The need for more pragmatic trials in glaucoma research.

AIM: There have been a number of clinical trials in glaucoma research published in the past two decades. Most of these trials were designed to evaluate very specific issues in selected populations placing them in the explanatory end of the pragmatic-explanatory continuum. The purpose of this study was to assess the level of pragmatism of published randomized controlled trials in glaucoma. METHODS: A PubMed search using 'glaucoma' from 1995 to 2022 and randomized controlled trial (RCT) article type was done. Each study was assessed by three independent examiners using the Pragmatic-Explanatory Continuum Indicator Summary version 2 (PRECIS-2) toolkit. Scores were calculated for each study to determine the level of pragmatism. A summed score ≥36 was indicative of a very pragmatic study. RESULTS: Thirty-two different articles were included in the analysis. These papers represented 13 different landmark trials. The median PRECIS-2 score was 32 (range, 25 for the Early Manifest Glaucoma Trial (EMGT) to 34 to the Collaborative Normal Tension Glaucoma Study (CNTGS) and the Ocular Hypertension Treatment Study). The Treatment of Advanced Glaucoma Study (TAGS), was considered very pragmatic and scored 33 points. CONCLUSION: Despite the number of RCTs in glaucoma, there is still a need for more pragmatic studies.

Impactos de incidentes de segurança do paciente na enfermagem: um olhar para a segunda vítima / Impacts of patient safety incidentes on nursing: a look at the second victim Impactos de incidentes de seguridad del paciente en enfermería: una mirada hacia la segunda víctima / Impacts of patient safety incidentes on nursing: a look at the second victim Impactos de incidentes de seguridad del paciente en enfermería: una mirada hacia la segunda víctima

Objetivo: compreender os impactos para os profissionais de enfermagem como segunda vítima de incidentes de segurança do paciente. Método: estudo qualitativo aprovado pelo comitê de ética em pesquisa, do tipo exploratório-descritivo, realizado com 20 profissionais de enfermagem em hospital universitário do Sul do Brasil, entre novembro de 2021 e janeiro de 2022, por meio de entrevistas semiestruturadas analisadas a partir da análise textual discursiva. Resultados: as categorias sentimentos das segundas vítimas, demonstrando a presença de sentimentos negativos, sendo o medo o mais recorrente; e, impacto na trajetória profissional e no ambiente de trabalho, questionando sua habilidade como um bom profissional e a escolha da profissão como sendo adequada permitiram compreender o impacto no profissional de enfermagem. Considerações finais: os impactos relacionaram-se ao sentimento de culpa pelo fato ocorrido, autojulgamento, julgamento pelos pares e pelo paciente, medo do desfecho ao paciente e das consequências para si e dúvidas quanto à sua habilidade e desempenho no trabalho.

Objective: to understand the impacts on nursing professionals as the second victim of patient safety incidents. Method: qualitative exploratory-descriptive study approved by the research ethics committee, carried out with 20 nursing professionals at a university hospital in southern Brazil, between November 2021 and January 2022, through semi-structured interviews analyzed from the discursive textual analysis. Results: the second victims' feelings categories, demonstrating the presence of negative feelings, with fear being the most recurrent; and impact on the professional path and on the work environment, questioning their ability as a good professional and the choice of profession as being adequate, allowed understanding the impact on the nursing professional. Final considerations: the impacts were related to the feeling of guilt for the fact that occurred, self-judgment, judgment by peers and by the patient, fear of the outcome for the patient and the consequences for himself, and doubts about his ability and performance at work.

Objetivo: comprender los impactos sobre los profesionales de enfermería como segunda víctima de los incidentes de seguridad del paciente. Método: estudio cualitativo, de tipo exploratorio-descriptivo, aprobado por el comité de ética en investigación, y realizado junto a 20 profesionales de enfermería de un hospital universitario del sur de Brasil, entre noviembre de 2021 y enero de 2022, a través de entrevistas semiestructuradas analizadas a partir del análisis textual discursivo. Resultados: las categorías de sentimientos de las segundas víctimas han permitido comprender el impacto sobre el profesional de enfermería: indican la presencia de sentimientos negativos, el miedo siendo el más recurrente; el impacto en la trayectoria profesional y en el ambiente de trabajo, ya que los enfermeros cuestionan su habilidad de buen profesional y si ha sido adecuada la elección de la profesión. Consideraciones finales: los impactos se relacionaron con el sentimiento de culpa por el hecho ocurrido, el juicio propio, el juicio de los pares y del paciente, el miedo al desenlace para el paciente y las consecuencias para él mismo, y las dudas sobre su capacidad y desempeño en el trabajo.

Bradicardia em atleta adolescente de alto rendimento. A importância da avaliação eletrocardiográfica e funcional / Bradycardia in a high-performance adolescent athlete. The importance of electrocardiographic and functional evaluation

INTRODUÇÃO E/OU FUNDAMENTOS: A presença de bradicardia durante o repouso é um achado comum em atletas de alto rendimento. Entretanto a avaliação funcional clínica pura e simples não é sinal de um atleta saudável. No mesmo cenário episódios de síncope podem ocorrer em até 20% dos adolescentes com coração normal. A avaliação clínica pré-participação avalia atletas e esportistas, antes de iniciar atividades de moderada à alta intensidade, com o objetivo de identificar doenças cardiovasculares e a detectar precocemente doenças causadoras de morte súbita cardíaca que possam contraindicar a realização do mesmo. OBJETIVO: Descrever o caso de uma atleta adolescente com bradicardia em repouso e pré sincope com diagnóstico diferencial entre over training e espectro de BAV congênito. RELATO DO CASO: Paciente de 12 anos, sexo feminino, previamente hígida, atleta competitiva. Admitida em nosso serviço após episódios de pré sincope, sem fatores desencadeantes. Na admissão identificado bradicardia com estabilidade hemodinâmica, FC de 43 batimentos por minuto (bpm) e eletrocardiograma (ECG), com diagnóstico de ritmo juncional ativo. Realizado, teste ergométrico com ritmo juncional ativo e períodos de ritmo sinusal com wenckebach (no pico do esforço) e déficit cronotrópico. Teste cardiopulmonar máximo com VO2 pico = 48,5ml.kg, 131% do valor predito para a idade, com presença de distúrbio cardiocirculatório pelo cronotropismo deprimido e ritmo cardíaco basal. Presença associada de doença do nó sinusal e comprometimento da condução atrioventricular no espectro clinico de BAVT congênito. Excluído miocardite ativa, com sorologias negativas, cintilografia cardíaca com gálio e ressonância magnética de coração. Por fim, paciente mantendo estabilidade hemodinâmica sem novos sintomas. Orientamos a suspensão das atividades físicas competitivas e instalação de monitorização prolongada para indicação precoce de marcapasso. CONCLUSÕES: Conclusão: 1) A realização do ECG associado à avaliação clínica (a amnésia e exame físico) é extremamente importante na triagem pré-participação esportiva. 2) Existem alterações eletrocardiográficas no coração de atleta que são variantes da normalidade para a condição como BAV de segundo grau do tipo I (Wenckebach) no repouso mas não no esforço. 3) O descondicionamento físico e a monitorização clínica é eletrocardiográfica prolongada pode evidenciar novas nuances para manutenção do seguimento clínico e esportivo mas também auxilia na indicação adequada do marcapasso.

Representação social da violência de homens e mulheres usuários da estratégia saúde da família / Social representation of the violence of men and women using the family health strategy / Representación social de la violencia de hombres y mujeres utilizando la estrategia de salud familiar

Objetivo: identificar a representação social da violência de homens e mulheres usuários da Estratégia Saúde da Família. Método: pesquisa qualitativa e descritiva, fundamentada na Teoria das Representações Sociais, realizada com 32 pessoas usuárias da Estratégia Saúde da Família, 16 homens e 16 mulheres, por meio de entrevista semiestruturada, analisadas com o auxílio do software IRAMUTEQ. Resultados: os homens retrataram a violência urbana, enquanto as mulheres a doméstica. De modo geral, os participantes demonstraram dificuldade na intervenção da violência, citando os motivos para manutenção de um relacionamento violento e as possíveis formas de prevenção dessas situações. Conclusão: a pesquisa contribuiu ao dar voz e evidenciar a representação social de homens e mulheres usuários da Estratégia Saúde da Família acerca da violência e, assim, possibilita a criação de ações e estratégias mais direcionadas em relação ao enfrentamento e prevenção da violência

Objective: to identify the social representation of violence by men and women using the Family Health Strategy. Method: qualitative and descriptive research, based on the Theory of Social Representations, carried out with 32 people using the Family Health Strategy, 16 men and 16 women, through semi-structured interviews, analyzed with the aid of the IRAMUTEQ software. Results: men portrayed urban violence, while women portrayed domestic violence. In general, the participants demonstrated difficulty in the intervention of violence, citing the reasons for maintaining a violent relationship and the possible ways of preventing these situations. Conclusion: the research contributed by giving a voice and highlighting the social representation of men and women using the Family Health Strategy about violence and, thus, allows the creation of more targeted actions and strategies in relation to confronting and preventing violence

Objetivo: Identificar la representación social de la violencia de hombres y mujeres utilizando la Estrategia de Salud de la Familia. Método: investigación cualitativa y descriptiva, basada en la Teoría de las Representaciones Sociales, realizada con 32 personas utilizando la Estrategia Salud de la Familia, 16 hombres y 16 mujeres, a través de entrevistas semiestructuradas, analizadas con la ayuda del software IRAMUTEQ. Resultados: los hombres retrataron la violencia urbana, mientras que las mujeres retrataron la violencia doméstica. En general, los participantes demostraron dificultad en la intervención de la violencia, citando las razones para mantener una relación violenta y las posibles formas de prevenir estas situaciones. Conclusión: la investigación contribuyó al dar voz y resaltar la representación social de hombres y mujeres utilizando la Estrategia de Salud de la Familia sobre la violencia y, así, permite la creación de acciones y estrategias más focalizadas en relación al enfrentamiento y prevención de la violencia

Perfil clínico dos portadores da síndrome congênita do zika vírus atendidos no centro especializado em reabilitação da cidade de Campina Grande- Pb / Clinical profile of patients with congenital syndrome of zika virus attended at the specialized center for rehabilitation in the city of Campina Grande-Pb

INTRODUÇÃO: No segundo semestre do ano de 2015 um surto de microcefalia foi registrado na região nordeste do Brasil. O presente artigo tem como objetivo traçar o perfil clínico dos portadores da síndrome congênita do zika vírus da cidade de Campina Grande. MÉTODOS: Tratou-se de um estudo documental com abordagem quantitativa. A coleta de dados deu-se no Centro Especializado em Reabilitação (CER), no município de Campina Grande no estado da Paraíba com análise de 66 prontuários. RESULTADOS: Maioria do sexo feminino (57,6%), com idade média de 3,36 anos. Houve predominância de infecção pelo vírus da Zika no 1º trimestre de gestação (69,7%), em mães com baixo grau de escolaridade em que apenas 28,8% completaram o ensino médio. A maioria das crianças, mesmo com a infecção, nasceram a termo (68,2%), porém, apresentaram baixo peso ao nascer, 2,697kg em média, perímetro cefálico médio de 29,97 cm, hipertonia, diminuição da amplitude de movimento, grande dependência nas atividades de vida diária e um importante atraso no desenvolvimento neuropsicomotor. CONSIDERAÇÕES FINAIS: Com isto é possível destacar que os distúrbios apresentados, contribuem de maneira negativa para o desenvolvimento motor das crianças gerando um impacto em sua qualidade de vida

INTRODUCTION: In the second half of 2015, an outbreak of microcephaly was recorded in the northeast of Brazil. This article aims to outline the clinical profile of patients with congenital Zika virus syndrome in the city of Campina Grande. METHODS: This was a documentary study with a quantitative approach. Data collection took place at the Specialized Center for Rehabilitation (CER), in the city of Campina Grande in the state of Paraíba, with the analysis of 66 medical records. RESULTS: Most of them were female (57.6%), with an average age of 3.36 years. There was a predominance of Zika virus infection in the first trimester of pregnancy (69.7%), in mothers with a low level of education, in which only 28.8% completed high school. Most of the children, even with the infection, were born at term (68.2%), however, they had low birth weight, 2.697 kg on average, average head circumference of 29.97 cm, hypertonia, decreased range of motion, great dependence on activities of daily living and an important delay in neuropsychomotor development. FINAL CONSIDERATIONS: With this it is possible to highlight that the disorders presented, contribute negatively to the motor development of children generating an impact on their quality of life

Epigenetic manipulation of filamentous fungi for biotechnological applications: a systematic review.

The study of the epigenetic regulation of gene function has reached pivotal importance in life sciences in the last decades. The mechanisms and effects of processes such as DNA methylation, histone posttranslational modifications and non-coding RNAs, as well as their impact on chromatin structure and dynamics, are clearly involved in physiology homeostasis in plants, animals and microorganisms. In the fungal kingdom, studies on the model yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe contributed enormously to the elucidation of the eukaryote epigenetic landscape. Epigenetic regulation plays a central role in the expression of virulence attributes of human pathogens such as Candida albicans. In this article, we review the most recent studies on the effects of drugs capable of altering epigenetic states and on the impact of chromatin structure-related genes deletion in filamentous fungi. Emphasis is given on plant and insect pathogens, endophytes, secondary metabolites and cellulases/xylanases producing species.

Effect of calcium orthophosphate: Reinforcing glass ratio and prolonged water storage on flexural properties of remineralizing composites.

OBJECTIVES: To compare the effects of replacing reinforcing barium glass particles by DCPD (dicalcium phosphate dihydrate), as opposed to simply reducing glass filler content, on composite flexural properties and degree of conversion (DC). On a second set of experiments, composites with different "DCPD: glass" ratios were exposed to prolonged water immersion to verify if the presence of DCPD particles increased hydrolytic degradation. METHODS: Two series of composites were prepared: 1) composites with total inorganic content of 50 vol% and "DCPD: glass" ratios ranging from zero (glass only) to 1.0 (DCPD only), in 0.25 increments, and 2) composites containing only silanized glass (from zero to 50 vol%). Disk-shaped specimens were fractured under biaxial flexural loading after 24 h in water. Another set of specimens of composites with different "DCPD: glass" ratios was stored in water for 24 h, 30, 60, 90 and 120 days and tested in flexure. DC was determined using FTIR spectroscopy. Data were analyzed using Kruskal-Wallis/Dunn test (flexural properties) or ANOVA/Tukey test (DC, alpha: 0.05). RESULTS: For glass-only composites, reducing inorganic content caused a linear decrease in strength. The presence of DCPD did not affect composite strength up until a "DCPD: glass" ratio of 0.5. On the other hand, materials with 0.75 and 1.0 DCPD showed significantly lower strength than the glass-only composite with 12.5 vol% filler and the unfilled resin, respectively (p < 0.001). Except for the 0.25 DCPD composite, the presence of DCPD did not contribute to increase flexural modulus. After water storage, composites containing DCPD showed higher percent reductions in properties than the control, but only in a few cases the effect was statistically significant (strength: 0.5 DCPD, modulus: 0.25 and 1.0 DCPD). DC was only marginally affected by DCPD fraction. SIGNIFICANCE: For composites with "DCPD: glass" of 0.25 and 0.5, reductions in strength were related to the lower glass content, and not due to the presence of DCPD. Flexural modulus was primarily defined by glass content. Overall, composites containing DCPD particles presented higher reductions in properties after water storage, but it remained within limits reported for commercial materials.

Precipitation, landscape properties and land use interactively affect water quality of tropical freshwaters.

Globally, conversion of pristine areas to anthropogenic landscapes is one of the main causes of ecosystem service losses. Land uses associated with urbanization and farming can be major sources of pollution to freshwaters promoting artificial inputs of several elements, leading to impaired water quality. However, how the effects of land use on freshwater quality are contingent on properties of the local landscape and climate is still poorly understood. The aim of this study was to evaluate the effects of landscape properties (morphometric measurements of lakes and their catchments), precipitation patterns, and land use properties (extent and proximity of the land use to freshwaters) on water quality of 98 natural lakes and reservoirs in northeast Brazil. Water quality impairment (WQI) was expressed as a composite variable incorporating parameters correlated with eutrophication including nitrogen (N), phosphorus (P) and Chlorophyll-a concentration. Regression tree analysis showed that WQI is mainly related to highly impacted "buffer areas". However, the effects of land use in these adjacent lands were contingent on precipitation variability for 13% of waterbodies and on surface area of the buffer in relation to the volume of waterbody (BA:Vol) for 87% of waterbodies. Overall, effects on WQI originating from the land use in the adjacent portion of the lake were amplified by high precipitation variability for ecosystems with highly impacted buffer areas and by high BA:Vol for ecosystems with less impacted buffer areas, indicating that ecosystems subjected to intense episodic rainfall events (e.g. storms) and higher buffer areas relative to aquatic ecosystem size (i.e. small waterbodies) are more susceptible to impacts of land use. Land use at the catchment scale was important for the largest ecosystems. Thus, our findings point toward the need for considering a holistic approach to managing water quality, which includes watershed management within the context of climate change.

Effects of seasonality, trophic state and landscape properties on CO2 saturation in low-latitude lakes and reservoirs.

The role of tropical lakes and reservoirs in the global carbon cycle has received increasing attention in the past decade, but our understanding of its variability is still limited. The metabolism of tropical systems may differ profoundly from temperate systems due to the higher temperatures and wider variations in precipitation. Here, we investigated the spatial and temporal patterns of the variability in the partial pressure of carbon dioxide (pCO2) and its drivers in a set of 102 low-latitude lakes and reservoirs that encompass wide gradients of precipitation, productivity and landscape properties (lake area, perimeter-to-area ratio, catchment size, catchment area-to-lake area ratio, and types of catchment land use). We used multiple regressions and structural equation modeling (SEM) to determine the direct and indirect effects of the main in-lake variables and landscape properties on the water pCO2 variance. We found that these systems were mostly supersaturated with CO2 (92% spatially and 72% seasonally) regardless of their trophic status and landscape properties. The pCO2 values (9-40,020 µatm) were within the range found in tropical ecosystems, and higher (p < 0.005) than pCO2 values recorded from high-latitude ecosystems. Water volume had a negative effect on the trophic state (r = -0.63), which mediated a positive indirect effect on pCO2 (r = 0.4), representing an important negative feedback in the context of climate change-driven reduction in precipitation. Our results demonstrated that precipitation drives the pCO2 seasonal variability, with significantly higher pCO2 during the rainy season (F = 16.67; p < 0.001), due to two potential main mechanisms: (1) phytoplankton dilution and (2) increasing inputs of terrestrial CO2 from the catchment. We conclude that at low latitudes, precipitation is a major climatic driver of pCO2 variability by influencing volume variations and linking lentic ecosystems to their catchments.

Idosos e exercícios físicos: motivações e contribuições para saúde e o lazer / Seniors and physical exercises: motivations and contributions to health and leisure

O estudo objetiva analisar fatores motivacionais para a participação de idosos em programa de atividades físicas do Centro de Convivência da Terceira Idade, em Teresina/PI. A pesquisa, qualitativa e descritiva, considerou as narrativas de 30 idosos, de 60 e 87 anos, entre novembro e dezembro de 2015, que apontaram como aspectos motivacionais para participar de programas de exercícios físicos: a prevenção de doenças, a reabilitação e manutenção da saúde e o lazer, sendo a iniciação nas atividades motivada pela família, iniciativa própria e indicação médica. A melhoria da saúde, a diminuição de dores, o aumento da força, da resistência, da flexibilidade, a perda de peso corporal e a ampliação do círculo de amizades foram as principais repercussões dessa participação. Assim, a manutenção de um estilo de vida ativo durante o envelhecimento potencializa fatores psicossociais e melhora a qualidade da vida dos idosos.

The study aims to analyze motivational factors for the participation of the elderly in a program of physical activities of the Center for the Coexistence of the Third Age, in Teresina/PI. The qualitative and descriptive research considered the narratives of 30 elderly, 60 and 87 years old, between November and December 2015, who pointed out as motivational aspects to participate in physical exercise programs: disease prevention, rehabilitation and maintenance of health and leisure, being the initiation in the activities motivated by the family, own initiative and medical indication. Improved health, reduced pain, increased strength, endurance, flexibility, loss of body weight and the expansion of the circle of friends were the main repercussions of this participation. Thus, maintaining an active lifestyle during aging enhances psychosocial factors and improves the quality of life of the elderly.

Does the Attention Deficit Hyperactivity Disorder interfere with bariatric surgery results?

Objective: to analyze possible negative effects of Attention Deficit Hyperactivity Disorder (ADHD) on the success of bariatric surgery. Methods: we evaluated forty patients undergoing bariatric surgery and with regular post-operative follow-up of at least one year. To all, we applied the questionnaire advocated in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association for ADHD, as well as analyzed their postoperative data. Results: fifteen (38%) patients presented a positive questionnaire for ADHD. Patients with ADHD presented higher BMI than patients without the disorder (45.8 vs. 40.9 kg/m2, p=0.017), and the difference remained in all postoperative stages. There was no statistically significant difference in surgery success (33.3% x 66.7%, p=0.505) or in BMI reduction (30.71% x 31.88%, p=0.671) one year after the procedure. Conclusion: ADHD patients have a higher BMI. However, the presence of ADHD does not influence the success of bariatric surgery and the reduction of BMI.

Objetivos: analisar possíveis efeitos negativos do Transtorno do Déficit de Atenção e Hiperatividade (TDAH) no sucesso da cirurgia bariátrica. Métodos: foram avaliados 40 pacientes submetidos à cirurgia bariátrica e com acompanhamento pós-operatório regular mínimo de um ano. Todos foram submetidos ao questionário preconizado na quarta edição do Diagnostic and Statistical Manual (DSM-IV) da Associação Americana de Psiquiatria para TDAH e analisados os dados pós operatórios. Resultados: quinze (38%) pacientes apresentaram questionário positivo para TDAH. Os pacientes com TDAH apresentaram IMC maior do que os pacientes sem o transtorno (45,8x40,9 Kg/m2; p=0,017), mantendo-se a diferença em todas as etapas do pós-operatório. Não foi encontrada diferença estatisticamente significativa no sucesso da cirurgia (33,3% x 66,7%; p=0,505), e na redução do IMC (30,71% x 31,88%; p=0,671) após um ano do procedimento. Conclusão: pacientes com TDAH apresentam maior IMC, entretanto, a presença do TDAH não apresenta influência no sucesso da cirurgia bariátrica e na redução do IMC.

Does the Attention Deficit Hyperactivity Disorder interfere with bariatric surgery results? / O Transtorno de Déficit de Atenção e Hiperatividade interfere nos resultados da cirurgia bariátrica?

ABSTRACT Objective: to analyze possible negative effects of Attention Deficit Hyperactivity Disorder (ADHD) on the success of bariatric surgery. Methods: we evaluated forty patients undergoing bariatric surgery and with regular post-operative follow-up of at least one year. To all, we applied the questionnaire advocated in the fourth edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association for ADHD, as well as analyzed their postoperative data. Results: fifteen (38%) patients presented a positive questionnaire for ADHD. Patients with ADHD presented higher BMI than patients without the disorder (45.8 vs. 40.9 kg/m2, p=0.017), and the difference remained in all postoperative stages. There was no statistically significant difference in surgery success (33.3% x 66.7%, p=0.505) or in BMI reduction (30.71% x 31.88%, p=0.671) one year after the procedure. Conclusion: ADHD patients have a higher BMI. However, the presence of ADHD does not influence the success of bariatric surgery and the reduction of BMI.

RESUMO Objetivos: analisar possíveis efeitos negativos do Transtorno do Déficit de Atenção e Hiperatividade (TDAH) no sucesso da cirurgia bariátrica. Métodos: foram avaliados 40 pacientes submetidos à cirurgia bariátrica e com acompanhamento pós-operatório regular mínimo de um ano. Todos foram submetidos ao questionário preconizado na quarta edição do Diagnostic and Statistical Manual (DSM-IV) da Associação Americana de Psiquiatria para TDAH e analisados os dados pós operatórios. Resultados : quinze (38%) pacientes apresentaram questionário positivo para TDAH. Os pacientes com TDAH apresentaram IMC maior do que os pacientes sem o transtorno (45,8x40,9 Kg/m2; p=0,017), mantendo-se a diferença em todas as etapas do pós-operatório. Não foi encontrada diferença estatisticamente significativa no sucesso da cirurgia (33,3% x 66,7%; p=0,505), e na redução do IMC (30,71% x 31,88%; p=0,671) após um ano do procedimento. Conclusão : pacientes com TDAH apresentam maior IMC, entretanto, a presença do TDAH não apresenta influência no sucesso da cirurgia bariátrica e na redução do IMC.

Tratamento de dentes com rizogênese incompleta após procedimentos regenerativos ou de apicificação: uma revisão sistemática de literatura / Treatment of immature permanent teeth with regenerative procedures or apicification: a systematic literature review

Objetivo: realizar uma revisão sistemática de literatura para verificar as taxas de sucesso do tratamento de dentes permanentes imaturos com periodontite apical após procedimentos tradicionais de apicificação ou de procedimentos de regeneração/revascularização pulpar. Material e Métodos: uma busca eletrônica de artigos foi executada em bancos de dados PubMed e Cochrane, usando termos médicos específicos, entre janeiro de 2000 a junho de 2015. Outras publicações presentes na seção de referência de cada artigo relavante foi analisada a partir de uma busca manual e foram acrescentadas na lista de artigos selecionados. Resultados: inicialmente, um total de 114 títulos foi identificado. Um estudo adicional foi identificado como relevantes após uma busca das listas de referência. Após o enquadramento nos critérios de inclusão e exclusão, apenas dois artigos foram selecionados. Os estudos incluídos demonstram resolução dos sinais clínicos, sintomas e radiolucência periapical para ambas as formas de tratamento. Em contrapartida os estudos foram divergentes no que diz respeito ao aumento de comprimento e espessura radicular após terapias regenerativas; enquanto um estudo apresentou dados mais favoráveis à terapia regenerativa, o outro não demonstrou diferenças entre as duas terapias testadas. Conclusão: a presente revisão sistemática indica a existência de poucos estudos comparando diretamente as duas técnicas avaliadas. Além disso, os protocolos de revascularização oferecem o potencial para tratar dentes permanentes com rizogênese incompleta, com o consequente desaparecimento dos sinais e sintomas e uma maior possibilidade de continuidade de formação radicular quando comparados aos tradicionais procedimentos de apicificação.

Objective: to perform a systematic literature review to evaluate the success rates of treatment of immature permanent teeth with apical periodontitis after traditional procedures like apexification or regeneration/pulp revascularization. Materials and Methods: an electronic search was executed in the PubMed and Cochrane databases using specific medical terms. Articles published between January 2000 and June 2015 were evaluated. Other publications in the reference section of each relevant article were analyzed in a manual search and were added to the selected articles list. Results: at first, a total of 114 titles and resumes was identified after an electronic search in both electronic databases, using a specific combination of terms and keywords. An additional study was identified as being relevant after a reference list search. After the framing in the inclusion/exclusion criteria, only two articles were selected. The included studies demonstrated resolution of clinical signs, symptoms, and periapical radiolucencies to both treatments. On the other hand, these studies were divergent in relation to increased length and root thickness after regenerative therapy; while one of the studies presented more favorable outcomes to regenerative therapy, the other one showed no differences between the two tested therapies. Conclusion: although there are few studies performing a direct comparison between conventional therapies and regenerative therapies, the present systematic review indicates that revascularization protocols offer the potential to treat permanent teeth with incomplete root formation, leading to the disappearance of the signals, symptoms, and an increased possibility of continuing root formation.

Type 2 segmental glomangioma--Case report.

Glomus tumors originate from modified perivascular muscle cells. The most common form is the solitary one. The multiple form may be associated with dominant genetic inheritance. We report a case of a patient with hemangiomatous lesions on the calcaneus and wrist since birth. In 6 years, there was progression of lesions throughout the body. Multiple glomangiomas are asymptomatic and more common in childhood. They can be confused with other vascular malformations. Histopathological diagnosis is essential. The case shows a type 2 segmental manifestation that can be explained by genetic mutation leading to the loss of heterozygosity. As the child grows, the lesions may disseminate due to mutation in distant parts of the skin. Literature shows few reports. The treatment is conservative.

Type 2 segmental glomangioma - Case report

Glomus tumors originate from modified perivascular muscle cells. The most common form is the solitary one. The multiple form may be associated with dominant genetic inheritance. We report a case of a patient with hemangiomatous lesions on the calcaneus and wrist since birth. In 6 years, there was progression of lesions throughout the body. Multiple glomangiomas are asymptomatic and more common in childhood. They can be confused with other vascular malformations. Histopathological diagnosis is essential. The case shows a type 2 segmental manifestation that can be explained by genetic mutation leading to the loss of heterozygosity. As the child grows, the lesions may disseminate due to mutation in distant parts of the skin. Literature shows few reports. The treatment is conservative.

Amelogenesis imperfecta: report of a successful transitional treatment in the mixed dentition.

The term amelogenesis imperfecta is applied to a clinically heterogeneous group of hereditary disorders that interfere with the normal development of dental enamel. These disorders cause a deficiency in the enamel's quantity and/or the quality that may result in poor dental esthetics. The purpose of this paper was to describe a case of hypoplastic amelogenesis imperfecta in an 8-year-old girl whose dissatisfaction with the appearance of her teeth led to impaired social functioning. Since the patient was in the mixed dentition stage, a temporary treatment aiming to improve dental esthetics, preserve oral function, and allow for the recovery of the patient's self-confidence was performed by a multidisciplinary team.