Diagnostic Accuracy of Cone Beam Computed Tomography and Periapical Radiography for Detecting Apical Root Resorption in Retention Phase of Orthodontic Patients: A Cross-Sectional Study.

Objectives: This clinical study aimed to evaluate and compare the diagnostic accuracy of intraoral periapical radiography (PR) and cone beam computed tomography (CBCT) in detecting external apical root resorption (EARR) in orthodontic patients during the retention phase. Methods: The research involved 41 Caucasian patients who had undergone comprehensive orthodontic treatment, with a total of 328 teeth analyzed. The Kappa values for inter- and intra-examiner agreement were high for both PR and CBCT, indicating a robust level of agreement among examiners. The study used a four-point scale for classifying EARR. Results: This study showed comparable accuracy, sensitivity, and specificity between PR and CBCT when using the most stringent criterion of "Definitely present". The data suggested that CBCT outperformed PR when using a less stringent criterion ("Definitely present" or "Probably present"), particularly for maxillary incisors. However, overall diagnostic performance, as measured by the area under the ROC curve, showed only a slight advantage for CBCT over PR. Areas under the ROC curve range between 0.85 and 0.90 for PR and between 0.89 and 0.92 for CBCT. According to DeLong's test, there is no evidence to conclude that the area under the ROC curve is different for PR and CBCT. Conclusions: Both PR and CBCT are accurate diagnostic tools for identifying EARR, with PR being deemed more suitable for routine clinical use due to its cost-effectiveness and lower radiation exposure. The findings emphasize the importance of considering the risk-benefit ratio when deciding on imaging modalities for monitoring EARR in orthodontic patients.

Influence of clinical factors on the protective or deleterious impact of genetic variants in orthodontically induced external root resorption: an observational study.

BACKGROUND: Prediction of susceptibility to Orthodontically Induced External Apical Root Resorption (OIEARR) has been hampered by the complex architecture of this multifactorial phenotype. The aim of this study was to analyze the impact of the interaction of multiple variables in the susceptibility to OIEARR. METHODS: The study evaluated 195 patients requiring orthodontic treatment. Nine clinical and treatment variables, single nucleotide polymorphisms (SNPs) from five genes and variables interactions were analyzed as risk factors for OIEARR using a multiple linear regression model. RESULTS: The model explained 29% of OIEARR variability (ANOVA: p < 0.01). Duration of treatment was the most important predictor and gender was the second, closely followed by premolar extraction. For genes encoding osteoprotegerin (OPG), the receptor activator of nuclear factor κ B (RANK) and the IL1 receptor antagonist (IL1RN), the effect of analyzed variants changed from protective to deleterious depending on the duration of treatment and the age of the patient. CONCLUSIONS: This work shows that in OIEARR the impact of genetic susceptibility factors is dynamic changing according to clinical variables.

Absorption, distribution, metabolism and excretion of selenium following oral administration of elemental selenium nanoparticles or selenite in rats.

A suspension of nanoparticles of BSA-stabilized red amorphous elemental selenium (Se) or an aqueous solution of sodium selenite was repeatedly administered by oral gavage for 28 days at 0.05 mg kg(-1) bw per day (low dose) or at 0.5 mg kg(-1) bw per day (high dose) as Se to female rats. Prior to administration, the size distribution of the Se nanoparticles was characterized by dynamic light scattering and transmission electron microscopy, which showed that the particles' mean diameter was 19 nm and ranged in size from 10 to 80 nm. Following administration of the high dose of Se nanoparticles or selenite the concentration of Se was determined by ICP-MS in the liver, kidney, urine, feces, stomach, lungs, and plasma at the µg g(-1) level and in brain and muscle tissue at the sub-µg g(-1) level. In order to test if any elemental Se was present in the liver, kidney or feces, an in situ derivatization selective to elemental Se was performed by treatment with sulfite, which resulted in formation of the selenosulfate anion. This Se species was selectively and quantitatively determined by anion exchange HPLC and ICP-MS detection. The results showed that elemental Se was present in the livers, kidneys and feces of animals exposed to low and high doses of elemental Se nanoparticles or to selenite, and was also detected in the same samples from control animals. The fraction of Se present as elemental Se in livers and kidneys from the high dose animals was significantly larger than the similar fraction in samples from the low dose animals or from the controls. This suggested that the natural metabolic pathways of Se were exhausted when given the high dose of elemental Se or selenite resulting in a non-metabolized pool of elemental Se. Both dosage forms of Se were bioavailable as demonstrated by the blood biomarker selenoprotein P, which was equally up-regulated in the high-dose animals for both dosage forms of Se. Finally, the excretion of Se in urine and its occurrence as Se-methylseleno-N-acetyl-galactosamine and the trimethylselenonium-ion demonstrated that both dosage forms were metabolized and excreted. The results of the study showed that both forms of Se were equally absorbed, distributed, metabolized and excreted, but the detailed mechanism of the fate of the administered elemental Se or selenite in the gastro-intestinal tract of rats remains unclear.

Dificuldade dos Cuidadores Formais De Idoso Institucionalizados / Difficulty of Formal Institutionalized Elderly Caregivers

O aumento progressivo da população idosa coloca novos desafios às instituições de terceira idade e aos cuidadores formais. Tais factos estiveram subjacentes ao objeto de estudo deste trabalho. Este estudo visa conhecer as dificuldades dos cuidadores formais de idosos institucionalizados, bem como identificar e analisar os fatores que influenciam essas dificuldades. A amostra da presente investigação é composta por 40 cuidadores formais de idosos institucionalizados de três Instituições Particulares de Solidariedade Social do Distrito da Guarda. A mesma foi selecionada por conveniência através do critério de acessibilidade e proximidade com as instituições. Realizou-se um estudo de natureza quantitativa, descritivo correlacional e transversal. Para a recolha de dados foi utilizado um Formulário elaborado especificamente para o estudo, de forma a permitir um melhor conhecimento sobre as dificuldades dos cuidadores formais de idosos institucionalizados onde se inclui a escala de autoavaliação de ansiedade de Zung. Como resultados principais salienta-se que os cuidadores formais de idosos institucionalizados apresentam maiores dificuldades na prestação de cuidados ao nível da deambulação/mobilização, da alimentação, da higiene, da comunicação e das alterações emocionais. Foram identificados e analisados os fatores que influenciam as dificuldades apresentadas pelos cuidadores formais, concluindo-se que os cuidadores que sofrem de alguma doença, que recorreram ao médico nos últimos seis meses e que tomam medicação tranquilizante ou antidepressiva evidenciam maiores dificuldades na prestação dos cuidados ao idoso institucionalizado. Constatou-se ainda que, quanto maior for o cansaço físico e psicológico e quanto maiores forem os níveis de ansiedade do cuidador, mais dificuldades estes apresentam na prestação de cuidados aos idosos. Os resultados obtidos sugerem a necessidade de desenvolver programas de formação direcionados às cuidadoras formais, de modo a adquirirem competências perante as dificuldades encontradas no estudo, mas também mediar estratégias de coping, contribuindo desta forma para a diminuição da sua ansiedade e, consequente melhoria da qualidade dos cuidados prestados aos idosos institucionalizados.

The progressive increasing of elder people puts new challenges to institutions for the eldest and their formal caring people. These are the subjacent facts that led to this study. So, the main target is to find the difficulties of taking care of the eldest as well as to identify and analyse the factors which can influence those difficulties. The sample of this investigation is composed by forty formal caring people of institutionalized old people of three Particular Institutions of Social Solidarity in the district of Guarda. They were chosen by criteria of convenience of accessibility and proximity. It was made a study of quantitative nature and a correctional transversal descriptive. It was used a formulary specifically made for the present study to get a better knowledge of the difficulties of formal caring people which includes a scale of selfevaluation of Zung anxiety. The main results are settled on the major difficulties found at the level of mobility, feeding, hygiene, communication and emotional changes. They were identified and analysed the factors which influence the difficulties found. So, caring people who suffer from any illness, who visited their doctors during the last six months or take anti-depressant medication feel more difficulties when taking care of institutionalized old people. The more the physical and psychological tiredness and the higher levels of anxiety are, the more difficulties they have. The results suggest the need of developing programmes of formation directed to formal caring people so that they can get new competences when facing the difficulties found in the study as well as find new strategies of coping. It will be possible then to diminish the anxiety and consequently to improve the quality of caring institutionalized old people.

Doença falciforme e qualidade de vida: um estudo da percepção subjetiva dos pacientes da Fundação Hemominas, Minas Gerais, Brasil / Sickle cell disease and quality of life: a study on the subjective perception of patients from the Fundação Hemominas, Minas Gerais, Brazil

Na presente investigação, buscou-se pesquisar se o conceito de qualidade de vida, preconizado pela Organização Mundial de Saúde (OMS) poderia ser utilizado para pacientes com doença falciforme (DF), uma vez que se apresenta como um problema de saúde pública no país. Utilizou-se uma abordagem qualitativa com a seguinte questão norteadora na entrevista: "Para você o que é QV?". De acordo com o relato dos pacientes, procurou-se identificar a presença dos domínios físico, psicológico, nível de independência, relações sociais, meio ambiente e espiritualidade/crenças pessoais na representação da QV. Participaram do estudo 25 pacientes, dos quais 80% eram portadores da hemoglobina SS (HbSS) e 20% com hemoglobina SC (HbSC). A médiada idade encontrada foi de 33,3 anos, 56% eram do sexo feminino e 44% eram casados(as). Em relação à escolaridade, 44% atingiram até 11 anos de estudo e 56% até 8 anos. A DF representou, para 72%, impedimento para o trabalho, o que revela seu impacto negativo no desenvolvimento das habilidades laborais. Todos os domínios de QV preconizados pela OMS foram detectados no relato dos participantes: domínio físico em 84%, psicológico e relações sociais em 76%, nível de independência em 60%,meio ambiente em 52% e espiritualidade/crenças pessoais em 4% deles. Os aspectos referentes à multidimensionalidade e à subjetividade, apresentados no conceito de QV preconizado pela OMS, e representados pelos seus domínios, podem ser tomadoscomo norteadores de estudos que envolvam o conceito de QV em pacientes com DF.

This study aimed at investigating whether the concept of quality of life advocated by the World Health Organization can be applied to sickle cell patients, as this disease is an important public health problem in the country. A qualitative approach was utilized with the following guide question in the interview: "What is quality of life for you?" According to the patients' replies, the following domains were identified: physical, psychological, level of independence, social relationships, environment and spirituality/personal beliefs. Twentyfivepatients took part in the study, 80% had hemoglobin SS and 20% hemoglobin SC. The average age was 33.3 years old, 56% of the patients were women and 44% were married. In relation to schooling, 12% had concluded the 4th grade of elementary school and 24% completed high school. Sickle cell disease represented a barrier in respect to work for 72% of the patients, which demonstrates its negative impact on the development of the work capabilities ofthe individuals. All quality of life domains advocated by the WHO were present in the patients' replies: physical domain in 84%, psychological and social relationships in 76%, level of independence in 60%, environment in 52% and spirituality/personal believes in 4%. To conclude, the aspects referring to multidimensionality andsubjectivity, presented in the quality of life concept advocated by the WHO and represented by their domains, can be taken as a guide for studies which involve the quality of life in sickle cell patients.