Acidentes de trabalho: análise epidemiológica dos casos e óbitos notificados em Minas Gerais, entre 2010 e 2019 / Work accidents: epidemiological analysis of cases and deaths reported in Minas Gerais, between 2010 and 2019

Os acidentes de trabalho no Brasil são agravos que, pelo seu expressivo impacto na morbimortalidade da população, são importante problema de saúde pública, sendo, objeto prioritário das ações do Sistema Único de Saúde. O objetivo geral consistiu na análise do perfil dos casos e óbitos, notificados como acidentes de trabalho, em Minas Gerais no período de 2010 a 2019. Metodologicamente tratou-se de estudo transversal descritivo, a partir da análise de dados secundários das fichas de acidente de trabalho do Sistema de Informações de Agravos de Notificações (SINAN) e das declarações de óbito por acidentes de trabalho (Sistema de Informação de Mortalidade ­ SIM). Foram calculadas as incidências e prevalências anuais, intervalos de confiança de 95% e análise espacial por meio de mapas temáticos, utilizando o software SPSS versão 19.0. Resultados: As maiores incidências ocorreram em 2018 e 2019 (1,4 e 1,39, por 1.000 trabalhadores, respectivamente). A maior taxa de mortalidade por AT foi em 2019 (0,07 por 1000 trabalhadores). Em relação a prevalência de AT: segundo Unidade Regional de Saúde (URS) destacaram-se Pirapora e Uberaba (23,9 e 22,6 por 1000 trabalhadores, respectivamente), por área de abrangência de Centro de Referência em Saúde do Trabalhador (CEREST) destacaram-se Poços de Caldas, Betim, Uberaba e Araxá (27,5, 24,5, 22,3 e 20,2 por 1000 trabalhadores, respectivamente). A taxa de mortalidade por AT: segundo URS destacaram-se Uberaba e Governador Valadares (1,1 e 1,0 por 1000 trabalhadores, respectivamente), já em relação aos CERESTs foram Araxá, Betim, Governador Valadares e Uberaba (1,7, 1,4, 1 e 0,9 por 1000 trabalhadores, respectivamente). Na análise municipal destaca-se Brumadinho com taxa de mortalidade de 15,5 por 1000 trabalhadores. Com relação ao perfil sociodemográfico predominaram os casos e óbitos no gênero masculino, na faixa etária de 18 a 39 anos. Negros representaram 52,8% (SINAN) e 54,5% (SIM) dos casos. Em relação a Escolaridade, 36,2% apresentaram o ensino fundamental incompleto (SINAN) e 38,9% ensino médio completo (SIM). A escolaridade apresentou significativo percentual de dados ignorados nos dois sistemas de informação (35,2% e 31%), assim com classificação étnico-racial (30,8% no SINAN e 1,6% no SIM). No SINAN predominaram os acidentes típicos (79,3%), com membros afetados (superior 47,5% e inferior 25,8%). Ocorreram em sua maioria nas instalações do contratante (53,3%), entre trabalhadores registrados com vínculo celetista (67,7%). Quanto a evolução a incapacidade temporária foi a mais frequente (69,8%) e o óbito por AT representou 4,3%. Em 57% dos casos foi emitida Comunicação de Acidente de Trabalho (CAT). Quanto as ocupações foram mais frequentes no SINAN e SIM, respectivamente: Trabalhadores da indústria extrativa e construção civil (17,8% e 17,6%), dos serviços (13,7% e 7,6%), da exploração agropecuária (12,1% e 10,2%) e de funções transversais (9,8% e 29,6%). Já a causa do acidente e causa básica do óbito, foram mais frequentes no SINAN o intervalo CID-10: W20-W49 - Exposição a forças mecânicas inanimadas (31,3%). No SIM foi o V40-V49 Ocupante de um automóvel traumatizado em um acidente de transporte (14,5%). Com concentração em ambos os sistemas, dos acidentes de transporte -V01 a V99, SINAN (19,5%) e SIM (53,1%) dos casos. Constatou-se que os dados sobre os AT estão difusos em vários sistemas. Porém ainda não existe vinculação dos casos entre os mesmos, o que contribui para o subdimensionamento, dificulta o processo de investigação dos AT e compromete a elucidação da real magnitude das estimativas de morbimortalidade relacionadas a ocorrência dos AT. Como produto técnico, foi elaborado um relatório com a caracterização geral do cenário epidemiológico de AT no estado de Minas Gerais e com recomendações dirigidas aos gestores municipais e Secretaria Estadual de Saúde de Minas Gerais e Coordenação-Geral de Saúde do Trabalhador do Ministério da Saúde.

Work accidents in Brazil are injuries that, due to their significant impact on the population's morbidity and mortality, are an important public health problem, being a priority object of the actions of the Unified Health System. The general objective consisted of analyzing the profile of cases and deaths , reported as work accidents, in Minas Gerais from 2010 to 2019. Methodologically, it was a descriptive cross-sectional study, based on the analysis of secondary data from work accident records from the Notifiable Diseases Information System (SINAN) and death certificates due to work accidents (Mortality Information System ­ SIM). Annual incidences and prevalences, 95% confidence intervals and spatial analysis were calculated using thematic maps, using SPSS version 19.0 software. Results: The highest incidences occurred in 2018 and 2019 (1.4 and 1.39, per 1,000 workers, respectively). The highest mortality rate from TA was in 2019 (0.07 per 1000 workers). Regarding the prevalence of TA: according to the Regional Health Unit (URS), Pirapora and Uberaba stood out (23.9 and 22.6 per 1000 workers, respectively), by area covered by the Reference Center for Occupational Health (CEREST ) Poços de Caldas, Betim, Uberaba and Araxá stood out (27.5, 24.5, 22.3 and 20.2 per 1000 workers, respectively). The mortality rate due to AT: according to URS, Uberaba and Governador Valadares stood out (1.1 and 1.0 per 1000 workers, respectively), while in relation to CERESTs they were Araxá, Betim, Governador Valadares and Uberaba (1.7, 1.4, 1 and 0.9 per 1000 workers, respectively). In the municipal analysis, Brumadinho stands out with a mortality rate of 15.5 per 1000 workers. Regarding the sociodemographic profile, cases and deaths predominated in males, aged between 18 and 39 years. Black people represented 52.8% (SINAN) and 54.5% (SIM) of cases. In relation to Education, 36.2% had incomplete primary education (SINAN) and 38.9% completed secondary education (SIM). Education presented a significant percentage of ignored data in both information systems (35.2% and 31%), as well as ethnic-racial classification (30.8% in SINAN and 1.6% in SIM). In SINAN, typical accidents predominated (79.3%), with affected limbs (upper 47.5% and lower 25.8%). They mostly occurred at the contractor's facilities (53.3%), among workers registered with a CLT (67.7%). Regarding evolution, temporary disability was the most frequent (69.8%) and death due to TA represented 4.3%. In 57% of cases, a Work Accident Report (CAT) was issued. The occupations were most frequent in SINAN and SIM, respectively: Workers in the extractive industry and civil construction (17.8% and 17.6%), services (13.7% and 7.6%), agricultural exploration ( 12.1% and 10.2%) and transversal functions (9.8% and 29.6%). As for the cause of the accident and the underlying cause of death, the ICD-10 range: W20- W49 - Exposure to inanimate mechanical forces (31.3%) was more frequent in SINAN. In SIM it was V40-V49 Occupant of a car injured in a transport accident (14.5%). With a concentration in both systems, from transport accidents -V01 to V99, SINAN (19.5%) and SIM (53.1%) of cases. It was found that data on AT are diffuse across several systems. However, there is still no link between the cases, which contributes to undersizing, complicates the process of investigating TAs and compromises the elucidation of the real magnitude of morbidity and mortality estimates related to the occurrence of TAs. As a technical product, a report was prepared with the general characterization of the TA epidemiological scenario in the state of Minas Gerais and with recommendations addressed to municipal managers and the State Health Department of Minas Gerais and the General Coordination of Workers' Health of the Ministry of Health.

Flavonoids: biological activities and therapeutic potential.

Flavonoids have aroused much interest in research, since they present a great diversity of biological activities observed in vitro, such as: antioxidant effect, modulation of the enzymatic activity and inhibition of cellular proliferation, exerting beneficial effects on the organism, as well as the use of its therapeutic potential. With wide distribution in the plant kingdom represent a class of phenolic compounds that differ in their chemical structure and particular characteristics. The objective of this review was to describe the relevant aspects of flavonoids, reporting the different known groups, the probable mechanisms by which they act, their pharmacological properties and to gain a better understanding of the reported beneficial health effects of these substances. This systematic review consisted of research using scientific databases such as Scopus, Science Direct, PubMed, SciVerse and SciELO, without time limitation. Some pharmacological properties of some flavonoids and their health benefits have been confirmed by previous studies.

CONHECIMENTO SOBRE BEIJO NA BOCA DE ADOLESCENTES DE UM GRUPO DE ESCOLAS PRIVADAS DE NOVA IGUAÇU/RIO DE JANEIRO ­ ESTUDO PILOTO / KNOWLEDGE ABOUT KISSING IN THE MOUTH OF ADOLESCENTS FROM A GROUP OF PRIVATE SCHOOLS IN NOVA IGUAÇU / RIO DE JANEIRO - PILOT STUDY

Objetivo: Descrever os conhecimentos sobre o beijo na boca e sua possibilidade de transmissão de doenças infecciosas em um grupo de adolescentes de escolas privadas de Nova Iguaçu/Rio de Janeiro, através deste estudo piloto. Metodologia: Estudo seccional em que foi aplicado um roteiro de perguntas semi-estruturado autoaplicável em adolescentes (de 18 e 19 anos) de ambos os gêneros, pertencentes a três escolas da rede de ensino privado do município de Nova Iguaçu no Estado do Rio de Janeiro. Resultados: De um total de 100 adolescentes que participaram deste estudo, mais da metade eram solteiros e do gênero feminino (61%), apenas estudantes como ocupação (88% do total) e 96% já haviam beijado na boca. A amostra selecionada demonstrou características próprias, com a alta frequência do conhecimento da possibilidade de transmissão de doenças infecciosas pelo beijo na boca e saliva (71%), que possivelmente se confirmou pela baixa ocorrência de lesões após o ato do beijo e pela observação da boca do parceiro antes de beijar. Conclusão: A pratica do beijo na boca e o sexo oral devem ser temáticas consideradas na assistência fornecida a adolescentes. O uso de estratégias preventivas e o acesso às redes sociais podem contribuir para a redução de situações de risco advindos de situações de vulnerabilidade.

Aim: To describe the knowledge about the kiss on the mouth and its possibility of transmission of infectious diseases in a group of adolescents from private schools in Nova Iguaçu / Rio de Janeiro, through this pilot study. Methodology: Cross-sectional study in which a self-administered semi-structured question script was applied to adolescents (18 and 19 years) of both genders, belonging to three schools of the private school system of Nova Iguaçu, Rio de Janeiro State. Results: Of a total of 100 adolescents who participated in this study, more than half were single and female (61%), only students as occupation (88% of the total) and 96% had already kissed the mouth. The selected sample demonstrated its own characteristics, with the high frequency of the knowledge of the possibility of transmission of infectious diseases by kissing in the mouth and saliva (71%), which was possibly confirmed by the low occurrence of lesions after the kiss and the observation of the mouth. of the partner before kissing. Conclusion: The practice of kissing on the mouth and oral sex should be thematic considered in the care provided to adolescents. The use of preventive strategies and access to social networks can contribute to the reduction of risk situations arising from vulnerability situations. Keywords: mouth, infectious diseases, adolescent (s), health education, strategies and oral health

Mixed methods evaluation explains bypassing of vouchers in micronutrient powder trial in Mozambique.

Micronutrient powders (MNP) are recommended by the World Health Organization as an effective intervention to address anaemia in children. A formative process evaluation was conducted to assess the viability of a model using free vouchers in two districts of Mozambique to deliver MNP and motivate adherence to recommendations regarding its use. The evaluation consisted of (a) an examination of programme outcomes using a cross-sectional survey among caregivers of children 6-23 months (n = 1,028) and (b) an ethnographic study to investigate delivery experiences and MNP use from caregiver perspectives (n = 59), programme managers (n = 17), and programme implementers (n = 168). Using a mixed methods approach allowed exploration of unexpected programme outcomes and triangulation of findings. The survey revealed that receiving a voucher was the main implementation bottleneck. Although few caregivers received vouchers (11.5%, CI [9.7, 13.6]), one-fourth received MNP by bypassing the voucher system (26.3%, CI [23.6, 29.0]). Caregivers' narratives indicated that caregivers were motivated to redeem vouchers but encountered obstacles, including not knowing where or how to redeem them or finding MNP were not available at the shop. Observing these challenges, many programme implementers redeemed vouchers and distributed MNP to caregivers. Virtually, all caregivers who received MNP reported ever feeding it to their child. This study's findings are consistent with other studies across a range of contexts suggesting that although programmes are generally effective in motivating initial use, more attention is required to improve access to MNP and support continued use.

Standardized extract of Erythrina velutina Willd. attenuates schizophrenia-Like behaviours and oxidative parameters in experimental animal models.

OBJECTIVES: To study the effects of the standardized extract from the leaves of Erythrina velutina in behavioural and oxidative parameters in the ketamine-induced schizophrenia model. METHODS: Mice received ketamine (KET) or saline for 7 days. From 8th to 14th day, the animals received Erythrine (Eryt) (100, 200 or 400 mg/kg) or olanzapine (Olanz), 1 h after KET administration. At 14th day, 30 min after the last administration of KET, the open-field and pre-pulse inhibition (PPI) tests were performed. Then, the animals were sacrificed and the prefrontal cortex (PFC), hippocampus (HC) and striatum (ST) were dissected for the oxidative tests. KEY FINDINGS: Ketamine increased spontaneous locomotor activity and grooming. KET decreased the PPI, which was reversed by combining it with Eryt or olanzapine. KET decreased GSH concentration in PFC and ST this was reversed by Eryt. KET increased MDA concentration in PFC and HC this was reversed by Eryt. Eryt and Olanzapine reduced MDA concentration in ST when compared to KET group. Nitrite concentration was reduced by administration of KET in the PFC. CONCLUSIONS: These results demonstrate that the standardized extract of E. velutina can prevent behavioural symptoms and oxidative stress induced by repeated doses of KET.

Ethanolic extract of Erythrina velutina Willd ameliorate schizophrenia-like behavior induced by ketamine in mice.

Background Schizophrenia is a chronic mental disorder, characterized by positive, negative and cognitive symptoms. In general, several plants have shown activity in diseases related to the central nervous system (e.g., Erythrina velutina (EEEV), also known as "mulungu"). For this reason, we aimed to investigate the effects of standardized ethanol extract obtained from the stem bark of EEEV on the schizophrenia-like behaviors induced by ketamine (KET) administration. Methods Swiss mice were treated with KET (20 mg/kg, i.p.) or saline for 14 days. In addition, from 8th to 14th days, saline, EEEV (200 or 400 mg/kg, p.o.) or olanzapine (OLAN 2 mg/kg, p.o.) were associated to the protocol. On the 14th day of treatment, schizophrenia-like symptoms were evaluated by the prepulse inhibition of the startle reflex (PPI), locomotor activity evaluated by the open field test (OFT), spatial recognition memory evaluated by the Y-maze task and social interaction test (SIT). Results KET has caused deficits in PPI, and it has also has caused hyperlocomotion in OFT and deficits in SIT as compared to control. EEEV in both doses used, reversed behavioral changes induced by KET, likewise results obtained with the administration of OLAN. Conclusions Taken together, the results demonstrate that the standard extract of EEEV was able to revert schizophrenia-like symptoms, due to the administration in repeated doses of ketamine. Thus, our findings lead to a new perspective for the use of EEEV an interesting alternative for drug discovery in schizophrenia.

Estudo por analisador de gases do Teste de Caminhada de seis minutos na insuficiência cardíaca com fração de ejeção normal / Study with a portable gas analyzer of the 6-minutes walk test in heart failure with normal ejection fraction

Background: Few studies have used portable gas analyzers during the 6-minute walk test (6MWT) in patients with heart failure and normal ejection fraction (HFNEF). Objectives: To analyze the kinetics of hemodynamic, ventilatory, and metabolic variables in patients with HFNEF during the T6m using a portable gas analyzer. Methods: Prospective, analytical study with an intentional, non-probabilistic, convenience sample. In total, 24 patients with HFNEF and past hospital admissions due to a clinical diagnosis of heart failure (HF) were included using the 2007 criteria established by the European Society of Cardiology. Three assessments were performed: 6MWT familiarization, 6MWT with the portable gas analyzer, and cardiopulmonary exercise test (CPET). Results: The heart rates (HRs) and the peak VO 2 at the end of the 6MWT corresponded to 85.7% and 86.45% of the values obtained during the CPET. The final HRs after the T6m were equivalent to those obtained at the CPET anaerobic threshold (AT), with relative VO 2 values at the end of the 6MWT above the VO 2 of the CPET AT. There was no difference between the maximum respiratory quotient (RQ) values in these two tests, which were both above 1.0. The VE/VO 2 slope descended initially and then ascended significantly after the fifth minute of the test, estimating the identification of the AT. Conclusions: In patients with HFNEF, the 6MWT represents an almost maximum effort, and is performed above the CPET AT and 85% above the maximum HR and the CPET peak VO 2 , with a maximum RQ similar to that in the CPET

Fundamentos: Poucos estudos utilizaram analisadores de gases portáteis no teste da caminhada de seis minutos (T6m) em portadores de insuficiência cardíaca com fração de ejeção normal (ICFEN). Objetivos: Analisar a cinética das variáveis hemodinâmicas, ventilatórias e metabólicas utilizando analisador de gases portátil em portadores de ICFEN durante o T6m. Métodos: Estudo prospectivo, analítico, com amostra não probabilística, intencional e por conveniência. Foram estudados 24 pacientes portadores de ICFEN com passado de internação por clínica de insuficiência cardíaca (IC), incluídos pelos critérios da European Society of Cardiology 2007. Realizaram-se três avaliações: T6m de aprendizado, T6m com o analisador de gases portátil e teste de esforço cardiopulmonar (TECP). Resultados: As frequências cardíacas (FC) e o consumo de oxigênio (VO 2 ) pico ao final do T6m corresponderam a 85,7% e 86,45% dos valores obtidos no TECP. As FC finais no T6m foram equivalentes às obtidas no limiar anaeróbio (LA) do TECP, com valores de VO 2 relativo ao final do T6m acima do VO 2 no LA do TECP. Não houve diferença entre os valores máximos do quociente respiratório (QR) entre os dois testes, ambos acima de 1,0. A curva de VE/VO 2 demonstrou descenso com posterior ascensão significativa após o quinto minuto de teste, estimando-se a identificação do LA. Conclusões: Para pacientes com ICFEN, o T6m representa um esforço quase máximo, sendo executado acima do LA do TECP e acima dos 85% da FC máxima e do VO 2 pico do TECP, com QR máximo semelhante ao do TECP

Influence of custom adaptation on the characteristics of fiber posts.

In this in vitro study, 3 experiments were conducted to evaluate the influence of customizing the apical portion on the characteristics of fiber posts. In the first experiment, 4 fiber posts were submitted to different custom adaptations (no customization, industrial shaping tool, diamond bur, or paper disc) and were observed with a scanning electron microscope to evaluate the micromorphologic changes. In the second experiment, 60 posts of different sizes were divided into 6 groups (n = 10): 0 (No. 0.5), 1 (No. 1), 2 (No. 2), 3 (No. 3), 4 (No. 4), and 5 (paper disc-remodeled No. 4). The posts were submitted to a 3-point bending test. In the third experiment, the crowns of 20 extracted, healthy permanent human canines were removed, and the teeth were endodontically treated, embedded in acrylic resin, and divided into 2 groups (n = 10): I (control), No. 4 posts cemented into post spaces prepared with a No. 4 drill; and II (test), remodeled No. 4 posts cemented into root spaces prepared with No. 2 and 4 drills. The posts were cemented with self-adhesive dual resin cement, and the specimens received direct resin crowns. Fracture strength was measured with a universal testing machine at 45 degrees until fracture. Results were submitted to analysis of variance (P ≤ 0.05). Customization of fiber posts with diamond burs or paper discs produced acceptable micromorphologic changes. Custom adaptation of fiber posts reduced their flexural strength, which remained at acceptable values. Teeth restored with customized fiber posts had greater fracture strength than those restored with intact posts. The results of this study indicated that post remodeling is a safe means to facilitate adaptation to root walls and preserve tooth structure.

Cardiotoxicidade Decorrente do Tratamento com Doxorrubicina e Exercício Físico: Revisão Sistemática / Cardiotoxicity of Doxorubicin Treatment and Physical Activity: A Systematic Review

O presente estudo investigou se a prática de exercícios possui um efeito protetor contra a toxicidade cardíaca decorrente do tratamento com doxorrubicina. Para tal, foi realizada uma revisão sistemática da literatura, de ensaios clínicos randomizados que verificam o exercício como meio de controle ou prevenção da cardiotoxicidade induzida pela utilização de DOX. Foram realizadas buscas nas bases de dados MEDLINE e LILACS. Foram utilizados os descritores: exercício, condicionamento físico, antraciclinas, doxorrubicina, adriamicina, agentes cardiotóxicos. Para seleção dos trabalhos que se incluíam nos critérios estabelecidos, foram avaliados os resumos de todos os artigos. Foram excluídos estudos que não abordaram o tema central da pesquisa, não se referiram ao exercício físico ou a DOX, abordaram exclusivamente outros tipos de toxicidade por antraciclinas (muscular, hepática e renal), ou verificaram outros efeitos do exercício sobre toxicidade da DOX (fadiga). O presente estudo observou, com relação às variáveis relacionadas à prescrição de exercício, que a frequência não apresentou relação direta com os resultados dos referidos estudos. A intensidade também não foi definitiva para a preservação da função cardíaca, porém o treinamento mais intenso esteve relacionado com melhoras no sistema antioxidante que não esteve presente em alguns estudos com intensidades mais baixas. Não houve diferença significativa nos efeitos dos exercícios quando realizados antes, durante ou depois do tratamento. Portanto, exercício aeróbio parece exercer um efeito protetor das funções cardíacas se realizado antes, durante ou depois do tratamento com DOX. Porém, os mecanismos associados a esse efeito ainda são desconhecidos

Effect of Non-Thermal Argon Plasma on Bond Strength of a Self-Etch Adhesive System to NaOCl-Treated Dentin.

Studies have been showing a decrease of bond strength in dentin treated with sodium hypochlorite (NaOCl). The aim of this study was to evaluate the effect of non-thermal argon plasma on the bond strength of a self-etch adhesive system to dentin exposed to NaOCl. Thirty-two flat dentin surfaces of bovine incisors were immersed in 2.5% NaOCl for 30 min to simulate the irrigation step during endodontic treatment. The specimens were divided into four groups (n=8), according to the surface treatment: Control (without plasma treatment), AR15 (argon plasma for 15 s), AR30 (argon plasma for 30 s) and AR45 (argon plasma for 45 s). For microtensile bond strength test, 5 specimens were used per group. In each group, the specimens were hybridized with a self-etch adhesive system (Clearfil SE Bond) and resin composite buildups were constructed. After 48 h of water storage, specimens were sectioned into sticks (5 per tooth, 25 per group) and subjected to microtensile bond strength test (µTBS) until failure, evaluating failure mode. Three specimens per group were analyzed under FTIR spectroscopy to verify the chemical modifications produced in dentin. µTBS data were analyzed using ANOVA and Tamhane tests (p<0.05). AR30 showed the highest µTBS (20.86±9.0). AR15 (13.81±6.4) and AR45 (11.51±6.8) were statistically similar to control (13.67±8.1). FTIR spectroscopy showed that argon plasma treatment produced chemical modifications in dentin. In conclusion, non-thermal argon plasma treatment for 30 s produced chemical changes in dentin and improved the µTBs of Clearfil SE Bond to NaOCl-treated dentin.

Effect of Non-Thermal Argon Plasma on Bond Strength of a Self-Etch Adhesive System to NaOCl-Treated Dentin

Abstract Studies have been showing a decrease of bond strength in dentin treated with sodium hypochlorite (NaOCl). The aim of this study was to evaluate the effect of non-thermal argon plasma on the bond strength of a self-etch adhesive system to dentin exposed to NaOCl. Thirty-two flat dentin surfaces of bovine incisors were immersed in 2.5% NaOCl for 30 min to simulate the irrigation step during endodontic treatment. The specimens were divided into four groups (n=8), according to the surface treatment: Control (without plasma treatment), AR15 (argon plasma for 15 s), AR30 (argon plasma for 30 s) and AR45 (argon plasma for 45 s). For microtensile bond strength test, 5 specimens were used per group. In each group, the specimens were hybridized with a self-etch adhesive system (Clearfil SE Bond) and resin composite buildups were constructed. After 48 h of water storage, specimens were sectioned into sticks (5 per tooth, 25 per group) and subjected to microtensile bond strength test (μTBS) until failure, evaluating failure mode. Three specimens per group were analyzed under FTIR spectroscopy to verify the chemical modifications produced in dentin. μTBS data were analyzed using ANOVA and Tamhane tests (p<0.05). AR30 showed the highest μTBS (20.86±9.0). AR15 (13.81±6.4) and AR45 (11.51±6.8) were statistically similar to control (13.67±8.1). FTIR spectroscopy showed that argon plasma treatment produced chemical modifications in dentin. In conclusion, non-thermal argon plasma treatment for 30 s produced chemical changes in dentin and improved the μTBs of Clearfil SE Bond to NaOCl-treated dentin.

Resumo Estudos vêm demonstrando uma diminuição na resistência adesiva em dentina tratada com hipoclorito de sódio (NaOCl). O objetivo desse estudo foi avaliar o efeito do plasma de argônio não-térmico na resistência de união de um sistema adesivo autocondicionante à dentina exposta ao NaOCl. Trinta e duas superfícies dentinárias lisas de incisivos bovinos foram imersas em NaOCl a 2,5% por 30 min para simular o passo de irrigação durante o tratamento endodôntico. Os espécimes foram divididos em 4 grupos (n=8), de acordo com o tratamento de superfície: Controle (sem tratamento de plasma), AR15 (plasma de argônio por 15 s), AR30 (plasma de argônio por 30 s) e AR45 (plasma de argônio por 45 s). Para teste de resistência de união por microtração, cinco espécimes foram utilizadas por grupo. Em cada grupo, os espécimes foram hibridizados com um sistema adesivo autocondicionante (Clearfil SE Bond, Kuraray) e blocos de resina composta foram construídos. Após 48 h de armazenamento em água, os espécimes foram seccionados em palitos (5 por dente - 25 por grupo) e submetidos ao teste de resistência de união por microtração (μTBS) até a fratura, avaliando o padrão de fratura. Três amostras por grupo foram analisadas sob espectroscopia por FTIR para verificar as modificações químicas produzidas pelos tratamentos na dentina. Os dados de microtração foram avaliados estatisticamente utilizando os testes de ANOVA e Tamhane (p<0,05). AR30 apresentou o maior μTBS (20,86±9,0). AR15 (13,81±6,4) e AR45 (11,51±6,8) foram estatisticamente semelhantes ao controle (13,67±8,1). A espectroscopia por FTIR mostrou que o tratamento de plasma produziu modificações químicas na dentina. Como conclusão, o tratamento de plasma de argônio não-térmico por 30 s produziu alterações químicas na dentina e melhorou o μTBS do Clearfil SE Bond à dentina tratada com NaOCl.

Reestabelecendo a estética com restauração de resina composta anterior / Reestablishing aesthetics with composite resin anterior restorations

O traumatismo dentário é uma das principais causas de perda de estrutura dentária em jovens por etiologia não bacteriana. Esse tipo de lesão acomete comumente elementos anteriores. A abordagem conservadora desses casos, quando possível, é a colagem de fragmento, mas quando não houver essa possibilidade é necessária a reabilitação com compósitos resinosos. O presente trabalho descreve a substituição de uma restauração em resina composta que se apresenta pigmentada no elemento 21, que havia sido fraturado por trauma durante a adolescência(AU)

Dental trauma is major causes of tooth structure loss in young patients, which is not related to bacterial ethiology. This type of lesion occurs more commonly in anterior teeth. Tooth fragment reattachment is a conservative approach to these cases, whenever it is possible. When this option is not feasible, composite resin restoration may be indicated. This article presents the replacement of a discolored composite restoration in tooth # 21, which has been fractured by trauma when the patient was a teenager(AU)

Amálgama dental e seu papel na Odontologia atual / Dental amalgam and its role in current dentistry

O Amálgama de Prata (AP) é um material restaurador consagrado pelo uso na Odontologia. Embora nos últimos anos tenha havido uma procura maior pelas restaurações estéticas, ao se considerar aspectos inerentes à eficácia, eficiência, custo e efetividade, particularmente em Saúde Pública, o AP, quando indicado, permanece como material de eleição para restaurações posteriores intracoronárias. Há uma tendência mundial de banir o uso do AP devido à toxicidade do mercúrio para o ambiente e para a saúde humana, mas não existem evidências científicas sobre isto. De concreto, há necessidade de realizar o gerenciamento de resíduos químicos de AP. Sendo assim, o objetivo deste estudo é revisar na literatura sobre o gerenciamento de resíduos do AP e colaborar nesta orientação, propondo um guia.

The Silver Amalgam (SA) is a restorative material established by custom in dentistry. Although in recent years there has been a greater demand for esthetic restorations, when considering issues related to the effectiveness, efficiency, cost-effectiveness, particularly in Public Health, the SA, when indicated, remains the material of choice for intra-coronary posterior restorations. There is a global trend to ban the use of SA due to the toxicity of mercury to the environment and to human health, but have no scientific evidence of this. Specifically, there is need for the management of chemical waste SA. Thus, the aim of this study is to review the literature on the SA waste management and collaborate in this direction by proposing a guide.

Properties evaluation of silorane, low-shrinkage, non-flowable and flowable resin-based composites in dentistry.

Purpose. This study tested the null hypothesis that different classes of direct restorative dental materials: silorane-based resin, low-shrinkage and conventional (non-flowable and flowable) resin-based composite (RBC) do not differ from each other with regard to polymerization shrinkage, depth of cure or microhardness. Methods. 140 RBC samples were fabricated and tested by one calibrated operator. Polymerization shrinkage was measured using a gas pycnometer both before and immediately after curing with 36 J/cm(2) light energy density. Depth of cure was determined, using a penetrometer and the Knoop microhardness was tested from the top surface to a depth of 5 mm. Results. Considering polymerization shrinkage, the authors found significant differences (p < 0.05) between different materials: non-flowable RBCs showed lower values compared to flowable RBCs, with the silorane-based resin presenting the smallest shrinkage. The low shrinkage flowable composite performed similarly to non-flowable with significant statistical differences compared to the two other flowable RBCs. Regarding to depth of cure, low-shrinkage flowable RBC, were most effective compared to other groups. Microhardness was generally higher for the non-flowable vs. flowable RBCs (p < 0.05). However, the values for low-shrinkage flowable did not differ significantly from those of non-flowable, but were significantly higher than those of the other flowable RBCs. Clinical Significance. RBCs have undergone many modifications as they have evolved and represent the most relevant restorative materials in today's dental practice. This study of low-shrinkage RBCs, conventional RBCs (non-flowable and flowable) and silorane-based composite-by in vitro evaluation of volumetric shrinkage, depth of cure and microhardness-reveals that although filler content is an important determinant of polymerization shrinkage, it is not the only variable that affects properties of materials that were tested in this study.

Dental bleaching agents with calcium and their effects on enamel microhardness and morphology

Aim: To evaluate enamel microhardness and morphology after bleaching with hydrogen peroxide containing calcium in different concentrations. Methods: One hundred specimens of human teeth were ground and polished and had the initial microhardness evaluated. The specimens were randomly assigned into five groups (n=20): Group 1 - Control group (no treatment); Group 2 - Home Peroxide 6% (without calcium); Group 3 - Home Peroxide 7.5% (without calcium); Group 4 - White Class 6% (with calcium); Group 5 - White Class 7.5% (with calcium). For each group, the bleaching was performed according to the manufacturer's specifications. The specimens were bleached once a day for 5 days and subjected to pH cycling. Microhardness and scanning electron microscopy (SEM) analysis were performed before and after bleaching. Results: The results showed that groups submitted to bleaching treatment presented hardness loss compared to the control group. The group of 7.5% hydrogen peroxide with calcium showed a lower percentage of hardness loss in relation to other groups. Conclusion: Calcium in association with a higher hydrogen peroxide concentration may decrease microhardness changes on enamel.

Surface roughness of different composite resins subject to in-office bleaching.

This study used atomic force microscopy to evaluate the effects of an in-office dental bleaching protocol on the surface roughness of 3 resins: microfilled, microhybrid, and nanofilled. Two disks of each resin were prepared and evaluated. Twenty-four areas (5 x 5 µm) were scanned using an atomic force microscope. Then, each disk was treated with 35% hydrogen peroxide activated by a light emitting diode. After bleaching, the disks were scanned again. Data from the 24 areas before and after bleaching were evaluated qualitatively using topographical and 3-dimensional images, as well as profile lines. Quantitatively, roughness data (mean roughness and root mean square) were statistically evaluated using standard ANOVA and Student-Newman-Keuls tests (P < 0.05). The bleaching procedure increased roughness for each resin analyzed. Based on the results, it was concluded that in-office bleaching with 35% hydrogen peroxide-based gel significantly increased the surface roughness of microfilled, microhybrid, and nanofilled resins.

Complicações da sífilis congênita: uma revisão de literatura / Complications of congenital syphilis: a review of the literature

A sífilis congênita ocorre após infecção transplacentária, através do agente Treponema pallidum. As consequências da ausência do tratamento do recém-nascido podem acarretar sequelas irreversíveis, como surdez, cegueira e retardo mental. O estudo teve como objetivo realizar uma revisão bibliográfica atualizada sobre as complicações da sífilis congênita. Trata-se de estudo descritivo e bibliográfico. A coleta de dados foi realizada através de levantamento bibliográfico nas bases de dados LILACS, MEDLINE e SciELO, no período de março a junho de 2012, usando os descritores: sífilis congênita, complicações, recém-nascido e enfermagem. A seleção dos artigos foi realizada através da leitura do resumo relacionado com sífilis congênita, sífilis congênita e complicação, sífilis congênita e tratamento, sífilis. Resultados mostram que a contaminação do feto se dá devido à falha no pré-natal.

Teste de esforco cardiopulmonar na insuficiencia cardiaca de fracao de ejecao normal / Cardiopulmonary stress testing in heart failure with normal ejection fraction / La prueba de esfuerzo cardiopulmonar en la insuficiencia cardiaca de fraccion de eyeccion normal

INTRODUÇÃO: O teste de esforço cardiopulmonar (TECP) fornece dados que orientam tratamento, prognóstico e tomadas de decisões. Entretanto, seu uso na insuficiência cardíaca de fração de ejeção normal (ICFEN) ainda não está bem esclarecido, em especial considerando novas variáveis que vêm despontando. OBJETIVOS: Comparar o comportamento das principais variáveis diagnósticas e prognósticas do TECP entre dois grupos: pacientes com insuficiência cardíaca de fração de ejeção reduzida (ICFER) e pacientes com ICFEN. MÉTODOS: Foram avaliados 36 pacientes com insuficiência cardíaca em classe funcional II-III da NYAH: 20 com ICFEN e 16 com ICFER do ambulatório de insuficiência cardíaca do Hospital Universitário Antônio Pedro (UFF). Os pacientes do Grupo ICFER selecionados foram os com FE < 35% e os do grupo ICFEN seguiram os critérios diagnósticos da Sociedade Europeia de Cardiologia de 2007. Realizou-se TECP, em esteira com protocolo de rampa, com analisador de gases VO2000. Foram aplicados teste t de Student, Mann-Whitney, teste de Fisher, modelo linear generalizado e de Cochran-Mantel-Haenszel para as análises estatísticas. RESULTADOS: O grupo ICFEN apresentou níveis mais elevados da pressão arterial em repouso, na resposta ao esforço, na potência circulatória e ventilatória, além de um maior tempo de recuperação da cinética do consumo de oxigênio. Não houve diferença em relação a outras variáveis prognósticas do TECP para o grupo ICFER. CONCLUSÕES: A pressão arterial de repouso e em esforço, a potência circulatória e ventilatória e a cinética de recuperação do VO2 (T1/2) foram as variáveis que apresentaram maior ...

INTRODUCTION: The cardiopulmonary exercise testing (CPX) provides data that guide treatment, prognosis and decision making. However its use in heart failure with normal ejection fraction (HFnEF) is still not all clear, especially considering new variables that are emerging. OBJECTIVE: To compare the behavior of key diagnostic and prognostic variables of CPX testing between two groups; patients with heart with reduced ejection fraction of (HfrEF) and those with HFnEF). METHODS: 36 patients with heart failure were evaluated in Nyah functional class II-III: 20 with HFnEF and 16 patients with HFrEF at the Hospital Universitário Antônio Pedro (UFF). The patients from HFrEF group were those with EF<35%, and those from the HFnEF group follow the diagnostic criteria of the European Society of Cardiology 2007. CPX was performed on a treadmill with a ramp protocol, with gas analyzer VO2000. The Student t test, Mann-Whitney test and Fisher, generalized linear model and the Cochran-Mantel-Haenszel test for statistical analysis were applied. RESULTS: The HFnEF group presented higher levels of blood pressure at rest, higher response to exertion, higher circulatory and ventilatory power, and longer recovery kinetics of oxygen uptake. There was no difference in relation to other prognostic variables of CPX in the HFrEF group. CONCLUSIONS: The blood pressure at rest and during exercise, the circulatory and ventilatory capacity and the kinetics of VO2 (T1/2), were the variables that showed the highest discriminative value between the two populations by CPX. .

INTRODUCCIÓN: La prueba de esfuerzo cardiopulmonar (PECP) suministra datos que orientan tratamiento, pronóstico y tomas de decisiones. No obstante, su uso en la insuficiencia cardíaca de fracción de eyección normal (ICFEN) todavía no está bien aclarado, en especial, considerando nuevas variables que vienen apareciendo. OBJETIVOS: Comparar el comportamiento de las variables principales de diagnóstico y de pronóstico de la PECP, entre dos grupos: pacientes con insuficiencia cardíaca de fracción de eyección reducida (ICFER) y pacientes con ICFEN. MÉTODOS: Se evaluaron 36 pacientes con insuficiencia cardíaca en clase funcional II-III de la NYAH: 20 con ICFEN y 16 con ICFER del dispensario de insuficiencia cardíaca del Hospital Universitário Antonio Pedro (UFF). Los pacientes del grupo ICFER fueron seleccionados con FE <35% y el grupo ICFEN siguieron los diagnósticos de la Sociedad Europea de Cardiología 2007 criterios. Se realizó la PECP, en estera con regulador de rampa, con analizador de gases VO2000. Se aplicaron las pruebas t de Student, Mann-Whitney, prueba de Fisher, modelo linear generalizado y de Cochran-Mantel-Haenszel para los análisis estadísticos. RESULTADOS: El grupo ICFEN presentó niveles más altos de presión arterial en reposo, en la respuesta al esfuerzo, en las potencias circulatoria y ventilatoria, además de un tempo más prolongado de recuperación de la cinética del consumo de oxígeno. No hubo diferencia en relación con otras variables de pronóstico de la PECP para el grupo ICFER. CONCLUSIONES: La presión arterial de reposo y en esfuerzo, las potencias circulatoria y ventilatoria y la cinética de recuperación del VO2 (T1/2) fueron las variables que presentaron más valor discriminativo entre los grupos según la PECP. .