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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 3-8, maio-ago. 2021. graf
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1252889

RESUMO

Dentes necrosados com rizogêneze incompleta representam um desafio para os endodontistas e odontopediatras, visto que as paredes radiculares desses dentes são mais finas, o que as tornam mais susceptíveis a fraturas. Durante muitos anos a técnica preconizada foi a apicificação que ainda é bastante utilizada. Nesta técnica são realizadas trocas constantes de medicação intracanal. O dente continua fragilizado e existe o risco do paciente não concluir o tratamento já que tal técnica demanda várias sessões clínicas. Com os avanços da ciência, surge a revascularização pulpar, trazendo vários beneficíos, entre os quais estão a continuidade apical e o ganho de espessura das paredes, além do benefício de conclusão do tratamento em uma ou duas sessões. Entretanto é necessária sua proservação que leva em média dois anos. O objetivo desta pesquisa foi avaliar o nível de conhecimento dos odontopediatras e endodontistas do município de Ilhéus-Bahia, frente a casos de necrose pulpar de dentes com formação radicular incompleta. O método e forma de análise de dados foram de um estudo observacional, transversal, realizado em consultórios do município de Ilhéus-BA que foram selecionados por amostragem aleatória. Os dados foram coletados por meio de um questionário contendo 10 questões de múltipla escolha sobre revascularização pulpar, especialização do profissional e tempo de formação. 20 profissionais aceitaram participar da pesquisa. Desses, 10% não sabiam ou nunca tinham ouvido falar sobre a revascularização pulpar. Conclui-se que ainda existem especialistas no Município de Ilhéus-BA que apresentam conhecimento insuficiente sobre a terapia endodôntica regenerativa, sendo que os mesmos deveriam ter conhecimento desta técnica já que são os profissionais que prestam o atendimento ao paciente jovem com dentes necrosados, reforçando a necessidade de elaboração de estratégia de conscientização e educação de saúde para habilitação e atualização dos mesmos(AU)


Necrotic teeth with incomplete rizogenesis representa challenge for endodontists and pediatric dentists, since the root walls of these teeth are thinner, which makes them more susceptible to fractures. For many years the recommended technique was apexification, which is still widely used. In this technique, constant changes of intracanal medication are performed. The tooth remains fragile and there is a risk that the patient will not complete the treatment as this technique requires several clinical sessions. With advances in science, pulp revascularization appears, bringing several benefits, among which are the apical continuity and the gain in thickness of the walls, in addition to the benefit of completing the treatment in one or two sessions. However, its preservation is necessary, which takes on average two years. The objective of this research was to evaluate the level of knowledge of pediatric dentists and endodontists in the municipality of Ilhéus-Bahia, in the face of cases of pulp necrosis of teeth with incomplete root formation. The method and form of data analysis were from an observational, cross-sectional study, carried out in offices in the municipality of Ilheus-BA that were selected by random sampling. Data were collected through a questionnaire containing 10 multiple-choice questions about pulp revascularization, professional specialization and training time. 20 professionals agreed to participate in the research. Of these, 10% did not know or had never heard of pulp revascularization. It is concluded that there are still specialists in the municipality of Ilhéus-BA who have insufficient knowledge about regenerative endodontic therapy, and they should have knowledge of this technique since they are the professionals who provide care to young patients with necrotic teeth, reinforcing the need to develop a health awareness and education strategy to enable and update them(AU)


Assuntos
Humanos , Masculino , Feminino , Necrose da Polpa Dentária , Conhecimentos, Atitudes e Prática em Saúde , Necrose da Polpa Dentária/terapia , Conhecimento , Odontólogos , Endodontistas , Endodontia Regenerativa
2.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 9-17, maio-ago. 2021. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1252898

RESUMO

As reabsorções radiculares são classificadas em interna e externa e um correto diagnóstico é fundamental para o sucesso no tratamento e é de suma importância que a resolução clínica seja feita precocemente para que se tenha um prognóstico clínico favorável. Reabsorção interna não é comum em dentes permanentes, e seu processo se caracteriza por um aumento do canal radicular de forma oval. O presente estudo teve como objetivos demonstrar e descrever através de um relato de prontuário o tratamento de reabsorção radicular interna de incisivos superiores permanentes. Através da seleção de uma paciente pela disciplina de Triagem da clínica odontológica do Centro Universitário da Serra Gaúcha, a qual apresentou alterações radiográficas compatíveis com reabsorção radicular interna inflamatória na região de dois incisivos superiores permanentes, com lesão periapical estabelecida em ambos, concluiu-se o tratamento para então gerar este estudo do tipo retrospectivo observacional. A reabsorção quando não tratada pode avançar e envolver estruturas além do tecido conjuntivo inflamado e a lesão pode avançar em direção apical. Após estabelecido o diagnóstico, iniciou-se os tratamentos endodônticos dos elementos utilizando hidróxido de cálcio como medicação intracanal, após as trocas de medicações as reabsorções foram controladas e então, as obturações dos canais foram realizadas, buscando um preenchimento adequado para o caso. A reabsorção radicular interna inflamatória causa danos irreversíveis, mas seu processo foi controlado através de terapia endodôntica. Este desempenho é considerado uma patologia, e pode comprometer qualquer extensão da raiz, é comum que os casos permaneçam assintomáticos, portanto, deve ser tratado o mais breve possível assim que descobertos para evitar sua progressão, e consequentemente danos maiores(AU)


Root resorption is classified as either internal or external, and a correct diagnosis is essential for successful treatment. Internal resorption is not common in permanent teeth, and its process is characterized by an enlarged oval root canal. The present study aims to demonstrate and describe, through a medical record, the treatment of internal root resorption of permanent upper incisors. A patient was selected from the Triage Course of the Dental Clinic (Centro Universitário da Serra Gaúcha) who presented radiographic changes associated with inflammatory internal root resorption in two permanente upper incisors, with a periapical lesion established in both and a treatment was then carried out in order to generate this retrospective observational study. Resorption when left untreated can progress and involve structures beyond the inflamed connective tissue and the lesion can advance in the apical direction. After the diagnosis was confirmed, endodontic treatments were initiated using calcium hydroxide as an intracanal medication. After changing the medication, the resorption was controlled and then the canal fillings were performed, seeking an adequate filling for the case. Inflammatory internal root resorption causes irreversible damage, but its process has been controlled through endodontic therapy. This performance is considered a pathology, and can compromise any extension of the root, it is common for the cases to remain asymptomatic, therefore, it should be treated as soon as it's discovered to prevent its progression, and consequently greater damage(AU)


Assuntos
Humanos , Feminino , Adulto , Tratamento do Canal Radicular , Reabsorção da Raiz , Reabsorção da Raiz/terapia , Incisivo , Hidróxido de Cálcio , Dentição Permanente , Dente não Vital , Cavidade Pulpar
3.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 30-34, maio-ago. 2021. tab, graf
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1252909

RESUMO

Dentre as principais consequências da fissura labial e/ou palatina não sindrômica (FL/ PNS) estão dificuldades com fonação e autoestima, a primeira uma questão funcional e a segunda um problema social derivado não raro de contextos de bullying que, dentre outros, podem levar o indivíduo à evasão escolar. O objetivo deste estudo foi avaliar o atraso de escolaridade e a dificuldade de socialização de pacientes com FL/PNS quando comparados a uma população não afetada da mesma faixa etária de 7 a 20 anos, atendidos na Universidade José do Rosário Vellano ­UNIFENAS, campus de Alfenas. Os sujeitos foram agrupados em duas categorias de indivíduos, o grupo caso composto por indivíduos com FL/PNS em tratamento no Centro Pró-Sorriso da UNIFENAS; e o grupo controle composto por indivíduos sem FL/PNS em tratamento nas clínicas de Odontopediatria e Integrada da UNIFENAS. Os resultados demonstraram que a proporção de pacientes com FL/PNS atrasados na escola foi de quase 5 vezes maior que o número de pacientes sem fissuras (p<0,01). Constatou-se que a presença da FL/PNS pode ser o ponto de partida para outros contribuintes, com interferências psicológicas e/ou sociais, interferindo negativamente no processo de socialização (bullying) do paciente (p=0,0018). Portanto devem ser tratadas com abordagem multidisciplinar, incluindo diversos profissionais, dentre eles pedagogos, psicólogos e odontólogos(AU)


Among the main consequences of Non Syndromic Cleft Lip and Palate (NSCLP) are the difficulties with phonation and self estime, the first being a functional issue na the later being social that is derived from, not rarely, bullying contexts, that among other things, may lead na individual to school evasion. The objective of this study was to avaluate the levels of scholarity of patients with NSCLP when compared to a non affected population of the same age in individuals from 7 to 20 years old, attended the Pediatric and Integrated Pediatric Clinic of UNIFENAS, Alfenas campus. The subjects were grouped into two categories of individuals, the case group was composed of individuals with FL/PNS with treatment at the ProSmile center at UNIFENAS. The control group was composed of individuals without FL/PNS in treatment at the clinics of pediatric and integrated denistry at UNIFENAS. The results demonstrated the number of patients with FL/PNS that presented scholar delay were almost 5 times the number of patients that didn't present FL/PNS (p<0,01). The presence of NFL/PNS may be the starting point for other contributors with psychological and/or social interferences, interfering negatively with the socialization process (bullying) of the patient (p=0,0018). They should be treated with a multidisciplinary manner, including multiple professionals, among them pedagogues, psychologist and dentist(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Evasão Escolar , Fenda Labial , Fissura Palatina , Bullying , Fonação , Socialização
4.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. tab, graf
Artigo em Inglês | LILACS, CUMED | ID: biblio-1252328

RESUMO

Hepatitis B infection is one of the most important health problems around the world. The high mortality rate of the hepatitis B encouraged research that led to the finding of an effective vaccine against it. The aim of the present study was to find out the use of the Euvax-B vaccine in sectors of Nineveh province. According to the results obtained in this study, in the next five years, the vaccination coverage for the second and third doses needs to improve(AU)


La infección por hepatitis B es uno de los más importantes problemas de salud del mundo. La alta tasa de mortalidad de la hepatitis B impulsó las investigaciones que llevaron a encontrar una vacuna eficaz contra la misma. El objetivo del presente estudio fue conocer el uso de la vacuna Euvax-B en sectores de la provincia de Nínive. De acuerdo con los resultados obtenidos, en los próximos cinco años, se debe incrementar la cobertura de inmunización de la segunda y tercera dosis de la vacuna(AU)


Assuntos
Humanos , Masculino , Feminino , Vacinas contra Hepatite B , Infecções por Hepadnaviridae , Hepatite B/mortalidade , Antígenos de Superfície da Hepatite B , Iraque
5.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252327

RESUMO

La gastroenteritis causada por rotavirus constituye un importante problema de salud mundial, por lo que se recomienda incluir la vacunación contra el rotavirus en los programas de inmunización. Para evaluar el impacto de una futura introducción en Cuba de una vacuna contra este patógeno, resulta necesario crear una línea de base pre-vacunación de la carga de la gastroenteritis causada por este virus. Entre noviembre 2017 a abril 2018 se implementó en el Hospital Pediátrico de Centro Habana un sistema de vigilancia para la gastroenteritis causada por rotavirus. Se establecieron las definiciones para las categorías de caso sospechoso, probable y confirmado. Por cada niño captado se recogió una muestra de heces que se analizó con tiras rápidas y se confirmó la presencia de rotavirus por ELISA. Para determinar la severidad de la enfermedad se utilizó la escala de Vesikari. Los resultados fueron expresados en cifras absolutas y relativas, el análisis se realizó a través de la prueba de chi-cuadrado. Del total de ingresos por enfermedad diarreica aguda, el 26 por ciento cumplió los criterios de inclusión y el 46 por ciento resultó confirmado como rotavirus. El hacinamiento en el hogar y asistir al círculo infantil se comportaron como factores de riesgo. El servicio de gastroenterología absorbió la mayor carga de ingresos hospitalarios por esta causa. Los resultados mostrados validan la funcionalidad del sistema de vigilancia implementado y brindan nuevas evidencias sobre la carga de la enfermedad y la utilización de los servicios de un hospital pediátrico cubano, debido a la gastroenteritis provocada por rotavirus, lo que justifica la introducción de la vacuna(AU)


Gastroenteritis caused by rotavirus is a major global health problem, therefore it is recommended that vaccination against rotavirus be included in immunization programs. To evaluate the impact of a future introduction in Cuba of a vaccine against this pathogen, it is necessary to have a pre-vaccination baseline of the burden of gastroenteritis caused by rotavirus. Between November 2017 and April 2018, a surveillance system for gastroenteritis caused by rotavirus was implemented in the Paediatric Hospital of Centro Habana. Definitions were established for the categories of suspected, probable and confirmed cases. For each captured child, stool samples were collected, analyzed with rapid strips and confirmated by ELISA. To determine the severity of the disease, the Vesikari score was used. The results were expressed in absolute and relative figures; the analysis was performed through chi-square. Of the total admissions for acute diarrheal disease, 26 percent met the inclusion criteria and 46 percent were confirmed for rotavirus. Overcrowding at home and attending a day care center were risk factors. The gastroenterology service absorbed the greatest burden of hospital admissions for this cause. The results shown validate the role of the implemented surveillance system and provide new evidence on the burden of disease and use of services for rotavirus gastroenteritis in a cuban pediatric hospital(AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Infecções por Rotavirus/prevenção & controle , Fatores de Risco , Vacinas contra Rotavirus , Diarreia/etiologia , Gastroenterite/epidemiologia , Epidemiologia Descritiva , Estudos Prospectivos , Cuba , Estudos Observacionais como Assunto
6.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252326

RESUMO

Este reporte corresponde al análisis de la calidad de vida de los pacientes que se incluyeron en el ensayo clínico fase III de evaluación de la vacuna CIMAvaxEGF® en cáncer de pulmón de células no pequeñas. La calidad de vida se evaluó empleando los cuestionarios EORTC QLQ-C30 y QLQ-C13, al inicio y cada 3 meses hasta el fallecimiento del paciente a criterio del investigador. Para comparar las medianas entre los dos grupos se utilizó la prueba no paramétrica de Mann-Whitney. Las comparaciones entre el nivel basal y los diferentes tiempos de seguimiento se realizaron a través de la prueba no paramétrica de Wilcoxon. El cuestionario QLQ-C30 evidenció un beneficio en cuanto a calidad de vida para el grupo vacunado con la vacuna CIMAvaxEGF® en las escalas funcionales (global, rol y social), en las escalas de síntomas de la enfermedad y del tratamiento (dolor) se observó que mejora la calidad de los mismos a favor de los pacientes tratados con la vacuna CIMAvaxEGF®. El cuestionario QLQ-C13, también evidenció ventajas para el grupo vacunado desde el punto de vista de beneficio clínico en los síntomas (disnea, disfagia, alopecia y dolor en el pecho). Se señala como significativo que disminuye la hemoptisis y la tos en el grupo vacunado, observándose un empeoramiento en el grupo control(AU)


This report corresponds to quality of life analysis of patient with non-small cell lung cancer included in the phase III clinical trials Evaluation of CIMAvaxEGF® vaccine in lung cancer. The quality of life was evaluate using the EORTC questionnaires QLQ-C30 y QLQ-C13, at the beginning and every 3 months. To compare the median between two groups the Mann-Whitney non-parametric test was used. To compare the baseline and different follows times the Wilcoxon non-parametric test was used. The QLQ-C30 questionnaire showed a benefit in terms of the quality of life for the CIMAvaxEGF® vaccine group on the functional scores (global, role and social) and symptoms of the disease (pain). The QLQ-LC13 questionnaire showed a benefit in terms of the quality of life for the CIMAvaxEGF® vaccine group on the symptoms scores (dyspnea, dysphagia, alopecia and chest pain). It is noted as significant that the hemoptysis decreases in the group vaccinated as well as the dysphagia, the cough and the dyspnea observing a worsening in the control group(AU)


Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Inquéritos e Questionários , Ensaios Clínicos Fase III como Assunto , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Vacinas Anticâncer
7.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1252323

RESUMO

En diciembre de 2019 en Wuhan, provincia China de Hubei, se notificó un caso de neumonía de etiología desconocida. Con posterioridad se diagnosticó como un síndrome agudo respiratorio severo (SARS, por sus siglas en inglés) causado por un coronavirus denominado SARS-CoV-2.1 A principios de marzo de 2020, la Organización Mundial de la Salud (OMS) notificó casi 100.000 casos positivos y 3.880 víctimas mortales en 47 países, convirtiéndose en pandemia la enfermedad COVID-19 que ha afectado al mundo hasta la actualidad.2 La pandemia de la COVID-19 ha tenido un gran impacto en la vida de las personas y la sociedad en su conjunto y ha causado perjuicios a la economía mundial, afectándose sectores como turismo, recreación, viajes internacionales, educación, entre otros. Para la salud humana, ha tenido repercusión en términos de enfermedad, discapacidad y elevado número de muertes, así como en las complejas interrogantes impuestas a la ciencia para contener el impacto de la misma. La implementación de una estrategia dirigida a mitigar la dispersión de la enfermedad incluye numerosas acciones de salud pública, entre ellas: la higiene de las manos, el uso extendido y obligatorio de la mascarilla, el distanciamiento social y la vacunación.3 Una vacuna contra la COVID-19, esperada ansiosamente por el mundo, debe ser una vacuna segura y eficaz que permita poder reanudar un estilo de vida normal, libre de las medidas de restricción recomendadas y que evite que se saturen los servicios de salud. La carrera por la invención y desarrollo de una vacuna contra la COVID-19 no tiene precedentes en la era moderna y ha comprometido como nunca antes a la ciencia, llevando a la movilización e intercambio de datos en un período muy corto; a la coordinación acelerada, a nivel mundial, de los procesos regulatorios para el desarrollo de vacunas y fármacos; así como a la creación de marcos de colaboración internacional donde se incluyen, junto a la OMS, la Alianza Global para las Vacunas (GAVI), la Coalición para la Promoción de Innovaciones en pro de la Preparación ante Epidemias (CEPI) y el Fondo de Acceso Global para Vacunas COVID-19 (COVAX, por su siglas en inglés).4 El proceso de desarrollar un nuevo producto farmacéutico es caro e implica una inversión considerable de tiempo. Como promedio, se precisan 10 años desde el momento en que se descubre una molécula hasta que se comercializa el producto, con un costo de millones de dólares. Acortar los tiempos de este proceso es de los retos más importantes, donde la etapa de desarrollo clínico es la que se ve más presionada en todo momento.1 El desarrollo clínico de una vacuna implica un número de fases por las que debe transcurrir el producto farmacéutico. En el caso particular de las vacunas contra la COVID-19, las fases se han ido llevando a cabo simultáneamente, bajo aprobaciones rápidas. Varias vacunas ya han recibido autorizaciones para el uso de emergencia y se están utilizando para inmunizar a las personas.5) Desafortunadamente, acortar el tiempo para que las vacunas estén disponibles, puede conllevar a problemas éticos relacionados con la investigación, el desarrollo y aquellos que se puedan presentar en las etapas de distribución y acceso equitativo a las mismas.6 Para que la investigación en seres humanos que sea éticamente justificada, debe haber un balance favorable de beneficios para el sujeto y la sociedad, sobre los riesgos a los que el individuo se expone. Entre los dilemas éticos a los que se enfrentan los investigadores, uno de los más complejos en el caso de las vacunas contra la COVID-19, es el empleo de grupo control o placebo en los estudios clínicos, si tenemos en cuenta que esta es una enfermedad nueva, con limitaciones de las opciones de tratamiento y de elevada mortalidad, todo lo cual implica un alto riesgo para este grupo. Según el diseño del estudio, los participantes incluidos en el grupo placebo podrían infectarse en dependencia del tiempo de permanencia en dicho grupo, la tasa de transmisión local donde se realiza el ensayo clínico y las medidas preventivas adoptadas por cada uno de los participantes.7 Uno de los escenarios que puede afrontar el investigador cuando se usa placebo, es que el tratamiento (fármaco o vacuna) resulte efectivo, entonces, una parte de los participantes perdería la oportunidad de recibir ese beneficio, lo cual nos llevaría a decidir que todos los voluntarios reciban la profilaxis y sacrificar el conocimiento y valor social que aportan los estudios con grupos placebo.8) Actualmente, algunos desarrolladores de vacunas han esbozado la obligación ética de ofrecer la vacuna a participantes que hayan recibido placebo en los ensayos clínicos, para que queden protegidos contra la COVID- 19 y, además, para la contribución a la investigación.8 Otro tema de discusión global y que compete a la bioética relacionada a las vacunas contra la COVID-19, es la distribución justa dentro de una población una vez que las vacunas están disponibles en el mercado. ¿Qué criterios deben utilizarse? ¿Qué personas deben recibirla primero dentro de una población? ¿Quiénes tienen prioridad, y por qué? Es un criterio general entre los especialistas, que el personal de salud que se encuentra en la primera línea de batalla contra la COVID-19, debe ser el primero en acceder a la vacuna, lo cual previene el daño directo e indirecto a los mismos, al prevenir la propagación del SARS-CoV-2 en las instalaciones médicas, protegiendo de este modo a los grupos de pacientes que acuden con mayor frecuencia a los hospitales con diagnóstico de cáncer o con tratamiento de hemodiálisis.6 La crisis sanitaria mundial causada por el SARS-CoV-2 no tiene precedentes y el acceso a la vacuna se ha mostrado difícil desde el inicio. Es un hecho que los países desarrollados se han apresurado desde antes de la comercialización a adquirir y contratar cantidades suficientes de la vacuna para su población, siendo entonces el panorama aún más sombrío para los países de bajos ingresos.6 Debido a la pandemia, las operaciones logísticas de las vacunas también se ven afectadas por lo que se convierten en obstáculos para garantizar la distribución mundial de manera coordinada e interconectada (fabricación, distribución de la cadena de suministro, cadena de frío, almacenamiento, etc.). De ahí, el llamado constante de la OMS a lograr y mantener el compromiso de los gobiernos a garantizar un acceso equitativo y a colaborar en planes multinacionales como COVAX, CEPI y GAVI para asegurar la fabricación y distribución de vacunas contra la COVID-19.4 Con el fin de hacer el bien para todos y ante la premura de obtener resultados terapéuticos eficaces para enfrentar y mitigar la pandemia, no se deben sacrificar las normas científicas, la integridad y trasparencia del proceso de revisión de las vacunas y se debe cumplir con los principios éticos fundamentales que se exigen en las investigaciones en humanos(AU)


Assuntos
Humanos , Masculino , Feminino , Ética , Vacinas contra COVID-19/uso terapêutico
8.
Med. intensiva (Madr., Ed. impr.) ; 45(5): 289-297, jun.-jul. 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-186896

RESUMO

Objetivo: Describir las características y la evolución de los pacientes con bronquiolitis ingresados en una unidad de cuidados intensivos pediátricos. Comparar el tratamiento administrado pre y pospublicación de la guía de práctica clínica de la Academia Americana de Pediatría. Diseño: Estudio descriptivo y observacional realizado entre septiembre de 2010 y septiembre de 2017. Configuración: Unidad de cuidados intensivos pediátricos. Pacientes: Menores de un año con bronquiolitis grave. Intervenciones: Se compararon 2 períodos (2010-14 y 2015-17), antes y después de la modificación del protocolo de manejo de la bronquiolitis en el hospital, según las guías de la Academia Americana de Pediatría. Principales variables: Sexo, edad, comorbilidades, gravedad, etiología, tratamiento administrado, infecciones bacterianas, soporte respiratorio e inotrópico, estancia y mortalidad. Resultados: Se recogieron 706 pacientes, 414 (58,6%) varones, con una mediana de edad de 47 días (RIC 25-100,25). Mediana de escala de gravedad de bronquiolitis (BROSJOD) al ingreso: 9 puntos (RIC 7-11). La etiología por virus respiratorio sincitial se dio en 460 (65,16%) pacientes. El primer período (2010-14) incluyó 340 pacientes y el segundo (2015-17), 366 pacientes. En el segundo período se administraron más nebulizaciones de adrenalina y suero salino hipertónico, y más tratamiento con corticoides. Se usó más ventilación no invasiva y menos ventilación mecánica convencional y precisaron menos soporte inotrópico, sin diferencias significativas. La tasa de antibioterapia disminuyó de forma estadísticamente significativa (p = 0,003). Conclusiones: Pese a la disminución en la antibioterapia, se debería limitar la utilización de nebulizaciones y corticoides en estos pacientes, como recomienda la guía


Objective: To describe the characteristics and evolution of patients with bronchiolitis admitted to a pediatric intensive care unit, and compare treatment pre- and post-publication of the American Academy of Pediatrics clinical practice guide. Design: A descriptive and observational study was carried out between September 2010 and September 2017. Setting: Pediatric intensive care unit. Patients: Infants under one year of age with severe bronchiolitis. Interventions: Two periods were compared (2010-14 and 2015-17), corresponding to before and after modification of the American Academy of Pediatrics guidelines for the management of bronchiolitis in hospital. Main variables: Patient sex, age, comorbidities, severity, etiology, administered treatment, bacterial infections, respiratory and inotropic support, length of stay and mortality. Results: A total of 706 patients were enrolled, of which 414 (58.6%) males, with a median age of 47 days (IQR 25-100.25). Median bronchiolitis severity score (BROSJOD) upon admission: 9 points (IQR 7-11). Respiratory syncytial virus appeared in 460 (65.16%) patients. The first period (2010-14) included 340 patients and the second period (2015-17) 366 patients. More adrenalin and hypertonic saline nebulizations and more corticosteroid treatment were administered in the second period. More noninvasive ventilation and less conventional mechanical ventilation were used, and less inotropic support was needed, with no significant differences. The antibiotherapy rate decreased significantly (P = .003). Conclusions: Despite the decrease in antibiotherapy, the use of nebulizations and glucocorticoids in these patients should be limited, as recommended by the guide


Assuntos
Humanos , Masculino , Feminino , Lactente , Bronquiolite/terapia , Guias de Prática Clínica como Assunto , Tomada de Decisão Clínica , Doença Aguda/terapia , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Academias e Institutos/normas , Infecções por Vírus Respiratório Sincicial/etiologia , Insuficiência Respiratória/etiologia , Estudos Retrospectivos , Algoritmos
9.
Eur. j. psychol. appl. legal context (Internet) ; 13(1): 1-7, ene.-jun. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-201543

RESUMO

Sexual double standard (SDS) involves evaluating the same sexual behaviors in men and women using different criteria. The support for man-favorable SDS is related to sexual aggression and sexual victimization. Yet to date, studies have not examined the prevalence of SDS adherence. This study aims to identify the prevalence per gender and age of the Spanish population who adheres to the SDS typologies (man-favorable, woman-favorable, egalitarian, ambivalent) by considering sexual freedom and sexual shyness areas. A sample of 2,002 Spanish heterosexual adults (50% men, 50% women), distributed into four age groups (18-25, 26-35, 36-55 and over 55 years old), answered the Sexual Double Standard Scale. The results showed differences in the prevalence of SDS typologies by gender and age. By gender, a higher prevalence of the man-favorable typology was observed in men and a higher prevalence of the egalitarian typology and the woman-favorable typology was observed in women. By age groups, significant differences in man-favorable and woman-favorable typologies were found in both men and women. Based on the evidence of four adherence to SDS typologies, it is recommended studying the relation of these typologies with sexual aggression/victimization to design more efficient programs for prevention and intervention of sexual violence


El doble estándar sexual (DES) consiste en evaluar los mismos comportamientos sexuales en hombres y mujeres usando diferentes criterios. El apoyo al DES favorable al hombre está relacionado con la agresión y la victimización sexual. Sin embargo, hasta la fecha, los estudios no han examinado la prevalencia de la adhesión al DES. Este estudio pretende identificar la prevalencia por género y edad de la población española que se adhiere a las tipologías de DES (favorable al hombre, favorable a la mujer, igualitaria, ambivalente) considerando los ámbitos de la libertad sexual y del recato sexual. Una muestra de 2.002 adultos heterosexuales españoles (50% hombres, 50% mujeres), distribuidos en cuatro grupos de edad (18-25, 26-35, 36-55 y más de 55 años), respondió a la Sexual Double Standard Scale. Los resultados mostraron diferencias en la prevalencia de las tipologías de DES por género y edad. Por género se observó una mayor prevalencia de la tipología favorable al hombre en los hombres y una mayor prevalencia de la tipología igualitaria y la tipología favorable a la mujer en las mujeres. Por grupos de edad se encontraron diferencias significativas en las tipologías favorable al hombre y favorable a la mujer, tanto en hombres como en mujeres. De acuerdo con la evidencia de las cuatro tipologías de adhesión al DES, se recomienda estudiar la relación de estas tipologías con la agresión/victimización sexual para diseñar programas más eficientes de prevención de la violencia sexual e intervención en la misma


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Sexualidade/psicologia , Estereotipagem de Gênero , 57445 , Identidade de Gênero , Biotipologia , Sexismo/psicologia , Feminismo , Androcentrismo , Poder Psicológico , Empoderamento para a Saúde/psicologia
10.
Eur. j. psychol. appl. legal context (Internet) ; 13(1): 9-19, ene.-jun. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-201544

RESUMO

Cognitive Credibility Assessment (CCA) is a verbal lie detection tool consisting of several interview techniques. These techniques have been examined separately but never together. Reflecting the dynamic nature of CCA we combined several of the techniques (free recall followed by a model statement, followed by a reverse order instruction, and followed by a sketch instruction). We examined the new information provided after each stage of the interview and also compared the information provided in the initial recall with the information provided after the entire interview. A total of 47 truth tellers and 47 lie tellers went on a mission. Truth tellers were asked to report their mission truthfully, whereas lie tellers were requested to lie about several aspects of the mission. We measured the total units of information (total details) provided in the interview and the number of complications reported. The results indicate that the pre-registered hypothesis (Hypothesis 1) was supported for complications. Truth tellers reported more complications than lie tellers in each stage of the interview and the difference was more pronounced after the entire interview than after the free recall. As a conclusion, CCA was an effective lie detection method when complications were taken into account


La evaluación cognitiva de la credibilidad (ECC) es una herramienta verbal de detección de mentiras que incluye varias técnicas de entrevista. Dichas técnicas se han examinado por separado pero nunca juntas. Para reflejar el carácter dinámico de la ECC combinamos varias de las técnicas (recuerdo libre seguido de una declaración tipo, seguido de una instrucción de recuerdo en orden inverso, y de una instrucción para que hagan un sketch -esquema- durante la narración del evento). Analizamos la información nueva proporcionada tras cada etapa de la entrevista y también comparamos la información procedente del recuerdo inicial con la aportada por toda la entrevista. Un total de 47 sujetos que decían la verdad y 47 que mentían fueron enviados a una misión. A los participantes de la condición de testimonio verdadero se les pidió que informaran de su misión de modo veraz, mientras que los de la condición de mentira se les solicitó que mintieran sobre distintos aspectos de la misión. Se midió el total de unidades de información (detalles totales) de la entrevista y el número de complicaciones de las que se informaba. Los resultados mostraron que los participantes de la condición de verdad informaban de más detalles y complicaciones (hipótesis 1) en cada fase de la entrevista siendo las mayores diferencias tras la entrevista global que tras el recuerdo libre. En conclusión, la categoría complicaciones de la ECC es eficaz en la detección de la mentira


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Entrevista Psicológica/métodos , Valor Preditivo dos Testes , Revelação da Verdade , Detecção de Mentiras/psicologia , Cognição/classificação , Reprodutibilidade dos Testes , Rememoração Mental/classificação , Estudo de Prova de Conceito
11.
Eur. j. psychol. appl. legal context (Internet) ; 13(1): 21-28, ene.-jun. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-201545

RESUMO

Employees in the healthcare sector are the professionals who are the most exposed to violence. The severity of its consequences makes it necessary to inquire into its effects and associated factors. The objective of this study was to analyze the relationship between violence toward nursing staff and job satisfaction, and to find out the mediating role of social support in this relationship. The sample was made up of 1,357 nurses aged 22 to 58, who were administered the Negative Acts Questionnaire, Healthcare-Workers Aggressive Behaviour Scale-Users, Brief Perceived Social Support Questionnaire, and Overall Job Satisfaction. The results showed that violence and bullying by coworkers, users, family members, or other people accompanying the patient had a direct negative effect on internal and external job satisfaction, and this effect was mediated by perceived social support. These outcomes suggest the need to stimulate a firm healthcare support network to improve nurses' job satisfaction by buffering the adverse effects of workplace violence


Los trabajadores del sector sanitario son los más expuestos a situaciones de violencia laboral. La gravedad de sus consecuencias hace necesario indagar en sus efectos y los factores asociados. El objetivo del presente trabajo fue analizar la relación entre la violencia hacia el personal de enfermería y la satisfacción laboral, así como establecer el papel mediador del apoyo social en esta relación. La muestra estuvo formada por 1,357 profesionales de enfermería de entre 22 y 58 años, a quienes se les administró el Negative Acts Questionnaire, la Healthcare-Workers Aggressive Behaviour Scale-Users, el Brief Perceived Social Support Questionnaire y la Overall Job Satisfaction. Los resultados mostraron que la violencia y acoso por parte de compañeros, usuarios y acompañantes o familiares ejercía un efecto directo negativo sobre la satisfacción laboral interna y externa, siendo este efecto mediado por el apoyo social percibido. Estos resultados muestran la necesidad de estimular una red de apoyo firme en el sector sanitario para mejorar la satisfacción con el trabajo entre los profesionales de enfermería, amortiguando los efectos adversos de la violencia laboral


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Violência no Trabalho/psicologia , Exposição à Violência/psicologia , Enfermeiras e Enfermeiros/psicologia , Esgotamento Profissional/psicologia , Condições de Trabalho , Satisfação no Emprego , Apoio Social , Equipe de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
12.
Eur. j. psychol. appl. legal context (Internet) ; 13(1): 29-36, ene.-jun. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-201546

RESUMO

Drugs are sold on both dark web services and on social media, but research investigating these drug purchases online is still emerging. The aim of this study is to analyze risk factors associated with buying drugs online. Utilizing theories of criminology and addiction research, it was hypothesized that social bonds, low levels of self-control, and poor mental health are associated with buying drugs online. Additionally, it was predicted that purchases of drugs online would mediate the relationship between low self-control and regular drug use. Participants of this nationwide study were 15 to 25 years old living in the United States (N = 1,212) and Spain (N = 1,212). Measures of impulsivity, a sense of mastery, social belonging, psychological distress, excessive behaviors (drinking, gambling and internet use) were utilized to predict purchasing drugs online. Two percent of the U.S. and Spanish respondents reported buying drugs online with 77% of them utilizing social media services to buy drugs. Results from multinomial logistic regression, penalized maximum-likelihood logistic regression, and binary mediation regression models indicated that buying drugs online was associated with lower self-control, higher psychological distress, and excessive gambling behavior and excessive Internet use. Having online friends was not a risk factor, but having strong social bonds with offline friends served as a protective factor. Additionally, buying drugs online mediated the relationship between low self-control and regular use of drugs. Results indicate that more focus should be placed on mainstream social media services as sources of drug acquisition as online drug buyers have multiple self-control and mental health problems


Las drogas se venden en páginas web oscuras y en las redes sociales, aunque la investigación de estas adquisiciones online está aún en sus comienzos. Este estudio tiene como objetivo examinar los factores de riesgo vinculados a la compra de drogas online. De acuerdo con las teorías de la criminología y la investigación sobre adicciones, se planteó la hipótesis de que los vínculos sociales, el bajo nivel de autocontrol y los problemas de salud mental están relacionados con la compra online de drogas. Además, se postuló que la adquisición online de drogas estaría mediada por la relación entre el bajo autocontrol y el consumo frecuente de drogas. Participaron en el estudio un total de 2,424 jóvenes residentes en Estados Unidos (N = 1,212) y en España (N = 1,212), que fueron evaluados en impulsividad, sensación de dominio, pertenencia social, malestar psicológico, comportamientos abusivos (bebida, juego y utilización de internet) , con el objetivo de predecir la compra online de drogas. El 2% de los participantes de EE UU y España dijeron que compraban drogas online, de los cuales el 77% utilizaba servicios de redes sociales para tal fin. Los resultados de una regresión logística multinomial, regresión logística de máxima verosimilitud penalizada y modelos de regresión de mediación binaria mostraron que la adquisición online de drogas se relaciona con un menor autocontrol y un mayor malestar emocional y abuso del juego, y del uso de internet. El hecho de tener amigos por internet no constituía un factor de riesgo y tener vínculos sociales estrechos con amigos fuera de internet constituía un factor protector. A su vez, la compra online de drogas es un factor que media la relación entre bajo autocontrol y uso habitual de drogas. Los resultados sugieren que debería prestarse mayor atención a las redes sociales como medio habitual de adquisición de drogas, dado que los compradores online de drogas tienen múltiples problemas de salud mental y autocontrol


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Tráfico de Drogas/tendências , Comércio Eletrônico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Rede Social , Estados Unidos/epidemiologia , Espanha/epidemiologia , Controle de Medicamentos e Entorpecentes/tendências
14.
Am J Case Rep ; 22: e930026, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34097671

RESUMO

BACKGROUND Calciphylaxis is a rare and lifethreatening syndrome characterized by small vascular calcifications, which lead to the occlusion of blood vessels and painful skin lesions with tissue necrosis. Although the disease can develop in a population without kidney failure, it is typically detected in patients receiving dialysis, with an increasing frequency ranging from 1% to 4%. Therefore, the disease is also known as calcific uremic arteriolopathy. The prognosis in patients with coexisting chronic kidney disease is very poor, with a 1-year mortality rate of up to 80%. Numerous risk factors for calciphylaxis have been described, such as obesity, diabetes mellitus, female sex, White race, overuse of calcium and vitamin D supplements, and vitamin K deficiency. The disease is often accompanied by disorders such as hyperphosphatemia, elevated parathyroid hormone level, and a deficiency of natural calcification inhibitors, such as fetuin-A and matrix Gla protein. However, not all patients with calciphylaxis have the abnormalities described above, suggesting that the pathogenesis of calciphylaxis is multifactorial and unfortunately still uncertain. CASE REPORT We report a case of calciphylaxis in a 52-year-old White woman with multiple comorbidities and on chronic hemodialysis treatment, who presented with severe subcutaneous painful nodules and necrotic ulcers on both legs. CONCLUSIONS Although the prognosis of this rare and underrecognized disease is poor, an early diagnosis and interdisciplinary treatment including pain relief, wound care, appropriate nutritional support, correction of mineral parameters, administration of sodium thiosulphate, and adequate hemodialysis therapy can improve patient quality of life.


Assuntos
Calciofilaxia , Falência Renal Crônica , Calcificação Vascular , Calciofilaxia/complicações , Calciofilaxia/diagnóstico , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Pessoa de Meia-Idade , Qualidade de Vida , Diálise Renal , Calcificação Vascular/complicações
15.
Mol Biol (Mosk) ; 55(3): 412-421, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34097676

RESUMO

Molecular profiling of tumors may provide promising options for personalized treatment. We have examined the spectrum of germline and somatic mutations in 23 breast cancers (ВС) of various molecular subtypes, including tumors 1) with expression of estrogen, progesterone and/or epidermal growth factor receptor HER2/neu, and 2) with a triple negative phenotype. Genomic DNA specimens were isolated from archived tumor and normal tissue samples and subjected to targeted sequencing of the coding regions of 25 cancer-associated genes with a mean coverage of x 1000. In the triple negative subtype of ВС, the pathogenic germline mutations BRCA1 c.66_67delAG (185delAG) and BRCA1 c.3226_3227AG (3347delAG) were detected, while the germline mutation BRCA2 658_659del (886delGT) was found in patients with positive receptor staining. Mutations in BRCAl/2 were overrepresented by frequency (80%), pointing at common loss of heterozygosity affecting the normal allele. Somatic mutations in the TP53 gene were found in 7/10 (70%) patients with the triple negative subtype of ВС and in 3/13 (23%) in the group with positive receptor staining. Additionally, in both groups of patients, somatic mutations of the PTEN, MSH2, MSH6, and MUTYH genes were detected.


Assuntos
Neoplasias da Mama , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Feminino , Predisposição Genética para Doença , Células Germinativas , Mutação em Linhagem Germinativa , Humanos , Mutação
16.
Mol Biol (Mosk) ; 55(3): 441-459, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34097679

RESUMO

Preeclampsia (PE) is a severe hypertensive pathology and affects 2-8% of pregnancies worldwide. Its etiopathogenesis is poorly understood, and prognostic biomarkers and effective treatments are unavailable for this pregnancy complication, determining the high rates of maternal and perinatal morbidity and mortality. Racial and ethnic differences in PE incidence are of interest to study in terms of evolutionary medicine because such variability can be considered as a side effect of adaptive changes that have occurred in the genetic structure of modern populations since the dispersal of Homo sapiens from Africa. Genetic diversity at 10 regulatory single nucleotide polymorphisms (rSNPs) associated with PE was studied in North Eurasian populations and world populations of the 1000 Genomes Project. The role of natural selection in the formation of this genetic diversity was assessed at the microevolutionary level. High interpopulation diversity was observed with the greatest contribution being made by allele frequencies of NDRG1 rs3802252 (FST = 0.157). Signatures of natural selection were detected for rs10423795 of LHB, rs2167270 of LEP, rs2227262 and rs3802252 of NDRG1, rs56153523 and rs8109071 of SYDE1, and rs72959687 of INHA. The results are consistent with two evolutionary hypotheses of PE, namely, those of ancestral susceptibility and genetic conflicts.


Assuntos
Pré-Eclâmpsia , Feminino , Frequência do Gene , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo Único , Pré-Eclâmpsia/genética , Gravidez , Seleção Genética
17.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 517-524, 2021 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-34098666

RESUMO

Objective: To determine the correlation between the diabetes mellitus control and periodontitis. Methods: This study was a cross-sectional survey using stratified system sampling model design. The target population was the patients with diabetes investigated from May to July 2018 in Huangpu District of Shanghai. In the present study, severe periodontitis was defined as at least at two sites in different quadrants with probing depth (PD)≥6 mm and clinical attachment loss (CAL)≥ 5 mm. Edentulous induced by periodontitis were also classified as severe periodontitis and the others were classified as non-severe periodontitis subjects. Diabetes control levels were divided into the following three groups: poorly controlled group [glycated hemoglobin (HbA1c)>7.5% and fasting blood glucose (FPG)>7.0 mmol/L], well controlled group (6.5%≤HbA1c≤7.5% or 6.1 mmol/L≤FPG≤7.0 mmol/L) and ideally controlled group (HbA1c<6.5% and FPG<6.1 mmol/L). SPSS 25.0 was used for statistical analysis. Chi square test was used for demographic data and frequency distribution, α=0.05, two-sided test. Ordinal regression model was used for PD and diabetes control status to balance confounding factors (including age, gender, education and smoking status). After matching the propensity scores between severe periodontitis group and non-severe periodontitis group, logistic regression analysis was used to analyze the level of diabetes control and periodontitis. Results: A total of 5 220 adults over the age of 18 with a medical history of diabetes participated in the survey, of which 3 064 subjects with diabetes mellitus type 2 (T2DM) who were given both oral and laboratory examinations and were included in this study. Statistics showed that the prevalence of moderate and severe periodontitis was 10.57% (324/3 064). In the severe periodontitis group, 79.01% (256/324) of the subjects were over 65 years old, 55.56% (180/324) were male, 58.33% (189/324) had lower education level than high school level, and 21.91% (71/324) were smokers, which were significantly higher than those in the non-severe periodontitis group (P<0.01). In different T2DM status groups, the percentage of severe periodontitis increased with the aggravation of T2DM status. In severe periodontitis group, the proportion of patients with poor glycemic control was higher. T2DM patients with poor glycemic control accounted for 68.52% (222/324) in severe periodontitis group, which was significantly higher than the proportion of non-severe periodontitis group of 60.99% (1 671/2 740) (P<0.05). The regression coefficient of PD was 0.191, and PD had a significant negative effect on the level of blood glucose (P<0.01). There was a significant positive correlation between diabetes glycemic control and severe periodontitis (OR=2.800, P<0.05). Conclusions: In Huangpu District of Shanghai, among T2DM patients, the age of severe periodontitis group was higher than that of non-severe periodontitis group, most of them were male, with lower education level and higher proportion of smoking. The severity of diabetes was related to periodontitis and the proportion of severe periodontitis was higher in patients with poor glycemic control.


Assuntos
Diabetes Mellitus Tipo 2 , Periodontite , Adulto , Idoso , Glicemia , China , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Hemoglobina A Glicada , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/complicações
18.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 576-580, 2021 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-34098674

RESUMO

To explore the technical process and the therapeutic effect of using sequential surgical guide with independent intellectual property rights assisting immediate implantation and restoration of the full arch, with the support from the periodontal splint for mobile supporting teeth, patients with severe periodontitis who planned to undergo immediate full arch implantation were recruited from August 2019 to December 2020 at the Department of Prosthodontics, Department of Periodontology, Department of Implantology and First Clinical Division, Peking University School and Hospital of Stomatology. Through the procedure of collecting preoperative maxillofacial data, making systematic diagnostic design, making periodontal splints fixation, producing surgical guide, and carrying out guided surgery for full arch immediate implantation, eight cases were included. By registering the postoperative cone-beam CT (CBCT) with the preoperative data, the difference between the actual three-dimensional position of the implants and the virtual design was observed, and the accuracy of the implant placement position guided by the sequential guide was statistically analyzed using SPSS 25.0 software. Analysis indicators include coronal and apical global displacement, coronal horizontal and vertical displacement, apical horizontal and vertical displacement, and angular deviation. Results revealed that the 8 patients [2 males and 6 females, aged (49.0±9.3) years (38-65 years)] of recruited cases included 7 cases of maxilla and 1 cases of mandible. A total of 48 implants, of which 44 implants were placed upright and 4 were placed tilted, 16 implants in the anterior region and 32 implants in the posterior region. No guide plate fracture or damage to important anatomical structures were reported. The overall displacement at the coronal point [(0.83±0.48) mm] and the global displacement at the apical point [(1.36±0.57) mm] were within the clinically acceptable safety range, and the horizontal displacement and vertical displacement at the coronal point, horizontal displacement and vertical displacement at the apical point, and the angle deviation of implants axial have no statistic significant difference in the anterior and posterior region (P>0.05). Periodontal splints combined with sequential surgical guides to assist patients with severe periodontitis for immediate full arch implantation and immediate restoration can expand the indications of guide assisted implant surgery. It meets the safety requirements in clinical applications.


Assuntos
Implantes Dentários , Periodontite , Cirurgia Assistida por Computador , Desenho Assistido por Computador , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endo-Óssea , Feminino , Humanos , Imageamento Tridimensional , Masculino , Periodontite/cirurgia
19.
Zhonghua Yi Xue Za Zhi ; 101(21): 1560-1565, 2021 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-34098682

RESUMO

Objective: To analyze the occurrence of rod fracture after surgery for lumbosacral deformity associated sacral agenesis and discuss the relevant salvage methods. Methods: The clinical records of 19 patients who underwent surgical treatment for lumbosacral deformity associated sacral agenesis from January 2001 to January 2018 were retrospectively reviewed, including 11 boys and 8 girls. The average age was (9.6±5.2) years. The outcomes of surgical correction and internal fixation were evaluated by postoperative regular follow-up. We also recorded the time and position of rod fracture occurrence. The Cobb angle, coronal balance and sagittal balance were measured and compared to analyze the corresponding salvage methods and revision outcomes. Results: Three patients encountered rod fracture during follow-up, so the incidence of rod fracture after surgery for lumbosacral deformity associated sacral agenesis was 15.8%(3/19). Based on their own conditions, we formulated the individualized strategy and performed the revision surgery through the posterior-only approach. The most critical step was abundant bone-grafting and fusion in the defected sacroiliac joint. After revision, the scoliotic Cobb angle improved in two patients (91.5° vs 47.5°, 49.0° vs 28.0°) and coronal balance improved in one patient (40.3 mm vs 24.3 mm). No complication reoccurred during follow-up. Conclusion: The rod fracture after surgery for lumbosacral deformity associated sacral agenesis is quite common, which is probably correlated with its unique deformed structure and biomechanical characteristics. The individualized salvage methods and adequate bone-grafting and fusion for the defected sacroiliac joint will guarantee the reconstruction and maintenance of spine balance after revision.


Assuntos
Anormalidades Múltiplas , Meningocele , Fusão Vertebral , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos , Região Sacrococcígea/anormalidades
20.
Zhonghua Yi Xue Za Zhi ; 101(21): 1592-1597, 2021 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-34098686

RESUMO

Objective: To report a method of visualized saphenous nerve block (VSNB) through minimally invasive far medial-subvastus approach distal to the adductor canal in total knee arthroplasty (TKA), and investigate the effect of VSNB in this way on postoperative pain relief. Methods: A total of 100 patients with knee osteoarthritis were prospectively included from June 2018 to October 2019, 29 males and 71 females, aged 50-87(70±8) years. All patients undergoing TKA through minimally invasive far medial-subvastus approach were randomized to visualized saphenous nerve block combined with periarticular infiltration analgesia group (Group VSNB+PIA) or only periarticular infiltration analgesia group (Group PIA),50 cases in each group. The visual analogue scale (VAS) was used to evaluate the pain degree of patients. Furthermore, the scores of VAS in resting and active state at 4, 8, 12, 24, 48, 72 hours after operation and the proportion of patients receiving parecoxib within 72 hours after operation were compared between the two groups. Results: There was statistically significant difference between the two groups in terms of VAS scores in resting state after surgery(F=15.295,P<0.05).The postoperative VAS scores of Group VSNB+PIA at 4, 8, 12, 24 hours at resting state were 1.3±0.8, 1.4±0.7, 1.7±0.8, 3.1±0.8 respectively, which were all significantly lower than those of Group PIA (1.6±0.9, 1.8±0.8, 2.3±0.9, 3.6±0.8) (P<0.05). The overall difference in terms of VAS scores at active state after surgery was statistically significant between the two groups(F=18.532, P<0.05). The postoperative VAS scores of Group VSNB+PIA at 4, 8, 12, 24 hours at active state were 2.0±0.8, 2.2±0.7, 2.7±0.6, 3.7±0.7 respectively, which were all significantly lower than those of Group PIA (2.3±0.8, 2.7±0.7, 3.3±0.8, 4.4±0.7)(P<0.05). Fourteen percent of patients (7/50) in VSNB+PIA group accepted parecoxib within 72 hours after surgery, which was significantly lower than that in PIA group (34%, 17/50) (P<0.05). Conclusions: It is easy to expose the saphenous nerve beyond the adductor canal through minimally invasive far medial-subvastus approach. The Combination therapy of VSNB+PIA is more effective than the simple per-articular infiltration analgesia in providing pain relief after total knee arthroplasty.


Assuntos
Analgesia , Artroplastia do Joelho , Bloqueio Nervoso , Anestésicos Locais , Feminino , Humanos , Masculino , Manejo da Dor , Dor Pós-Operatória
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