A construção de sentidos na avaliação de múltipla escolha do SARESP

Pós-graduação em Estudos Linguísticos - IBILCE

Evaluation of laryngeal mask as an alternative to endotracheal intubation in cats anesthetized under spontaneous or controlled ventilation

Objective To compare the cardiorespiratory effects and incidence of gastroesophageal reflux with the use of a laryngeal mask airway (LMA) or endotracheal tube (ET) in anesthetized cats during spontaneous (SV) or controlled ventilation (CV).Study design Prospective randomized experimental trial.Animals Thirty-two adult crossbred cats, weighing 2.7 +/- 0.4 kg.Methods the cats were sedated with intramuscular (IM) methotrimeprazine (0.5 mg kg(-1)) and buprenorphine (0.005 mg kg(-1)), followed 30 minutes later by induction of anesthesia with intravenous (IV) thiopental (12.5-20 mg kg(-1)). An ET was used in 16 cats and an LMA in the remaining 16 animals. Anesthesia was maintained with 0.5 minimum alveolar concentration (0.6%) of halothane in oxygen using a Mapleson D breathing system. Cats in both groups were further divided into two equal groups (n = 8), undergoing either SV or CV. Neuromuscular blockade with pancuronium (0.06 mg kg(-1)) was used to facilitate CV. Heart and respiratory rates, direct arterial blood pressure, capnometry (PE'CO2) and arterial blood gases were measured. Gastric reflux and possible aspiration was investigated by intragastric administration of 5 mL of radiographic contrast immediately after induction of anesthesia. Cervical and thoracic radiographs were taken at the end of anesthesia. Data were analyzed using ANOVA followed by Student-Newman-Keuls, Kruskal-Wallis or Friedman test where appropriate.Results Values for PaCO2 and PE'CO2 were higher in spontaneously breathing cats with the LMA when compared with other groups. Values of PaO2 and hemoglobin oxygen saturation did not differ between groups. Gastroesophageal reflux occurred in four of eight and two of eight cats undergoing CV with ET or LMA, respectively. There was no tracheal or pulmonary aspiration in any cases.Conclusions and clinical relevance the use of an LMA may be used as an alternative to endotracheal intubation in anesthetized cats. Although aspiration was not observed, gastric reflux may occur in mechanically ventilated animals.

Noncarious Cervical Lesions and Their Association With Toothbrushing Practices: In Vivo Evaluation

Objectives: This pilot study aims to investigate the prevalence of noncarious cervical lesions (NCCLs) in a student population at the Faculty of Dentistry of Aracatuba-UNESP and to assess the potential relation between buccal hygiene habits and the presence and number of NCCLs.Methods: This study was conducted with a sample of 58 young volunteers (15 men and 43 women; mean age, 23.6 +/- 1.8 years and 22.3 +/- 2.4 years, respectively). The research was divided into three steps: 1) clinical assessment; 2) oral-hygiene practices self-report questionnaire; and 3) analysis of toothbrush filament deformations. After the clinical exam the participants were divided into two groups, a control group (without NCCLs) and a test group (NCCLs), according to NCCL presence. The data were statistically analyzed with SPSS 16.0 software, using t-test, chi(2), Fisher exact test, and Spearman correlation.Results: NCCLs were present in 53% of the subjects. The presence of NCCLs was marginally statistically associated with age (p=0.15) and proportionally more prevalent in male (80%) subjects (p=0.01). NCCLs were more concentrated in the posterior-superior quadrant (93%) in both the right (90%) and left (55%) sides of the mouth. The direct rank correlation was presented between presence of NCCLs and toothbrush firmness; and between number of NCCLs and age and force applied during toothbrushing.Conclusion: Within the limitations of this pilot study, the use of medium and hard toothbrushes and greater force applied during toothbrushing might contribute to the development and/or aggravation of NCCLs.

Comparative evaluation of the efficacy of occlusal splints fabricated in centric relation or maximum intercuspation in temporomandibular disorders patients

Fabrication of occlusal splints in centric relation for temporomandibular disorders (TMD) patients is arguable, since this position has been defined for asymptomatic stomatognathic system. Thus, maximum intercuspation might be employed in patients with occlusal stability, eliminating the need for interocclusal records. This study compared occlusal splints fabricated in centric relation and maximum intercuspation in muscle pain reduction of TMD patients. Twenty patients with TMD of myogenous origin and bruxism were divided into 2 groups treated with splints in maximum intercuspation (I) or centric relation (II). Clinical, electrognathographic and electromyographic examinations were performed before and 3 months after therapy. Data were analyzed by the Student's t test. Differences at 5% level of probability were considered statistically significant. There was a remarkable reduction in pain symptomatology, without statistically significant differences (p>0.05) between the groups. There was mandibular repositioning during therapy, as demonstrated by the change in occlusal contacts on the splints. Electrognathographic examination demonstrated a significant increase in maximum left lateral movement for group I and right lateral movement for group II (p<0.05). There were no significant differences (p>0.05) in the electromyographic activities at rest after utilization of both splints. In conclusion, both occlusal splints were effective for pain control and presented similar action. The results suggest that maximum intercuspation may be used for fabrication of occlusal splints in patients with occlusal stability without large discrepancies between centric relation and maximum intercuspation. Moreover, this technique is simpler and less expensive.

Evaluation of the Effect of Retightening and Mechanical Cycling on Preload Maintenance of Retention Screws

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

Biologic width changes around loaded implants inserted in different levels in relation to crestal bone: histometric evaluation in canine mandible

Objectives: The aim of the present study was to evaluate histometric changes around dental implants inserted at different levels in relation to the crestal bone, under different loading conditions.Material and methods: Thirty-six implants were inserted in the edentulous mandible of six mongrel dogs. Each implant was assigned to an experimental group according to the distance from the top of the implant to the crestal bone: Bone Level (at the crestal bone level), Minus 1 (1 mm below the crestal bone) or Minus 2 group (2 mm below the crestal bone). Each hemimandible was submitted to a loading protocol: conventional or immediate restoration. After 90 days, the animals were killed. Specimens were processed, and measurements were performed concerning the length of soft and hard peri-implant tissues. Data were analyzed using ANOVA and Student's t test (alpha=5%).Results: Among conventionally restored sites, the distance from the most coronal position of soft tissue margin (PSTM) and first bone-implant contact (fBIC) was greater for Minus 2 than for Bone Level and Minus 1 sites (P=0.03), but significant differences were not observed among immediately restored sites. Differences among groups were not observed concerning the PSTM, and the distance from the implant-abutment junction to fBIC. Greater amounts of lateral bone loss were observed for conventionally than for immediately restored sites (P=0.006).Conclusions: These findings suggest that the apical positioning of the top of the implant may not jeopardize the position of soft peri-implant tissues, and that immediate restoration can be beneficial to minimize lateral bone loss. Further studies are suggested to evaluate the clinical significance of these results in longer healing periods.

Clinical and Radiographic Evaluation of Factors Influencing the Presence or Absence of Interproximal Gingival Papillae

This study evaluated factors that may influence the presence or absence of interproximal papillae. Clinical evaluation consisted of visual determination, and quantitative analyses were made using millimeter grids on radiographs. Patients (n = 45) were divided into three groups according to age. Data were analyzed using the chi-square test followed by the Student t test (alpha = .05). The distance from the contact point to the bone crest had significant influence on papilla presence in both anterior and posterior sites (P < .05), whereas the width between roots of adjacent teeth did not. The papilla was missing more frequently in anterior sites. The presence of papillae was not age-dependent. (Int J Periodontics Restorative Dent 2012;32:e68-e74.)

Fresh-frozen human bone allograft in vertical ridge augmentation: clinical and tomographic evaluation of bone formation and resorption

The aim of the current study is to evaluate fresh-frozen human bone allografts (FHBAs) used in vertical ridge augmentation clinically and by computed tomography, and to analyze the resulting bone formation and graft resorption. Sixteen FHBAs were grafted in the maxillae and mandibles of 9 patients. The FHBAs, which were provided by the Musculoskeletal Tissue Bank of Marilia Hospital (Unioss), were frozen at -80A degrees C. After 7 months, dental implants were placed and bone parameters were evaluated. Vertical bone formation was measured by computerized tomography before (T0) and at 7 months (T1) after the surgical procedure. Bone graft resorption was measured clinically from a landmark screw head using a periodontal probe. The results were analyzed by Student's t-test. Significant differences existed in the bone formation values at T0 and T1, with an average change of 4.03 +/- A 1.69 mm. Bone graft resorption values were 1.0 +/- A 0.82 mm (20%). Implants were placed with varying insertion torque values (35-45 Ncm), and achieved primary stability. This study demonstrates that FHBAs promote satisfactory vertical bone formation with a low resorption rates, good density, and primary implant stability.

Cephalometric evaluation of skeletal alterations induced by Herbst appliance during mixed dentition

OBJECTIVE: The present prospective clinical study was designed in order to evaluate horizontal and vertical skeletal alterations induced by the use of Herbst appliance in individuals with Class II, division 1 malocclusion during mixed dentition stage. METHODS: The sampling consisted of 15 pre-pubertal individuals (12 boys and 3 girls; initial age 9 years and 6 months), who were treated with Herbst appliance for a period of 7 months. The effects of the treatment were compared to a group of 15 individuals with Class II, division 1 malocclusion (8 boys and 7 girls, initial age averaged 9 years and 1 month), orthodontically untreated, who were followed up for a period of 12 months. Statistical analysis was performed with Student's t-test with significance level at 5%. RESULTS: It was showed that the treatment with Herbst appliance in mixed dentition stage has restricted maxilla growth. Mandibular and palatal planes have not undergone significant alteration; however, anterior and posterior facial heights have increased significantly. Facial convexity and maxillomandibular relationship were altered positively. Mandible has positioned significantly forward and its effective length increased 2.5 times more than the increase observed in control group. CONCLUSION: It was possible to conclude that Herbst appliance was able to provide satisfactory results in individuals during mixed dentition stage.

Oldenburg Burnout Inventory - student version: cultural adaptation and validation into Portuguese

Realizou-se adaptação cultural do Inventário de Oldenburg para estudantes (OLBI-S) em português e estimou-se sua confiabilidade e validade. O OLBI-S foi preenchido por 958 estudantes universitários brasileiros e 602 portugueses. O modelo fatorial original apresentou ajustamento adequado mas foram removidos dois itens com confiabilidade individual baixa (λ<0,5). A nova estrutura apresentou bom ajustamento a 2/3 da amostra total sendo invariante no 1/3 restante da amostra. Verificou-se baixa consistência interna e validade convergente, confiabilidade compósita aceitável, boa validade discriminante, concorrente e divergente. O OLBI-S não foi invariante nas amostras de Brasil e Portugal. O OLBI-S apresentou limitações e ausência de validade transcultural nas amostras estudadas.

Copenhagen Burnout Inventory - student version: adaptation and transcultural validation for Portugal and Brazil

Realizou-se adaptação cultural do Inventário de Burnout de Copenhagen para estudantes (CBI-S) em português e estimou-se sua confiabilidade e validade. O CBI-S foi preenchido por 958 estudantes universitários brasileiros e 556 portugueses. O modelo fatorial original apresentou bom ajustamento entretanto, foram removidos dois itens com confiabilidade individual baixa (λ<0,5). A nova estrutura apresentou bom ajustamento a 2/3 da amostra total sendo invariante no 1/3 restante da amostra original. Verficou-se adequada consistência interna e validade convergente, discriminante e concorrente. Os pesos fatoriais do CBI-S não foram invariantes nas amostras de Brasil e Portugal. O CBI-S apresentou adequada confiabilidade e validade entretanto, verificou-se ausência de estabilidade transcultural.

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.

Defining the student burnout construct: a structural analysis from three burnout inventories

College student burnout has been assessed mainly with the Maslach Burnout Inventory (MBI). However, the construct's definition and measurement with MBI has drawn several criticisms and new inventories have been suggested for the evaluation of the syndrome. A redefinition of the construct of student burnout is proposed by means of a structural equation model, reflecting burnout as a second order factor defined by factors from the MBI-Student Survey (MBI-SS); the Copenhagen Burnout Inventory-Student Survey (CBI-SS) and the Oldenburg Burnout Inventory-Student Survey (OLBI-SS). Standardized regression weights from Burnout to Exhaustion and Cynicism from the MBI-SS scale, Personal Burnout and Studies Related Burnout from the CBI, and Exhaustion and Disengagement from OLBI, show that these factors are strong manifestations of students' burnout. For college students, the burnout construct is best defined by two dimensions described as "physical and psychological exhaustion" and "cynicism and disengagement."

In vivo microbiological evaluation of the effect of biomechanical preparation of root canals using different irrigating solutions

The aim of this study was to evaluate the antimicrobial effect of biomechanical preparation using different irrigating solutions. Seventy-eight root canals from premolars of four dogs were used. After experimental induction of periapical lesions, the root canals were prepared using the following solutions for irrigation: Group 1) 2.5% sodium hypochlorite (NaOCl); Group 2) 2% chlorhexidine (CHX); Group 3) saline solution and Group 4) control group with no biomechanical preparation. The microbiological evaluation of the root canals was performed by counting the colony forming units (CFUs) using different culture mediums. Two absorbent paper cones were used in each root canal in order to collect the microbiological samples before, and thirty days after the biomechanical preparation. The culture plates were incubated in aerobic, anaerobic and microaerophilic environment. Statistical evaluation was carried out using analysis of variance, Tukey and Student tests. The results demonstrated that there was reduction in the number of microorganisms in the NaOCl and CHX groups (p<0.05). There was greater effectiveness in the chlorhexidine group. The group that used saline solution and the control group presented an increased number of microorganisms. It can be concluded that the use of antimicrobial irrigating solutions during biomechanical preparation promotes the reduction of endodontic microbiota. However, a considerable number of microorganisms were still observed.