Lesion sterilization and tissue repair with chloramphenicol, tetracyline, zinc oxide/eugenol paste versus conventional pulpectomy: A 36-month randomized controlled trial.

BACKGROUND: Endodontic treatment of primary molars represents one of the challenges in pediatric dentistry. There is a lack of consensus in the literature about the endodontic techniques and filling paste for primary teeth with pulp necrosis. AIM: To compare the effectiveness of the LSTR technique (lesion sterilization and tissue repair) with CTZ paste (chloramphenicol, tetracycline, zinc oxide and eugenol) and pulpectomy with ZOE paste (zinc oxide and eugenol) in the treatment of primary molars with pulp necrosis. DESIGN: Eighty-eight primary molars with pulp necrosis from 70 children between the ages of 3 and 8 years were included. The teeth were randomized to the LSTR with CTZ paste group or pulpectomy with ZOE paste group. Clinical and radiographic evaluations were performed at 18, 24, 30 and 36 months. RESULTS: At 36 months, clinical success was 86.4% in LSTR with CTZ paste and 90.9% in pulpectomy with ZOE paste (p = .45). Radiographic success was 43.2% in both groups (p = 1.00). The overall success was 40.9% in LSTR with CTZ paste and 43.2% in pulpectomy with ZOE paste (p = 1.00). CONCLUSION: After 36 months of evaluation, the effectiveness of the LSTR technique with CTZ paste and pulpectomy with ZOE paste was similar for the treatment of primary molars with pulp necrosis.

Impact of Pulp Necrosis on Oral Health-Related Quality of Life of Children with Early Childhood Caries.

Purpose: To assess the impact of pulp necrosis on the oral health-related quality of life (OHRQoL) of children with early childhood caries and their caregivers.
Methods: A cross-sectional study was performed with a consecutive sample of children who were divided into three groups: (1) caries-free children; (2) with untreated carious lesions and without pulp necrosis; and (3) with untreated carious lesions and at least one tooth with pulp necrosis. Data were collected using a sociodemographic questionnaire, the Early Childhood Oral Health Impact Scale (ECOHIS) and a dental clinical examination using the International Caries Detection and Assessment System index. Descriptive statistics, Kruskal-Wallis tests, Mann-Whitney tests and Poisson regression were performed (P <0.05).
Results: A total of 532 children and their legal guardians participated in the study. Children with pulp necrosis had a greater negative impact on the OHRQoL versus those with untreated carious lesions without pulp necrosis (ratio of unadjusted and adjusted rates [RR] = 1.59; 95 percent confidence interval [95% CI] = 1.36 to 1.86; P <0.001), as measured by the total ECOHIS score. in Group 3, four- and five-year-old children had a greater negative impact on the OHRQoL than two- and three-year-old peers (RR = 1.36; 95% CI = 1.08 to 1.72; P <0,001).
Conclusion: The presence of pulp necrosis increased the negative impact on OHRQoL of children with untreated carious lesions and their guardians.

LSTR Antibiotic Paste Versus Zinc Oxide and Eugenol Pulpectomy for the Treatment of Primary Molars with Pulp Necrosis: A Randomized Controlled Trial.

Purpose: The purpose of this study was to compare the effectiveness of lesion sterilization and tissue repair (LSTR) antibiotic paste comprised of chloramphenicol, tetracycline, and zinc oxide and eugenol (CTZ) versus zinc oxide eugenol (ZOE) pulpectomy in the treatment of primary molars with pulp necrosis. Methods: A total of 70 three- to eight-year-old subjects with 88 primary mandibular molars with pulp necrosis were included. The teeth were randomized to the CTZ group or ZOE group. The time taken to perform both techniques was recorded. The parents of the children and the dentist who performed clinical evaluations were blind to the group assignment, although the radiographic evaluator could see the difference in treatments. Clinical and radiographic assessments were performed at three, six, nine, and 12 months. Results: At the 12-month evaluation, the clinical success was 86.4 percent for CTZ and 90.9 percent for ZOE (P=0.50), the radiographic success was 75.0 percent for CTZ and 72.7 percent for ZOE (P=0.81), and the overall success was 70.5 percent for CTZ and 72.7 percent for ZOE (P=0.81). The mean time taken to perform was 61.4 (±20.5 standard deviation) minutes for CTZ and 145.1 (±53.2) minutes for ZOE (P<0.001). Conclusions: At 12 months, both techniques presented no significant difference in success rates for nonvital pulp therapy in primary molars with necrosis. The lesion sterilization and tissue repair procedure time using chloramphenicol, tetracycline, zinc oxide, and eugenol was significantly shorter than for a zinc oxide eugenol pulpectomy.

Effects of temperature, proportion and organic loading rate on the performance of anaerobic digestion of food waste.

In Brazil, a significant amount of organic waste is produced in households and restaurants. This study thus aimed to determine the ideal conditions for generating methane from the treatment of household waste by anaerobic digestion, under mesophilic (37 °C) and thermophilic (55 °C) conditions, to determine the maximum organic loading rate (OLR) in the reactors, and to evaluate kinetic parameters by statistical models: Modified Gompertz, First-Order, Logistic and Transference functions. The experiments were conducted in anaerobic batch reactors. Different proportions of pre-prepared waste (PPW)/leftover waste (LW) were used: 100/0, 75/25, 50/50, 25/75, and 0/100 and different ORL: 0.15; 0.30; 0.45; 0.60; and 0.90 g TVS (Total Volatile Solids).L-1.d-1. For both conditions, the optimal proportions of PPW/LW were 100/0 and 75/25 %. Under mesophilic condition, the best results were observed (869 mL of CH4.g TVS-1). The maximum organic load was 0.30 g TVS.L-1.d-1. The best data adjustment was performed by the Transference function.

Memorization of daily routines by children with Down syndrome assisted by a playful virtual environment.

A child with Down syndrome, like any other child, may benefit from interacting with memory stimuli, but needs additional support and help. The use of special teaching methods, which add playfulness and use of the computer, can enhance the memory processes of these children. In this work, we present the virtual environment "Nossa Vida (Our Life)", which was developed to assist children with Down syndrome to memorize action sequences of their daily routine. A daily routine memorization test (DRMT), consisting of a weekly reminder of typical daily routines completed by the children and parents, was performed before (pre-test) and after (post-test) the intervention. The work involved a multidisciplinary team and assessed the effectiveness of the test performed by 30 children with Down syndrome from APAE, a special education school for children with intellectual disabilities in São Paulo, Brazil. The children were separated into two groups (Experimental - GE and Control - GC) with homogeneity and normality of the data. Two hypotheses were tested in this study: H0 and H1, where: H0 = There is no statistical difference between memorizing daily tasks between individuals with Down syndrome who used our ludic virtual environment and those who used the conventional memory method.H1 = There is a difference between the group of subjects with Down Syndrome who used our virtual game environment and the group that did not use it in relation to memorizing the daily task. This produces t = -14.98 and p <0.0001, with H1 being accepted. The results showed that the EG presented significance in relation to the CG and the evolution mean of the children in the EG was 81.82% higher. According to experts (psychologist and pedagogue) from APAE and parents, the playful activities implemented in this virtual environment have been of great interest to children, who had fun, tested hypotheses and questioned them about the sequences of actions performed in their routine daily.

Desenvolvimento de correlação para estimativa da taxa de geração per capita de resíduos sólidos urbanos no estado de São Paulo: influências da população, renda per capita e consumo de energia elétrica / Development of a correlation to estimate per capita municipal solid waste generation rates in São Paulo state, Brazil: population, per capita income and electricity consumption influences

RESUMO A previsão da geração dos resíduos sólidos urbanos (RSU) é fundamental para escolha e dimensionamento das operações e dos processos envolvidos na cadeia de gerenciamento em âmbito municipal. O desafio da sustentabilidade financeira desse gerenciamento passa pela criação de indicadores que permitam a cobrança individualizada e proporcional da geração per capita de cada munícipe. Buscou-se, então, desenvolver equações para estimar a taxa de geração per capita (TGP) de RSU nos municípios do estado de São Paulo. Adotou-se a premissa de que as variáveis população (P), renda per capita diária (RPC) e consumo per capita diário de energia elétrica (Ce) nos municípios eram intervenientes na TGP. A série de dados envolveu 238 municípios que rotineiramente pesaram seus resíduos no ano-base de 2013. Diversas funções foram testadas com o intuito de ajustar as TGPs observadas às calculadas pelo método dos mínimos quadrados. A qualidade dos ajustes foi avaliada por meio da comparação dos valores previstos e observados com a reta bissetriz do primeiro quadrante, dos coeficientes de correlação de Pearson (r) e de determinação (R2), das raízes quadradas dos erros médios ao quadrado (RMSEs) e dos erros percentuais médios (Ep). A equação que melhor representou o conjunto de dados forneceu r de 0,49, R2 de 0,24, RMSE de 0,217 kg.hab-1.d-1 e Ep de -14,1%. Apesar de R2 relativamente baixo, foi demonstrado, pelo teste de t de Student, que a equação proposta foi capaz de representar valores médios e resultar em mesma variância com probabilidade acima de 99%, fato que permitiu considerar a equação adequada para prever as TGPs nos municípios paulistas.

ABSTRACT Forecasting municipal solid waste (MSW) generation is fundamental in choosing and scaling the operations and processes involved in municipal management. The challenge for the financial sustainability of this management is to create indicators that enable municipal solid waste fees to be charged in proportion to the amount of MSW generated by each resident. To this end, we sought to develop equations to estimate the per capita waste generation rate (TGP) in the municipalities of the state of São Paulo, Brazil. It was assumed that the variables of population (P), daily per capita income (RPC) and daily per capita consumption of electric energy (Ce) in the municipalities were determining factors of the TGP. The dataset involved 238 municipalities that routinely weighed their solid wastes in the baseline year of 2013. Several functions were tested in order to adjust the observed TGP to those calculated by the least squares method. The quality of the adjustments was evaluated by comparing the expected and observed values with the bisector of the first quadrant, as well as by the Pearson (r) and determination (R2) coefficients, root-mean-square error (RMSE), and mean percentage error (Ep) values. The equation that best represented the dataset had an r of 0.49, R2 of 0.24, RMSE of 0.217 kg.person-1.d-1 and Ep of -14.1%. Despite the relatively low R2, it was demonstrated by Student's t-test that the proposed equation was able to represent mean values and result in the same variance with probability higher than 99%. This fact allows to consider the equation adequate for predicting the TGP in the municipalities of the state of São Paulo.

Effect of a virtual environment on the development of mathematical skills in children with dyscalculia.

In this study, we show the effectiveness of a virtual environment comprising 18 computer games that cover mathematics topics in a playful setting and that can be executed on the Internet with the possibility of player interaction through chat. An arithmetic pre-test contained in the Scholastic Performance Test was administered to 300 children between 7 and 10 years old, including 162 males and 138 females, in the second grade of primary school. Twenty-six children whose scores showed a low level of mathematical knowledge were chosen and randomly divided into the control (CG) and experimental (EG) groups. The EG participated to the virtual environment and the CG participated in reinforcement using traditional teaching methods. Both groups took a post-test in which the Scholastic Performance Test (SPT) was given again. A statistical analysis of the results using the Student's t-test showed a significant learning improvement for the EG and no improvement for the CG (p≤0.05). The virtual environment allows the students to integrate thought, feeling and action, thus motivating the children to learn and contributing to their intellectual development.

Integração de critérios técnicos, ambientais e sociais em estudos de alternativas locacionais para implantação de aterro sanitário / Integrating technical, environmental and social criteria in landfill sitting studies

A Política Nacional do Meio Ambiente tem como objetivo a conciliação do desenvolvimento econômico e social com a qualidade ambiental, e dispõe de vários instrumentos que procuram contemplara capacidade de suporte do meio. Assim, a discussão sobre a localização das atividades é uma etapa importante para a avaliação da viabilidade ambiental de um determinado empreendimento, notadamente em processos de licenciamento ambiental. O trabalho apresenta uma abordagem metodológica para integração de critérios técnicos, ambientais e sociais em estudos de alternativas de localização de aterros sanitários, com especial atenção à interação entre os aspectos ambientais e os elementos fundamentais de um projeto (a saber, requisitos locacionais e concepção tecnológica), aplicado em um estudo de caso em São Carlos (SP). Como resultados principais, destacam-se o maior foco nos impactos significativos e a possibilidade de envolvimento de segmentos importantes da sociedade previamente à elaboração dos estudos ambientais.

The National Environment Policy aims to reconcile economic and social development with environmental quality and has several instruments to address environmental issues within the decision making processes. Thus, the discussion about the location of activities is an important step in the evaluation of the environmental acceptability of aparticular activity, even though the systematic procedures do not require neither to the entrepreneur or to the government studies of sitting alternatives. This paper presents the integration of technical, environmental and social criteria in a landfill sitting study, in order to present a systematic integration of environmental factors and applies in a case study in São Carlos, Brazil. The results allowed the development of an environmental impact statement more focused on significant impacts and the participation of segments of society at early stages of project's development.

Cirurgia da ptose palpebral: análise de dois tipos de procedimentos cirúrgicos / Surgical repair blepharoptosis: analysis of two types of surgical procedures

Introdução: A ptose palpebral ou blefaroptose caracteriza-se pela disfunção, ou inabilidade do paciente em realizar a abertura da fenda palpebral de maneira normal. Geralmente é decorrente do acometimento do músculo levantador da pálpebra, possuindo diferentes etiologias, quais sejam, congênitas ou adquiridas. Método: No período de 2005 a 2008, foram diagnosticados 16 pacientes portadores de ptose palpebral, totalizando 24 pálpebras submetidas a tratamento cirúrgico, pelo autor. Foram realizadas 18 cirurgias abordando a fáscia do músculo levantadore, em 6 casos, a ressecção do músculo levantador da pálpebra. Resultados: O grau de ptose nos casos estudados variou entre 2,0 e 7,0 mm, com média de 4,33 mm. Os resultados pós operatóriosforam avaliados por meio de exame físico e de análise fotográfica e classificados em insatisfatórios, regulares e bons, de acordo com o grau de ptose residual. A média de seguimento foi de 14,87 meses. Em 83,3% dos casos, os resultados foram considerados bons, em 12,5%, regulares e, em 4,16%, insatisfatórios. A complicação mais frequentemente observada foi a hipocorreção cirúrgica e a assimetria entre as fendas palpebrais. Encontrou-se um caso com retração cicatricial na pálpebra superior e apenas um paciente foi submetido à revisão cirúrgica após seis meses do ato operatório.

Introduction: Eyelid ptosis or blepharoptosis is characterized by dysfunction or the patient’sinability to elevate the upper eyelid normally. It is usually due to a compromised levator muscle and has different etiologies, namely congenital or acquired. Method: From 2005 to 2008, 16 patients were diagnosed with ptosis, perfoming a total of 24 surgically treated eyelids. Eighteen surgeries were performed approaching the fascia of the eyelid levator muscle and in 6 cases through resection of the eyelid levator muscle. Results: The degree of ptosis in the cases studied ranged between 2.0 and 7.0 mm, with an average of 4.33 mm. The postoperative results were evaluated by physical examination and photographic analysis and classified as poor, fair and good, according to the degree of residual ptosis. The average follow-up was 14.87 months. In 83.3% of the cases, the results were considered good, regular in 12.5% and in 4.16% unsatisfactory. The most frequently observed complication was surgical under correction and asymmetry of the eyes. In one case we could observe of scar retraction in the upper eyelid and only one patient underwent surgical revision six months after the initial surgery.

Iodoterapia: avaliação crítica de procedimentos de precaução e manuseio dos rejeitos radioativos / Iodotherapy: critical assessment of the precautionary and handling procedures of radioactive wastes

Investigações sobre os procedimentos de precaução e manipulação dos rejeitos radioativos, gerados na iodoterapia, são muito pouco discutidas na literatura. A aplicação destes procedimentos de precaução, atendendo às normas da legislação vigente, depende diretamente do grau de conhecimento da equipe de enfermagem na manipulação do 131 I, radioisótopo empregado na iodoterapia. Este trabalho apresenta uma avaliação crítica dos procedimentos de precaução e manipulação adotados pela equipe de enfermagem na terapêutica da iodoterapia utilizando um instrumento de análise, validado por um pré-teste e aplicado à equipe de enfermagem da unidade de internação da iodoterapia, em três hospitais (A, B - filantrópicos; C - privado), analisando: conhecimento específico da equipe de enfermagem e atendimento às normatizações. A análise comparativa mostrou significativa diferença dos procedimentos realizados na iodoterapia pela equipe de enfermagem nos hospitais estudados. Os procedimentos de precaução e a adequação da infra-estrutura na realização da terapêutica da iodoterapia dependem fundamentalmente da fiscalização dos órgãos competentes, doconhecimento específico e responsabilidade do profissional responsável pelo serviço de Medicina Nuclear, e do incentivo da direção do estabelecimento prestador de saúde.

Microsurgical replantation of avulsed scalp - 7 years of experience

Scalp avulsion is a devastating physical, functional, and psychological injury to patients. The emergence of surgery and the first replantation by Miller, in 1976, was a major breakthrough in the management of scalp avulsion that became the treatment of choice, whenever possible.This study aims to present the 7 last years of experience of the Discipline of Plastic Surgery of the Medical School of the University of São Paulo and to compare it with the literature, so as to standardize the care for the cases herein addressed and thus achieve the best possible results.The cases presented consist of 6 female patients with scalp avulsion, their ages ranging between 9 and 29 years. Warm ischemia time ranged between 9 and 25 hours (average 14 hours). Four cases were totally successful, one case was partially successful (40 (per cent)), and the remaining cases lost the replantation.The current techniques and the structure available in specialized facilities enable the appropriate management of avulsed scalps through microsurgical replantation, thus leading to satisfactory results that are superior to the previously available options.

Agenesia de vesícula biliar: relato de um caso / Gallblader agenesis: case report

A agenesia da vesícula é uma anomalia congênita rara, ocorrendo de 13 a 65 casos em cada 100.000 habitantes, com uma incidência em necrópsias de 0,016 por cento. Descreve-se o caso de uma mulher de 61 anos com dor biliar, icterícia, febre e ultra-sonografia compatível com colelitíase. A AG foi confirmada durante a cirurgia quando foi realizada exploraçäo para excluir uma localizaçäo ectópica da vesícula biliar. Follow-up pós-operatório com CT confirmou o diagnóstico

Higroma cístico - linfangioma cavernoso: diagnóstico pré-natal: relato de um caso / Cystic hygroma - cavernous lymphangioma: prenatal diagnosis: a case report

The cystic hygroma are a severe fetal anomaly associated with cromossome patology, fetal and neonatal death, and poor perinatal results. The diagnosis is based uppon ultrasonographic examination, leading to adequate mannagement. One case of cystic hygroma diagnosticated during antenatal period by ultrasound is presented, and literature is rewied.