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1.
Prosthes. Esthet. Sci ; 8(31): 54-62, abr./mai./jun. 2019.
Artigo em Português | BBO - Odontologia | ID: biblio-1016200

RESUMO

A era digital da odontologia e as ferramentas disponíveis no mercado para o planejamento de casos clínicos proporcionam novas possibilidades de diagnóstico e de plano de tratamento. Com isso, é possível o planejamento dos diversos casos clínicos digitalmente, permitindo um workflow no qual as diversas áreas da odontologia podem interagir, proporcionando para o paciente e os clínicos melhor prognóstico, maior agilidade e precisão nos diversos procedimentos, sendo eles menos invasivos; ou até mesmo tratamento mais complexos dentro das diversas áreas da odontologia como a ortodontia, periodontia, cirurgias, procedimentos restaurativos ou protéticos. Este artigo relata um caso clínico realizado com fluxo digital e aborda alguns temas referentes ao passado, presente e futuro da era digital na odontologia. (AU).


The digital era of dentistry and the tools available in the market provide new possibilities for clinical planning, diagnosis, and treatment plan. These permit to plan the various clinical cases digitally, allowing a workflow in which the different áreas of dentistry can Interact. Their implementation can lead to two desired outcomes. First, better diagnosis for patients and clinicians, more expedited diagnoses, and more precise procedures. Second, less invasive procedures within complex treatments in orthodontics, periodontics, surgery, and dental restoration. This article Will report a clinical case carried out with digital flow and Will address some issues related to the past, present, and future of the digital age in dentistry.


Assuntos
Humanos , Masculino , Adulto , Prostodontia , Tecnologia Odontológica , Estética Dentária
2.
J Mech Behav Biomed Mater ; 100: 103366, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31422314

RESUMO

This study evaluated the MMP inhibition of the zinc oxide and copper nanoparticles (ZnO/CuNp), and the effects of their addition into adhesives on antimicrobial activity (AMA), ultimate tensile strength (UTS), in vitro degree of conversion (in vitro-DC), as well as, resin-dentin bond strength (µTBS), nanoleakage (NL) and in situ-DC on caries-affected dentin. Anti-MMP activity was evaluated for several MMPs. ZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added into Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. UTS were tested after 24 h and 28d. After induced caries, adhesives and composite were applied to flat dentin surfaces, and specimens were sectioned to obtain resin-dentin sticks. µTBS, NL, in vitro-DC and in situ-DC were evaluated after 24 h. ANOVA and Tukey's test were applied (α = 0.05). ZnO/CuNp demonstrated anti-MMP activity (p < 0.05). The addition of ZnO/CuNp increased AMA and UTS (AMB; p < 0.05). UTS for PBA, in vitro-DC, in situ-DC and µTBS for both adhesives were maintained with ZnO/CuNp (p > 0.05). However, lower NL was observed for ZnO/CuNp groups (p < 0.05). The addition of ZnO/CuNp in adhesives may be an alternative to provide antimicrobial, anti-MMP activities and improves the integrity of the hybrid layer on caries-affected dentin.

3.
J Dent ; 82: 45-55, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30738850

RESUMO

OBJECTIVES: To evaluate the effect of addition of zinc oxide and copper nanoparticles (ZnO/CuNp) into universal adhesives, on antimicrobial activity (AMA), cytotoxicity (CTX), water sorption (WS) and solubility (SO), microhardness (MH) and in vitro degree of conversion (DC), as well as resin-dentin microtensile bond strength (µTBS), nanoleakage (NL) and in situ DC. METHODS: ZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added in Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. For CTX, Saos-2 cell-line was used. For WS and SO, specimens were tested for 28d. For MH, specimens were tested after 24 h and 28d and for in vitro DC, specimens were evaluated after 24 h. After, the adhesives were applied to flat dentine surfaces, composite resin build-ups, specimens were sectioned to obtain resin-dentine sticks. It was evaluated in µTBS, NL and in situ DC after 24 h of water storage. ANOVA and Tukey's test were applied (α = 0.05). RESULTS: The addition of 5/0.2 ZnO/CuNp increase AMA and WS, but decrease the SO when compared to control (p < 0.05). The CTX and µTBS were maintaining with adhesive-containing ZnO/CuNp (p > 0.05). MH, in vitro DC and in situ DC was significant increase (AMB) or maintaining (PBA) with ZnO/CuNp addition. However, significantly lower NL was observed for ZnO/CuNp groups (p < 0.05). CONCLUSIONS: The addition of ZnO/CuNp in the tested concentrations in universal adhesive systems may be an alternative to provide antimicrobial activity and improves the integrity of the hybrid layer, without jeopardizing biological, adhesives and mechanical properties. SIGNIFICANCE: This is the first study that demonstrates that the addition of zinc oxide and copper nanoparticles in concentrations up to 5/0.2 wt% in two universal adhesive systems is a feasible approach and may be an alternative to adhesive interfaces with antimicrobial properties and less defects in the resin-dentin interface.

4.
Cien Saude Colet ; 23(12): 4259-4268, 2018 Dec.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30540009

RESUMO

The Plenary of the National Health Council (CNS) approved the Resolution 568/2017, convening the 16th National Health Conference to be held in 2019 and decided to promote thematic activities in eight areas, including Pharmaceutical Policy and Science and Technology. CNS partnership with FIOCRUZ and the National School of Pharmacists proposed the 8th National Symposium on Science and Technology and Pharmaceutical Policy, preceded by ten regional preparatory meetings for the symposium throughout the country. The purpose of this article is to present and analyze the results of the first stage of meetings. A participatory methodology was developed for the meetings that included the presentation of problem situations reported in the form of "cases" built by real narratives, fictitious or adapted from reality. Debates in groups and proposals construction, compilation and weighting, with general discussion completed the meetings. The set of 150 proposals from the 5 meetings was read individually by each of the members of the analysis team and pre-categorized. The 5 meetings had a total of 238 participants. Four categories were defined: Health as a right; Consolidation of SUS principles; Adequate and sufficient financing for SUS; Participatory democracy.


Assuntos
Tecnologia Biomédica , Política de Saúde , Programas Nacionais de Saúde/organização & administração , Brasil , Controle de Medicamentos e Entorpecentes , Humanos , Controle Social Formal
6.
Cien Saude Colet ; 23(6): 1937-1949, 2018 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29972501

RESUMO

This article examines pharmaceutical services and access to essential medicines in Brazil during the 30 years since the advent of Brazil's Unified Health System from a comprehensiveness perspective. The following topics are addressed: the "realignment" of pharmaceutical services; human resources in pharmaceutical services; the essential medicines concept; the rational use of medicines; technological advances and drug manufacturing; and ethical regulation. With a strong regulatory focus and a structural framework centered on the National Medicines Policy, the past three decades represent a mixture of progress and setbacks, considering the national complexities of the healthcare system and the political, economic and social changes that have influenced policy and access to medicines, which is a key concern even in the world's richest countries, as the forums of discussion on global health have demonstrated. We show that major steps forward have been taken, highlighting that the recent fiscal austerity measures imposed by the government threaten to seriously undermine social progress.


Assuntos
Indústria Farmacêutica/tendências , Acesso aos Serviços de Saúde/tendências , Programas Nacionais de Saúde/organização & administração , Assistência Farmacêutica/organização & administração , Brasil , Assistência Integral à Saúde/organização & administração , Assistência Integral à Saúde/tendências , Assistência à Saúde/organização & administração , Assistência à Saúde/tendências , Medicamentos Essenciais/provisão & distribução , Saúde Global , Política de Saúde , Humanos , Programas Nacionais de Saúde/tendências , Assistência Farmacêutica/tendências , Política
7.
Ciênc. Saúde Colet ; 23(6): 1937-1949, jun. 2018. tab
Artigo em Português | LILACS-Express | ID: biblio-952651

RESUMO

Resumo Os autores analisam a Assistência Farmacêutica (AF) e o acesso a medicamentos no Brasil na perspectiva do princípio da integralidade nos 30 anos do SUS. A partir da sua inclusão no movimento de reforma sanitária, foram selecionados temas relevantes, incluindo a reorientação da AF, a questão de recursos humanos, o conceito de medicamentos essenciais, o uso apropriado de medicamentos, o desenvolvimento tecnológico e a produção industrial e a regulação ética. Com fortes componentes regulatórios e tendo a política nacional de medicamentos como eixo estruturante, as três décadas do SUS são confrontadas entre avanços e retrocessos, considerando a complexidade nacional, as mudanças políticas, econômicas e sociais que impactaram políticas públicas e o acesso a medicamentos, tema que hoje mostra sua importância mesmo nas economias mais ricas do mundo, a partir de foros de discussão relacionados com Saúde Global. As conquistas ao longo do tempo são destacadas, considerando a preocupação decorrente do regime fiscal que compromete as áreas sociais.


Abstract This article examines pharmaceutical services and access to essential medicines in Brazil during the 30 years since the advent of Brazil's Unified Health System from a comprehensiveness perspective. The following topics are addressed: the "realignment" of pharmaceutical services; human resources in pharmaceutical services; the essential medicines concept; the rational use of medicines; technological advances and drug manufacturing; and ethical regulation. With a strong regulatory focus and a structural framework centered on the National Medicines Policy, the past three decades represent a mixture of progress and setbacks, considering the national complexities of the healthcare system and the political, economic and social changes that have influenced policy and access to medicines, which is a key concern even in the world's richest countries, as the forums of discussion on global health have demonstrated. We show that major steps forward have been taken, highlighting that the recent fiscal austerity measures imposed by the government threaten to seriously undermine social progress.

9.
Vigil. sanit. debate ; 6(2): 3-6, maio 2018.
Artigo em Inglês | LILACS-Express | ID: biblio-916395

RESUMO

Pope Francis' Encyclical Laudato Si', albeit not explicitly, has drawn attention worldwide to the access to medicines as a fundamental human right, as it raises awareness about the current situation of the world and the poor. The reflections set forward by the Encyclical Laudato Si' bring us to the intersections between trade and health care, and how to correctly frame the need for innovation, affordable and accessible health technologies to those in need and how to reach the poorest of the poor. The issues of how to provide access, promote innovation, stimulate reasonable competitive market forces and ensure viable supply are central to the question of how to address Universal Human Rights. Also in this context, intellectual property has gained particular significance with increased attention to new essential medicines for the treatment of diseases of global incidence, including communicable and non-communicable diseases. This article intends to bring elements for a reflection on the debate on universal access to medicines.


A Encíclica Laudato Si' do Papa Francisco, ainda que não explicitamente, chamou a atenção mundial para o acesso aos medicamentos como um direito humano fundamental, quando conscientiza sobre a situação atual do mundo e dos pobres. As reflexões propostas pela Encíclica Laudato Si' nos trazem as interseções entre o comércio e a saúde, como enquadrar corretamente a necessidade de ter tecnologias de saúde inovadoras, acessíveis aos necessitados e como alcançar os mais pobres dos pobres. As questões sobre maneiras de fornecer acesso, promover inovação, estimular forças de mercado competitivas razoáveis e assegurar fornecimento viável são centrais para a questão de como abordar os Direitos Humanos Universais. Também neste contexto, a propriedade intelectual ganhou particular importância com maior atenção a novos medicamentos essenciais para o tratamento de doenças de incidência global, tanto as transmissíveis como as não transmissíveis. Este artigo pretende trazer elementos de reflexão para o debate sobre o acesso universal a medicamentos.

10.
J Health Organ Manag ; 32(2): 321-337, 2018 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-29624133

RESUMO

Purpose The purpose of this paper is to describe and analyze a teleconsultation modality based on a simple telephone call, using either landline or mobile phone, made available to more than two million people. Telecommunication systems are an increasingly common feature in modern healthcare. However, making teleconsultations available to the entire population covered by a public health system is a challenging goal. Design/methodology/approach This retrospective longitudinal observational study analyzed how this modality was used at the primary care level in Galicia, a region in the Northwest of Spain, in 2014 and 2015, focusing on demand, gender and age preferences, rural vs urban population and efficiency. Findings Of 28,472,852 consultations requested in this period, 9.0 percent were telephone consultations. Women requested more telephone consultations (9.9 percent of total consultations) than men (7.7 percent of total consultations). The highest demand occurred for the over 85 age group for both men and women. In both years, 2014 and 2015, the number of telephone consultations per inhabitant was higher in urban (0.53 and 0.69) than in rural areas (0.34 and 0.47). In 10.9 percent of cases, the telephone consultations required further face-to-face consultation. Originality/value Conventional voice telephone calls can efficiently replace conventional face-to-face consultations in primary healthcare in roughly 10 percent of cases. Women are more likely than men to use primary care services in both face-to-face and telephone consultation modalities. Public healthcare systems should consider implementing telephone consultations to deliver their services.


Assuntos
Atenção Primária à Saúde , Consulta Remota/estatística & dados numéricos , Telefone , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distribuição por Sexo , Espanha , Adulto Jovem
12.
Med. UIS ; 30(3): 89-100, sep.-dic. 2017. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-894222

RESUMO

Resumen Introducción: La muerte de un hijo es un proceso complejo y dramático; el equipo de salud describe dificultades para abordar esta situación. Objetivos: Identificar en la literatura científica las principales prácticas de los profesionales en la atención de padres o familiares de un recién nacido que fallece en institución hospitalaria y determinar cuáles facilitan el desarrollo del duelo. Metodología de búsqueda: Revisión integrativa de la literatura científica. 33 artículos superaron la evaluación de calidad metodológica y se incluyeron en la revisión. Resultados: Se identificaron dos tipos de prácticas que los profesionales desarrollan con la familia en duelo: de soporte, por ejemplo facilitar el acercamiento al bebé fallecido y la fotografía postmortem; y de no soporte, por ejemplo la ausencia de consentimiento previo antes de que un grupo de estudiantes presencien un procedimiento específico o asumir actitudes hostiles hacia el paciente. Discusión: Como reportan otros estudios, las prácticas de soporte tienen como base una comunicación veraz, adecuada y permanente entre el profesional y los familiares. Las prácticas de no soporte podrían relacionarse con el estrés de los profesionales, ante el fallecimiento de los pacientes y de las características propias de la formación médica. Conclusiones: Los profesionales desarrollan diversas prácticas en el acompañamiento al familiar doliente, algunas de las cuales brindan un mejor desarrollo del duelo, como las prácticas de soporte. MÉD. UIS. 2017;30(3):89-100.


Abstract Introduction: A child's death is a complex and painful process; the health staff describes difficulties to affront it. Objective: To identify the practices performed by the health staff to tackle the family of a newborn death into the hospital and determine which facilitates the grieving process. Searching methodology: Integrative review of scientific literature. 33 articles surpassed the methodological quality assessment and were included in the review. Results: Two kinds of practices were identified: support practices, such as facilitating the approach to the deceased baby and the postmortem photography; and non-support practices, such as the absence of prior consent before a group of students witness a specific procedure or hostile attitudes towards the patient. Discussion: The support practices are based on a truthful, adequate and ongoing communication between family and staff. On the contrary, the non-support practices are in relation with the high stress professionals are feeling, which come from the nature of the death event and the medical education characteristics. Conclusions: Professionals implement practices in the acompaniment to the suffering family member, some of which allow a better development of the grieving process. MÉD.UIS. 2017;30(3):89-100.

14.
Cien Saude Colet ; 22(8): 2435-2439, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28793061

RESUMO

Within the context of the recently released United Nations Secretary-General´s Report of the High-Level Panel on Access to Medicines, the author reviews issues related to the context and discussions on access to medicines and the conflict between trade and health during the last decades. These issues have been relevant and outstanding in Global Health, especially questioning the current system of innovation, R&D and IP protection. Lessons learned from the HLP Report are highlighted and the need to further discuss and implement concrete actions, as the world has moved from the MDGs to the SDGs, demand strong actions derived from the United Nations and a strong interaction with other key stakeholders. Affordability and unaffordability of new technologies are discussed, making clear that we need to implement bold actions in order to ensure access to medicines as a human right.


Assuntos
Saúde Global , Acesso aos Serviços de Saúde , Preparações Farmacêuticas/provisão & distribução , Tecnologia Biomédica , Política de Saúde , Direitos Humanos , Humanos , Nações Unidas
15.
Ciênc. Saúde Colet ; 22(8): 2435-2439, Ago. 2017.
Artigo em Inglês | LILACS-Express | ID: biblio-890414

RESUMO

Abstract Within the context of the recently released United Nations Secretary-General´s Report of the High-Level Panel on Access to Medicines, the author reviews issues related to the context and discussions on access to medicines and the conflict between trade and health during the last decades. These issues have been relevant and outstanding in Global Health, especially questioning the current system of innovation, R&D and IP protection. Lessons learned from the HLP Report are highlighted and the need to further discuss and implement concrete actions, as the world has moved from the MDGs to the SDGs, demand strong actions derived from the United Nations and a strong interaction with other key stakeholders. Affordability and unaffordability of new technologies are discussed, making clear that we need to implement bold actions in order to ensure access to medicines as a human right.


Resumo No contexto do Relatório do Painel de Alto Nível em acesso a medicamentos do Secretario-Geral das Nações Unidas, relatório recém liberado, o autor revisa questões relacionadas ao contexto e discussões sobre o acesso a medicamentos e o conflito entre saúde e comércio presente nas últimas décadas. Estas questões tem sido relevantes na Saúde Global, em especial questionando o atual sistema de inovação, P&D e proteção da propriedade intelectual. As lições aprendidas do Relatório do Painel de Alto Nível são destacadas e a necessidade de discutir com maior profundidade e implementar ações concretas, com o mundo mudando dos ODMs para os ODSs, exige ações fortes por parte das Nações Unidas e uma forte interação com outros atores chaves. A capacidade de aquisição de novas tecnologias, ou incapacidade, são discutidas, deixando claro que precisamos de implementar ações corajosas para assegurar o acesso a medicamentos como um direito humano.

18.
J Dairy Sci ; 99(5): 3358-3366, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26923043

RESUMO

Five commercial dairy plants were monitored over a 17-mo period to determine the seasonal occurrence of Clostridium spores in streams from the cheesemaking process. Every 2 mo, samples of raw milk (RM), separated cream (SC), pasteurized and standardized vat milk (PSVM), PSVM + lysozyme (PSVM+L), and manufactured cheese aged for 60 to 90 d were processed for analysis. Molecular diversity of the main species identified was determined using repetitive element palindromic PCR. The mean anaerobic spore counts (µ ± SE) were 3.16±0.054, 3.00±0.054, 2.89±0.059, and 2.03±0.054 log10 most probable number/L for RM, PSVM, PSVM+L, and SC, respectively. Although spore counts did not differ between dairy plants, seasonal variation was observed; spore counts of RM, PSVM, and PSVM+L were higher during winter (June to August) and summer (December to February) months, but no seasonal variation was seen in SC counts. The most frequently isolated species was Clostridium tyrobutyricum, ranging from 50 to 58.3% of isolates from milk and cream samples. Clostridium sporogenes was the second most common species identified (16.7-21.1%); Clostridium beijerinckii and Clostridium butyricum were also found, although at lower prevalence (7.9-13.2%). Analysis of the C. tyrobutyricum and C. sporogenes population structure through repetitive element palindromic PCR indicated a high diversity, with unique isolates found in each positive sample. The occurrence of Clostridia spores in incoming streams to cheesemaking was most prominent in the winter and summer seasons, with higher prevalence of C. tyrobutyricum in the months of June and August.


Assuntos
Queijo/microbiologia , Clostridium , Variação Genética , Estações do Ano , Esporos Bacterianos/genética , Esporos Bacterianos/isolamento & purificação , Animais , Clostridium/genética , Clostridium tyrobutyricum/genética , Contagem de Colônia Microbiana , Indústria de Laticínios , Microbiologia de Alimentos , Sequências Repetidas Invertidas , Leite/microbiologia , Reação em Cadeia da Polimerase
20.
Health Aff (Millwood) ; 34(6): 1068, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26056219
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