divided into 4 groups (n = 8), including the lateral opening syringe group, sonic vibration group, ultrasonic group, and Er: YAG laser group. Before and after calcium hydroxide removal, the samples were scanned by cone-beam CT, and the data were imported into Mimics for 3D reconstruction. The root canal was divided into the following segments: superior root segment, middle and apical, and the calcium hydroxide volume of each segment of the root canal was calculated. The volumes of calcium hydroxide before and after removal were V1 and V2, respectively, with a clearance rate = (V1-V2)/V1×100%. Three-factor ANOVA was used for statistical analysis. After Groups A and B were reconstructed, the apical region with residual calcium hydroxide was selected, and the blank control was observed by scanning electron microscopy (SEM). @*Results @# Two types of calcium hydroxide could not be completely removed by the four flushing methods. The clearance rate of water-soluble calcium hydroxide was higher than that of oil-soluble calcium hydroxide (P<0.001). Among the three segments of the root canal, the clearance rate of the apical segment was lower (P<0.05). The Er: YAG laser treatment group showed the highest removal efficiency of two kinds of calcium hydroxide, which was higher than that of the other groups, especially in apical of the root. Compared with the sonic wave washing group and the syringe washing group, the ultrasonic wave washing group exhibited significant advantages (P<0.05). The clearance rate of the sonic wave washing group was higher in the oily calcium hydroxide root middle group than in the syringe washing group (P<0.05). SEM showed that the two kinds of calcium hydroxide could not be completely removed, but the residual rate of oil-soluble calcium hydroxide was large.@*Conclusion @# Both types of calcium hydroxide could not be completely removed, and compared to water-soluble calcium hydroxide, oil-soluble calcium hydroxide was more difficult to remove. Among the four cleaning methods, Er:YAG laser swing washing showed the higher cleaning efficiency.
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Objective @#To observe the clearance of smear layer on the root canal wall in different action time by scanning electron microscope (SEM), and to determine the optimal amount of time using sonically activated irrigation to wash root canal in clinic. @*Methods@# Fifty-six ex vivo human anterior teeth with single straight root canal were selected. After routine mechanical preparation, they were divided into two experimental groups according to different irrigating agents: saline group and EDTA group. Each group was assisted by VDW sonic activation EDDY. The saline group was divided into three subgroups according to the irrigating time: 5 s, 30 s and 50 s; EDTA group was divided into six subgroups according to the irrigating time: 5 s, 10 s, 20 s, 30 s, 40 s and 50 s. The control group did not undergo root canal irrigation. After irrigation, the root was cut longitudinally. The smear layer of crown, middle and apical of root canal wall was observed by SEM.@* Results@# After irrigating for 30 seconds, there was a significant difference between the normal saline group and the control group and the 5 second group (P<0.05), and there was no difference in the middle and apical part (P>0.05). After 50 seconds, there was a significant difference in the score of the smear layer between the apical area and the other groups (P<0.05). After irrigating for 5 seconds or 10 seconds in EDTA group, there was a significant difference between the scores of the crown and middle area of the root canal and the control group (P<0.05), and there was no significant difference in the apical area (P>0.05). There was a significant difference between the 20-40 second group and the first two groups (P<0.05). There was a significant difference between the 50 second group and the other groups (P<0.05). Comparing the cleaning effect on the smear layer after 50 seconds of irrigating between the two experimental groups, the whole root canal showed significant statistical difference (P<0.05). @*Conclusion @#The EDTA-assisted sonic activated device used for 50 seconds has the best cleaning effect.
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Objective:To analyze the site of vestibular nerve damaged in patients with acute vestibular neuritis. Methods:Fifty-seven patients with acute vestibular neuritis were recruited, and each patient underwent caloric irrigation test, video head impulse test（vHIT） and vestibular evoked myogenic potentials（VEMPs）. The results were further analyzed. Results:Analysis of abnormal rates of different vestibular function tests: the abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and posterior semicircular canal vHIT were 92.98%, 92.98%, 92.98%, and 52.63%, respectively. The abnormal rate of cervical vestibular evoked myogenic potentials（cVEMP） and ocular vestibular evoked myogenic potentials（oVEMP） were 52.63% and 89.47%. The abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP were significantly higher than posterior semicircular canal vHIT and cVEMP（P<0.01）. Combination analysis of different vestibular function tests: there are twenty-six patients（45.61%, superior and inferior vestibular nerve） with abnormal caloric irrigation test, video head impulse test, and VEMPs. There are twenty-five patients（43.86%, superior vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP. There are 4 patients（7.02%, inferior vestibular nerve） with abnormal posterior semicircular canal vHIT and cVEMP. There are two patients（3.51%, ampullary vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, and anterior semicircular canal vHIT. The rate of superior and inferior vestibular neuritis and superior vestibular neuritis were significantly higher than inferior vestibular neuritis and ampullary vestibular neuritis（P<0.01）. Conclusion:Acute vestibular neuritis subtypes can be divided into four categories: superior and inferior vestibular neuritis, superior vestibular neuritis, inferior vestibular neuritis, and ampullary vestibular neuritis. Video head impulse test can accurately assess the site of vestibular nerve damage in patients with acute vestibular neuritis. In addition, vHIT combined with VEMPs can provide objective evidence for the diagnosis of ampullary vestibular neuritis.
Subject(s)
Humans , Vestibular Neuronitis/diagnosis , Vestibule, Labyrinth , Vestibular Nerve , Semicircular Canals , Head Impulse Test/methodsABSTRACT
This study aimed to describe the brain base arteries of the Myrmecophaga tridactyla using ten cadavers of adults from this species, including five male and five female specimens. The arterial vascular bed was perfused via the thoracic aorta with a dyed natural latex solution, and the animals were fixed and preserved with a 10% formaldehyde buffered solution. The encephala were removed, and their vessels dissected. Basilar artery formation occurred by anastomosis of the thick ventral spinal artery with vertebral arteries. The basilar artery formed two arterial islands and gave bulbar and pontine branches, and cranial, middle, and caudal cerebellar arteries and ended by forking into its terminal branches, the caudal communicating arteries. The blood supply of the encephalon derived solely from the vertebrobasilar system, and the arterial circle of the brain was closed caudally and rostrally. The absence of participation of internal carotid arteries in encephalon irrigation, the island formations by the basilar artery, and the fusiform shape of the arterial circle of the brain are peculiar characteristics of the vascular anatomy of the brain base of M. tridactyla.
Subject(s)
Xenarthra , Cerebrum/anatomy & histology , VermilinguaABSTRACT
The cotton boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), is a key cotton crop pest in Brazil. Adverse climatic factors, such as high temperatures and low soil moisture, dehydrate oviposited cotton squares (bud flowers) on the ground and cause high mortality of its offspring within these plant structures. The objective of this research was to evaluate the mortality of the cotton boll weevil in drip and sprinkler irrigated cotton crops. The experimental was in included randomized blocks with two treatments: drip (T1) and sprinkler (T2, control) irrigated cotton crops with sixteen replications. Each parcel had one emergence cage, installed between two cotton rows per irrigation system, with 37 cotton squares with opened oviposition punctures and yellowish bracts, to capture adult cotton boll weevils. The average number of boll weevils that emerged from the cotton squares and the causes of mortality at different development stages were determined per treatment. Third-generation life tables of the boll weevil were prepared using the natural mortality data in drip and sprinkler irrigation treatments and plus actual, apparent and indispensable mortality rates and the lethality of each mortality cause. We conclude that the application of water directly to the root zone of the plants in a targeted manner, using the drip irrigation system, can cause high mortality of the cotton boll weevil immature stages inside cotton squares fallen on the ground. This is because the cotton squares fallen on the drier and hotter soil between the rows of drip-irrigated cotton dehydrates causing the boll weevils to die. This is important because it can reduce its population density of the pest and, consequently, the number of applications of chemical insecticides for its control. Thus, contributing to increase the viability of cotton production, mainly in areas of the Brazilian semiarid region where the cotton is cultivated in organic system.
O bicudo-do-algodoeiro, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), é uma praga-chave da cultura do algodão no Brasil. Fatores climáticos adversos, como altas temperaturas e baixa umidade do solo, desidratam os botões florais de algodão ovipositados caídos ao solo e causam alta mortalidade de seus descendentes dentro dessas estruturas vegetais. O objetivo desta pesquisa foi avaliar a mortalidade do bicudo-do-algodoeiro em lavouras de algodão irrigadas por gotejamento e aspersão. O delineamento experimental foi em blocos casualizados com dois tratamentos: cultivo de algodão irrigado por gotejamento (T1) e aspersão (T2, testemunha) com dezesseis repetições. Cada parcela possuía uma gaiola de emergência, instalada entre duas fileiras de algodão por sistema de irrigação, com 37 botões florais de algodão com orifícios de oviposição, brácteas abertas e amarelecidas, para captura do bicudo adulto. O número médio de bicudos que emergiu dos botões florais de algodão e as causas de mortalidade, em diferentes estágios de desenvolvimento, foram determinados por tratamento. As tabelas de vida de terceira geração do bicudo-do-algodoeiro foram preparadas usando os dados de mortalidade natural em tratamentos de irrigação por gotejamento e aspersão e as taxas de mortalidade reais, aparentes e indispensáveis e a letalidade de cada causa de mortalidade. Concluímos que a aplicação de água diretamente na zona radicular das plantas de forma direcionada, utilizando o sistema de irrigação por gotejamento, pode causar altas mortalidade dos estágios imaturos do bicudo-do-algodoeiro nos botões florais de algodão caídos no solo. Isso ocorre porque os botões florais de algodão caídos no solo mais seco e mais quente entre as fileiras do algodão irrigado por gotejamento desidratam, causando a morte dos bicudos. Isso é importante por poder reduzir a densidade populacional desse inseto e, consequentemente, o número [...].
Subject(s)
Animals , Irrigation Channels/methods , Pest Control , Weevils , Gossypium , Trickling Irrigation , Agricultural PestsABSTRACT
Abstract The cotton boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), is a key cotton crop pest in Brazil. Adverse climatic factors, such as high temperatures and low soil moisture, dehydrate oviposited cotton squares (bud flowers) on the ground and cause high mortality of its offspring within these plant structures. The objective of this research was to evaluate the mortality of the cotton boll weevil in drip and sprinkler irrigated cotton crops. The experimental design was in randomized blocks with two treatments: drip (T1) and sprinkler (T2, control) irrigated cotton crops with sixteen replications. Each parcel had one emergence cage, installed between two cotton rows per irrigation system, with 37 cotton squares with opened oviposition punctures and yellowish bracts, to capture adult cotton boll weevils. The average number of boll weevils that emerged from the cotton squares and the causes of mortality at different development stages were determined per treatment. Third-generation life tables of the boll weevil were prepared using the natural mortality data in drip and sprinkler irrigation treatments and plus actual, apparent and indispensable mortality rates and the lethality of each mortality cause. We conclude that the application of water directly to the root zone of the plants in a targeted manner, using the drip irrigation system, can cause high mortality of the cotton boll weevil immature stages inside cotton squares fallen on the ground. This is because the cotton squares fallen on the drier and hotter soil between the rows of drip-irrigated cotton dehydrates causing the boll weevils to die. This is important because it can reduce its population density of the pest and, consequently, the number of applications of chemical insecticides for its control. Thus, contributing to increase the viability of cotton production, mainly in areas of the Brazilian semiarid region where the cotton is cultivated in organic system.
Resumo O bicudo-do-algodoeiro, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), é uma praga-chave da cultura do algodão no Brasil. Fatores climáticos adversos, como altas temperaturas e baixa umidade do solo, desidratam os botões florais de algodão ovipositados caídos ao solo e causam alta mortalidade de seus descendentes dentro dessas estruturas vegetais.O objetivo desta pesquisa foi avaliar a mortalidade do bicudo-do-algodoeiro em lavouras de algodão irrigadas por gotejamento e aspersão. O delineamento experimental foi em blocos casualizados com dois tratamentos: cultivo de algodão irrigado por gotejamento (T1) e aspersão (T2, testemunha) com dezesseis repetições. Cada parcela possuía uma gaiola de emergência, instalada entre duas fileiras de algodão por sistema de irrigação, com 37 botões florais de algodão com orifícios de oviposição, brácteas abertas e amarelecidas, para captura do bicudo adulto. O número médio de bicudos que emergiu dos botões florais de algodão e as causas de mortalidade, em diferentes estágios de desenvolvimento, foram determinados por tratamento. As tabelas de vida de terceira geração do bicudo-do-algodoeiro foram preparadas usando os dados de mortalidade natural em tratamentos de irrigação por gotejamento e aspersão e as taxas de mortalidade reais, aparentes e indispensáveis e a letalidade de cada causa de mortalidade. Concluímos que a aplicação de água diretamente na zona radicular das plantas de forma direcionada, utilizando o sistema de irrigação por gotejamento, pode causar altas mortalidade dos estágios imaturos do bicudo-do-algodoeiro nos botões florais de algodão caídos no solo. Isso ocorre porque os botões florais de algodão caídos no solo mais seco e mais quente entre as fileiras do algodão irrigado por gotejamento desidratam, causando a morte dos bicudos. Isso é importante por poder reduzir a densidade populacional desse inseto e, consequentemente, o número de aplicações de inseticidas químicos para seu controle. Assim, contribuindo para aumentar a viabilidade da produção de algodão, principalmente em áreas do semiárido brasileiro em sistema orgânico.
ABSTRACT
Abstract The cotton boll weevil, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), is a key cotton crop pest in Brazil. Adverse climatic factors, such as high temperatures and low soil moisture, dehydrate oviposited cotton squares (bud flowers) on the ground and cause high mortality of its offspring within these plant structures. The objective of this research was to evaluate the mortality of the cotton boll weevil in drip and sprinkler irrigated cotton crops. The experimental design was in randomized blocks with two treatments: drip (T1) and sprinkler (T2, control) irrigated cotton crops with sixteen replications. Each parcel had one emergence cage, installed between two cotton rows per irrigation system, with 37 cotton squares with opened oviposition punctures and yellowish bracts, to capture adult cotton boll weevils. The average number of boll weevils that emerged from the cotton squares and the causes of mortality at different development stages were determined per treatment. Third-generation life tables of the boll weevil were prepared using the natural mortality data in drip and sprinkler irrigation treatments and plus actual, apparent and indispensable mortality rates and the lethality of each mortality cause. We conclude that the application of water directly to the root zone of the plants in a targeted manner, using the drip irrigation system, can cause high mortality of the cotton boll weevil immature stages inside cotton squares fallen on the ground. This is because the cotton squares fallen on the drier and hotter soil between the rows of drip-irrigated cotton dehydrates causing the boll weevils to die. This is important because it can reduce its population density of the pest and, consequently, the number of applications of chemical insecticides for its control. Thus, contributing to increase the viability of cotton production, mainly in areas of the Brazilian semiarid region where the cotton is cultivated in organic system.
Resumo O bicudo-do-algodoeiro, Anthonomus grandis grandis Boheman (Coleoptera: Curculionidae), é uma praga-chave da cultura do algodão no Brasil. Fatores climáticos adversos, como altas temperaturas e baixa umidade do solo, desidratam os botões florais de algodão ovipositados caídos ao solo e causam alta mortalidade de seus descendentes dentro dessas estruturas vegetais.O objetivo desta pesquisa foi avaliar a mortalidade do bicudo-do-algodoeiro em lavouras de algodão irrigadas por gotejamento e aspersão. O delineamento experimental foi em blocos casualizados com dois tratamentos: cultivo de algodão irrigado por gotejamento (T1) e aspersão (T2, testemunha) com dezesseis repetições. Cada parcela possuía uma gaiola de emergência, instalada entre duas fileiras de algodão por sistema de irrigação, com 37 botões florais de algodão com orifícios de oviposição, brácteas abertas e amarelecidas, para captura do bicudo adulto. O número médio de bicudos que emergiu dos botões florais de algodão e as causas de mortalidade, em diferentes estágios de desenvolvimento, foram determinados por tratamento. As tabelas de vida de terceira geração do bicudo-do-algodoeiro foram preparadas usando os dados de mortalidade natural em tratamentos de irrigação por gotejamento e aspersão e as taxas de mortalidade reais, aparentes e indispensáveis e a letalidade de cada causa de mortalidade. Concluímos que a aplicação de água diretamente na zona radicular das plantas de forma direcionada, utilizando o sistema de irrigação por gotejamento, pode causar altas mortalidade dos estágios imaturos do bicudo-do-algodoeiro nos botões florais de algodão caídos no solo. Isso ocorre porque os botões florais de algodão caídos no solo mais seco e mais quente entre as fileiras do algodão irrigado por gotejamento desidratam, causando a morte dos bicudos. Isso é importante por poder reduzir a densidade populacional desse inseto e, consequentemente, o número de aplicações de inseticidas químicos para seu controle. Assim, contribuindo para aumentar a viabilidade da produção de algodão, principalmente em áreas do semiárido brasileiro em sistema orgânico.
Subject(s)
Animals , Coleoptera , Weevils , Insecticides , Oviposition , Crops, AgriculturalABSTRACT
ABSTRACT Objective: to compare the effect of clinical simulation and of a lectured class on Nursing students' knowledge about the colostomy irrigation procedure. Method: a quasi-experimental study conducted in September 2019 with Nursing students attending Universidade Federal do Rio Grande do Norte in Natal, Brazil. The instruments used were a questionnaire targeted at sociodemographic issues and a knowledge analysis tool at three different moments. The Control Group had a lectured class and the Intervention Group took part in the laboratory simulation. The Chi-Square and Mann-Whitney tests were used for data analysis. Results: no statistically significant differences were observed between the groups in terms of the sociodemographic profile. In the analysis of the means of correct answers, better measures were observed in the post-test of both groups when compared to the pre-test; however, in the retention test, the students from the Intervention Group had better and statistically significant results than those from the Control Group (p-value=0.015). Conclusion: it is noticed that both teaching strategies exerted a positive effect on the students' learning process. Although both are equally important and effective, simulation showed better performance in knowledge retention. It is expected that this research enables educators to reflect on their work and allows them to use strategies that enhance their teaching practice, in order to benefit teaching and the students' development.
RESUMEN Objetivo: comparar el efecto de la simulación clínica y de una clase expositiva en los conocimientos de estudiantes de Enfermería sobre el procedimiento de irrigación de colostomía. Método: estudio cuasiexperimental realizado en septiembre de 2019 con estudiantes de Enfermería de la Universidade Federal do Rio Grande do Norte en Natal, Brasil. Como instrumentos se utilizaron un cuestionario dirigido a cuestiones sociodemográficas y una herramienta de análisis del conocimiento, en tres ocasiones diferentes. Al Grupo Control se le ofreció la clase expositiva y el Grupo Intervención participó de la simulación en laboratorio. Para el análisis de los datos se emplearon las pruebas de Chi-Cuadrado y de Mann-Whitney. Resultados: no se observaron diferencias estadísticas significativas entre los grupos en relación con el perfil sociodemográfico. En el análisis de los valores medios de respuestas correctas se observaron mejores medidas en el post-test de ambos grupos, en comparación con el pre-test; sin embargo, en el test de retención, los estudiantes del Grupo Intervención obtuvieron mejores resultados que los del Grupo Controle, además de ser estadísticamente significativos (valor p =0,015). Conclusión: se percibió que ambas estrategias de enseñanza produjeron un efecto positivo en el proceso de aprendizaje de los estudiantes. Aunque ambas son importantes y eficaces, la simulación presentó mejor desempeño en la retención de conocimientos. Se espera que este trabajo de investigación permita que los educadores reflexiones acerca de su trabajo y haga posible la utilización de estrategias que mejoren su práctica docente, a fin de beneficiar la educación y el desarrollo de los estudiantes.
RESUMO Objetivo: comparar o efeito da simulação clínica e da aula expositiva dialogada no conhecimento de estudantes de enfermagem sobre o procedimento de irrigação de colostomia. Método: estudo quase experimental, realizado em setembro de 2019 com acadêmicos de enfermagem da Universidade Federal do Rio Grande do Norte, em Natal, Brasil. Utilizaram-se como instrumentos um questionário voltado para questões sociodemográficas e um de análise de conhecimento em três diferentes ocasiões. O grupo controle teve aula expositiva dialogada e o grupo intervenção participou da simulação em laboratório. Para análise de dados foram usados os testes Qui-Quadrado e o de Mann-Whitney. Resultados: observou-se ausência de diferenças estatísticas significantes entre os grupos quanto ao perfil sociodemográfico. Na análise das médias de acertos, observaram-se melhores medidas no pós-teste dos dois grupos, quando comparado ao pré-teste, contudo, no teste de retenção os discentes do grupo intervenção tiveram resultados melhores que o grupo controle e estatisticamente significantes (p-valor=0,015). Conclusão: percebeu-se que as duas estratégias de ensino produziram efeito positivo no processo de aprendizagem dos discentes. Apesar de ambas serem importantes e eficazes, a simulação apresentou melhor desempenho na retenção do conhecimento. Espera-se que a pesquisa possibilite aos educadores a reflexão de seu trabalho e oportunize a utilização de estratégias que aprimorem sua prática docente, com vistas a beneficiar o ensino e desenvolvimento dos estudantes.
ABSTRACT
Introducción: A pesar de su baja incidencia, las infecciones osteoarticulares pueden generar complicaciones y secuelas devastadoras para el niño en desarrollo con su esqueleto en crecimiento. El manejo general de la patología debe ser multidisciplinario, asociando la terapia antibiótica y un tratamiento quirúrgico adecuado si se requiere. El objetivo de nuestro trabajo es analizar los resultados sobre las diferentes opciones terapéuticas quirúrgicas (punción-aspiración, lavado artroscópico o lavado abierto) en el tratamiento de la artritis séptica en la edad, mediante la realización de revisión sistematizada de la bibliografía. Metodología: Realizamos una búsqueda bibliográfica online en los buscador PubMed y en la Biblioteca Virtual en Salud (BVS) utilizando los siguientes términos MESH: ("Arthritis, Infectious/surgery"(Mesh) OR "Arthritis, Infectious/therapy"(Mesh)), utilizando filtros de búsqueda y aplicando criterios de inclusión y exclusión según nuestro objetivo. De los artículos incluidos se obtuvieron entre otros los siguiente datos: país, año, nivel de evidencia, número de pacientes con artritis séptica, articulación afectada, edad media, seguimiento promedio, tipo de tratamiento quirúrgico realizado de inicio y sus resultados según cada autor : complicaciones (de la enfermedad y del procedimiento ) y/o secuelas (en base a evolución clínica y radiológica), necesidad de un tratamiento quirúrgico adicional ante la falla del método terapéutico inicial y además de conclusiones relevantes de cada autor. Resultados: Se incluyeron un total de 22 artículos: 8 para el lavado por artroscopia, 6 para el lavado por artrocentesis, 4 para el lavado por artrotomía, ademas de otros 4 artículos que realizaba un análisis comparativo: dos de ellos entre lavado artroscópico y lavado por artrotomía y los otros dos entre lavado por artrocentesis y lavado abierto. El lavado artroscópico se encuentra en lo más alto de nuestra revisión ya que presenta los mejores resultados con solo un 6% complicaciones y/o secuelas (en solo 4 de los 8 artículos incluidos), con un total de 13 pacientes (8,7% ) que requirieron un tratamiento adicional (5 artrotomías y 8 un nueva lavado artroscópico ) y se destacan ademas 3 artículos con un 100% de buenos resultados, en los que no se presentaron complicaciones y/o secuelas, ni se requirió un segundo lavado, mientras que solo en 3 trabajos, de los 8, se necesitó de la artrotomía adicional para la resolución final. Para el lavado por artrocentesis se obtuvo el menor porcentaje de complicaciones y/o secuelas con un 2%, (reportado en tres de los 6 trabajos), y solo el 9,7% necesitaron de un segundo método terapéutico diferente a la aspiración articular (23 artrotomías y 2 artroscopias), destacando ademas la repetición de la punción (hasta 4 veces) como dentro de la directiva terapéutica del autor en dos artículos, y que para éste método se encontró el mayor número de pacientes. El lavado por artrotomía como método inicial obtuvo los peores resultados, con un 12% de complicaciones y/o secuelas y un 22,6% de lavados adicionales. Conclusiones: A pesar de que el lavado abierto por artrotomía se toma como el ¨ gold-standard ¨, teniendo indicaciones absolutas en el tratamiento quirúrgico de la artritis séptica en niños (especialmente en cadera), de nuestro análisis se desprende que ésta opción arroja los peores porcentajes de resultados, duplicando el porcentaje de necesidad de lavado adicional y el de complicaciones, en comparación con el lavado artroscópico. Existen otros métodos terapéuticos que se presentan como procedimientos menos invasivos, seguros y eficaces, respaldados por buenos resultados en la biografiaría, como son: el lavado por artroscopia (que presentó el porcentaje más bajo de pacientes con necesidad de lavado adicional, con el mayor número de artículos con buenos resultados en general, con un porcentaje de complicaciones por debajo del lavado por artrotomía) y el lavado por artrocentesis (que presentó el porcentaje de compilaciones más bajo de las 3 opciones analizadas.
Introduction: Despite its low incidence, osteoarticular infections can generate devastating complications and sequelae for the developing child with his growing skeleton. The general management of the pathology must be multidisciplinary, associating antibiotic therapy and adequate surgical treatment if required. The objective of our work is to analyze the results on the different surgical therapeutic options (puncture-aspiration, arthroscopic lavage or open lavage) in the treatment of septic arthritis in the pediatric age, by carrying out a systematic review of the bibliography. Methodology: We conducted an online bibliographic search in the PubMed search engine and in the Virtual Health Library (VHL) using the following MESH terms: ("Arthritis, Infectious/surgery"(Mesh) OR "Arthritis, Infectious/therapy"(Mesh)), using search filters and applying inclusion and exclusion criteria according to our objective. The following data were obtained from the included articles, among others: country, year, level of evidence, number of patients with septic arthritis, affected joint, mean age, average follow-up, type of initial surgical treatment and its results according to each author: complications (of the disease and of the procedure) and/or sequelae (based on clinical and radiological evolution), the need for additional surgical treatment in the event of failure of the initial therapeutic method, and in addition to relevant conclusions of each author. Results: A total of 22 articles were included: 8 for arthroscopic lavage, 6 for arthrocentesis lavage, 4 for arthrotomy lavage, in addition to another 4 articles that performed a comparative analysis: two of them between arthroscopic lavage and lavage. by arthrotomy and the other two between lavage by arthrocentesis and open lavage. Arthroscopic lavage is at the top of our review as it presents the best results with only 6% complications and/or sequelae (in only 4 of the 8 articles included), with a total of 13 patients (8.7% ) that required additional treatment (5 arthrotomies and 8 a new arthroscopic lavage) and also highlight 3 articles with 100% good results, in which there were no complications and/or sequelae, nor did a second lavage be required, while that only 3 of the 8 studies required an additional arthrotomy for the final resolution. For lavage by arthrocentesis, the lowest percentage of complications and/or sequelae was obtained with 2% (reported in three of the 6 works), and only 9.7% required a second therapeutic method other than joint aspiration (23 arthrotomies and 2 arthroscopies), also highlighting the repetition of the puncture (up to 4 times) as within the author's therapeutic directive in two articles, and that the largest number of patients was found for this method. Arthrotomy lavage as the initial method obtained the worst results, with 12% complications and/or sequelae and 22.6% additional lavages. Conclusions: Even though open lavage by arthrotomy is taken as the ¨ gold-standard ¨, having absolute indications in the surgical treatment of septic arthritis in children (especially in the hip), from our analysis it can be deduced that this option yields the worse percentages of results, doubling the percentage of need for additional lavage and the percentage of complications, compared to arthroscopic lavage. There are other therapeutic methods that are presented as less invasive, safe and effective procedures, supported by good results in the biography, such as: arthroscopic lavage (which presented the lowest percentage of patients requiring additional lavage, with the highest number of articles with good results in general, with a percentage of complications below lavage by arthrotomy) and lavage by arthrocentesis (which presented the lowest percentage of compilations of the 3 options analyzed).
Introdução: Apesar de sua baixa incidência, as infecções osteoarticulares podem gerar complicações e sequelas devastadoras para a criança em desenvolvimento com seu esqueleto em crescimento. O manejo geral da patologia deve ser multidisciplinar, associando antibioticoterapia e tratamento cirúrgico adequado, se necessário. O objetivo do nosso trabalho é analisar os resultados das diferentes opções terapêuticas cirúrgicas (punção-aspiração, lavagem artroscópica ou lavagem aberta) no tratamento da artrite séptica em idade pediátrica, através da realização de uma revisão sistemática da bibliografia. Metodologia: Foi realizada uma busca bibliográfica online no buscador PubMed e na Biblioteca Virtual em Saúde (BVS) utilizando os seguintes termos MESH: ( "Arthritis, Infectious/surgery"(Mesh) OR "Arthritis, Infectious/therapy"(Mesh) ), utilizando filtros de busca e aplicando critérios de inclusão e exclusão de acordo com nosso objetivo. Os seguintes dados foram obtidos dos artigos incluídos, entre outros: país, ano, nível de evidência, número de pacientes com artrite séptica, articulação afetada, idade média, seguimento médio, tipo de tratamento cirúrgico inicial e seus resultados de acordo com cada autor: complicações (da doença e do procedimento) e/ou sequelas (com base na evolução clínica e radiológica), necessidade de tratamento cirúrgico adicional em caso de falha do método terapêutico inicial e, além das conclusões relevantes de cada autor. Resultados: Foram incluídos 22 artigos: 8 para lavagem artroscópica, 6 para lavagem artrocentese, 4 para lavagem artrotômica, além de outros 4 artigos que realizaram uma análise comparativa: dois deles entre lavagem artroscópica e lavagem por artrotomia e a outros dois entre lavagem por artrocentese e lavagem aberta. A lavagem artroscópica está no topo da nossa revisão por apresentar os melhores resultados com apenas 6% de complicações e/ou sequelas (em apenas 4 dos 8 artigos incluídos), com um total de 13 doentes (8,7%) que necessitaram de tratamento adicional (5 artrotomias e 8 uma nova lavagem artroscópica) e também destacam 3 artigos com 100% de bons resultados, nos quais não houve complicações e/ou sequelas, nem foi necessária uma segunda lavagem, enquanto que apenas 3 dos 8 estudos necessitaram de uma artrotomia para a resolução final. Para a lavagem por artrocentese, o menor percentual de complicações e/ou sequelas foi obtido com 2% (relatado em três dos 6 trabalhos), e apenas 9,7% necessitaram de um segundo método terapêutico diferente da aspiração articular (23 artrotomias e 2 artroscopias), destacando também a repetição da punção (até 4 vezes) conforme diretriz terapêutica do autor em dois artigos, e que o maior número de pacientes foi encontrado para este método. A lavagem por artrotomia como método inicial obteve os piores resultados, com 12% de complicações e/ou sequelas e 22,6% de lavagens adicionais. Conclusões: Apesar de a lavagem aberta por artrotomia ser tida como ¨padrão-ouro¨, tendo indicações absolutas no tratamento cirúrgico da artrite séptica em crianças (especialmente no quadril), da nossa análise pode-se deduzir que esta opção rende os piores percentuais de resultados, dobrando o percentual de necessidade de lavagem adicional e o percentual de complicações, em comparação com a lavagem artroscópica. Existem outros métodos terapêuticos que se apresentam como procedimentos menos invasivos, seguros e eficazes, corroborados por bons resultados na biografia, tais como: a lavagem artroscópica (que apresentou a menor percentagem de doentes que necessitaram de lavagem adicional, com o maior número de artigos com boa resultados em geral, com percentual de complicações abaixo da lavagem por artrotomia) e lavagem por artrocentese (que apresentou o menor percentual de compilações das 3 opções analisadas).
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Arthroscopy , Arthritis, Infectious/surgery , Arthrocentesis , Therapeutic Irrigation , Joints/surgery , Treatment Outcome , Patient Safety , Systematic ReviewABSTRACT
Abstract Objective To map available scientific evidence about the pediatric population with spina bifida submitted to transanal irrigation to manage signs and symptoms of neurogenic bowel. Source of data This research was developed according to recommendations from the Joanna Briggs Institute Reviewers' Manual and the PRISMA Extension for Scoping Reviews. Searches were carried out in the databases: CINAHL, Medline/Pubmed, Scielo, Scopus, Web of Science, Embase, LILACS, Proquest, and the CAPES catalog of theses and dissertations. Quantitative and qualitative studies on the topic were included, as long as they dealt with this population. There was no predetermined time frame. Summary of the findings The authors found 1.020 studies, selected 130 for close reading, and included 23 in the review, all of which had been published from 1989 to 2021. The authors mapped the characteristics of the studies, including their definitions of concepts and use of scales, criteria for the indication of transanal irrigation, training to carry out the procedure, devices and solutions used, number and frequency of transanal irrigations, health care actions, time spent, associated complications, complementary exams, adherence rate, follow-up, and outcomes, focusing on the benefits for bowel management. Conclusions Despite the variability of evaluation parameters and term definitions, evidence suggests that transanal irrigation is a safe and effective method to manage fecal incontinence. Studies in the field are likely to grow, using standardized scales and longitudinal follow-ups. The authors suggest further research on transanal irrigation in the pediatric population with spina bifida in the Latin American context.
ABSTRACT
This study evaluated the effects of ultrasonic activation (US) associated to glycolic acid (GA) on smear layer, dentin structure and bond strength (BS) of filling/restorative material to root dentin. The roots were used for antimicrobial activity, dentin structure and BS evaluation, being distributed into seven groups, according to irrigation protocols: G1:DW+US; G2:17% EDTA; G3:QMix; G4:17% GA; G5:17% EDTA+US; G6:QMix+US; G7:17% GA+US. Scanning electronic microscopy, transmission electronic microscopy and push-out were performed, with specific statistical analysis for each evaluation. The highest smear layer removal occured in Groups 6 and 7 (p<0.05), and the largest collagen dispersion in Group 7, being similar to Group 2 and 5 (p>0.05). The highest BS of filling and restorative material occurred in Groups 6 and 7, and Groups 5, 6 and 7, respectively, being similars between them (p>0.05). The use of GA+US promoted effective smear layer removal and dentin structure preservation, improving the BS of filling/restorative material to root dentin.