90 resultados para Public hospital service


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Objective: The aim of this study was to evaluate the 5-year clinical performance of composite restorations of non-carious cervical lesions (NCCL) using a total-etch adhesive system with or without collagen removal with 10% sodium hypochlorite (NaOCl).Methods: In this study randomized controlled split-mouth clinical trial, one-hundred and thirty-eight NCCL were restored into 30 patients. Each patient received at least one pair of composite restorations (Filtek A110/3M ESPE), bonded either with 2 techniques: Conventional Technique - acid etching with 37% phosphoric acid + Prime & Bond NT (Denstply DeTrey); Deproteinization Technique - acid etching with 37% phosphoric acid + 10% NaOCl for 1 min + Prime & Bond NT. The two techniques were evaluated using the United States Public Health Service (USPHS) criteria at baseline, 18 months, 3 and 5 years. After five years, one-hundred and six restorations were evaluated in 24 patients. Data were analyzed using the Chi-Square test (p < 0.05).Results: There were no statistically significant differences between the two techniques regarding the evaluated parameters (p > 0.05).Conclusion: After 5 years, the application of 10% NaOCl deproteinization on etched dentine did not affect the clinical performance of composite restorations placed in NCCL when compared to the conventional total-etch technique.Clinical significance: Clinical studies evaluating the performance of the Deproteinization Technique are scarce. In this study, this technique showed similar clinical performance at the end of 5 years when compared to a conventional total-etch technique. (C) 2014 Elsevier Ltd. All rights reserved.

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

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Purpose: The purpose of this study was to comparatively assess the seven-year clinical performance of a one-bottle etch-and-rinse adhesive with resin composite (RC) and resin-modified glass ionomer (RMGI) restorations in noncarious cervical lesions.Methods and Materials: One operator placed 70 restorations (35 restorations in each group) in 30 patients under rubber dam isolation without mechanical preparation. The restorations were directly assessed by two independent examiners, using modified US Public Health Service criteria at baseline and 6, 12, 24, 60, and 84 months. The obtained data were tabulated and statistically analyzed using the Fisher and McNemar tests. A difference was significant if p<0.05.Results: Twenty patients were available for recall after seven years (66.6%), and 25 RC and 26 RMGI restorations out of 70 restorations were evaluated. Excellent agreement was registered for all criteria between examiners (kappa >= 0.85). Alfa and bravo scores were classified as clinically acceptable. The McNemar test detected significant differences within RC restorations between baseline and seven-year evaluations for anatomic form, marginal integrity, and retention (p<0.05). For RMGI restorations, a significant difference was identified for marginal integrity (p<0.05). As to material comparison, the Fisher exact showed a better retention performance for RMGI restorations than for RC restorations (p<0.05). Twelve composite restorations were dislodged (52.0% retention) and three ionomer restorations were lost (88.5% retention). The cumulative success rate for RC and RMGI was 30% and 58.1%, respectively.Conclusions: After seven years of service, the clinical performance of RMGI restorations was superior to that of the adhesive system/resin composite restorations in this study.

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The aim of this study is to investigate the significance of educational practices aimed at children in non formal education, in this case, specifically, the hospital context. The chosen methodology is part of an investigation conducted in two phases. In the first phase was carried out a theoretical stage, scientifically based studies guided by an historical-cultural and Sociology of Childhood, enabling placement on the particularities of children, the playfulness and the positioning of Pedagogy in the hospital. After this theoretical study was performed the second phase, with the completion of an empirical study with a research and intervention in a hospital playroom, in a public hospital considered a regional center in the northwestern city of São Paulo. The methodological procedures adopted for this empirical study were participant observation, interviews, action research and a questionnaire. Participant observation and action research are conducted within the brinquetodeca in five meetings with about 15 children, interviews were conducted with three family members and the questionnaire was applied to a healthcare professional. Among the results we can mention the following findings: a confirmation of the necessity of work in the hospital directing playful adaptations for the preservation and development of children's learning, and recent publications are scarce about the Hospital Education and underscore the need for the professional practice of education in non-school, the educational activities carried out reveals the possibilities of offering the child the continuation of their educational activities involving the playful and educational, the international and national literature on educational practices in the hospital allow to check ...(Complete abstract click electronic access below)

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In this work was developed a fuzzy computational model type-2 predictive interval, using the software of the type-2 fuzzy MATLAB toolbox, the final idea is to estimate the number of hospitalizations of patients with respiratory diseases. The interest in the creation of this model is to assist in decision makeshift hospital environment, where there are no medical or professional equipment available to provide the care that the population need. It began working with the study of fuzzy logic, the fuzzy inference system and fuzzy toolbox. Through a real database provided by the Departamento de Informática do Sistema Único de Saúde (DATASUS) and Companhia de Tecnologia de Saneamento Básico (CETESB), was possible to start the model. The analyzed database is composed of the number of patients admitted with respiratory diseases a day for the public hospital in São José dos Campos, during the year 2009 and by factors such as PM10, SO2, wind and humidity. These factors were analyzed as input variables and, through these, is possible to get the number of admissions a day, which is the output variable of the model. For data analysis we used the fuzzy control method type-2 Mamdani. In the following steps the performance developed in this work was compared with the performance of the same model using fuzzy logic type-1. Finally, the validity of the models was estimated by the ROC curve

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

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Pós-graduação em Odontologia Preventiva e Social - FOA

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The aim of this study was to compare the efficacy of a direct clinical evaluation method with an indirect digital photographic method in assessing the quality of dental restorations. Seven parameters (color, occlusal marginal adaptation, anatomy form, roughness, occlusal marginal stain, luster, and secondary caries) were assessed in 89 Class I and Class II restorations from 36 adults using the modified US Public Health Service/Ryge criteria. Standardized photographs of the same restorations were digitally processed by Adobe Photoshop software, separated into the following four groups and assessed by two calibrated examiners: Group A: The original photograph displayed at 100%, without modifications (IMG100); Group B: Formed by images enlarged at 150% (IMG150); Group C: Formed by digital photographs displayed at 100% (mIMG100), with digital modifications (levels adjustment, shadow and highlight correction, color balance, unsharp Mask); and Group D: Formed by enlarged photographs displayed at 150% with modifications (mIMG150), with the same adjustments made to Group C. Photographs were assessed on a calibrated screen (Macbook) by two calibrated clinicians, and the results were statistically analyzed using Wilcoxon tests (SSPS 11.5) at 95% CI. Results: The photographic method produced higher reliability levels than the direct clinical method in all parameters. The evaluation of digital images is more consistent with clinical assessment when restorations present some moderate defect (Bravo) and less consistent when restorations are clinically classified as either satisfactory (Alpha) or in cases of severe defects (Charlie). Conclusion: The digital photographic method is a useful tool for assessing the quality of dental restorations, providing information that goes unnoticed with the visual-tactile clinical examination method. Additionally, when analyzing restorations using the Ryge modified criteria, the digital photographic method reveals a significant increase of defects compared to those clinically observed with the naked eye. Photography by itself, without the need for enlargement or correction, provides more information than clinical examination and can lead to unnecessary overtreatment.

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The aim of this prospective, blind, and randomized clinical trial was to assess the effectiveness of repair of localized clinical defects in amalgam restorations that were initially scheduled for replacement. A cohort of 20 patients with 40 (Class I and Class II) amalgam restorations that presented one or more clinical features that deviated from the ideal (Bravo or Charlie) according to US Public Health Service criteria, were randomly assigned to either the repair or the replacement group—A: repair, n = 19; and B: replacement, n = 21. Two examiners who had calibration expertise evaluated the restorations at baseline and 10 years after according to seven parameters: marginal occlusal adaptation, anatomic form, surface roughness, marginal staining, contact, secondary caries, and luster. After 10 years, 30 restorations (75%) were evaluated (Group A: n = 17; Group B: n = 13). Repaired and replaced amalgam restorations showed similar survival outcomes regarding marginal defects and secondary caries in patients with low and medium caries risk, and most of the restorations were considered clinically acceptable after 10 years. Repair treatment increased the potential for tooth longevity, using a minimally interventional procedure. All restorations trend to downgrade over time.

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Purpose: The objective of this study was to clinically evaluate sealed composite restorations after 10 years and compare their behavior with respect to controls. Methods and Materials: The cohort consisted of 20 patients aged 18 to 80 years with 80 composite restorations. All participants in the sealing and no-treatment groups presented with clinical features for the marginal adaptation that deviated from the ideal and were rated Bravo (United States Public Health Service criteria). Composites with Alfa values for the marginal adaptation were used as the positive control. Results: The marginal adaptation behavior was similar between the sealing and control (+) groups, with a high frequency of Bravo values in the 10th year (80% and 51%, respectively). Most of the no-treatment (-) group maintained the Bravo values (91%) for 10 years, although some restorations (9%) progressed to Charlie values. The anatomy parameter differed significantly between the first and 10th years, with deterioration in all three groups (p,0.05). The secondary caries parameter had a similar behavior in the three groups (p.0.05). Conclusions: Sealing the margins of the composite resin restorations had no significant effect compared with the control groups, under the conditions of this study. Sealing the restorations substantially improved the marginal staining and marginal adaptation parameters, although by the tenth year they were similar to the group without intervention.

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