Chemical Methods for Cleaning Conventional Dentures: What is the Best Antimicrobial Option? An In Vitro Study.

PURPOSE: To investigate the antimicrobial efficacy of different chemical agents used for denture cleaning. MATERIALS AND METHODS: Biofilm samples collected from 10 removable dentures were subjected to 10 disinfection protocols: distilled water for 30 min (negative control); 1% sodium hypochlorite for 10 min (positive control); diluted sodium hypochlorite for 10 min; vinegar for 20 min; 0.2% peracetic acid for 5 min; alkaline peroxide solution for 5 min; alkaline peroxide solution for 30 min; 0.12% chlorhexidine digluconate for 10 min; 0.05% sodium salicylate solution for 10 min; and enzymatic detergent for 2 min. Each of the samples was plated on petri dishes with Mueller-Hinton agar. The numbers of microbial colonies after 48 h at 37°C were compared using the Kruskal-Wallis and Dunn's tests (α = 0.05). RESULTS: Diluted sodium hypochlorite, vinegar, and chlorhexidine digluconate inhibited bacterial growth, with an effect similar to that of 1% sodium hypochlorite. The 0.2% peracetic acid and 0.05% sodium salicylate solutions were ineffective against bacterial growth, while enzymatic detergent and alkaline peroxide achieved an intermediate effect. CONCLUSION: Diluted sodium hypochlorite, vinegar, and chlorhexidine digluconate can be considered adequate products for cleaning dentures due to their potential for inhibiting bacterial growth, similar to 1% sodium hypochlorite. However, the effect of these chemical agents on acrylic resin (polymethylmethacrylate) denture base materials needs to be examined to provide complete information about their clinical indication.

Abnormal heart rate recovery and deficient chronotropic response after submaximal exercise in young Marfan syndrome patients.

BACKGROUND: Marfan syndrome patients present important cardiac structural changes, ventricular dysfunction, and electrocardiographic changes. An abnormal heart rate response during or after exercise is an independent predictor of mortality and autonomic dysfunction. The aim of the present study was to compare heart rate recovery and chronotropic response obtained by cardiac reserve in patients with Marfan syndrome subjected to submaximal exercise. METHODS: A total of 12 patients on ß-blocker therapy and 13 off ß-blocker therapy were compared with 12 healthy controls. They were subjected to submaximal exercise with lactate measurements. The heart rate recovery was obtained in the first minute of recovery and corrected for cardiac reserve and peak lactate concentration. RESULTS: Peak heart rate (141±16 versus 155±17 versus 174±8 bpm; p=0.001), heart rate reserve (58.7±9.4 versus 67.6±14.3 versus 82.6±4.8 bpm; p=0.001), heart rate recovery (22±6 versus 22±8 versus 34±9 bpm; p=0.001), and heart rate recovery/lactate (3±1 versus 3±1 versus 5±1 bpm/mmol/L; p=0.003) were different between Marfan groups and controls, respectively. All the patients with Marfan syndrome had heart rate recovery values below the mean observed in the control group. The absolute values of heart rate recovery were strongly correlated with the heart rate reserve (r=0.76; p=0.001). CONCLUSION: Marfan syndrome patients have reduced heart rate recovery and chronotropic deficit after submaximal exercise, and the chronotropic deficit is a strong determinant of heart rate recovery. These changes are suggestive of autonomic dysfunction.

[Birth, life, and death of a public policy: an ethnography of the Open Arms program]. / Nascimento, vida e morte de uma política pública: uma etnografia do programa De Braços Abertos.

Public policies for the crack cocaine scene known as Crackland (São Paulo, Brazil) have been implemented for decades, but there has been no comprehensive description of such policies. We conducted this study due to the importance and innovative nature of the Open Arms program, in order to provide a comprehensive picture of the program, from its beginning until it was closed down. The description involves: (i) a survey of the activities developed by public agents who preceded the program and who directly influenced its formulation; (ii) a description of the status of Crackland when Open Arms was launched; (iii) specification of the institutional actors and their respective roles; and (iv) an explanation of the main events marking this public policy's development until its extinction. We drew on our ethnographic experience at Crackland, comparable to an important share of the literature on this topic. We identified strong influence from prior work by the professional staff, especially in the field of mental health in the municipal government in designing and developing the Open Arms program; however, the program developed with active participation by various entities, with important collaboration between municipal departments and agencies. The study revealed a close and adaptive relationship between the program and the Crackland scene, as well as clashes with organized crime and the police, requiring the development of specific skills by the municipal agents. When the program was dismantled, it left an important legacy with the emergence of activism in defense of the rights recently acquired by crack users, which should certainly play out in the form of some resistance to government measures.

Effect of phenylmethylsulfonyl fluoride, a protease inhibitor, on enamel surface remineralization

Phenylmethylsulfonyl fluoride (PMSF) is a protease inhibitor widely used in research, but fluoride is released during its action and this knowledge has been neglected in dental research. Aim: to evaluate if fluoride released by salivary protease action on PMSF affects enamel remineralization and fluoride uptake. Methods: Groups of 10 enamel slabs, with caries-like lesions and known surface hardness (SH), were subjected to one of the following treatment groups: Stimulated human saliva (SHS), negative control; SHS containing 1.0 µg F/mL (NaF), positive control; and SHS containing 10, 50 or 100 µM PMSF. The slabs were subjected to a pH-cycling regimen consisting of 22 h/day in each treatment solution and 2 h/day in a demineralizing solution. After 12 days, SH was again measured to calculate the percentage of surface hardness recovery (%SHR), followed by enamel fluoride uptake determination. The time-related fluoride release from 100.0 µM PMSF by SHS action was also determined. Data were analyzed by ANOVA followed by Newman-Keuls test. Results: The release of fluoride from PMSF by SHS was rapid, reaching a maximum value after 10 min. Fluoride released from PMSF was more effective in enhancing %SHR and increasing fluoride uptake in enamel compared with SHS alone (p < 0.05); furthermore, it was equivalent to the positive control (p > 0.05). Conclusion: In conclusion, fluoride released by saliva from PMSF is available to react with enamel and needs to be taken into account in research using this protease inhibitor

[Different patterns for the 6-minute walk test as a test to measure exercise ability in elderly with and without clinically evident cardiopathy]. / Diferentes padronizações do teste da caminhada de seis minutos como método para mensuração da capacidade de exercício de idosos com e sem cardiopatia clinicamente evidente.

OBJECTIVES: Evaluate the correlation between peak oxygen consumption (VO2peak), from cardiopulmonary test with the distance covered in the six-minute walk test (6MWT) in healthy elderly and with myocardial infarction (MI). METHODS: Thirty individuals were studied, with age range 65-87 years (76.03 +/- 4.75), divided into 2 groups: Group I--14 with clinically evident coronary heart disease (CHD) and Group II--16 without clinically evident CHD. They were submitted to cardiopulmonary test (CPT) and 2 types of 6MWT, standard test 6MWTs. Variables measure at rest and exertion were heart rate (HR) and respiratory rate (RR), blood pressure (BP), distance covered (DC), and Borgs rate subjective perceived exertion (RPE). RESULTS: The study showed significant, strong correlation between distances covered for both 6MWT, and (VO2peak) obtained from cardiopulmonary test (CPT) for all elderly included in the study. When comparing the 6MWT with physiotherapist support (6MWTphy) and without support (6MWTw), statistically significant difference was observed, with higher average values of the DC, of the RH and RR and Borgs RPE in the 6MWTphy, both of the groups. Additionally, the RH reached at final the exertion in 6MWTphy was similar to that obtained in CPT (p<0.05) suggesting that the 6MWT stimulates higher cardiovascular performance. CONCLUSION: 6MWTw, adopted a worldwide, by being submaximal imposes lower cardiovascular overburden as compared to 6MWTphy and is probably safer for elderly who are cardiopaths.

Nascimento, vida e morte de uma política pública: uma etnografia do programa De Braços Abertos / Birth, life, and death of a public policy: an ethnography of the Open Arms program / Nacimiento, vida y muerte de una política pública: una etnografía del programa De Brazos Abiertos

Resumo: Políticas públicas direcionadas à Cracolândia (São Paulo, Brasil) vêm sendo implementadas há décadas e carecem de uma descrição abrangente. Realizamos este estudo pela importância e caráter inovador do programa De Braços Abertos (DBA), com o propósito de oferecer um quadro compreensivo desde seu início até o encerramento. Isso por meio: (i) do levantamento das atividades desenvolvidas por agentes públicos que precederam o Programa e que influenciaram diretamente a sua formulação; (ii) da descrição do estado em que se encontrava a Cracolândia no momento de implantação do DBA; (iii) da especificação dos atores institucionais e suas atribuições; e (iv) da exposição dos principais acontecimentos que marcaram o desenvolvimento dessa política pública até sua extinção. Para tanto, nos valemos de nossa vivência etnográfica na Cracolândia, que pôde ser cotejada com uma parcela importante do material bibliográfico existente sobre o tema. Identificamos uma forte influência do trabalho pregresso de profissionais, principalmente do campo da Saúde Mental do município na concepção e desenvolvimento do DBA, mas que, no entanto, aconteceu com a participação ativa de diversos entes, com importante caráter intersecretarial. A pesquisa mostrou a relação íntima e adaptativa entre o Programa e o ambiente da Cracolândia, assim como os conflitos com o crime organizado e as polícias que fomentaram o desenvolvimento de competências específicas por parte dos agentes do município. Ao ser desmantelado, o Programa deixou uma importante herança no surgimento de uma militância em prol dos direitos recém-adquiridos pelos usuários de crack, o que certamente poderá significar alguma resistência contra medidas do poder público.

Abstract: Public policies for the crack cocaine scene known as Crackland (São Paulo, Brazil) have been implemented for decades, but there has been no comprehensive description of such policies. We conducted this study due to the importance and innovative nature of the Open Arms program, in order to provide a comprehensive picture of the program, from its beginning until it was closed down. The description involves: (i) a survey of the activities developed by public agents who preceded the program and who directly influenced its formulation; (ii) a description of the status of Crackland when Open Arms was launched; (iii) specification of the institutional actors and their respective roles; and (iv) an explanation of the main events marking this public policy's development until its extinction. We drew on our ethnographic experience at Crackland, comparable to an important share of the literature on this topic. We identified strong influence from prior work by the professional staff, especially in the field of mental health in the municipal government in designing and developing the Open Arms program; however, the program developed with active participation by various entities, with important collaboration between municipal departments and agencies. The study revealed a close and adaptive relationship between the program and the Crackland scene, as well as clashes with organized crime and the police, requiring the development of specific skills by the municipal agents. When the program was dismantled, it left an important legacy with the emergence of activism in defense of the rights recently acquired by crack users, which should certainly play out in the form of some resistance to government measures.

Resumen: Las políticas públicas dirigidas a Cracolandia (São Paulo, Brasil) se han implementado hace décadas y carecen de una descripción amplia. Realizamos este estudio por la importancia y carácter innovador del programa De Brazos Abiertos (DBA), con el propósito de ofrecer un cuadro comprensivo desde su inicio hasta su desmantelamiento. A través de: (i) la relación de las actividades desarrolladas por agentes públicos que precedieron el programa y que influenciaron directamente en su formulación; (ii) la descripción del estado en el que se encontraba Cracolandia en el momento de la implantación del DBA; (iii) la especificación de los actores institucionales y sus atribuciones; (iv) la exposición de los principales acontecimientos que marcaron el desarrollo de esta política pública hasta su extinción. Para tal fin, nos valemos de nuestra vivencia etnográfica en Cracolandia, que puede ser cotejada con una parte importante del material bibliográfico existente sobre el tema. Identificamos una fuerte influencia del trabajo anterior de profesionales, principalmente procedentes del campo de la salud mental en el municipio tanto en la concepción, como en el desarrollo del DBA; pese a que hubo participación activa de diversos entes, con una importante interrelación. La investigación mostró la relación íntima y adaptativa entre el programa y el ambiente de Cracolandia, así como conflictos con el crimen organizado y organismos que fomentaron el desarrollo de competencias específicas por parte de los agentes del municipio. Al ser desmantelado, el programa dejó una importante herencia en el surgimiento de una militancia en pro de los derechos recién adquiridos por los consumidores de crack, lo que ciertamente podría significar alguna resistencia contra las medidas del poder público.

The dysfunction of ammonia in heart failure increases with an increase in the intensity of resistance exercise, even with the use of appropriate drug therapy.

BACKGROUND: Hyperammonemia during rest periods is a dysfunction in heart failure (HF). The low formation of ammonia during exercise reflects an inefficiency of purine metabolism. Hyperkalemia in response to physical exercise is common in HF and may contribute to a contractile inefficiency in type II fibers, leading to early fatigue. We tested the hypothesis that during resistance exercise of high intensity and low volume, this disorder of ammonia metabolism would be more intense, due to the hyperkalemia present in HF. METHODS: Alternating resistance exercise (RE) of low intensity and high volume, and high intensity and low volume, were applied to 18 patients with an interval of 7 days between them (functional class II-III New York Heart Association, FE = 33.5 ± 4%) and compared with 22 healthy controls matched for age and gender. Ammonia, potassium and lactate levels were assessed before and immediately after the RE. RESULTS: Significant differences: Deltas (control vs. HF) in 40% RE: lactate (mg/dl) 26.3 ± 10 vs. 37.7 ± 7; p < 0,001, ammonia (ug/dl) 92.5 ± 18 vs. 48.9 ± 9; p < 0.001. Deltas (control vs. HF) in 80%RE: lactate(mg/dl) 45.0 ± 12 vs. 54.1 ± 11; p < 0.05, ammonia(ug/dl) 133.5 ± 22 vs. 32.2 ± 7; p < 0.001, potassium (mEq/L) 1.6 ± 0.4 vs. 2.0 ± 0.8; p < 0.05. A negative correlation was found between the deltas of ammonia and potassium (r = -0.74, p < 0.001) in the HF group. CONCLUSIONS: We conclude that in HF, there is an inefficiency of purine metabolism that increases with increasing exercise intensity, but not with an increase of total volume. These findings suggest that hyperkalemia may play an important role in the disorders of purine metabolism.

Aspectos da sobrecarga e qualidade de vida de cuidadores de pacientes hospitalizados: uma análise baseada na Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) / Burden and quality of life of hospitalized patients' caregivers: an analysis based on the International Classification of Functioning, Disability and Health (ICF)

Resumo Objetivo: caracterizar o perfil e a relação entre sobrecarga e qualidade de vida (QV) de cuidadores de pacientes hospitalizados de acordo com o modelo biopsicossocial da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Analisar a correlação entre a sobrecarga do cuidador e o nível de dependência motora e cognitiva do paciente. Métodos: estudo transversal com 68 cuidadores de pacientes hospitalizados há 12 ou mais dias. Para avaliação da QV e da sobrecarga dos cuidadores foram utilizados, respectivamente, o Short Form Health Survey (SF-36) e a escala de Zarit (Zarit Burden Interview). Utilizou-se a Medida de Independência Funcional para caracterizar a dependência motora e cognitiva dos pacientes. Os resultados foram relacionados aos conceitos da CIF. Resultados: de acordo com os qualificadores da CIF, um comprometimento progressivo na QV dos cuidadores foi observado com o aumento da sobrecarga. Houve correlação negativa, estatisticamente significante e de fraca magnitude, entre a percepção de QV e sobrecarga. Não houve correlação entre a sobrecarga do cuidador e o nível de dependência do paciente. Conclusão: o SF-36 é capaz de analisar 13 categorias da CIF, permitindo avaliar o cuidador de forma integral, de acordo com o modelo biopsicossocial, e facilitando o uso da CIF na prática clínica.

Abstract Objective: to characterize the profile and the relationship between burden and quality of life (QOL) of hospitalized patients' caregivers according to the International Classification of Functioning Disability and Health (ICF) biopsychological model. To analyze the correlation between caregiver's burden and the level of patients' motor and cognitive dependency. Methods: cross-sectional study, involving 68 caregivers of patients hospitalized for 12 or more days. Caregivers' QOL and burden were assessed by the Short Form Health Survey (SF-36) and the Zarit scale (Zarit Burden Interview), respectively. Functional Independence Measure was used to characterize patients' motor and cognitive dependency. The relationship between the results and the ICF concepts was analyzed. Results: according to ICF qualifiers, a progressive impairment in the caregivers' QOL was observed with burden increasing. There was a statistically significant negative correlation, of low magnitude, between perception of QOL and burden. There was no correlation between caregiver's burden and patient's dependency level. Conclusion: SF-36 can analyze 13 ICF categories. It allows evaluating caregivers in a comprehensive way and in accordance with the biopsychosocial model. It can also help to apply ICF in clinical practice.

Atuação do enfermeiro em um serviço de atendimento pré-hospitalar privado / Actuación del enfermero en un servicio de atención prehospitalaria privada / Nurse performance on a private prehospital assistance

Objective: to know the perception of health workers performing as nurses on a pre-hospital care service. Method: descriptive exploratory study with a qualitative approach, which was carried out on a Prehospital private assistance in the northwest of the State of Rio Grande do Sul. The participants were doctors, nurses and nursing technicians. Data collection was conducted in February and March 2016, through semistructured interview. The analysis followed the assumptions of a so called Content Analysis. Results: The nurses develop managerial and assistance activities requiring technical and scientific knowledge, skills, and teamwork. Autonomy, good relationship and scientific knowledge were identified as factors that facilitate the job. However, lack of knowledge, relationship difficulties and bad weather are factors that hinder the work. Conclusions: The nurse is a very important front for the team, when performing their duties with suitable skills and great knowledge.

Objetivo: conhecer a percepção de trabalhadores de saúde sobre a atuação do enfermeiro em um serviço de atendimento pré-hospitalar. Método: estudo exploratório-descritivo, com abordagem qualitativa realizado em um serviço de Atendimento Pré-hospitalar privado do noroeste gaúcho. Participaram da pesquisa médicos, enfermeiros e técnicos de enfermagem. A coleta de dados foi realizada nos meses de fevereiro e março de 2016, por meio de entrevista semiestruturada. A análise obedeceu aos pressupostos da Análise de Conteúdo. Resultados: os enfermeiros desenvolvem ações gerenciais e assistenciais requerendo conhecimento técnico científico, habilidade, e trabalho em equipe. A autonomia, bom relacionamento e conhecimento científico foram apontados como fatores que facilitam o trabalho. No entanto, a falta de conhecimento, dificuldades de relacionamento e as intempéries climáticas são fatores que dificultam o trabalho. Conclusões: o enfermeiro é de grande importância frente à equipe, desempenhando suas funções com habilidade e conhecimento.

Objetivo: conocer la percepción de trabajadores de salud sobre la actuación del enfermero en un servicio de atención prehospitalaria. Método: investigación exploratoria descriptiva, con enfoque cualitativo realizada en un servicio de Atención Prehospitalaria privada del noroeste gaucho. Participaron de la investigación médicos, enfermeros y técnicos de enfermería. La recolección de datos fue realizada en los meses de febrero y marzo de 2016, por medio de entrevista semiestructurada. El análisis obedeció a las hipótesis de Análisis del Contenido. Resultados: los enfermeros desarrollaron acciones gerenciales y asistenciales requiriendo conocimiento técnico científico, habilidad, y trabajo en equipo. La autonomía, buena relación y conocimiento científico fueron apuntados como factores que facilitan el trabajo. No obstante, la falta de conocimiento, dificultades de relación y las intemperies climáticas son factores que dificultan el trabajo. Conclusiones: el enfermero es de gran importancia delante del equipo, desempeñando sus funciones con habilidad y conocimiento.

Effect of a physical exercise program in a patient with Marfan syndrome and ventricular dysfunction.

Marfan syndrome (MS) is an autosomal dominant disorder that affects multiple organs and systems. Several cardiac alterations are present, with the main ones being aortic root and ascending aorta dilatation, mitral valve prolapse and left ventricle (LV) dilatation. Aerobic exercise has not shown to be a non-drug therapy that promotes anti-remodeling effect in patients with heart failure. This case report describes the echocardiographic changes in a patient with Marfan syndrome during four years of cardiovascular physical therapy.

Anthropometric and musculoskeletal assessment of patients with Marfan syndrome.

BACKGROUND: Marfan syndrome (MS) is an autosomic dominant condition of the connective tissue that involves the ocular, cardiovascular and musculoskeletal systems. MS is caused by mutations in the fibrillin-1 gene, leading to joint ligaments flaccidity, joint hypermobility and an overgrowth of the long bones. OBJECTIVES: The aim of the present study was to assess anthropometry, musculoskeletal alterations and the prevalence of physical therapy treatments among patients with MS. METHODS: Twenty-six patients were included in this study [17 females (age: 13.23±2.77 years; body mass 51.5±24-68 Kg; height 1.70±1.40-1.81 m; arm span: 1.73±0.12 m) and 9 males (age: 14.44±2.18; body mass: 61.0±42-72 Kg; height: 1.83±1.66-1.97 m; arm span: 1.93±0.13 m)]. Anthropometric measurements and musculoskeletal abnormalities were determined in a standardized fashion: pectus and scoliosis were assessed through radiography and angulation (â) of the scoliosis curve using the Cobb method; arachnodactyly was assessed through the thumb sign and Walker-Murdoch test and dolichostenomelia was assessed by arm span in relation to height. Patients also responded to a questionnaire addressing participation in physical therapy. RESULTS: In comparison to values estimated for the Brazilian population, mass and height were greater among the patients with MS (females: p=0.001 e p<0.0005 e males p=0.019 e p=0.0001, respectively). The following musculoskeletal abnormalities were found: pectus in 3 patients (11%), pectus and scoliosis in 19 (73%), dolichostenomelia in 11 (42%) and arachnodactyly in 21 (80%). Eleven patients (42%) with MS had previously undergone physical therapy. CONCLUSIONS: Patients with MS exhibit altered musculoskeleto and anthropometry and have infrequent physical therapy treatment.

In vitro antifungal action of different substances over microwaved-cured acrylic resins.

OBJECTIVE: The presence of Candida albicans on the surfaces of denture-base acrylic resins is strongly related to the development of oral stomatitis. This study evaluated the antifungal action of different agents over microwave-cured acrylic resin without polishing specimens previously contaminated with Candida albicans. MATERIAL AND METHODS: Sixty specimens were immersed in BHI broth previously inoculated with the yeast and stored for 3 h at 37 degrees C. They were divided into 5 experimental groups (n=10): G1: 2% chlorhexidine solution (10 min); G2: 0.5% sodium hypochlorite (10 min); G3: modified sodium hypochlorite (10 min); G4: effervescent agent (5 min); G5: hydrogen peroxide 10 v (30 min). The specimens of the control group 1 (C1) were not disinfected. Ten additional specimens of the control group 2 (C2) were not infected with the yeast, aiming to check the asepsis during the experiment. The disinfection agents were neutralized and the acrylic resin specimens were immersed in BHI Broth for 24 h. Culture media turbidity was evaluated spectrophotometrically according to the transmittance degree, i.e. the higher the transmittance the stronger the antimicrobial action. Statistical analysis was performed (Kruskal-Wallis Test, p<0.05). RESULTS: The results, represented by the medians, were: G1 = 40; G2 = 100; G3 = 100; G4 = 90; G5 = 100; C1 = 40; C2 = 100. CONCLUSIONS: This in vitro study suggested that sodium hypochlorite-based substances and hydrogen peroxide are more efficient disinfectants against C. albicans than 2% chlorhexidine solution and the effervescent agent.

A maçã limpa os dentes. Verdade ou mito? Avaliação da capacidade da maçano controle do biofilme dental / The apple cleans the teeth. True or mith? Evaluation of the apple’s capacity on dental biofilm control

Avaliar a eficácia da mastigação da maça na redução da colonização bacteriana nas superfícies dentárias e na concentração de micro-organismos da saliva. Métodos: Quinze voluntários suspenderam a higiene bucal por 18 horas e consumiram uma dieta com alta concentração de sacarose. Após, submeteram-se ao protocolo com solução evidenciadora de biofilme, coleta de saliva, registro fotográfico das arcadas e análise do Índice de Placa, antes e após o consumo da maça. Resultados: a concentração microbiana não apresentou diferenças significativas entre as amostras coletadas de antes e após o consumo da fruta. A avaliação do Índice de Placa Visível (IPV) demonstrou redução do biofilme nas superfícies livres. Conclusão: A maça possui uma capacidade relativa de desorganizar o biofilme dentário recém-formado, sendo que o consumo da fruta não altera a concentração de microorganismos oral da saliva...

Evaluated the efficacy of chewing the apple in reducing biofilm on tooth surfaces and in the concentration of micro-organisms in the saliva. Methods: Fifteen volunteers suspended oral hygiene for 18 hours and consumed a diet with a high concentration of sucrose. After, followed the protocol with plaque disclosing agents, saliva collection, photography record and analysis of plaque index, before and after chewing the apple. Results: The microbial concentration showed no significant differences between the samples before and after consumption of the fruit. Evaluation of Plaque Index Visible (IPV) showed a reduction in biofilm on surfaces free. Conclusions: The apple has a relative ability to disrupt dental biofilm newly formed, being that the consumption of fruit not alter the concentration of oral microorganisms of saliva...

Short-term transcutaneous electrical nerve stimulation after cardiac surgery: effect on pain, pulmonary function and electrical muscle activity.

This study aimed to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) for treatment of postoperative pain in patients who underwent cardiac surgery. In addition, we sought to determine whether TENS would be related to improved pulmonary function and muscle electrical activity in this patient population. Forty-five patients, 32 males and 13 females, aged 41-74 years were randomly allocated to receive TENS (n=23) or sham treatment (n=22) during 4 h on the third postoperative day. A 0-10 visual analogic scale was used to assess pain; lung function was evaluated by spirometry and surface electromyography (n=10 in each group) was used to quantify electrically-induced muscle activity (trapezius and pectoralis major). TENS was associated with significant reductions on spontaneous and cough-induced postoperative pain as compared to sham (P<0.05). There was also improvement in chest wall-pulmonary mechanics after TENS with proportional increases in tidal volume and vital capacity (P<0.05). In addition, electrical activity of both muscle groups was enhanced after TENS, but not post sham (P<0.05). TENS is a valuable strategy to alleviate postoperative pain following cardiac surgery with positive effects on pulmonary ventilatory function and electrical activity of thoracic and girdle muscles.

Efeito de um programa de exercício físico em portador da Síndrome Marfan com disfunção ventricular / Effect of a physical exercise program in a patient with Marfan Syndrome and ventricular dysfunction / Efecto de un programa de ejercicio físico en portador del Síndrome Marfan con disfunción ventricular

A Síndrome de Marfan (SM) é uma desordem autossômica dominante que afeta múltiplos órgãos e sistemas. Diversas alterações cardíacas estão presentes, sendo as principais a dilatação da raiz da aorta e da aorta ascendente, o Prolapso de Valva Mitral e a dilatação do Ventrículo Esquerdo (VE). O exercício aeróbico tem-se mostrado um recurso terapêutico não medicamentoso, por promover efeito de antirremodelamento em pacientes com insuficiência cardíaca. Este relato de caso descreve as alterações ecocardiográficas de um paciente com Síndrome de Marfan durante quatro anos de um programa de fisioterapia cardiovascular.

Marfan syndrome (MS) is an autosomal dominant disorder that affects multiple organs and systems. Several cardiac alterations are present, with the main ones being aortic root and ascending aorta dilatation, mitral valve prolapse and left ventricle (LV) dilatation. Aerobic exercise has not shown to be a non-drug therapy that promotes anti-remodeling effect in patients with heart failure. This case report describes the echocardiographic changes in a patient with Marfan syndrome during four years of cardiovascular physical therapy.

El Síndrome de Marfan (SM) es un desorden autosómico dominante que afecta múltiples órganos y sistemas. Diversas alteraciones cardíacas están presentes, siendo las principales la dilatación de la raíz de la aorta y de la aorta ascendente, el Prolapso de Válvula Mitral y la dilatación del Ventrículo Izquierdo (VI). El ejercicio aeróbico ha mostrado ser un recurso terapéutico no medicamentoso, por promover efecto de antirremodelado en pacientes con insuficiencia cardíaca. Este relato de caso describe las alteraciones ecocardiográficas de un paciente con Síndrome de Marfan durante cuatro años de un programa de fisioterapia cardiovascular.

Avaliação antropométrica e musculoesquelética de pacientes com síndrome de Marfan / Anthropometric and musculoskeletal assessment of patients with Marfan syndrome

CONTEXTUALIZAÇÃO: A Síndrome de Marfan (SM) é uma doença autossômica dominante do tecido conjuntivo que envolve os sistemas ocular, cardiovascular e musculoesquelético, causada por mutações no gene da fibrilina1, gerando flacidez nos ligamentos articulares, favorecendo a hipermobilidade articular e redução na contenção do crescimento ósseo. OBJETIVOS: Avaliar as medidas antropométricas, alterações musculoesqueléticas e a frequência do tratamento fisioterapêutico nos pacientes com SM. MÉTODOS: Participaram deste estudo 26 pacientes, sendo 17 do gênero feminino, com idade de 13,23±2,77 anos, massa corpórea de 51,5±24-68 Kg, altura de 1,70±1,40-1,81 m e envergadura de 1,73±0,12 cm, e nove do gênero masculino, com idade de 14,44±2,18, massa corpórea de 61,0±42-72 Kg, altura de 1,83±1,66-1,97 m e envergadura de 1,93±0,13. Foram obtidas medidas antropométricas, alterações ME de forma padronizada, sendo o pectus e a escoliose, por avaliação radiológica, e a angulação (â) da curva escoliótica, pelo método de Cobb; a aracnodactilia, pelo sinal do polegar e teste de Walker-Murdoch, e a dolicostenomelia, pela envergadura em relação à altura. Os pacientes responderam a um questionário quanto à participação em tratamento de fisioterapia. RESULTADOS: Quando comparados com a estimativa brasileira, a massa corpórea e a altura apresentaram valores maiores no gênero feminino (p=0,001 e p<0,0005) e masculino (p=0,019 e p=0,0001). Das alterações musculoesqueléticas, encontrou-se pectus em 3 (11 por cento), pectus e escoliose em 19 (73 por cento), dolicostenomelia em 11 (42 por cento) e aracnodactilia em 21(80 por cento). Onze (42 por cento) pacientes com SM já haviam realizado tratamento de fisioterapia. CONCLUSÕES: As alterações antropométricas e musculoesqueléticas estão presentes na SM, e o tratamento fisioterapêutico é pouco frequente.

BACKGROUND: Marfan syndrome (MS) is an autosomic dominant condition of the connective tissue that involves the ocular, cardiovascular and musculoskeletal systems. MS is caused by mutations in the fibrillin-1 gene, leading to joint ligaments flaccidity, joint hypermobility and an overgrowth of the long bones. OBJECTIVES: The aim of the present study was to assess anthropometry, musculoskeletal alterations and the prevalence of physical therapy treatments among patients with MS. METHODS: Twenty-six patients were included in this study [17 females (age: 13.23±2.77 years; body mass 51.5±24-68 Kg; height 1.70±1.40-1.81 m; arm span: 1.73±0.12 m) and 9 males (age: 14.44±2.18; body mass: 61.0±42-72 Kg; height: 1.83±1.66-1.97 m; arm span: 1.93±0.13 m)]. Anthropometric measurements and musculoskeletal abnormalities were determined in a standardized fashion: pectus and scoliosis were assessed through radiography and angulation (â) of the scoliosis curve using the Cobb method; arachnodactyly was assessed through the thumb sign and Walker-Murdoch test and dolichostenomelia was assessed by arm span in relation to height. Patients also responded to a questionnaire addressing participation in physical therapy. RESULTS: In comparison to values estimated for the Brazilian population, mass and height were greater among the patients with MS (females: p=0.001 e p<0.0005 e males p=0.019 e p=0.0001, respectively). The following musculoskeletal abnormalities were found: pectus in 3 patients (11 percent), pectus and scoliosis in 19 (73 percent), dolichostenomelia in 11 (42 percent) and arachnodactyly in 21 (80 percent). Eleven patients (42 percent) with MS had previously undergone physical therapy. CONCLUSIONS: Patients with MS exhibit altered musculoskeleto and anthropometry and have infrequent physical therapy treatment.

The dysfunction of ammonia in heart failure increases with an increase in the intensity of resistance exercise, even with the use of appropriate drug therapy

Background: Hyperammonemia during rest periods is a dysfunction in heart failure (HF). The low formation of ammonia during exercise reflects an inefficiency of purine metabolism. Hyperkalemia in response to physical exercise is common in HF and may contribute to a contractile inefficiency in type II fibers, leading to early fatigue. We tested the hypothesis that during resistance exercise of high intensity and low volume, this disorder of ammonia metabolism would be more intense, due to the hyperkalemia present in HF.Methods: Alternating resistance exercise (RE) of low intensity and high volume, and high intensity and low volume, were applied to 18 patients with an interval of 7 days between them (functional class II-III New York Heart Association, FE = 33.5 ± 4%) and compared with 22 healthy controls matched for age and gender. Ammonia, potassium and lactate levels were assessed before and immediately after the RE.Results: Significant differences: Deltas (control vs. HF) in 40% RE: lactate (mg/dl) 26.3 ± 10 vs. 37.7 ± 7; p < 0,001, ammonia (ug/dl) 92.5 ± 18 vs. 48.9 ± 9; p < 0.001. Deltas (control vs. HF) in 80%RE: lactate(mg/dl) 45.0 ± 12 vs. 54.1 ± 11; p < 0.05, ammonia(ug/dl) 133.5 ± 22 vs. 32.2 ± 7; p < 0.001, potassium (mEq/L) 1.6 ± 0.4 vs. 2.0 ± 0.8; p < 0.05. A negative correlation was found between the deltas of ammonia and potassium (r = −0.74, p < 0.001) in the HF group.Conclusions: We conclude that in HF, there is an inefficiency of purine metabolism that increases with increasing exercise intensity, but not with an increase of total volume. These findings suggest that hyperkalemia may play an important role in the disorders of purine metabolism.

In vitro antifungal action of different substances over microwaved-cured acrylic resins

OBJECTIVE: The presence of Candida albicans on the surfaces of denture-base acrylic resins is strongly related to the development of oral stomatitis. This study evaluated the antifungal action of different agents over microwave-cured acrylic resin without polishing specimens previously contaminated with Candida albicans. MATERIAL AND METHODS: Sixty specimens were immersed in BHI broth previously inoculated with the yeast and stored for 3 h at 37ºC. They were divided into 5 experimental groups (n=10): G1: 2 percent chlorhexidine solution (10 min); G2: 0.5 percent sodium hypochlorite (10 min); G3: modified sodium hypochlorite (10 min); G4: effervescent agent (5 min); G5: hydrogen peroxide 10v (30 min). The specimens of the control group 1 (C1) were not disinfected. Ten additional specimens of the control group 2 (C2) were not infected with the yeast, aiming to check the asepsis during the experiment. The disinfection agents were neutralized and the acrylic resin specimens were immersed in BHI Broth for 24 h. Culture media turbidity was evaluated spectrophotometrically according to the transmittance degree, i.e. the higher the transmittance the stronger the antimicrobial action. Statistical analysis was performed (Kruskal-Wallis Test, p<0.05). RESULTS: The results, represented by the medians, were: G1 = 40; G2 = 100; G3 = 100; G4 = 90; G5 = 100; C1 = 40; C2 = 100. CONCLUSIONS: This in vitro study suggested that sodium hypochlorite-based substances and hydrogen peroxide are more efficient disinfectants against C. albicans than 2 percent chlorhexidine solution and the effervescent agent.

Effect of bicarbonate on fluoride reactivity with enamel / Efeito do bicarbonato na reatividade do fluoreto com esmalte

Purpose: Bicarbonate (HCO-3) is an alkaline and buffering substance found in dentifrices, which could improve the anti-caries effect of fluoride (F). However, HCO-3 could reduce the formation of calcium fluoride-like (CaF2), the most important product of F reactivity with enamel, whose formation is higher in low pH. The aim of this in vitro study was to evaluate if HCO-3 interferes with the reactivity of F with human enamel. Methods: Five dentifrice formulations were evaluated: placebo of F and HCO-3 (pH 7.0); HCO-3 (pH 9.0); F (pH 7.0); F (pH 9.0) and F+HCO-3 (pH 9.0). F dentifrices contained NaF and all dentifrices were silica-based. The concentrations of total F (TF), CaF2 and firmly bound F (FA, fluorapatite-like) formed in enamel after 1-min reaction with dentifrice slurries (1:3) were determined. Results: The formation of TF, CaF2 and FA was reduced in 22.1 %, 47.9 % and 4.8 %, respectively, by the presence of HCO-3 in the dentifrice formulation. Conclusion: This in vitro data suggest that addition of HCO-3 to a dentifrice may interfere with the reactivity of F with enamel, reducing mainly the concentration of CaF2 formed.

Objetivo: O bicarbonato (HCO-3 ) é uma substância alcalina e tamponante encontrada em dentifrícios, que poderia melhorar o efeito anticárie do fluoreto (F). No entanto, HCO-3 poderia reduzir a formação de fluoreto de cálcio (CaF2), o mais importante produto da reatividade do F com esmalte, cuja formação é maior em baixo pH. O objetivo deste estudo foi avaliar in vitro se o HCO-3 interfere na reatividade do F com o esmalte humano. Metodologia: Cinco formulações de dentifrícios foram avaliadas: placebo de F e HCO-3(pH 7,0); HCO-3 (pH 9,0); F (pH 7,0); F (pH 9,0) e F+HCO-3 (pH 9,0). Os dentifrícios fluoretados continham NaF e todos continham sílica como abrasivo. As concentrações de F total (FT), CaF2 e F firmemente ligado (FA, tipo flúorapatita) formadas no esmalte após 1 minuto de reação com as suspensões dos dentifrícios (1:3) foram determinadas. Resultados: A formação de FT, CaF2 e FA foram reduzidas em 22,1 %; 47,9 % e 4,8 %, respectivamente, pela presença de HCO-3 na formulação do dentifrício. Conclusão: Os resultados in vitro sugerem que a adição de HCO-3 a um dentifrício pode interferir com a reatividade do F com o esmalte, principalmente reduzindo a concentração de CaF2 formado no esmalte.

Diferentes padronizações do teste da caminhada de seis minutos como método para mensuração da capacidade de exercício de idosos com e sem cardiopatia clinicamente evidente / Different patterns for the 6-minute walk test as a test to measure exercise ability in elderly with and without clinically evident cardiopathy

OBJETIVOS: Avaliar a correlação do consumo de oxigênio pico (VO2pico), no teste cardiopulmonar, com a distância percorrida no teste da caminhada de seis minutos (TC6) em idosos saudáveis e com infarto do miocárdio (IM). MÉTODOS: Avaliados 30 indivíduos, idade entre 65 e 87 anos (76,03 ± 4,75), divididos em 2 grupos: Grupo I - 14 com doença cardíaca clinicamente evidente (DCCE) Grupo II - 16 sem DCCE. Foram submetidos ao teste cardiopulmonar (TCP) e a 2 tipos de TC6. As variáveis mensuradas foram: a freqüência cardíaca (FC) e respiratória (FR), pressão arterial (PA), distância percorrida (DP), e a percepção subjetiva de esforço de BORG. RESULTADOS: O estudo mostrou uma forte correlação das distâncias percorridas, em ambas as formas do (TC6), com o VO2pico obtido no TCP, em todos idosos incluídos neste estudo. Na comparação entre os TC6, quando aplicado com acompanhamento (TC6ac) e sem acompanhamento (TC6s), foi observada diferença estatisticamente significante, com maiores valores médios da DP, da FC e FR, e da percepção subjetiva de esforço no TC6ac, em ambos os grupos. Além disso, a FC atingida ao final do esforço, no TC6ac, foi semelhante à obtida no TCP máximo (p <0,05), sugerindo que esta forma de padronização do TC6 estimula a um maior desempenho cardiovascular. CONCLUSÃO: O TC6s, por ser submáximo, impõe uma sobrecarga cardiovascular menor do que TC6ac, sendo provavelmente mais seguro em idosos cardiopatas.