Cinnamaldehyde modulates host immunoinflammatory responses in rat ligature-induced periodontitis and peripheral blood mononuclear cell models.

Cinnamaldehyde is a natural product with anti-inflammatory and immune-modulatory properties, known to regulate host responses to bacterial stimuli. This study aimed to investigate the effects of cinnamaldehyde on ligature-induced periodontitis in rats, and its impact on the modulation of human peripheral blood mononuclear cells (PBMC). Male Wistar rats were assigned into three groups:i) control: no ligature + vehicle; ii) ligature: ligature + vehicle; and iii) ligature + cinnamaldehyde (50 mg/kg); all treatments by daily oral gavage. After 14 days of induced periodontitis, the hemimandibles were collected for bone loss evaluation. The gingival levels of IL-1ß, MMP-9 and iNOS mRNA were evaluated. Nitric oxide (NO) was measured in both rat saliva and plasma. PBMC were stimulated with Aggregatibacter actinomycetemcomitans (Aa) in the presence or absence of cinnamaldehyde (5, 20 e 40 µM), and cytokine production was quantified in cell supernatant. Proliferating lymphocytes were taken for flow cytometer reading, while culture supernatants were used for IFN-γ and IL-10 assessment. The ligature group had both increased alveolar bone loss and gingival expression of IL-1ß, MMP-9 and iNOS compared to the control group. All parameters were attenuated by cinnamaldehyde treatment. Lower salivary but not plasma NO was detected in the cinnamaldehyde compared to the ligature group. Aa-stimulated PBMCs treated with cinnamaldehyde produced less IL-1ß; the compound also attenuated lymphocyte proliferation in a dose-dependent manner, as well as cell IL-10 production. Cinnamaldehyde treatment reduced periodontal bone loss, and downregulated key inflammatory mediators and human PBMC responses, pointing to novel potential therapeutic effects of this compound.

Relationship between craniofacial and dental arch morphology with pharyngeal airway space in adolescents.

PURPOSE: The aim of the study was to investigate a possible relationship between pharyngeal airway space, craniofacial variables, and dental arch form in adolescents grouped by sex. METHODS: This cross-sectional study included 108 adolescents aged between 12 and 17 years. Lateral cephalometric radiographs were used to analyze sagittal craniofacial variables and the pharyngeal airway space. For evaluation of the dental arch form, we used plaster models. Statistical analysis included Student's t­test and Pearson's correlation coefficient (r). RESULTS: Maxillary length was directly proportional to upper nasopharyngeal airway dimensions in males (r = 0.312, p = 0.021) and females (r = 0.310, p = 0.022). In the female group, upper oropharyngeal measurements showed an inverse correlation with a labial inclination of the upper incisors (r = -0.415, p = 0.001), protrusion of the upper incisors (r = -0.364, p = 0.006), and soft palate thickness (r = -0.27, p = 0.043). In the male group, upper nasopharynx measurements showed an inverse correlation with soft palate thickness (r = -0.277, p = 0.042). The upper arch form appeared to be related to oropharyngeal measurements in females, while the lower arch form was related to oropharyngeal dimensions in males. CONCLUSION: The findings suggest that there are sex-dependent correlations of the nasopharyngeal and oropharyngeal airway space with the sagittal craniofacial morphology and the transversal dental arch form.

Oropharyngeal complex differences related to sex and occlusal factors in adolescents aged 12-17 years.

OBJECTIVE: To investigate oropharyngeal complex differences related to sex and occlusal factors in adolescents. METHODS: A cross-sectional study was conducted with 108 patients aged 12-17 years. The oropharyngeal complex was evaluated by imaging exams. Occlusal variables included molar relationship, facial growth pattern, maxilla shape, tooth loss, anterior crossbite, and anterior open bite. Statistical analysis included independent t-test, Mann-Whitney, ANOVA, and Kruskal-Wallis tests. The significance level was 5%. RESULTS: There were increases of the tongue measurement (p = 0.026) and the hyoid approach at the base of the mandible among boys (p = 0.016) and the distance from the hyoid at the base of the mandible among girls (p = 0.039). There was shortening of the soft palate measurements (p = 0.003 and p = 0.007) and tongue (p = 0.018) among adolescents with an anterior crossbite. CONCLUSION: Findings suggest sex, age, and anterior crossbite can be related to oropharyngeal morphology.

The influence of periodontal status and serum biomarkers on salivary leptin levels in systemic lupus erythematosus patients.

Objective: This study aimed to investigate the influence of periodontal status, clinical data, and serum markers on salivary leptin levels in patients with systemic lupus erythematosus (SLE). Methods: A case-control study was conducted with 38 patients with SLE and 29 healthy controls. Periodontal data included periodontal probing depth (PPD), clinical attachment level (CAL), and gingival bleeding on probing (BOP). Stimulated saliva samples were collected to analyze salivary leptin levels. Clinical and serum data were collected from the SLE group. Statistical analysis included the t-test, Mann-Whitney test, Spearman correlation coefficient, and a structural equation model. Results: The SLE group had a lower salivary leptin level than the control group (P = 0.002). The model revealed that SLE had an inverse and independent effect on salivary leptin (standardized estimate =  - 0.289, P = 0.023). Moreover, salivary leptin level negatively correlated with the serum levels of triglyceride, creatinine, and leukocytes, positively correlated with the serum total cholesterol, but was not significantly correlated with the periodontal status. Conclusion: These findings suggest that patients with SLE have a lower salivary leptin level. In addition, the level of salivary leptin does not appear to be related to periodontal status in patients with SLE.

Effect of the intra-alveolar administration of dexamethasone on swelling, trismus, and pain after impacted lower third molar extraction: a randomized, double-blind clinical trial

Background: To evaluate the efficacy of intra-alveolar administration of dexamethasone 4 mg in the control of edema, trismus, and pain resulting from the extraction of impacted lower third molars and the drug permeability through the oral mucosa by in silico prediction. Material and Methods: The randomized, double-blind, split-mouth clinical trial included patients who had both impacted lower third molars in equivalent positions. Hemiarches were divided into control side when dexamethasone was administered orally and experimental side when dexamethasone was administered using the intra-alveolar route. Patients were evaluated considering edema, trismus, and pain. The permeability of dexamethasone through the oral mucosa was assessed by in silico prediction. Student’s t-test was selected for comparative analysis of edema and trismus, and the chi-square test analyzed the distribution of postoperative pain between the sides. Results: There were no significant differences between the routes of administration in measuring symptoms between the pre and postoperative times (p>0.05). In silico prediction suggested that dexamethasone molecular characteristics facilitate intra-alveolar administration. Conclusions: Intra-alveolar administration had similar efficacy to oral administration in controlling symptoms of post-surgical inflammation of impacted lower third molars.(AU)

Oral health care for people with disabilities in Brazil: Transition from the specialized dental services between 2014 and 2018.

OBJECTIVE: To identify changes in the dental service provision to people with disabilities (PD) in the Dental Specialties Centers (acronym CEO in Portuguese-Centro de Especialidades Odontológicas) between the first and second cycles of the Program for the Improvement of Access and Quality of CEO and analyse factors associated with any changes. METHODS: This nationwide ecological time series study adopted the CEO as the analysis unit. The 827 CEO who participated in the two program's cycles (2014 and 2018) were included. Data on the structure and the work process were considered to identify features of providing services to PD in both cycles. Latent transition analysis (LTA) was performed to identify latent status (LS) with similar features and model the transition between LS over time. Models with five variables and with two to five LS were tested, considered best conceptual interpretability and best model fit parameters: human resources structure (dentist working exclusively with PD) and work process that identified guarantee of PD treatment at the CEO, the CEO's interface with primary care, and the interface with tertiary care. Spatial analysis was performed to identify spatial patterns of LS in the Brazilian territory with choropleth maps. A multinomial logistic regression model was performed to identify factors associated with changes in the provision of CEO (improved, remained or worsened). FINDINGS: The best-fit model identified four LS: 'Better', 'Medium better', 'Medium worse' and 'Worse'. CEO remained in the LS 'Better' (94%), LS 'Medium' (5.3%) and LS 'Worse' (78.4%). It is noteworthy that the highest proportion of CEO, in both cycles, was in the LS 'Better', featured by the CEO, characterized by all the CEO guaranteeing treatment to users with PD, high proportions of professionals working exclusively with PD, and most CEO articulated with primary care and with tertiary care. However, there is a decrease in the number of postgraduate professionals specializing in this service profile (1.3%). The higher the population growth, the greater the likelihood of the CEO achieving 'improved' in the LS. Moreover, the higher the number of goals, the lower the likelihood of the CEO getting 'worse' in the LS. CONCLUSION: Advances in dental service provision were observed, with more significant transitions to the 'Better' class, with improvements mainly in the interface with primary and tertiary care. Disability will be an even more significant concern as the population ages. Initiatives that can remove barriers and empower PD are potent in the provision of oral health services.

Camuflagem ortodôntica na correção da má oclusão de Classe II divisão 1ª de Angle, utilizando-se o aparelho de protração mandibular associado à técnica MEAW ­ relato de caso / Orthodontic camouflage in correction of Class II division 1 Angle malocclusion, using mandibular protraction appliance associated with MEAW technique ­ case report

Resumo O objetivo deste trabalho é relatar um caso clínico de camuflagem ortodôntica de má oclusão de Classe II divisão 1ª com retrognatismo mandibular através do Aparelho de Protração Mandibular (APM) e da técnica Multiloop Edgewise Archwire (MEAW). A paciente de 16 anos e 8 meses de idade, tinha como queixa principal o retrognatismo mandibular. No exame clínico, foi verificado o perfil convexo, incisivos superiores vestibularizados, sobremordida e sobressaliência acentuadas, mandíbula retrognática e má oclusão de Classe II divisão 1ª. O APM foi utilizado simultaneamente à técnica MEAW para camuflagem da Classe II. Ao final do tratamento, foi obtida uma melhora no perfil facial, oclusão com sobremordida e sobressaliência normais e boa intercuspidação. O APM e a técnica MEAW demonstraram eficácia na camuflagem ortodôntica da má oclusão de Classe II divisão 1ª com retrognatismo mandibular. (AU)

Abstract The objective of this work is to report a clinical case of orthodontic camouflage of Class II division 1 malocclusion with mandibular retrognathism using the Mandibular Protraction Appliance (MPA) and the Multiloop Edgewise Archwire (MEAW) technique. The female patient, 16 years and 8 months old, had as main complaint mandibular retrognathism. In the clinical examination, convex profile, buccal upper incisors, increased overbite and overjet, retrognathic mandible, and Class II division 1 malocclusion were verified. MPA was used simultaneously with the MEAW technique for Class II camouflage. At the end of the treatment, an improvement in facial profile, occlusion with normal overbite and overjet, and good intercuspation were obtained. MPA and the MEAW technique demonstrated effectiveness in orthodontic camouflage of Class II division 1 malocclusion with mandibular retrognathism. (AU)

Tratamento de má oclusão de classe III e mordida cruzada posterior bilateral através de camuflagem ortodôntica ­ relato de caso / Treatment of class III malocclusion and bilateral posterior crossbite through orthodontic camouflage ­ case report

Resumo A má oclusão de Classe III é caracterizada pela dimensão transversal insuficiente e as mordidas cruzadas são recorrentes nos pacientes com esse padrão esquelético. O objetivo deste trabalho é apresentar um caso clínico de tratamento Classe III e mordida cruzada posterior bilateral através de camuflagem ortodôntica. O paciente do sexo masculino, 18 anos e 7 meses, relatou como queixa principal a falta de oclusão entre os dentes superiores e inferiores. Apresentava má oclusão de Classe III, mordida cruzada posterior bilateral, desvio de linha média e assimetria facial. A correção da mordida cruzada foi realizada através da utilização de uma sequência de arcos ortodônticos superiores expandidos e arcos inferiores contraídos e a Classe III foi camuflada através da técnica Multiloop Edgewise Archwire (MEAW). Ao fim do tratamento, foi obtida a relação oclusal de Classe I entre os caninos, correção da mordida cruzada posterior bilateral e coincidência entre as linhas médias. A técnica MEAW mostrou eficácia na camuflagem da Classe III, assim como a sequência de arcos expandidos e contraídos na correção da mordida cruzada posterior bilateral. (AU)

Abstract Class III malocclusion is characterized by insufficient transverse size and crossbites are recurrent in patients with this skeletal pattern. The aim of this work is to present a clinical case treatment of Class III and bilateral posterior crossbite through orthodontic camouflage. Male patient, 18 years old and 7 months, reported as main complaint lack of occlusion between upper and lower teeth. He had Class III malocclusion, bilateral posterior crossbite, midline deviation, and facial asymmetry. Crossbite correction was performed using a sequence of expanded upper orthodontic arches and contracted lower arches and Class III camouflage by Multiloop Edgewise Archwire (MEAW) technique. At the end of treatment, it was obtained Class I occlusal relationship between canines, bilateral posterior crossbite correction and coincidence between the midlines. MEAW technique showed efficacy in Class III camouflage as well as the expanded and contracted arches sequence to correct bilateral posterior crossbite. (AU)

Efeito de um programa de acompanhamento farmacoterapêutico em pacientes com hipertensão arterial sistêmica / Effect of a pharmacotherapeutic follow-up program in patients with systemic arterial hypertension

A Hipertensão Arterial Sistêmica (HAS) é uma condição clínica multifatorial, com tratamento não-farmacológico e/ou farmacológico, que necessita de acompanhamento farmacoterapêutico para gestão da condição de saúde. O objetivo foi avaliar o impacto de um programa de acompanhamento farmacoterapêutico em pacientes com HAS, através do estudo quase-experimental, longitudinal e prospectivo. Foram avaliados 28 pacientes, 50% estavam com pressão arterial descompensada, os PRM (Problemas Relacionados à Medicamentos) identificados foram interações medicamentosas (57,1%), duplicidade farmacoterapêutica (28,8%), medicamentos potencialmente inapropriados para idosos (38,5 %) e não adesão ao tratamento (89,3%). Dos RNM (Resultado Negativos associados à Medicação) 56,2% relacionavam-se à segurança e 37,5% à efetividade. Após o acompanhamento, 56,3% dos RNM foram resolvidos, 57,1% dos pacientes aderiram ao tratamento e houve redução da Pressão Arterial Sistólica (p=0,010) e Pressão Arterial Diastólica (p=0,020). O programa mostrou-se favorável na redução da pressão arterial sistêmica e resolução dos PRM e RNM.

Systemic Arterial Hypertension (SAH) is a multifactorial clinical condition with non-pharmacological and/or pharmacological treatment that requires pharmacotherapeutic monitoring in order to manage the health condition. The objective was to evaluate the impact of a pharmacotherapeutic follow-up program of patients with SAH through a quasi-experimental, longitudinal, and prospective study. Twenty-eight patients were evaluated, 50% of which had decompensated blood pressure; the DRPs identified were drug interactions (57.1%), pharmacotherapeutic duplication (28.8%), potentially inappropriate medication use in older adults (38.5%), and non-adherence to treatment (89.3%). Of the NOM identified (Negative Outcomes associated with Medication), 56.2% were related to safety, and 37.5% to effectiveness. After the follow-up, 56.3% of the NOM were resolved, 57.1% of patients adhered to treatment, and there was a reduction in the Systolic Blood Pressure (p = 0.010) and Diastolic Blood Pressure (p = 0.020). The program proved to be efficient in reducing systemic blood pressure and resolving DRPs and NOM.

Treatment of localized aggressive periodontitis alters local host immunoinflammatory profiles: A long-term evaluation.

AIM: To evaluate the local immunoinflammatory profiles in localized aggressive periodontitis patients (LAP) before and after periodontal treatment and maintenance. METHODS: Sixty-six African-Americans with LAP (7-21 years old) were included. After periodontal examination, all patients received periodontal treatment with mechanical debridement plus systemic amoxicillin/metronidazole for 7 days. Gingival crevicular fluid was collected from diseased and healthy sites at baseline and 3, 6, 12, and 24 months following treatment. Levels of 16 inflammatory/bone resorption markers were determined using Milliplex® . Univariate and correlation analyses were performed among all parameters/biomarkers. Discriminant analyses (DA) evaluated profile differences between LAP diseased and healthy sites at each time point as compared to the baseline. RESULTS: Reductions in the clinical parameters (except for visible plaque) were observed at all time points compared to the baseline. Levels of IL-12p70, IL-2, IL-6, MIP-1α, RANKL, and OPG were reduced after treatment, and several cytokines/chemokines were correlated with clinical parameters reductions. DA showed that differences in the immunoinflammatory profiles between LAP diseased and healthy sites decreased after periodontal treatment compared to the baseline. CONCLUSIONS: Periodontal treatment modified the local immunoinflammatory profile of LAP sites in the long term, as suggested by changes in biomarkers from baseline, along with clinical stability of the disease. (Clinicaltrials.gov number, NCT01330719).

Morphological changes in the temporomandibular joints in women with fibromyalgia and myofascial pain: A case series.

Objective: This study investigated the temporomandibular joint (TMJ) morphological changes in women with fibromyalgia (FM) through clinical and tomographic evaluation.Methods: Ten women diagnosed with myofascial pain who were being treated for FM in a university hospital were included in this study. The data were collected through clinical examination and cone beam computed tomography evaluation of the TMJ in closed and open mouth positions.Results: All patients had crackling in the joint, a habit of grinding teeth during sleep, muscle stiffness, and tinnitus. The tomographic findings revealed a higher frequency of condylar bone wear, reduction of joint space, and posterior positioning of the mandibular condyle. The temporomandibular disorders with the highest prevalence were osteoarthritis and disc displacement with reduction.Conclusion: The findings suggest that women with FM have a high frequency of TMD related to the displacement of the articular disc, condyle position, and occurrence of osteoarthritis.

Tratamento de má oclusão de Classe III subdivisão com mordida cruzada posterior unilateral através da técnica multiloop edgewise archwire (MEAW) ­ relato de caso / Treatment of Class III subdivision malocclusion with unilateral posterior crossbite through multiloop edgewise archwire (MEAW) technique ­ case report

Resumo O objetivo deste trabalho foi relatar um caso clínico de tratamento de má oclusão de Classe III subdivisão com mordida cruzada posterior unilateral através da técnica Multiloop Edgewise Archwire (MEAW). O paciente do sexo masculino, 19 anos de idade, relatou o prognatismo mandibular como queixa principal. Apresentava má oclusão de Classe III de Angle, mordida cruzada posterior unilateral direita, mordida de topo na região anterior, linhas médias não coincidentes e assimetria facial. Devido à recusa ao tratamento cirúrgico pelo paciente, foi proposto uma compensação ortodôntica dentoalveolar. Foi utilizada a técnica MEAW associada ao uso de elásticos intermaxilares 3/16". Ao final do tratamento, foi obtida relação oclusal de Classe I entre caninos e molares, correção da mordida cruzada posterior unilateral, coincidência entre as linhas médias. A técnica MEAW mostrou eficácia na correção da má oclusão de Classe III subdivisão e mordida cruzada posterior unilateral. (AU)

Abstract The aim of this study was to report a clinical case of treatment of Class III subdivision malocclusion with unilateral posterior crossbite using the Multiloop Edgewise Archwire (MEAW) technique. A 19-year-old male patient reported mandibular prognathism as the main complaint. He had Angle Class III malocclusion, unilateral posterior crossbite on the right side, top bite in the anterior region, non-coincident midlines and facial asymmetry. Due to the patients refusal of surgical treatment, dentoalveolar orthodontic compensation was proposed. The MEAW technique associated with 3/16" intermaxillary elastics were used. At the end of the treatment, a Class I occlusal relationship between canines and molars, correction of the unilateral posterior crossbite and coincidence between the midlines was obtained. The MEAW technique was effective in correcting Class III subdivision malocclusion and unilateral posterior crossbite. (AU)

Effect of photobiomodulation therapy as an adjunct to scaling and root planing in a rat model of ligature-induced periodontitis: a histological and radiographic study.

This study aimed to histologically and radiographically evaluate the effectiveness of low-intensity laser irradiation of different wavelengths (660 or 808 nm) as an adjunct to scaling and root planing in the treatment of experimental periodontitis in rats. Periodontitis was induced by placing a ligature around the mandibular first molar of the rats. In total, 40 Wistar rats were randomly divided into five groups (n = 8 each): control (CG), periodontal disease (PD), scaling and root planing (SRP), SRP + 660 nm laser (GL660) and SRP + 808 nm laser (GL808). Groups with laser use received radiation at 6 points in the first molar. The animals were euthanized at baseline and at 7 and 14 days after the interventions. Mandibles were surgically removed for histomorphometric and radiographic assessment of periodontal tissues. The GL660 group showed lesser bone loss than the PD group (P < 0.05) and greater alveolar bone margin after 14 days, indicating a better long-term treatment response (P < 0.05). These findings suggest that SRP with the 660 nm laser as an adjunct results in more favorable radiographic and histological responses than the 808 nm laser.

Tooth loss and craniofacial factors associated with changes in mandibular condylar morphology.

Objective: To investigate the association between tooth loss and craniofacial factors with changes in mandibular condylar morphology. Methods: A total of 123 patients participated in this cross-sectional study. The mandibular condylar morphology was evaluated using digital panoramic radiography. The exposure variables included gender, age group, molar relationship, facial growth pattern, facial asymmetry, dental midline, posterior crossbite, presence of fixed dental prosthesis, and tooth loss. Results: Unilateral and bilateral mandibular condyle structural alterations were found in 20.3% and 28.5% of the sample, respectively. After the adjustment analysis, posterior crossbite (adjusted OR = 3.34, 95% CI = 1.23-9.06) and tooth loss (adjusted OR = 4.08, 95% CI = 1.72-9.64) were associated with the outcome. The tooth type associated with mandibular condyle structural alterations were premolars and upper molars. Conclusion: The findings suggest that posterior crossbite and tooth loss are associated with mandibular condyle structural alterations.

Fechamento de espaço de molar inferior com ancoragem através de aparelho de protração mandibular ­ relato de caso / Mandibular molar space closure with anchorage through mandibular protraction appliance ­ case report

O objetivo deste trabalho é apresentar um relato de caso clínico de fechamento de espaço de molar inferior, utilizando como ancoragem o Aparelho de Protração Mandibular instalado unilateralmente. A paciente do sexo feminino, 24 anos de idade, relatou como queixa principal os múltiplos diastemas e o espaço correspondente ao primeiro molar inferior esquerdo extraído. Apresentava má oclusão de Classe I, perfil reto, selamento labial passivo, simetria facial, linhas médias coincidentes, giroversões, diastemas entre incisivos laterais e caninos nos arcos superior e inferior, entre caninos e primeiros pré-molares inferiores e espaço referente ao primeiro molar inferior esquerdo extraído. Foi proposto o fechamento do espaço através da mesialização do segundo e terceiro molar com alça de Bull, utilizando o Aparelho de Protração Mandibular (APM) como ancoragem dos dentes anteriores inferiores. A técnica Multiloop Edgewise Archwire (MEAW) com elásticos intermaxilares 1/8 força média foi utilizada para corrigir os efeitos colaterais provocados pelo uso unilateral do APM. Ao final do tratamento, foi obtido o fechamento de todos os diastemas e do espaço correspondente ao primeiro molar inferior esquerdo. O Aparelho de Protração Mandibular utilizado unilateralmente mostrou eficácia como dispositivo de ancoragem durante o fechamento de espaço do elemento posterior extraído (AU)

The aim of this work is to present a clinical case report of lower molar space closure using as anchorage Mandibular Protraction Appliance unilaterally installed. A female patient, 24 years old, reported as main complaint multiple diastemas and the space corresponding to the extracted lower left first molar. She presented Class I malocclusion, straight profile, passive labial sealing, facial symmetry, coincident median lines, gyroversions, diastemas between lateral incisors and canines in the maxillary and mandibular arches, between canines and lower first premolars and space of the extracted lower first molar. It was proposed closure of the space through mesialization of the second and third molars with Bull loop, using the Mandibular Protraction Appliance (MPA) as anchorage of lower anterior teeth. Multiloop Edgewise Archwire (MEAW) technique with 1/8 medium strength intermaxillary elastics were used to correct the side effects caused by unilateral use of MPA. At the end of treatment, all diastemas and the space corresponding to the first lower left molar were closed. The Mandibular Protraction Appliance used unilaterally proved to be effective as an anchor device during space closure of the extracted posterior element (AU)

Malformações congênitas: um relato de reabilitação fisioterapêutica em paciente com transposição das grandes artérias / Congenital abnormalities: a physical therapy rehabilitation report in patient with transposition of great vessels

Objetivo: descrever uma abordagem fisioterapêutica na reabilitação neuropsicomotora e respiratória pediátrica em paciente com transposição das grandes artérias. Relato de caso: paciente R. S. C. R, sexo masculino, nascido de parto cesáreo, com diagnóstico clínico de malformações congênitas, portador de Transposição das Grandes Artérias ­ TGA, Comunicação Interatrial ­ CIA e Comunicação Interventricular Ampla ­ CIV. Avaliado aos 09 meses de idade com diagnóstico fisioterapêutico de atraso no desenvolvimento neuropsicomotor. Conclusão: esse relato de caso evidenciou efetiva abordagem fisioterapêutica na reabilitação neuropsicomotora e respiratória de uma criança com TGA + CIA + CIV em acompanhamento clínico, resultando em melhora neuropsicomotora identificada pelo melhor controle cervical e maior tempo na posição sentada, e melhora do desconforto respiratório passando de moderado para leve

Impasses e Invenções no Reingresso Escolar de Crianças e Adolescentes em Tratamento Onco-Hematológico: uma Intervenção Interdisciplinar e Intersetorial / Impasses and Inventions in School Readmission of Children and Adolescents on Oncohematological Treatment: an Interdisciplinary and Intersectorial Intervention / Imposiciones e Invenciones en el Reingreso Escolar de Niños y Adolescentes en Tratamiento Onco Hematológico: una Intervención Interdisciplinaria e Intersectorial

Introdução: o presente trabalho problematiza o relato de duas adolescentes acompanhadas em um hospital de referência para o tratamento oncológico infantojuvenil, por uma equipe de pesquisa voltada à reinserção escolar, composta por professoras, psicólogas, terapeuta ocupacional, enfermeira e assistente social. o grupo de pesquisa, atuante desde o ano de 2013, vem promovendo a mediação interdisciplinar e intersetorial entre as áreas de saúde e educação, e, por intermédio dos relatos, procura contextualizar a importância da preservação do lugar do desejo de duas pacientes de prosseguir com os estudos durante o tratamento oncológico. Relato dos casos: MP pôde imortalizar seu voto e a si mesma e dar origem a uma escola inaugurada com seu nome em seu município de residência. M, por sua vez, pôde tornar a escola um lugar menos inóspito e mais acolhedor para ela, a partir do recurso ao dispositivo de visitação escolar. Conclusão: como discussão, aponta-se a relevância da atuação interdisciplinar para a construção dos laços para além do hospital, bem como a necessária articulação intersetorial, fundamental para o êxito da reinserção escolar efetiva. ressalta-se que a equipe de pesquisa pôde acolher as adolescentes, cada qual com seus impasses, e, a partir da sustentação de um laço de referência, viabilizar uma real possibilidade de criar pontes com a vida, além dos muros do hospital.

Introduction: The present paper problematizes the report of two adolescents followed in a reference hospital for child and adolescent oncological treatment by a research team on school reinsertion, composed by teachers, psychologists, occupational therapy, nurse and social assistance. the research group, active since the year of 2013, have been promoting the interdisciplinary and intersectorial mediation between areas of health and education, and through reports seeks contextualize the importance of preserving the place of wish of two patients of continuing studying during oncological treatment. Case reports: MP could immortalize her vote and herself and giving origin to a school innagurated with her name in the city of residence. M in turn could make the school a place less inhospitable and more welcoming for her from the resort to the device of school visitation. Conclusion: as discussion, we point out the relevance of interdisciplinary activities to construct bonds beyond the hospital, as well as the needed intersectorial articulation, fundamental to the success of effective school reintegration. it is highlighted that the research team could welcome adolescents, each one with their issues and, through sustaining a reference bond, viabilize a real possibility to create bridges with life beyond the hospital walls.

Introducción: el presente estudio hizo una problematización del reporte de dos adolescentes acompañadas en un hospital de referencia para el tratamiento oncológico infanto-juvenil por un equipo de investigación con la mirada a la reinserción escolar, compuesta por maestras, psicólogas, terapeuta ocupacional, enfermera y asistente social. el grupo de investigación, que actúa desde 2013, sigue promocionando la mediación interdisciplinar y intersectorial entre las áreas de salud y educación y, a través de los reportes, procura contextualizar la importancia de la preservación del lugar del deseo de dos pacientes en seguir con los estudios durante el tratamiento oncológico. Relato de los casos: MP puede inmortalizar su voto y a si misma y dar origen a una escuela inaugurada con su nombre en la ciudad que ella vive. M, por su vez, puede tornar la escuela en un lugar menos inhóspito y más receptivo para ella a partir del recurso al dispositivo de visitación en la escuela. Conclusión: como discusión, apuntase la relevancia de la actuación interdisciplinaria para la construcción de los lazos para allá del hospital, bien como la necesaria intersectorial, fundamental para el éxito de la reinserción escolar efectiva. enfatizase que el equipo de investigación puede oír a las adolescentes, cada cual con suyas incertidumbres, y, a partir de la sustentación de un lazo de referencia, viabilizar una real posibilidad de criar puentes con la vida para allá del espacio del hospital.

Consenso brasileiro multi-institucional de pacientes sobre medicamentos biossimilares / Brazilian patients multi-institutional consensus on biosimilar drugs

Objetivo: O presente trabalho tem como objetivo emitir um consenso de diversas associações de pacientes sobre os produtos biossimilares. Métodos: O consenso foi produzido em reunião presencial com 15 representantes de 11 diferentes associações de pacientes. Previamente ao encontro, realizou- -se exercício Delphi contemplando 12 diferentes tópicos referentes a medicamentos biossimilares, sendo os temas de menor concordância selecionados para aulas informativas. Posteriormente, os participantes reuniram-se para discussão dos temas e elaboração do consenso. Resultados: O consenso concentrou-se em torno de oito temas gerais: nomenclatura, farmacovigilância, mercado nacional, RDC nº 55/2010, extrapolação de indicações, substituição automática, intercambialidade e estudos clínicos. Conclusões: Os medicamentos biossimilares representam avanço referente ao acesso à terapia biológica devido, especialmente, à competitividade econômica. Todavia, sua utilização deve ser respaldada por exercícios clínicos apropriados ­ exercício de biossimilaridade ­, respeitando a autonomia do prescritor e sempre apoiado em metodologias apropriadas de farmacovigilância.

Objective: This paper aims to publish a consensus from diverse patient associations on biossimilar drugs. Methods: The consensus was produced in a live meeting that gathered 15 representatives from 11 different patient associations. Previously to the meeting a Delphi exercise was elaborated contemplating 12 different subjects regarding biosimilar drugs. The subjects with smaller agreement were chosen to be discussed in informative lectures. Posteriorly, the attendants discussed the subjects and elaborated the consensus. Results: The consensus focused on eight different general subjects: nomenclature, pharmacovigilance, national Market, RDC nº 55/2010, extrapolation of controindications, automatic substitution, interchangeability, clinical trials. Conclusions: Biosimilar drugs represent progress regarding the access to biologic treatment, especially due to its economic competitiveness. However, its use must be supported by proper clinical trials ­ biosimilarity exercise ­ respecting the prescritor autonomy and counting on solid pharmacovigilance methods.

O adolescente e o sintoma na escola diante dos desafios da contemporaneidade / Adolescence and symptoms at school in present days

Este artigo trata das questões que surgem na contemporaneidade, suas interferências no contexto escolar e como os adolescentes reagem a esses novos tempos. Considerando-se a escola cenário das relações de socialização, este artigo se propõe a analisar a importância e a participação da escola na sociedade atual. Baseia-se nas ideias de alguns autores contemporâneos, tendo a psicanálise como referencial teórico. De acordo com recentes estudos na interface psicanálise e educação, percebe-se que a psicanálise pode trazer grande contribuição para as questões que serão desenvolvidas(AU)

This article deals with the issues that arise in contemporary society, its interference in the school context and how teenagers react to these new times. Considering the scenario of school socialization relatioships, this article aims to analyze the school's participation and its importance in today's society. It is based on the ideas of some contemporary authors, having psychoanalysis as a theoretical framework. According to recent studies in psychoanalysis as a theoretical framework. According to recent studies in psychoanalysis and education interface, one realizes that psychoanalysis can bring great contribution to the issues to be developed(AU)

Multiplicidade de papéis da mulher e os seus efeitos para o bem-estar psicológico

Uma das metas da Psicologia Social tem sido o entendimento dos fatores que afetam o bem-estar psicológico. Muitos estudos em processo do stress social e as conseqüências da multiplicidade de papéis têm sido feitos com o propósito para explicar e prognosticar saúde mental. A teoria social que tem sido confirmada nestes estudos é a teoria da expansão ou teoria da acumulação de papéis, que leva em consideração relacionamentos sociais e de papéis como capazes de beneficiar o enriquecimento do Eu, o tempo e energia necessárias para todas as atividades podem ser expandidas quando as recompensas são mais elevadas que as preocupações, porque neste caso o compromisso também é elevado. A preocupação sobre os efeitos do envolvimento das mulheres em múltiplos papéis começa no momento em que a mulher ingressa em atividades de trabalho não tradicionais. Desta maneira, com o objetivo de analisar este relacionamento entre múltiplos pápeis e bem-estar psicológico, o presente trabalho foi realizado em duas etapas: Na primeira etapa, as escalas de papéis que mensuram recompensas e preocupações em papéis particulares (trabalho pago, mãe) foram validadas. Os dados foram de uma amostra de 519 mulheres; e também foi validado o Questionário de Saúde Geral (QSG-12), que mensura bem-estar psicológico, com uma amostra de 200 pessoas, 78 por cento eram mulheres. Na segunda etapa, um questionário composto com as escalas validadas, e uma escala de satisfação com o casamento foi aplicada a uma nova amostra de 132 mulheres com características sócio-demográficas semelhantes as da primeira amostra. Regressões múltiplas foram feitas entre todas as variáveis e a variável critério, o bem-estar psicológico. Nossos resultados são apoiados por pesquisas anteriores. Eles mostram que as recompensas a partir de autonomia no trabalho e autoridade de decisão predizem as medidas de bem-estar psicológico para todas as mulheres e satisfação com o casamento predizem para todas exceto para mulheres com elevado status socioeconômico e mulheres com mais de 39 anos. Os dados obtidos podem servir de base para novas pesquisas ou para promover dentro da sociedade a necessidade para criar melhores condições para trabalho pago e mãe, o que ajudará na prevenção de saúde mental e diminuição de depressão. Para futuras pesquisas, é recomendado levar em consideração variáveis de suporte social(AU)