O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

Effects of topical levobunolol or fixed combination of dorzolamide-timolol or association of dorzolamide-levobunolol on intraocular pressure, pupil size, and heart rate in healthy cats

Estudaram-se e compararam-se os efeitos do levobunolol, da combinação fixa de dorzolamida 2%-timolol 0,5% e da associação de dorzolamida 2% com levobunolol 0,5% sobre a pressão intra-ocular (PIO), o diâmetro pupilar (DP), a freqüência cardíaca (FC) e a hiperemia conjuntival em 18 gatos saudáveis. PIO, DP, FC e hiperemia conjuntival foram aferidos diariamente, em três horários distintos (9h, 14h e 18h). Três grupos foram formados (n=6) e um olho de cada animal recebeu, aleatoriamente, uma gota de levobunolol (L), ou a combinação comercial à base de dorzolamida-timolol (DT), ou a associação de dorzolamida com levobunolol (DL). Parâmetros basais foram aferidos no primeiro dia (dia 0). Nos quatro dias consecutivos, os fármacos foram instilados às 8h e 20h e os parâmetros aferidos nos mesmos horários. Todos os parâmetros decresceram significativamente em relação aos valores basais (P<0,001) e não se observou hiperemia conjuntival. O levobunolol reduziu significativamente a PIO, o DP e a FC e o foi o fármaco que mais reduziu a FC. Não se observou efeito sinérgico na redução da PIO quando a dorzolamida foi adicionada ao levobulol.

Influência da idade no comportamento da pressão intraocular em uma população da região Sul-brasileira

OBJETIVO: Verificar influência da idade no comportamento da pressão intraocular (PIO) em população acima de 40 anos. MÉTODOS: Neste estudo observacional transversal realizado no município de Piraquara - PR, a PIO foi aferida através da tonometria de Goldmann. Todos os indivíduos foram submetidos a exame de triagem, sendo os suspeitos de glaucoma ou hipertensão ocular encaminhados ao atendimento de retorno para realização de exame oftalmológico completo. Para fins de análise estatística, os pacientes foram divididos em grupos etários (40-49; 50-59; 60-69 e acima de 70 anos). Posteriormente todos os pacientes portadores de glaucoma ou suspeita, hipertensão arterial sistêmica (HAS) ou Diabetes mellitus (DM) foram excluídos. RESULTADOS: Avaliaram-se 3360 indivíduos com média de idade de 54,04 ± 10,52 anos, sendo 59,79% do sexo feminino. Não se observou diferença estatisticamente significativa entre a média da PIO nos diferentes grupos etários (p=0,19; teste ANOVA). da mesma forma, não foi observada correlação significativa entre a PIO e a idade (p = 0,11; correlação linear de Pearson). Após exclusão dos indivíduos portadores de HAS (1671), DM (n=360), glaucoma ou suspeita de glaucoma (n=161) não se observou diferença estatisticamente significativa entre a média da PIO e a idade (p=0,17; teste ANOVA). No entanto, uma fraca correlação negativa, porém significativa, foi encontrada entre PIO e idade (p=0,03; R=-0,055, correlação linear Pearson). CONCLUSÃO: Na presente amostra, não foi observada influência significativa da idade na PIO, entretanto, após a exclusão de indivíduos com glaucoma, HAS e DM, observou-se uma fraca correlação linear negativa e significativa entre as duas variáveis.

Estudo Comparativo de Juntas Soldadas a TIG e Laser Empregando-se Ti com Pureza Comercial Utilizado em Prótese sobre Implantes

Welding in the dentistry has been used for great part of the specialized dentist-surgeons in the implants area to solve prosthesis supported by implant adaptation problems. The development of new equipments Laser and TIG allowed a larger use of these processes in the prosthesis production. In this work, it was studied welded joints made by Laser and TIG, using commercial purity titanium, cpTi, applied in prosthesis supported by implants. The weld characterizations were carried out by light microscopy, EDS_elementary mapping, microhardness and tensile test. Through metallographic characterization, the weld bead presented a martensitic microstructure in the Laser welding process, originated from shear provoked by deformations in the lattice. This caused structural changes of the transformed area, which determines a fine plate-like morphology. In the weld bead from TIG, besides presenting higher hardness, was observed formation of Widmansttaten structure, which is characteristic of a geometric model, resulted of new phase formation along of the crystallographic plans. The martensitic structure is more refined than Widmansttaten structure, due to the high-speed cooling (10(3)degrees C/s) imposed by the Laser process.

Effects of travoprost 0.004% compared with latanoprost 0.005% on the intraocular pressure of normal dogs

Purpose To compare the effects of travoprost 0.004% and latanoprost 0.005% on the intraocular pressure (IOP) of normal dogs.Methods Twenty mixed breed dogs were randomized to two groups: latanoprost was used in group A and travoprost in group B. The drugs were instilled in the right eye of the dogs, whereas the left eye received placebo. Both drugs were instilled once a day at 8 AM during 5 days. IOP measurements were made at 8 AM, 10 AM, 2 PM and 8 PM during the 5 days of treatment, the 3 days that preceded treatment, and 3 days following treatment. Presence of blepharospasm, miosis, anterior chamber flare, and conjunctival hyperemia were evaluated during the study.Results Mean IOP was significantly reduced in the eyes treated with both latanoprost and travoprost, when compared with the eyes treated with placebo (P < 0.05). There was no statistically significant difference between the mean IOPs of eyes treated with latanoprost and travoprost at all time intervals during baseline, treatment, and recovery (P > 0.05). on the fifth day of treatment and on the first day of the recovery period, a severe ocular hypotension was noted with both drugs, resulting in imprecise readings with the tonometer. Miosis and conjunctival hyperemia were observed in the treated eyes of both groups, whereas flare was noticed in one latanoprost-treated eye.Conclusion Travoprost 0.004% significantly reduces the IOP in normal dogs. The hypotensive effect obtained with travoprost 0.004% is comparable to that obtained with latanoprost 0.005%.

Evaluation of intraocular pressure in association with cardiovascular parameters in normocapnic dogs anesthetized with sevoflurane and desflurane

The objective of this study was to determine intraocular pressure (IOP) and cardiac changes in normocapnic dogs maintained under controlled ventilation and anesthetized using sevoflurane or desflurane. Sixteen healthy adult mixed-breed dogs, seven males and nine females, weighing 10-15 kg were used. The dogs were randomly assigned to one of two groups composed of eight animals anesthetized with sevoflurane (SEVO) or desflurane (DESF). In both groups, anesthesia was induced with propofol (10 mg/kg), and neuromuscular blockade was achieved with rocuronium (0.6 mg/kg/h IV). No premedication was given. Ventilation was adjusted to maintain end-tidal carbon dioxide partial pressure at 35 mmHg. Anesthesia was maintained with 1.5 minimum alveolar concentration (MAC) of sevoflurane or desflurane. In both groups IOP was measured by applanation tonometry (Tono-Pen) before induction of anesthesia. IOP, mean arterial pressure (MAP), heart rate (HR), cardiac index (CI) and central venous pressure (CVP) were also measured 45 min after the beginning of inhalant anesthesia and then every 20 min for 60 min. A one-way repeated measures ANOVA was used to compare data within the same group and Student's t-test was used to assess differences between groups. P < 0.05 was considered statistically significant. Measurements showed normal IOP values in both groups, even though IOP increased significantly from baseline during the use of desflurane. IOP did not differ between groups. CI in the desflurane group was significantly greater than in the sevoflurane group. Sevoflurane and desflurane have no clinically significant effects on IOP, MAP, HR, CI or VCP in the dog.

Fadiga de grampos de retenção em prótese parcial removível. Efeito de ligas, espessuras e técnicas de fusão. Parte I.

The authors looked for the verification of the fatigue of retentive clasps utilized on the removable partial denture. According to this, it was idealized and built on assay machine, that through movements, simulate the insertion and removal of the clasp for a pattern tooth, manufactured on cobalt-chromium which has all the preparation normally utilized to the correct confection of this type of prosthesis. It was utilized three different commercial alloys based on cobalt-chromium: L1-Biosil; L2-Steldent; L3-Duracron. It was utilized the T clasp of Roach, with was tested upon three different proportions among width and thickness: E1-1.7;E2-2.0 and E3-2.3 and was casted through two casting techniques: F1-oxygen-gas and F2-oxygen-acetylene. The clasps were tested on the machine, which allowed the reading of the number of insertion and removal cycles made until fatigue appeared. The obtained results were submitted to the statistic analysis and the authors concluded that: a) L3 (Duracrom) obtained the best results followed by L1 (Biosil) and finally L3 (Steldent); b) among the analyzed thickness, the best results were obtained by E3, followed by E2 and after this E1; c) form the casting techniques, F2 gave us the best results.

Fadiga de grampos de retenção em prótese parcial removível. Efeito de ligas, espessuras e técnicas de fusão. Parte II.

The authors tested the T clasp of Roach in three differents proportions among width and thickness: E1-1.7; E2-2.0 and E3-2.3, with a constant length of 15 mm. These clasps were casted with three cobalt-chromium alloys (L1-Biosil; L2-Steldent and L3-Duracrom), through two casting techniques (F1-oxygen-gas and F2-oxygen-acetylene). The fatigue of the clasps were verified by using and assay machine, that through movements, simulate the insertion and removal of the clasps for a pattern which were obtained from a premolar, prepared in a surveyor. This machine detect the fatigue of the clasps and count the number of cycles of insertion and removal realized. The obtained results of the interaction between the analysed factors, were submitted to the statistic analysis and the authors concluded that: a) the interaction of factors, Alloy x Thickness, Alloy x Casting Technique and Thickness x Casting Technique did not change the order of effects that the factors showed separately but gave rise to effects of different magnitude for any observed sense; b) the simultaneous interaction of the factors Alloy x Thickness x Casting Technique confirmed the superiority of the L3 alloy, the thickness E3 and the F2 casting technique.

Effects of metaraminol bitartrate on intraocular pressure in dogs under halothane anesthesia

The effects of metaraminol bitartrate on intraocular pressure (IOP) were studied in dogs anesthetized with halothane. Forty-five healthy, adult, mixed-breed dogs, of both sexes, were divided into three groups of 15 dogs each (GI, GII and GIII) and maintained under general anesthesia with halothane after tranquilization with levomepromazine and induction with thiopental. Saline (0.9%) was administered intravenously (IV) to GI through continuous infusion, at a velocity of 0.125 mL kg -1 min -1. GII and GIII received metaraminol 0.004% IV, at a dose of 5 μg kg -1 min -1, at 0.125 mL kg -1 min -1 and at a dose of 2 μg kg -1 min -1, at 0.06 mL kg -1 min -1, respectively. IOP was measured by applanation tonometry (Tono-Pen) before and during anesthesia. Results showed that IOP decreased in GI, increased in GII, and remained at basal levels in GIII. Continuous infusion of metaraminol at 2 μg kg min -1 maintained IOP at pretest levels, while infusion at 5 μg kg -1 min -1 produced an elevation of IOP.

Evaluation of intraocular and partial CO2 pressure in dogs anesthetized with propofol

The effects of propofol on intraocular pressure (IOP) and end tidal CO2 (ETCO2) were studied because an elevation in the latter may alter IOP. Twenty dogs were divided into two groups (G1 and G2). G1 dogs were induced with 10 mg/kg (IV) of propofol followed by a 0.4 mg/kg/min continuous infusion of the same agent diluted in a 0.2% dextrose solution for 1 h. G(CAPS) 2 dogs served as the control group, where only dextrose solution was administered, under the same time intervals as in G1. Applanation tonometry (Tono-Pen) was used to determine IOP and ETCO2 as a method to determine partial CO2 pressure. Measurements were taken every 15 min for 1 h, with M1 occurring immediately before IV administration. IOP and ETCO2 were not statistically significant in either groups. Based on the results, it may be concluded that propofol does not alter IOP and ETCO2.

Formulário do perfil psicossocial do paciente anoftálmico com indicação de prótese ocular

The patient with anophthalmia may present feelings of inferiority and rejection. Knowing his/her needs and expectations contribute to a better technical intervention. Purpose: To elaborate a questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis. Methods: An exploratory research was used to elaborate the questionnaire, by means of a guided interview followed by writing down what was said by the interviewees, who were adult patients of the Bucco-Maxillo-Facial Prosthesis Center of FOSJC - UNESP. The guided interview was made up of 14 items directly related to the future outline of the profile. Each item of the interview resulted in questions of the questionnaire, which was pretested twice before reaching its final version. Results: The patients reported, in the exploratory research, unpleasant feelings with the loss of the eye; relationship shyness; expectations regarding surgery and prosthesis use; a wish to receive explanations and to hold their opinion about the treatment. The questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis is, therefore, made of 43 questions divided into 5 blocks in order to aid the comprehension of the inquired aspects and to facilitate both the computation of data and discussion, and also to improve the selection of questions according to the objective of the researcher or professional. Conclusions: It was concluded that the questionnaire was viable, can be used in full or by selecting blocks and provide a panorama of the patient's history related to the problem he/she faces, from the loss of the ocular globe to the confection of the prosthesis.

Avaliação das condutas de biossegurança em laboratórios de prótese dentária de João Pessoa, PB, Brasil

Objective: To evaluate the biosecurity measures adopted in dental prosthesis laboratories of the city of João Pessoa, PB, Brazil with respect to prosthetic works sent by dentists. Method: Twenty-five dental prosthesis technicians (DPT) of the city of João Pessoa, PB, filled out a questionnaire referring to their knowledge of the biosecurity principles, disinfection of impressions and other prosthetic items, and the use of individual protection equipment (IPE). Results: Although 92% of the interviewees believed in the possible occurrence of cross-infection between dental prosthesis laboratories and dental offices, 64% declared that the prosthetic works received in their laboratories do not undergo any disinfection procedure. It was also observed that, for disinfection of impressions and stone casts, the chemical substances are not used as recommended by the manufacturers or are innocuous to microorganisms. Regarding the use of IPE, 60% of the DPT used mask, but only 4% used gowns. With respect to the measures taken regarding the impressions received from dental offices, 56% of the interviewees only wash them in running tap water, and 56% of the stone casts that arrive at the laboratory are not disinfected in any way. Conclusion: There is a need for more motivation and instructions to DPT regarding the prevention of cross-contamination during sending and receiving of prosthetic works between dental prosthesis laboratories and dental offices because the DPT evaluated in this study were found negligent with respect to disinfection procedures.

The value of intraocular pressure asymmetry in diagnosing glaucoma

PURPOSE