88 resultados para refusal of medical treatment


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Traumatic tooth injuries involve function and aesthetics and cause damage that range from minimal enamel loss to complex fractures involving the pulp tissue and even loss of the tooth crown. Technical knowledge and clinical experience are essential to establish an accurate diagnosis and provide a rational treatment. The purpose of this study was to evaluate the knowledge of Restorative Dentistry specialists about the management of crown and crown-root fractures based on treatment plans proposed by these professionals for these cases. A descriptive questionnaire was mailed to 245 Restorative Dentistry specialists with questions referring to their professional profile and the treatment plans they would propose for the management of crown and crow-root fractures resulting from dental trauma. One hundred and fifty-four questionnaires were returned properly filled. The data were subjected to descriptive statistics and the chi-square test was used to determine the frequency and the level of the significance among the variables. The analysis of data showed that in spite of having a specialist title, all interviewees had great difficulty in planning the treatments. As much as 42.8% of the participants were unable to treat all types of dental trauma. Complicated and uncomplicated crown-root fractures posed the greatest difficulties for the dentists to establish adequate treatment plans because these fractures require multidisciplinary knowledge and approach for a correct case planning and prognosis.

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This study evaluated the effect of heat treatment on CrNi stainless steel orthodontic archwires. Half of forty archwires of each thickness - 0.014 (0.35 mm), 0.016 (0.40 mm), 0.018 (0.45 mm) and 0.020 (0.50 mm) (totalling 160 archwires) - were subjected to heat treatment while the remainder were not. All of the archwires had their individual thickness measured in the anterior and posterior regions using AutoCad 2000 software before and after compressive and tensile strength testing. The data was statistically analysed utilising multivariance ANOVA at a 5% significance level. All archwires without heat treatment that were subjected to tensile strength testing presented with anterior opening, which was more accentuated in the 0.020 archwires. In the posterior region, the opening produced by the tensile force was more accentuated in the archwires without heat treatment. There was greater stability in the thermally treated archwires, especially those subjected to tensile strength testing, which indicates that the heat treatment of orthodontic archwires establishes a favourable and indispensable condition to preserve the intercanine width.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Research has clarified the properties required for polymers that resist bacterial colonisation for use in medical devices. The increase in antibiotic-resistant microorganisms has prompted interest in the use of silver as an antimicrobial agent. Silver-based polymers can protect the inner and outer surfaces of devices against the attachment of microorganisms. Thus, this review focuses on the mechanisms of various silver forms as antimicrobial agents against different microorganisms and biofilms as well as the dissociation of silver ions and the resulting reduction in antimicrobial efficacy for medical devices. This work suggests that the characteristics of released silver ions depend on the nature of the silver antimicrobial used and the polymer matrix. In addition, the elementary silver, silver zeolite and silver nanoparticles, used in polymers or as coatings could be used as antimicrobial biomaterials for a variety of promising applications. (C) 2009 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.

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Objective: The objective of this study was to evaluate the influence of homeopathic treatment with comfrey (Shymphytum officinalis 6CH) on radiographic bone density and area around titanium implants.Material and methods: Forty-eight rats were divided into two groups of 24 animals each: a control group (C) and a test group (SO). Each animal received one titanium micro-implant placed in the tibia. The animals in Group SO were subjected to 10 drops of comfrey 6CH per day mixed into their drinking water until the day of sacrifice. Eight animals of each group were sacrificed at 7, 14 and 28 days post-surgery, respectively.Standardized digital radiographs were obtained on the day of implant installation (baseline images) and on the day of sacrifice (final images). Digital subtraction of the two corresponding images was performed to evaluate changes in bone density and the area related to change around the implant between baseline and final images.Results: Subtraction images demonstrated that a significant difference existed in mean shade of gray at 14 days post-surgery between Group SO (mean 175.3 +/- 14.4) and Group C (mean 146.2 +/- 5.2). Regarding the area in pixels corresponding to the bone gain in Group SO, the differences observed between the sacrifice periods and groups were only significant at 7 days sacrifice between Group SO (mean 171.2 +/- 21.9) and Group C (mean 64.5 +/- 60.4).Conclusion: Within the limits of this study, comfrey administration promotes an increase in radiographic bone density around titanium implants in the initial period of bone healing.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Purpose: To evaluate the influence of surface treatment on the shear bond strength between a Co-Cr alloy and two ceramics.Materials and Methods: Forty-eight metal cylinders were made (thickness: 4 mm, height: 3.7 mm) according ISO TR 11405. The 48 metallic cylinders were divided into four groups (n = 12), according to the veneering ceramic (StarLight Ceram and Duceram Kiss) and surface treatments: air-particle abrasion with Al(2)O(3) or tungsten drill (W). Gr1: StarLight + Al(2)O(3); Gr2: StarLight + W; Gr3: Duceram + Al(2)O(3); and Gr4: Duceram + W. The specimens were aged using thermal cycling (3000 x, 5 to 55 degrees C, dwell time: 30 seconds, transfer time: 2 seconds). The shear test was performed with a universal testing machine, using a load cell of 100 kg (speed: 0.5 mm/min) and a specific device. The bond strength data were analyzed using ANOVA and Tukey's test (5%), and the failure modes were analyzed using an optical microscope (30x).Results: The means and standard deviations of the shear bond strengths were (MPa): G1 (57.97 +/- 11.34); G2 (40.62 +/- 12.96); G3 (47.09 +/- 13.19); and G4 (36.80 +/- 8.86). Ceramic (p = 0.03252) and surface treatment (p = 0.0002) significantly affected the mean bond strength values.Conclusions: Air-particle abrasion with Al(2)O(3) improved the shear bond strength between metal and ceramics used.

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Ferroelectric thin films belong to a class of materials with great technological importance in optic fibers, micro-electromechanical systems, and microprocessors and computers memories.The (1-x)PbMg1/3Nb2/3O3(x)PbTiO3 (PMN-PT) thin films, with x=0, 0.1, 0.35 and 0.5, were prepared by Pechini's process and deposited by spin-coating on Si(100), Pt/Ti/SiO2/Si(100) and quartz substrates. The goal of the present paper is to verify the thermal treatment influence on the perovskite phase formation, which is desirable for these applications. The phase formation was analyzed by X-ray diffraction. The film's surface was characterized by atomic force microscopy to analyze the roughness and the homogeneity. The results of this study indicate that the optimum conditions for obtaining the perovskite phase using a Pt/Ti/SiO2/Si(100) substrate, were drying each deposited layer at 140 degreesC (heating plate), and a final thermal treatment at 600 degreesC for 3 h in a closed system with a lead-rich atmosphere. (C) 2003 Elsevier B.V. All rights reserved.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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INTRODUÇÃO: a Ortodontia passa, atualmente, por um momento de importantes inovações e grande efervescência criativa. Somente para citar algumas mudanças introduzidas ou aprimoradas nos últimos anos, nós podemos relembrar a popularização dos braquetes autoligáveis e o surgimento da ancoragem absoluta com a utilização de implantes ortodônticos. No final da década de 1990, a adoção dos mini-implantes como ancoragem permitiu uma mudança de paradigma que tem influenciado até mesmo a forma de pensar a mecânica ortodôntica. A imbricação das especialidades de Ortodontia e Implantodontia, cujo início se deu com os preparos ortodônticos para posterior inserção de implantes protéticos, floresceu com o uso de implantes palatinos e, posteriormente, com a introdução de mini-implantes. O aprimoramento da técnica de inserção de mini-implantes com a introdução de parafusos autoperfurantes tem permitido, inclusive, o requinte do ortodontista concentrar em suas mãos o planejamento e a colocação dessa preciosa peça de ancoragem. Levando em consideração a versatilidade de posicionamento desses pequenos parafusos, foi desenvolvido um conceito que possibilita a construção de linhas de ação de força que buscam otimizar o planejamento e a previsibilidade da movimentação ortodôntica. OBJETIVO: apresentar alguns resultados clínicos de tratamentos conduzidos com o uso de um sistema de tratamento ortodôntico, o Centrex System, que aproxima a linha de ação da força do centro de resistência das unidades a serem movimentadas. O caminho trilhado até o seu desenvolvimento, cuja teoria mecânica foi apresentada anteriormente nesse periódico, será detalhado para uma melhor compreensão de seu funcionamento.

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Comments about education and medicine teaching were made. The learning and the curriculum in according with the priorities of the country's health had special emphasis.Students and teachers of Botucatu considered that the improvement of the 2nd year medical microbiological course was good with predominantly basic contents. The students prefer a balanced content or predominantly applied to medicine.Three phases of the teaching of microbiological contents are proposed: 1st - in the basic cycly (2nd year); 2nd - into the course of Clinical Laboratory (3rd or 4th year); 3rd - into the clinical cycle, following a program of integration.

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Diethylpropion (DEP) is an amphetamine-like compound used as a coadjutant in the treatment of obesity and which presents toxicological importance as a drug of abuse. This drug causes important behavioral and cardiovascular complications; however, the vascular and behavioral alterations during DEP treatment and withdrawal, have not been determined. We evaluated the effects of DEP treatment and withdrawal on the rat aorta reactivity to noradrenaline, focusing on the endothelium, and the rat behavior during DEP treatment and withdrawal. DEP treatment caused a hyporreactivity to noradrenaline in aorta, reversible after 2 days of withdrawal and abolished by both the endothelium removal and the presence of L-NAME, but not by the presence of indomethacin. Furthermore, DEP treatment increased the general activity of rats. Contrarily, DEP withdrawal caused a decrease in the locomotor activity and an increase in grooming behavior, on the 2nd and 7th days after the interruption of the treatment, respectively. DEP treatment also caused an adaptive vascular response to noradrenaline that seems to be dependent on the increase in the endothelial nitric oxide system activity, but independent of prostaglandins synthesis. The data evidenced chronological differences in the adaptive responses of the vascular and central nervous systems induced by DEP treatment. Finally, a reversion of the adaptive response to DEP was observed in the vascular system during withdrawal, whereas a neuroadaptive process was still present in the central nervous system post-DEP. These findings advance on the understanding of the vascular and behavioral pathophysiological processes involved in the therapeutic and abusive uses of DEP. (C) 2003 Elsevier B.V. (USA). All rights reserved.