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BACKGROUND: Metallothioneins (MTs) gene polymorphisms have been associated with the ability of free radical scavenging and detoxification of heavy metals leading to cancer development. Our aim was to revisit, in a Brazilian population, single-nucleotide polymorphisms (SNPs) of the MT gene family previously associated with oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: A case-control investigation with 28 OSCC patients and 45 controls was conducted, using conventional risk factors (tobacco use and alcohol consumption) as covariates. SNPs genotyping for rs8052334 (MT1B), rs964372 (MT1B), and rs1610216 (MT2A) was performed by PCR-RFLP, and SNPs for rs11076161 (MT1A) were analyzed by TaqMan assay. RESULTS: The only SNP associated with increased risk for OSCC was the MT-1A AA genotype (OR = 4.7; p = 0.01). We have also evidenced for the first time a significant linkage disequilibrium between the SNPs of MT-2A and MT-1A in this population with the highest frequency (30%) of the unfavorable haplotype G/A/C/T (rs1610216 / rs11076161 / rs964372 / rs8052334) of MT gene polymorphisms (OR = 6.2; p = 0.04). Interestingly, after removing the effects of conventional risk factors, we have uncovered the significance of the AA genotype of the rs11076161 with increased odds of 19-fold higher towards OSCC development. CONCLUSIONS: This is the first demonstration that a significant linkage disequilibrium among gene polymorphisms of the MT family may affect susceptibility to oral cancer, which is conditioned by the G/A/C/T haplotype (rs1610216/rs11076161/rs964372/ rs8052334) and the MT-1A gene polymorphism has a potential clinical utility for the OSCC risk assessment.
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Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Brasil , Carcinoma de Células Escamosas/genética , Estudos de Casos e Controles , Predisposição Genética para Doença , Genótipo , Humanos , Metalotioneína/genética , Neoplasias Bucais/genética , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Carcinoma de Células Escamosas de Cabeça e PescoçoRESUMO
BACKGROUND: The aim of this study was to describe the relative frequency and the main demographic and clinic-radiographic features related to patients diagnosed with Simple bone cyst (SBC) in an Oral Diagnosis Service in Southeast Brazil and present a review and discussion of international literature on this topic. MATERIAL AND METHODS: SBC cases from our service encompassing the period between 1978 and 2017 were selected. In addition, a literature search was performed in the Pubmed/MEDLINE online electronic database published between 1951 and 2019. RESULTS: A total of 2,459 cystic lesions were documented in our service, thus 60 patients were diagnosed with the SBC representing 2.4% of all jaw cystic. Most of cases were asymptomatic. Multiple SBC lesions were seen in two patients (3.4%) and association with cemento-osseous dysplasia was seen in one female patient (1.7%). A total of 793 cases were enrolled in this literature review. CONCLUSIONS: The SBC is an asymptomatic lesion often discovered in routine image exams in young patients. The unilocular, well defined margin with scalloped appearance is characteristic and helps the definition of diagnosis. This review suggests a different epidemiologic trend concerning to the sex and it confirms the posterior region of mandible as the more frequent location. The conservative treatment with limited exploration and curettage remains as the gold-standard treatment.
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Cistos Ósseos , Tumores Odontogênicos , Brasil , Feminino , Humanos , Mandíbula , Instituições AcadêmicasRESUMO
BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease mediated by T cells, which manifests as reticular (white) or erosive (red) lesions, that are eventually painful. Oral lichenoid lesion (OLL) are distinguished from OLP by the presence of precipitating factors. The aim of this study was to evaluate whether the presence of metallothionein, which is involved in anti-apoptotic pathways and the anti-oxidative response, could serve as a differential diagnostic for OLP and OLL. MATERIAL AND METHODS: We evaluated the expression of metallothionein in 40 cases of OLP and 20 cases of OLL using immunohistochemistry. RESULTS AND CONCLUSIONS: White OLP has higher concentrations of metallothionein than red OLP in basal and parabasal layers. Moreover, metallothionein was more frequently observed in the cytoplasm and nuclei of basal cells in OLP patients compared to the same regions of OLL cases. Metallothionein levels are related to OLP severity and may contribute to a differential diagnosis between OLP and OLL.
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Amálgama Dentário , Líquen Plano Bucal/diagnóstico , Líquen Plano Bucal/metabolismo , Metalotioneína/biossíntese , Adulto , Amálgama Dentário/efeitos adversos , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/diagnóstico , Doenças da Boca/etiologia , Doenças da Boca/patologiaRESUMO
BACKGROUND: Lower lip squamous cell carcinoma (LLSCC) is a common malignancy of the head and neck, being mainly a consequence of a chronic exposure to ultraviolet (UV) light solar radiation. Here, we evaluated the clinicopathological profile of patients with photosensitive disorders (xeroderma pigmentosum, lupus erythematosus and albinism) that developed LLSCC. MATERIAL AND METHODS: Data from patients who had a diagnosed LLSCC with a prior xeroderma pigmentosum, lupus erythematosus or albinism diagnosis that were treated at INCA from 1999 to 2012 were collected from patients medical records (n=16). The control group was composed of 68 patients with LLSCC without a medical history of photosensitivity. The clinicopathological data of this study population were collected and the association between these variables was analyzed by Fisher's exact test. Survival curves were constructed using the Kaplan-Meier method and compared by log-rank test. All statistical analyses were performed using SPSS statistics package. RESULTS: The mean age of patients in the photosensitive and non-photosensitive groups was 42 years and 67 years, respectively (p<0.0001). A previous history of malignant diseases was more common in the photosensitive group (p=0.001). In both groups, most tumors showed a pathological stage I/II disease. Overall and cancer-specific survival were not statistically different. However, disease-free interval showed a significant difference (p=0.01) between the photosensitive and non-photosensitive patients. CONCLUSIONS: Photosensitive patients presented LLSCC at earlier age but it usually was not the primary tumor in these patients. Furthermore, a more aggressive pathological behavior was not seen when compared with tumors from non-photosensitive patients. The disease-free interval was lower in photosensitive patients, as expected.
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Carcinoma de Células Escamosas/complicações , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias Labiais/complicações , Transtornos de Fotossensibilidade/complicações , Academias e Institutos , Adolescente , Adulto , Idoso , Brasil , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/terapia , Criança , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Neoplasias Labiais/epidemiologia , Neoplasias Labiais/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Fatores de Tempo , Adulto JovemRESUMO
The aim of this study was to determine the association between verbal school bullying and possible sleep bruxism (SB) in adolescents. A case-control study was carried out at the population level by recruiting 13- to 15-year-old participants among the attendants of schools of Itabira, Brazil. The case group was composed of 103 adolescents with possible SB (i.e. self- or parental-reported), while the control group included 206 adolescents without possible SB. All participants answered a questionnaire on the occurrence of their involvement in verbal school bullying episodes, based on the National School of Health Research (PeNSE) as well as an evaluation of their economic class according to the criteria of the Brazilian Association of Research Companies. Pearson's chi-square, McNemar test and conditional logistic regression were performed to assess the association between possible SB, verbal school bullying and economic class. There were 134 (43·3%) participants who reported involvement in verbal school bullying episodes as a victim, bully or both. The majority of them were males (90·3%). Adolescents with possible SB were more likely to have been involved in episodes of verbal school bullying (OR: 6·20; 95% CI: 3·67-10·48). Based on these findings, it can be suggested that possible SB in young teenagers is associated with a history of episodes of verbal school bullying.
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Bullying , Depressão/epidemiologia , Bruxismo do Sono/epidemiologia , Adolescente , Brasil/epidemiologia , Bullying/estatística & dados numéricos , Estudos de Casos e Controles , Depressão/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Fatores de Risco , Bruxismo do Sono/psicologia , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Thermal shock is widely recognized by modern medicine. Its pathophysiological mechanisms are known, as are its possible consequences, but scientific reports in the literature about clinical cases with severe consequences are sparse. The authors present a case of cardiorespiratory arrest after prolonged sun exposure followed by a dive in the ocean. Other aetiological causes were ruled out, by exclusion, leading to the diagnosis of cardiorespiratory arrest caused by thermal shock. It is important to inform the public in general of the risks of negligent behaviour on the beach.
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BACKGROUND: Molecular factors influencing Wilms tumor (WT) development remain largely unknown. TP53 mutations seem to be restricted to the anaplastic WT subtype. However, TP53 polymorphisms do not have a defined role in the disease. PROCEDURE: To assess the impact of TP53 mutations and polymorphisms (PIN2, PIN3, and PEX4) on risk of development, age at diagnosis, and survival in WT, we analyzed 46 blood DNA samples and 31 fresh tumor DNA samples from 52 patients with WT. Sequencing of TP53 exons 2-11 was performed. RESULTS: Tumor DNA analysis revealed TP53 pathogenic missense mutations (p.V197M, p.R213Q, p.R248W, and p.R337C) in four samples (12.9%). Blood DNA samples revealed a novel intronic mutation, IVS2 + 37C > T, in one patient (2.2%). Bilaterality was associated with a twofold decrease in survival (P = 0.00037). Diffuse anaplasia also presented a lower survival probability compared to patients with non-anaplastic tumors, or with focal anaplasia (P = 0.045). Patients with a TP53 somatic mutation showed survival probability of 37.5% versus 85.0% for patients with no somatic mutations, although the difference was not statistically significant (P = 0.0706). PIN3 duplicated allele was associated with a 20-month later mean age at diagnosis (P = 0.0084). TP53 PEX4 C allele showed an increased risk for WT development (P = 0.0379). No relationship was found between survival and gender, age at diagnosis, or the less frequent alleles of PIN2, PIN3, and PEX4. CONCLUSIONS: Our results demonstrate an association between PIN3 and age at diagnosis, as well as an association of PEX4 and risk of development of WT.
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Genes p53 , Neoplasias Renais/genética , Polimorfismo Genético , Tumor de Wilms/genética , Pré-Escolar , Feminino , Genótipo , Humanos , Lactente , Neoplasias Renais/etiologia , Neoplasias Renais/mortalidade , Masculino , Mutação , Risco , Tumor de Wilms/etiologia , Tumor de Wilms/mortalidadeRESUMO
PURPOSE: In recent years, minimal intervention procedures (MIPs) for treating dental caries in children have stood out as an innovative method. Nevertheless, the treatment decision should be based on scientific evidence, professional expertise, and parents' preference/acceptance. Evaluating the acceptance of MIPs by parents is an essential factor, but little information is available on what guides this preference. METHODS: This scoping review aims to synthesize the evidence on parents'/caregivers' acceptance of MIP for managing cavitated caries lesions in children. A search was performed in the PubMed, Cochrane Library, Lilacs and Google Scholar databases with no restriction on date or language. RESULTS: A total of 19 articles were selected (6 clinical trials, 1 longitudinal and 12 cross-sectional studies). The application of silver diamino fluoride (SDF) was the most commonly evaluated procedure (n = 17), followed by the atraumatic restorative technique (ART) and the Hall Technique (HT). The acceptance of MIPs ranged from 1.4% to 100%, and the application of SDF was better accepted in posterior teeth and in uncooperative children. ART had better aesthetic acceptance than HT. CONCLUSION: Application of SDF, Hall Technique and ART was well accepted by parents/caregivers. However, a gap remains in the literature regarding the acceptance of other procedures. Therefore, further studies in this area will contribute toward a better understanding of the opinion of parents/caregivers, and thus improve caries lesion management in children.
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Cárie Dentária , Fluoretos , Compostos de Prata , Criança , Humanos , Cárie Dentária/tratamento farmacológico , Estudos Transversais , Dente Decíduo , Assistência Odontológica , Pais , Fluoretos Tópicos/uso terapêuticoRESUMO
OBJECTIVE: To compare the proliferative activity in ameloblastoma and malignant odontogenic tumors, as assessed by Ki-67 immunostaining and determine whether expression of substance P (SP) and NK-1 receptor (NK-1R) is related to cell proliferation in these tumors. MATERIALS AND METHODS: Immunohistochemistry was used to evaluate protein expression in 44 benign and malignant odontogenic tumors from 39 patients. Immunohistochemistry was performed with anti-SP, anti-NK-1R, and anti-Ki-67 monoclonal antibodies, and the clinical and pathological data of the patients with odontogenic tumor were evaluated. RESULTS: Expression of Ki-67 in malignant odontogenic tumors was significantly higher than in ameloblastomas (P < 0.001), and the expression level was associated with higher expression of NK-1R. Among the ameloblastomas, there was significantly higher expression of Ki-67 in peripheral ameloblastic-like cells (3.3 ± 4.1) than in stellate reticulum-like cells (2.6 ± 3.7) (P = 0.04). In the majority of tissue locations of the malignant tumors, expression of SP and NK-1R was positively correlated with higher expression of Ki-67. CONCLUSION: These findings show that the expression level of Ki-67 in ameloblastomas was positively correlated with the rate of growth of odontogenic tumors. Overexpression of NK-1R complex in malignant odontogenic tumors could be part of the trigger stimulus that results in higher proliferative activity of the tumor.
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Ameloblastoma/metabolismo , Biomarcadores Tumorais/metabolismo , Neoplasias Mandibulares/metabolismo , Neoplasias Maxilares/metabolismo , Tumores Odontogênicos/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ameloblastoma/patologia , Proliferação de Células , Transformação Celular Neoplásica/metabolismo , Criança , Feminino , Humanos , Antígeno Ki-67/metabolismo , Masculino , Neoplasias Mandibulares/patologia , Neoplasias Maxilares/patologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/metabolismo , Tumores Odontogênicos/patologia , Receptores da Neurocinina-1/metabolismo , Substância P/metabolismo , Adulto JovemRESUMO
The aim of the present population study was to evaluate the impact of early childhood caries (ECC) on the oral health-related quality of life (OHRQoL) of preschool children and their parents/caregivers. A random sample of 638 children (aged 2-5 years) underwent a clinical oral examination to assess ECC, and their parents were invited to answer two questionnaires: one on the OHRQoL of the child, the Early Childhood Oral Health Impact Scale, and another on the characteristics and sociodemographic conditions of the child. Descriptive analysis, χ(2) test, Mann-Whitney test, Kruskal-Wallis test, and hierarchically adjusted Poisson regression models were used. The prevalence of ECC was 52.2%. The number of teeth with decay ranged from 1 (n = 42; 6.6%) to 20 (n = 5; 0.8%), averaging 2.86 (SD = 4.04). There was a significant difference between the severity of ECC and OHRQoL in terms of the impact on both child and family (p < 0.001). An increase in the severity of ECC resulted in an increased negative impact on the quality of life of the child (rate ratio, RR = 5.32; 95% confidence interval, CI: 3.67-7.71). Greater age of the mother had a positive impact on the OHRQoL of preschool children (RR = 0.72; 95% CI: 0.54-0.97). Increased age resulted in an increased negative impact on the quality of life of the child (RR = 2.97; 95% CI: 1.61-5.47). ECC has a negative impact on the OHRQoL of children aged 2-5 years and their parents. Mothers aged 30 or older reported better OHRQoL, independent of the presence of ECC and the age of the child.
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Cárie Dentária/psicologia , Pais/psicologia , Qualidade de Vida , Brasil , Distribuição de Qui-Quadrado , Pré-Escolar , Intervalos de Confiança , Índice CPO , Feminino , Humanos , Masculino , Idade Materna , Saúde Bucal , Relações Pais-Filho , Análise de Regressão , Perfil de Impacto da Doença , Fatores Socioeconômicos , Estatísticas não Paramétricas , Inquéritos e QuestionáriosRESUMO
PURPOSE: To evaluate the association between children's pain/distress levels and patient characteristics (age, sex, history of dental pain), sedation type (level of sedation, sedative regimen), nociception and pain intensity reported by the parents in sedated children undergoing minimally invasive dental treatment. METHODS: This clinical study evaluated secondary outcomes of an RCT that evaluated the efficacy of dexmedetomidine sedation with or without ketamine. Only children who had nociception levels recorded using the Analgesia Nociception Index (ANI) were included (0-100; 0 = highest nociception). FLACC scale (Face, Legs, Activity, Cry and Consolability) was used to assess children's pain/distress (0-10; 0 = no pain/distress). Parental proxy report of the child's pain intensity during the treatment was performed using the Visual Analogue Scale (VAS; 0-100; 0 = no pain). The association between ANI, children's age and sex, dental pain history, sedation level, sedative regimen, and VAS with the FLACC was verified using the generalised estimation equation analysis (alpha 0.05). RESULTS: Participants were 31 children (51.6% boys) and their parents (90.3% mothers). Median FLACC was 3.3 (25th-75th percentiles 1.7-8.2), ANI 80.9 (74.7-85.8), and VAS 10 (1-23). FLACC associated with ANI (OR 0.96; 95% CI 0.93-0.99; p = 0.02), moderate sedation (0.13; 0.03-0.50; p = 0.003), and VAS (1.05; 1.01-1.10; p = 0.01). CONCLUSION: Pain/distress was generally low and more prominent with minimal (versus moderate) sedation and higher nociception.
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Nociceptividade , Dor , Masculino , Feminino , Criança , Humanos , Pré-Escolar , Hipnóticos e Sedativos , Comportamento Infantil , Manejo da DorRESUMO
Autogenous tooth fragment bonding offers advantages over restorations with composite resins and porcelain, including better esthetics, greater durability, reestablishment of the natural function of the dental element and short execution time. A case is presented of a 14-year-old male patient who suffered an oblique crown fracture of the permanent right maxillary central incisor (11) due to a traumatic fall. The clinical examination revealed pulp exposure with no invasion of the biological space. Due to the extension of the fracture, endodontic treatment and the placement of an intra-root esthetic pin was needed. The tooth was restored using the autogenous fragment bonding method. Excellent esthetic and functional results were observed after two years of follow up.
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Colagem Dentária , Planejamento de Prótese Dentária , Estética Dentária , Incisivo/lesões , Técnica para Retentor Intrarradicular , Sorriso , Coroa do Dente/lesões , Fraturas dos Dentes/terapia , Condicionamento Ácido do Dente/métodos , Adolescente , Resinas Compostas/química , Materiais Dentários/química , Adesivos Dentinários/química , Seguimentos , Vidro/química , Humanos , Masculino , Metacrilatos/química , Tratamento do Canal Radicular/métodos , Dióxido de Silício/química , Zircônio/químicaRESUMO
External Thermal Insulation Composite Systems (ETICS) are multilayer solutions which provide an enhanced thermal performance to the building envelope. However, significant anomalies can be detected on ETICS facades, in some cases shortly after the application of these systems. This study intends to evaluate and compare the durability of six commercially available ETICS after two years of outdoor exposure at both urban and maritime conditions in Portugal. The systems were characterized by means of non-destructive testing (i.e., visual and microscopic assessment, water transport properties, thermal conductivity, surface roughness), thus allowing to evaluate the performance loss throughout natural aging. The bio-susceptibility and aesthetic properties (color and gloss) were also investigated. Results showed that the performance and durability of the complete system is significantly affected by the rendering system formulation. The lime-based specimens obtained the highest rate of mold development after one year of aging in a maritime environment, becoming considerably darker and with lower surface gloss. Fungal analysis of this darkish stained area indicated the presence of mold species of the genera Alternaria, Didymella, Cladosporium and Epicoccum, and yeasts of the genera Vishniacozyma and Cystobasidium. An increase of both capillary water absorption and water vapor permeability was also registered for the aged lime-based specimens. Acrylic-based systems obtained lower capillary water absorption after aging and greater dirt deposition on their surfaces, especially in urban conditions. These systems had also higher color variation and surface gloss decrease and slightly higher mold growth, when compared with those aged in a maritime environment. Finally, no mold growth was detected on the silicate-based specimens after two years of aging. However, these specimens obtained higher capillary water absorption and lower vapor permeability after aging, possibly leading to moisture accumulation within the system. Results contribute towards the development of ETICS with enhanced performance and durability.
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Resinas Compostas , Vapor , Compostos de Cálcio , Teste de Materiais , Óxidos , Propriedades de SuperfícieRESUMO
Introduction: Medical reports of patients admitted to the emergency services has been modified due to the social distancing needed in the COVID-19 epidemic. For this reason, it is essential to know the family members' perceptions about telephone medical reports. Objective: To determine the perception of care by family members of patients hospitalized due to COVID-19 on telephone medical reports in a tertiary hospital's emergency room in Lima, Peru. Methods: A non-experimental cross-sectional study, through a survey of family members of patients with COVID-19 admitted during July and August 2020. The "External user satisfaction survey of the Ministry of Health" adapted to this setting was used due to the absence of similar studies. Information, respect for the user, efficiency, accessibility, suitability, security, and overall satisfaction were considered. The sample size for finite populations was selected from 2 936 family members, obtaining 347 surveys from 641 calls. Relatives were called by phone, and after acceptance, the survey was sent to them via WhatsApp in Google Forms format. Once the survey was received, it was analyzed using descriptive statistical techniques. Results: We made 641 telephone calls with a response rate of 54.1%, obtaining 347 surveys. The mean age was 40.12 years (standard deviation: 11.93 years), with 61.4% of females and 38.0% married. We found that 65.1% received higher education and that Chorrillos was the most prevalent district (10.1%). Moreover, 42.4% of those surveyed were children of hospitalized patients, 17.3% were spouses, and 85% were not health personnel. We found a high level of agreement in overall satisfaction (73.2%) and in most dimensions, including information (88.8%), respect for the user (82.1%), efficiency (70.3%), accessibility (75.8%), suitability (79.0%), and security (87.9%). Conclusion: The telephone medical reports to relatives of patients hospitalized due to COVID-19 in the emergency room found an overall satisfaction of 73.2% . Telephone medical reports are essential alternatives to improve the quality of care during the COVID-19 epidemic.
Introducción: El informe médico sobre el estado de salud del paciente ingresado a los servicios de emergencia se ha modificado, debido al necesario distanciamiento por la epidemia de COVID-19. Por esto, es importante conocer la percepción que tienen los familiares informados sobre el reporte médico telefónico implementado. Objetivo: Determinar la percepción de los parientes sobre la atención de pacientes internados por COVID-19, a través del informe médico telefónico entregado a las familias en el servicio de emergencia de un hospital terciario del Seguro Social de Salud (EsSalud), Lima, Perú. Métodos: Estudio transversal observacional, mediante encuesta a familiares de pacientes con COVID-19 ingresados durante los meses de julio y agosto del año 2020. Se usó como base la "Encuesta de satisfacción de usuario externo del Ministerio de Salud" adaptada a esta realidad, no habiéndose realizado ningún trabajo similar a este en forma previa. Se consideraron las dimensiones información, respeto al usuario, eficacia, accesibilidad, oportunidad, seguridad y satisfacción global. Se seleccionó la muestra para poblaciones finitas de 2936 familiares, obteniéndose 347 encuestas de 641 llamadas realizadas. Se les llamó telefónicamente y, previa aceptación, se les envió la encuesta vía en formato . Recibida la encuesta, se procedió a su análisis mediante técnicas de estadística descriptiva. Resultados: Se realizaron 641 llamadas telefónicas con una tasa de respuesta de 54,1% obteniéndose 347 encuestas. La edad promedio fue de 40,12 años (desviación estándar de 11,93), de los cuales 61,4% era del sexo femenino y 38% estaban casados. El 65,1% de los entrevistados tenía educación superior. Dentro de los distritos de procedencia, Chorrillos tuvo más encuestados con 10,1%. El 42,4% de los encuestados fueron hijos de los pacientes internados, 17,3% fueron cónyuges y el 85% no era personal de salud. Las dimensiones con percepción de acuerdo fueron: información 88,8%, respeto de usuario 82,1%, eficacia 70,3%; accesibilidad 75,8%; oportunidad 79,0% y seguridad 87,9%. La satisfacción global obtuvo un 73,2% de acuerdo. Conclusiones: La información médica telefónica entregada a los familiares de pacientes internados por COVID-19 en las salas de emergencia, encontró una satisfacción global de 73,2% de acuerdo. La información médica telefónica es una alternativa importante para mejorar la calidad de atención durante la epidemia por COVID-19.
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COVID-19 , Adulto , Criança , Estudos Transversais , Serviço Hospitalar de Emergência , Família , Feminino , Humanos , Percepção , Inquéritos e Questionários , Telefone , Centros de Atenção TerciáriaRESUMO
Strain plays an important role for the optical properties of monolayer transition metal dichalcogenides (TMDCs). Here, we investigate strain effects in a monolayer MoSe2 sample with a large bubble region using µ-Raman, second harmonic generation (SHG), µ-photoluminescence and magneto µ-photoluminescence at low temperature. Remarkably, our results reveal the presence of a non-uniform strain field and the observation of emission peaks at lower energies which are the signatures of exciton and trion quasiparticles red-shifted by strain effects in the bubble region, in agreement with our theoretical predictions. Furthermore, we have observed that the emission in the strained region decreases the trion binding energy and enhances the valley g-factors as compared to non-strained regions. Considering uniform biaxial strain effects within the unit cell of the TMDC monolayer (ML), our first principles calculations predict the observed enhancement of the exciton valley Zeeman effect. In addition, our results suggest that the exciton-trion fine structure plays an important role for the optical properties of strained TMDC ML. In summary, our study provides fundamental insights on the behaviour of excitons and trions in strained monolayer MoSe2 which are particularly relevant to properly characterize and understand the fine structure of excitonic complexes in strained TMDC systems/devices.
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PURPOSE: The knowledge of the stress related to the practice of paediatric dentistry is scarce. The aim of this study was to verify the stress perceived by paediatric dentists related to young children's dental treatment under sedation and their association with child's behaviour and other independent variables. METHODS: A cross-sectional repeated measures study was performed with four paediatric dentists who treated 81 sedated preschoolers. Paediatric dentists reported their stress at the end of the session using the visual analog scale (VAS 0-100 mm). Samples of saliva were collected to measure the dentists' salivary cortisol level throughout the dental session. The sessions of dental treatment were video recorded for evaluation of the child's behaviour. Children's behaviour was assessed using the Ohio State University Behavioral Rating Scale (OSUBRS). The association between the VAS scores and the other variables was verified using bivariate tests and generalised estimating equation (alpha 0.05). RESULTS: Paediatric dentists felt slightly stressed in most of the sessions (VAS median 7 points; minimum 0, maximum 97 points). VAS associated with the struggling behaviour of the child (B 0.53; 95%CI 0.32-0.74; p ≤ 0.001) and the time since dentist's graduation (B - 1.41, 95% CI - 1.87 to - 0.94; p ≤ 0.001) but not with dentist's salivary cortisol (rho - 0.053, p = 0.639). CONCLUSION: The more frequent the child's struggling behaviour during dental treatment and the shorter the time elapsed since the professional's graduation, the higher the level of objectively and subjectively measured stress of the paediatric dentist during the dental procedure.
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Assistência Odontológica para Crianças , Atitude do Pessoal de Saúde , Criança , Pré-Escolar , Estudos Transversais , Odontólogos , Humanos , Odontopediatria , SalivaRESUMO
Objective. Recent technological advances are revealing the complex physiology of the axon and challenging long-standing assumptions. Namely, while most action potential (AP) initiation occurs at the axon initial segment in central nervous system neurons, initiation in distal parts of the axon has been reported to occur in both physiological and pathological conditions. The functional role of these ectopic APs, if exists, is still not clear, nor its impact on network activity dynamics.Approach. Using an electrophysiology platform specifically designed for assessing axonal conduction we show here for the first time regular and effective bidirectional axonal conduction in hippocampal and dorsal root ganglia cultures. We investigate and characterize this bidirectional propagation both in physiological conditions and after distal axotomy.Main results.A significant fraction of APs are not coming from the canonical synapse-dendrite-soma signal flow, but instead from signals originating at the distal axon. Importantly, antidromic APs may carry information and can have a functional impact on the neuron, as they consistently depolarize the soma. Thus, plasticity or gene transduction mechanisms triggered by soma depolarization can also be affected by these antidromic APs. Conduction velocity is asymmetrical, with antidromic conduction being slower than orthodromic.Significance.Altogether these findings have important implications for the study of neuronal functionin vitro, reshaping our understanding on how information flows in neuronal cultures.
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Axônios , Neurônios , Potenciais de Ação/fisiologia , Axônios/fisiologia , Gânglios Espinais , Sinapses/fisiologiaRESUMO
OBJECTIVES: To evaluate p63 expression in laryngeal squamous cell carcinoma and its prognostic significance. METHODS: p63 expression was examined by immunohistochemistry and scored in 127 patients with laryngeal squamous cell carcinomas. RESULTS: Sixty-two cases had scored 3, sixty had scored 2, four had scored 1 and one case did not show any expression (48.8, 47.2, 3.1 and 0.8%, respectively). Overall survival was 73.9% at 24 months and 59.5% at 60 months. The disease-free survival was 77.2 and 75.1%, and the disease-specific survival was 79 and 67% at 24 and 60 months, respectively. Uni- and multivariate analysis identified that decreased immunoexpression of protein p63 was a statistically significant factor for the risk of recurrence and death by cancer. CONCLUSIONS: p63 expression was highly prevalent in laryngeal squamous cell carcinomas, and its underexpression was correlated with a worse prognosis.
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Carcinoma de Células Escamosas/metabolismo , Neoplasias Laríngeas/metabolismo , Transativadores/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Laringectomia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Fatores de TranscriçãoRESUMO
We evaluated Fusarium verticillioides and fumonisin contamination in maize samples after application of a non-aflatoxigenic Aspergillus flavus strain in the field. The sampling was performed 150 days after planting. The results showed a reduction in F. verticillioides frequency, as well as in fumonisin levels when samples were obtained from field areas treated with non-aflatoxigenic A. flavus strain. These results suggested a competition for substrate or space between fungi reducing the frequency of F. verticillioides and, consequently, fumonisin production.
Assuntos
Aspergillus flavus , Fumonisinas/toxicidade , Fusarium , Zea mays , MicotoxinasRESUMO
Tungsten is a critical raw material for European and U.S. economies. Tungsten mine residues, usually considered an environmental burden due to e.g. arsenic content, are also secondary tungsten resources. The electrodialytic (ED) process and deep eutectic solvents (DES) have been successfully and independently applied for the extraction of metals from different complex environmental matrices. In this study a proof of concept demonstrates that coupling DES in a two-compartment ED set-up enhances the removal and separation of arsenic and tungsten from Panasqueira mine secondary resources. Choline chloride with malonic acid (1:2), and choline chloride with oxalic acid (1:1) were the DES that in batch extracted the average maximum contents of arsenic (16%) and tungsten (9%) from the residues. However, when ED was operated at a current intensity of 100 mA for 4 days, the extraction yields increased 22% for arsenic and 11% for tungsten, comparing to the tests with no current. From the total arsenic and tungsten extracted, 82% and 77% respectively were successfully removed from the matrix compartment, as they electromigrated to the anolyte compartment, from where these elements can be further separated. This achievement potentiates circular economy, as the final treated residue could be incorporated in construction materials production, mitigating current environmental problems in both mining and construction sectors.