As estratégias de coping e o impacto sofrido pela família quando um dos seus está em tratamento contra o câncer

The aim of the present study was to analyze the impact suffered by 40 people when discovering that one of their family members was diagnosed with cancer, to analyze their coping strategies and expectations towards the patient’s illness and future. The study made use of the Coping Strategies Inventory by Folkman and Lazarus. Results show that most of the patients’ caregivers are their married children, with an average age of 45.7 (dp=12.67), and gainfully employed. These family members reported the negative impact of the diagnosis, with the predominant feelings of sadness and fear of loss, even though they had a positive perspective about the future, expecting the patient’s recovery. As to the functional coping strategies, the most used were the resolution of problems, followed by social support; the least used was positive revaluation. As to the dysfunctional strategies, the most used ones were escape and avoidance and the least used was taking the responsibility for the illness. Conclusions are that despite suffering with the negative impact of the disease, the family members are optimistic about the patient’s future and seek to use strategies that solve the problem effectively, without blaming themselves for the patient’s illness.

Diretrizes de conduta e tratamento de síndromes febris periódicas associadas à criopirina (Criopirinopatias–CAPS)

To establish guidelines based on cientific evidences for the management of cryopyrin associated periodic syndromes. The Guideline was prepared from 4 clinical questions that were structured through Pico (Patient, Intervention or indicator, Comparison and Outcome), to search in key primary scientific information databases. After defining the potential studies to support the recommendations, these were graduated considering their strength of evidence and grade of recommendation. 1215 articles were retrieved and evaluated by title and abstract; from these, 42 articles were selected to support the recommendations. 1. The diagnosis of Caps is based on clinical history and clinical manifestations, and later confirmed by genetic study. Caps may manifest itself in three phenotypes: FCAS (mild form), MWS (intermediate form) and Cinca (severe form). Neurological, ophthalmic, otorhinolaryngological and radiological assessments may be highly valuable in distinguishing between syndromes; 2. The genetic diagnosis with NLRP3 gene analysis must be conducted in suspected cases of Caps, i.e., individuals presenting before 20 years of age, recurrent episodes of inflammation expressed by a mild fever and urticaria; 3. Laboratory abnormalities include leukocytosis and elevated serum levels of inflammatory proteins; 4. Targeted therapies directed against interleukin-1 lead to rapid remission of symptoms in most patients. However, there are important limitations on the long-term safety. None of the three anti-IL-1β inhibitors prevents progression of bone lesions.

Estudo randonizado duplo-cego da capacidade funcional e da prática de atividade física em indivíduos com diagnóstico polissonográfico de SAOS antes e após uso de CPAP

Pós-graduação em Bases Gerais da Cirurgia - FMB

Avaliação e correlação da presença de endotoxinas e MMP-3, -8 e -9 em canais radiculares com necrose pulpar submetidos ao tratamento endodôntico - estudo in vivo

It is know that endotoxin and various matrix metalloproteinases (MMPs) are involved in the development of periapical lesions. The purpose of this study was to evaluate and correlate the presence of endotoxins and MMP- 3, MMP-8 and MMP-9 in root canals of teeth with necrotic pulp and periapical lesion before, during and after the biomechanical preparation (PBM) using a combination of different irrigations solutions and intracanal dressing. Thirty-three single-root teeth with a diagnosis of pulp necrosis and periapical lesion radiographically visible were selected. Immediately after the coronal opening was collected the first sample from the root canal content. Then, all canals were prepared (cervical and middle thirds) by oscillatory instruments (EndoEze) and irrigated by 2.5% NaOCl. After, a manual preparation was made for the apical third and the teeth were divided into three groups according to the irrigation protocol: G1) 2.5% NaOCl (4 manual files); G2) 2.5% NaOCl (2 manual files) + [Ca (OH)2 0.14%] (2 manual files) and G3) 2.5% NaOCl (2 manual files) + polymyxin B (2 manual files). After the PBM, the second sample was collected; then the third collect was performed after using EDTA final flush. The fourth sample was collected 14 days after placing the dressing [2% chlorhexidine gel + Ca(OH)2]. Quantification of endotoxins was performed by a kinetic chromogenic lysate from amoebocytes of Limulus (LAL) and quantification of MMPs by ELISA assay. The results were analyzed statistically by Kruskal-Wallis and Dunn's test (5%) and ordinal Spearman correlation. Presence of endotoxin was observed in 100% of cases and G3 showed the greatest reduction of endotoxins from the 1st to the 2nd samples (97%), being statistically similar to G2 (84.2%) and different from G1 (49.4%) (p<0.05). The intracanal dressing promoted a significant reduction of endotoxin, no difference among the groups. For...

Quarto molar retido: a importância do diagnóstico precoce

Introductions: A supernumerary tooth is one that is additional to the normal series and can be found in almost any region of the dental arch. Its etiology is not fully understood. With regard to its prevalence, it occurs more commonly in permanent dentition and twice as often in men than in women. Supernumerary teeth are classified according to their morphology and location. Their presence can cause problems such as failure of eruption, displacement of teeth, crowding and odontogenic cysts and tumors. The diagnosis is usually by routine radiographs, for the majority of such teeth are impacted and asymptomatic. Objective and Case report: The purpose of this study was to make a brief review of the relevant literature and report one clinical case of the female patient, 23 years, melanoderma, featuring three quarters molars. Final considerations: The early diagnosis proved to be important for the resolution of the case in order to minimize or even prevent the development of complications and thus establish a proper plan of treatment.

Protocolo para tratamento de diastemas com laminados de porcelana: descrição de caso clínico

A percepção e o alcance da excelência estética traduzem-se especialmente em saber interpretar e satisfazer os anseios dos pacientes, empregando-se para isso todo o conhecimento disponível na literatura científica. No tratamento com laminados cerâmicos, a ciência fornece parâmetros para nos guiar com relação a um correto diagnóstico, planejamento seguro, técnica adequada e material mais indicado; porém, a subjetividade estética pode estar escondida nas entrelinhas da ciência. Contudo, o objetivo deste artigo é descrever um protocolo para fechamento de múltiplos diastemas, salientando a técnica empregada, bem como o material cerâmico utilizado e suas peculiaridades, implícitas dentro de um contexto estético específico.

Abordagem terapêutica nas desordens temporo-mandibulares: técnicas de fisioterapia associadas ao tratamento odontológico

Temporomandibular disorders (TMD) are related to discomfort in the temporomandibular joint (TMJ). These diseases are multifactorial and treatment usually requires a combination of different approaches because each patient presents with different and usually complex needs. It is necessary to know how each expert should plan for a successful treatment.

Tratamento cirúrgico de ameloblastoma mandibular

Ameloblastomas are benign, invasive locally and highly recurrent. It is an odontogenic tumor, characterized by the proliferation of epithelial ameloblastic in a fibrous stroma. This paper reports a case of mandibular ameloblastoma, in patients 27 years of age without pain with developments around 4 years, with about 20 mm at its greatest extent, sessile base and surface coatings full. The treatment of choice was the surgical conservative

Púrpura trombocitopênica idiopática: importância do cirurgião-dentista no diagnóstico

This paper presents a case report of a patient with idiopathic thrombocytopenic purpura (ITP) diagnosed in routine dental care. ITP is defined as a decrease in the number of circulating platelets and generally shows oral manifestations. In this light, we show that the general dental practitioner must be ready to detect ITP signs and symptoms, especially oral changes that are not of dental origin, so as to immediately prescribe the proper treatment. Without this treatment, this pathology may well be irreversible and fatal.

Diagnóstico e gestão dos resíduos gerados em aterro sanitário

The issue of environmental impacts to human health and the generation and disposal of solid waste has led to a change of paradigms for your face, highlighting the need for sustainable management of municipal solid waste (MSW). In this context, the expansion of landfills in Brazil in recent decades makes it necessary to sustainable management of waste generated by this type of enterprise, since its implementation. The aim of this study was to perform a diagnosis of the generation of waste in a landfill, in the expansion phase, and the alternatives adopted for its management. The qualitative diagnosis was made from observations on site and the wastes were classified and quantified from August 2011 to January 2012. In the diagnosis was considered the reduction, reuse and recycle, in that order. The results of this study showed that the residue of the greatest generation was PEAD geomembranes used in the waterproofing of the landfill, reaching 7 t, followed by PVC pipes, which reached 850 kg, both destined for recycling. The largest volume of wastewater generated corresponded to the leachate, reaching 11,500 m3 , which were sent for treatment

Contribuição metodológica para o diagnóstico da dinâmica erosiva linear e seu prognóstico evolutivo visando subsidiar projetos de recuperação

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

Diagnóstico diferencial entre Doença de Crohn e Hidradenite Supurativa: relato de caso

Crohn’s disease is a chronic infl ammatory bowel disease with segmental transmural infl ammation, which complicate with formation of fi stulas and abscesses. The hidradenitis suppurativa (HS) is characterized by recurrent abscesses, with a predilection for areas rich in apocrine glands such as the axillary, inguinal and perineal. The differential diagnosis between these diseases is diffi cult and may compromise treatment. Report case: C.R.M.A., 40 year-old, female, white, ileal and colonic Crohn’s disease complicated with perianal and rectovaginal fi stula for 12 years, treated with biological therapy since May 2010. In Sep/2010 presented with an abscess in the buttock D with purulent discharge refractory to the use of ciprofl oxacin and metronidazole. USG: collection of 30 cm3 in buttock D. The diagnosis was HS and the patient underwent extensive surgical removal of the affected areas (10 x 2 cm) with healing by secondary intention. Skin graft performed unsuccessfully in Dec/2010. The patient returned in jan/2011 with a new fi stula at the site of resection, consistent with Crohn’s disease. In fev/2011 underwent drainage of abscesses and placement of setons in perianal fi stulas. Currently in therapy with good biological evolution of fi stulas. The prevalence of HS varies from 0.3 to 4% of the population in general. The axilla is the region most affected and perianal lesions are associated with greater weakness. There are published reports of association between HS and Crohn’s disease sporadically and further studies are needed to assess a common pathogenesis. The differential diagnosis should be performed in all cases planning immediate treatment, avoiding complications and worsening of the patient’s quality of life.

Tratamento cirúrgico da úlcera loxoscélica: solução prática para um problema de difícil resolução

Contexto: O manuscrito descreve a reparação cirúrgica de uma úlcera crônica resultante da picada de uma aranhamarrom, um problema de difícil resolução, o qual habitualmente demora meses até a cicatrização. Descrição do caso: A vítima foi picada na coxa direita e desenvolveu fases de envenenamento típicas da picada de Loxosceles, incluindo a placa mármore, a escara e a úlcera profunda e de bordos emoldurados, características do acidente. Devido ao processo cicatricial lento, cuidados intensivos com curativos, dificuldade na deambulação, além do fator estético, optou-se por cirurgia excisional da lesão e sutura direta das bordas. O tratamento cirúrgico proporcionou cicatrização total da lesão dentro de 15 dias. Conclusões: A úlcera loxoscélica apresenta difícil cicatrização, evoluindo para a cronicidade. A cirurgia com excisão completa e síntese primária constitui técnica adequada para a cura da doença.

Características do processo de diagnóstico de hanseníase no atendimento primário e secundário

Contexto e objetivo: A hanseníase caracteriza-se por ter diagnóstico eminentemente clínico, principalmente através da constatação de hipo ou anestesia das lesões, ou seja, sem necessariamente o uso de exames adicionais, como baciloscopia e biópsia, utilizados para classificação clínica da doença. Buscou-se definir se há tendência à desvalorização da avaliação clínica em favor do excesso de exames complementares, investigar a adequação do registro nos atendimentos da atenção básica e compará-los com o obtido em serviço de média complexidade. Desenho e local: Estudo transversal, de base populacional, utilizando registros de prontuários, realizado em dois âmbitos de atendimentos de saúde da cidade de Campinas (SP): os Centros de Saúde e a assistência dermatológica especializada de hospital de ensino. Métodos: Os registros foram investigados por meio da aplicação de checklist, contendo itens indispensáveis ao atendimento a hansenianos. Associações foram testadas pela prova de Goodman e ao nível de 5% de significância. Resultados: Foram avaliados 33 prontuários oriundos dos centros de saúde e 36 do hospital, observou-se polarização entre registros adequados e ausentes, evidenciando a presença de efeito tudo ou nada nos atendimentos; de 26 variáveis, apenas em 5 (19,23%) obteve-se predomínio da avaliação do hospital sobre os centros de saúde; evidenciou-se dependência de exames complementares, solicitados em 67 dos 69 atendimentos (97,10%), para diagnóstico da doença. Conclusão: Confirmou-se, neste estudo, déficit da avaliação médica e indicação inadequada de exames adicionais. Por associar-se com excesso de solicitação de exames, a observação clínica mostrou-se incompleta, comprometendo a capacidade diagnóstica dos atendimentos a hansenianos.

Ensaio clínico randomizado duplo-cego do perfil inflamatório e do nível de estresse oxidativo em indivíduos com diagnóstico polissonográfico de SAOS antes e após o uso de CPAP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)