353 resultados para morbidade psiquiátrica.


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Bases Gerais da Cirurgia - FMB

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

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Hematological values from captive vampire bats Desmodus rotundus (E. Geoffroy, 1810). Desmodus rotundus is one of the hematophagous bat species that are responsible for significant losses to livestock and has important involvement on public health. The great interest on this bat species made it becomes the target of many investigations a required its maintenance in laboratories. Similarly to others mammals, hematological evaluation has been utilized to assess the health and morbidity state of bats, however there are scarce studies with captive bats. The aim of this study was to investigate the hypothesis that is possible to feed the vampire bat D. rotundus with frozen blood treated with citrate during a long captivity period without hematological dyscrasias. Therefore, complete blood count was performed monthly from 15 adult females kept for 345 days in cages and fed with frozen blood added to citrate. The erythrocyte concentration (9.02 ± 1.43 x1012/L), PCV (0.47 ± 0.08 L/L) and hemoglobin (163.9 ± 31.5 g/L) obtained from free-living bats (immediately after capture) were lower or similar to those obtained after 345 days of captivity, presenting erythrocytes’ count of 11.01 ± 0.82 x1012/L, packed cell volume of 0.50 ± 0.05 L/L and hemoglobin level of 158 ± 10.1 g/L. The total white blood cell (11.09 ± 6.07 x109 /L) and segmented neutrophil counts (9.85 ± 3.5 x109 /L) of free living D. rotundus decreased significantly after 345 days of captivity, with values of 3.98 ± 1.98 and 1.87 ± 978.6 x109 /L respectively, which are similar to bats from temperate regions in hibernation period. This study proved that is possible to feed D. rotundus for long periods of captivity with citrated blood without the occurrence of anemia, erythrocyte or other hematologic dyscrasia

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Fundamentation: The correction of maxillary transverse deficiencies involves orthodontic and surgical procedures that can be performed before or after skeletal maturity. The surgically assisted rapid maxillary expansion (SAR ME) is performed by osteotomies through the lateral walls of the maxilla, zygomatic and canines buttresses, palatal and pterygomaxillary sutures, causing the maxillary disjunction. Followed by activation of the expander to the desired over-expansion in order to correct intercuspal later. Objective: The purpose of this study was to discuss the issues involved in the diagnosis of maxillary atresia, SAR ME indications, as well as surgical technique, through a case study. Methods: The male patient, 19 years old, had severe transverse maxillary deficiency with facial pattern III , Class III , with great lip incompetence. The patient underwent general anesthesia in a hospital environment, the osteotomies was done according to the technique described by Epker and Wolford (1980). Postoperatively, the patient underwent activations daily for 15 days and after 6 months, the orthodontist installed fixed orthodontic appliance to prepare the patient to orthognathic surgery later. Conclusion: The diagnosis by clinical evaluation and models study is essential for the indication of SAR ME and this procedure provides good predictability in the correction of transverse deficiency, with minimal morbidity.

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A expansão rápida da maxila cirurgicamente assistida (ERMCA) é realizada por meio de osteotomias nos pilares da maxila e na sutura palatina mediana, promovendo a correção da deficiência transversa da maxila. Técnicas menos invasivas foram descritas, visando à realização desses procedimentos sob anestesia local, eliminando os custos de internação hospitalar e trazendo maior conforto aos pacientes. A proposta deste trabalho foi discutir os aspectos envolvidos na simplificação da técnica da ERMCA sob anestesia local por meio do relato de caso clínico-cirúrgico de paciente com 27 anos de idade. Conclui-se que o diagnóstico por meio da avaliação clínica e dos modelos de estudo é essencial para a indicação da ERMCA e esse procedimento proporciona boa previsibilidade na correção da deficiência transversal, com mínima morbidade. Além disso, a utilização de uma técnica minimamente invasiva é efetiva no tratamento de maxilas atrésicas, com índices de recidiva semelhantes aos das técnicas mais invasivas.

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Patients infected with HIV can present several complications related to oral health. Today, the reduction of morbidity and mortality is evidenttreatment with antiviral enhances the quality of life of patients. The increase in comfort, stability, function and improving quality of life have led these patients to seek treatment with osseointegrated implants. This study aimed to discuss, based on the literature, the rehabilitation treatment with osseointegrated implants in patients HIV positive. For this we carried out a literature review including the subject in the databases: PubMed, Cochrane, ISI Dentistry and Oral Science in the last 20 years. The issue was addressed for the first time in 1998, describing a clinical case, the patient had successful rehabilitation with osseointegrated implants. However, the literature states that the indications must be carefully analyzed (2007), since there are few prospective controlled studies. There is doubt as to the use of dental implant therapy in patients with HIV-positive, and the complications are related to the patient’s systemic condition. It is essential to understand the clinical manifestations and complications of the disease before the implant therapy. It is observed that the dental implant therapy in patients with HIV positive is a predictable treatment option, it´s need an adequate control of oral and systemic conditions, and studies with larger sample, longer follow-up and randomized studies are important for evaluating the success therapy.

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Neoplasias of the head and neck correspond to the fifth most common cancer in the world, with high mortality and morbidity. The aim of this study was to show, through a literature review, a little about the epidemiology, risk factors, diagnosis and therapy of the most common malignant tumors of each anatomical region of the head and neck. The research of the articles was made in MEDLINE data base, with a total of 52 articles used. In this review, we analyze the main aspects related to the tumors of oral cavity, pharynx, larynx and salivary glands. Almost all cancers of the head and neck affecting the mucosa of the upper aerodigestive tract are derived from squamous cells. Therefore, the risk factors between the various types of tumors are similar, with alcohol and tobacco being the main ones. To be composed of several distinct structures, the head and neck tumors deserve a diagnostic and therapeutic approach individualized for each anatomical region. Controllingthe risk factors and doing the right approach, it is expected that the incidence of cancers of the head and neck decreases, thereby reducing mortality from malignant neoplasms worldwide

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Investigated in this paper, as contributions to Foucault's genealogy of knowledge, the historical constitution of the joint activities between Work and Care in Mental Health (called Therapeutic Workshops, among other names) in their different purposes and dimensions that contributed to the production care of patients with psychological distress at different times. History is here understood as a multiplicity (and nonlinearity) of time series and various blending and shuffleforming speeches as truths. In conjunction we have discussed, we conclude that the work as a therapeutic modality in nursing homes, there emerged in the world of psychiatry, but of capitalism. Associated with measures of occupation "empty minds" of misfits, later earned the position of an instrument of discipline and social regulation. With the Psychiatric Reform, activities Work in Mental Health have been re-invented as spaces enablers of access to citizenship and contractuality social network users.

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Bone reconstructions are traditionally conducted with autogenous grafts harvested from intra- or extra-oral donor sites to reestablish the lost bone volume for further implant-prosthetic rehabilitation. The calvarial bone has been studied as an excellent donor site in large atrophic situations, presenting low resorption rates, as well as complications and minimal morbidity. The hospitalization time is short, with low pain levels, short functional limitations, and invisible scars. The skull microarchitecture is predominantly cortical in the presence of growth factors that demonstrate their osteogenic, osteoinductive, and osteoconductive abilities resulting in low resorption rate and high predictability when compared to the iliac crest. Dural lacerations, extra and subdural bleeding, cerebrospinal fluid leakage, and brain damage have been minimized due to the development of surgical technique. The delimitation of diploe, preserving the internal skull cortex before osteotomy at the donor made it possible to reduce accidents and complications. The aim of this paper is to show a technical and to discuss aspects of the use of calvarial bone in the reconstruction of severely atrophic maxilla for oral rehabilitation with osseointegrated implants.

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Bone is a specialized connective tissue, vascular and dynamic changes over the life of the organism. When injured, has a unique ability to regenerate and repair without the presence of scars, but in some situations due to the size of the defect, the bone tissue does not regenerate so completely, it is necessary to carry out bone grafting procedures. Considering there are various types of grafts and various donor sites. Thus, the aim of this study was to review the literature to some type of graft most commonly used in dentistry. Given the importance of bone reconstruction in oral and maxillofacial surgery, it is necessary to know the viability and influence of biomaterials, or not associated with autogenous grafts in bone repair. Even this, with many qualities, but further studies should be done to achieve each day, a synthetic material compatible with bone tissue lost in adequate amounts without requiring extra-oral surgeries that are considered to be devoted to higher morbidity.

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The techniques of bone reconstruction for atrophic maxillae have been improved in order to promote bone tissue growth in both height and thickness. The grafts performed with use of autogenous bone is considered the gold standard by most researchers, for demonstrating osteogenic capacity and not to promote antigenic response. However, this type of grafting is not possible to get bone tissue in large quantity for extensive renovations. In recent years, alternatives have been researched to overcome the limitations of autogenous bone. Several alternatives have been investigated to supply the disadvantages of autogenous bone grafts. In such studies, allogeneic bone grafts which are obtained from individuals with different genetic load, but from the same species have been extensively used. They can be indicated in cases of arthrosplasty, surgical knee reconstruction, and large bone defects as well as in oral and maxillofacial reconstruction. Besides showing great applicability and biocompatibility, this type of bone is available in unlimited quantities. To rehabilitate atrophic maxillae an option that has been performed with high success rate is the reconstruction with bone graft followed by osseointegrated dental implants to rehabilitate the patient aesthetics and functionally. This paper aims to show the feasibility of allogenic bone as material for reconstruction of atrophic maxilla, and subsequent rehabilitation with metal ceramic fixed prosthesis implant and dental restoration with accompanying three years through literature review and clinical case report.

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Pós-graduação em Patologia - FMB