Two-Year Outcome of Partial Lacrimal Punctal Occlusion in the Management of Dry Eye Related to Sjogren Syndrome

Purpose: To analyze the influence of thermal partial punctal occlusion on the ocular surface of dry eye related to Sjogren syndrome. Material and Methods: Thirty-seven eyes of 19 patients (3 male and 16 female; 49.11 +/- 14.33 years old) with keratoconjunctivitis sicca were enrolled in this study. Superior and inferior partial occlusion were performed in both eyes under topical anesthesia using thermal cautery with a sterile tip to obtain lacrimal punctum smaller than 0.5 mm. Schirmer I, break-up-time, diameter of lacrimal puncta, corneal fluorescein, and rose Bengal staining scores were analyzed before and after 24 weeks and after 24 months of the procedure. All measurements were performed under controlled climate. Results: The average lacrimal punctum diameter before the procedure was 0.65 +/- 0.134 mm. All lacrimal puncta were successfully reduced to less than 0.5 mm after 4 weeks of the procedure. The average Schirmer I test values improved statistically after 24 weeks and maintained stable after 24 months. Average break-up-time, rose Bengal, and fluorescein staining score values improved statistically after 24 weeks and improved even more after 24 months. Average Schirmer I test, break-up-time, rose Bengal, and fluorescein staining scores showed significant improvement (p < 0.0001) after 24 months of partial thermal punctal occlusion. Conclusion: Our study showed that reducing the punctum diameter to 0.5 mm can improve vital staining scores, break-up-time, and Schirmer I test in dry eye related to Sjogren syndrome.

Otitis media with effusion and dental occlusion: is there any relationship?

Aim Auditory tube dysfunction is one of the aetiological causes of otitis media. Studies suggest a correlation between otitis media with effusion and dental malocclusion. Our goal was to determine any correlation between dental malocclusion and otitis media with effusion in children with chronic upper airway obstruction due to tonsil and adenoid enlargement. Materials and methods This prospective study evaluated 52 children with otitis media with effusion and 48 without, aged 4.2 to 10.8 years. A questionnaire was answered by the parents about breast or bottle-feeding and bad oral habits. Malocclusion was diagnosed according to Angle`s classification for molar relationships in Classes I, II and III, posterior and anterior cross bite, open and deep bite, and overjet. Results and conclusion The results suggested no correlation between dental malocclusion and otitis media with effusion. Other potential confounders, such as breast or bottle-feeding and oral habits were also not correlated.

Antenatal steroid and tracheal occlusion restore vascular endothelial growth factor receptors in congenital diaphragmatic hernia rat model

OBJECTIVE: Investigate the effects of antenatal steroids and tracheal occlusion on pulmonary expression of vascular endothelial growth factor receptors in rats with nitrofen-induced congenital diaphragmatic hernia. STUDY DESIGN: Fetuses were exposed to nitrofen at embryonic day 9.5. Subgroups received dexamethasone or were operated on for tracheal occlusion, or received combined treatment. Morphologic variables were recorded. To analyze vascular endothelial growth factor receptor 1 and vascular endothelial growth factor receptor 2 expression, we performed Western blotting and immunohistochemistry. Morphologic variables were analyzed by analysis of variance and immunohistochemistry by Kruskal-Wallis test. RESULTS: Congenital diaphragmatic hernia decreased body weight, total lung weight, and lung-to-body weight ratio. Tracheal occlusion increased total lung weight and lung-to-body weight ratio (P < .05). Fetuses with congenital diaphragmatic hernia had reduced vascular endothelial growth factor receptor 1 and vascular endothelial growth factor receptor 2 expression, whereas steroids and tracheal occlusion increased their expression. Combined treatment increased expression of receptors, but had no additive effect. CONCLUSION: Vascular endothelial growth factor signaling disruption may be associated with pulmonary hypertension in congenital diaphragmatic hernia. Tracheal occlusion and steroids provide a pathway for restoring expression of vascular endothelial growth factor receptors.

Tooth-wear patterns in adolescents with normal occlusion and Class II Division 2 malocclusion

Introduction: In this study, we investigated tooth-wear patterns in adolescents with either normal occlusion or Class II Division 2 malocclusion. Methods: The sample consisted of dental casts from 165 subjects that were divided into 2 groups: 115 normal occlusion subjects (mean age, 14.3 years) and 50 complete Class II Division 2 subjects (mean age, 13.9 years). Dental wear was assessed by using a modified version of the tooth wear index. The 2 groups were compared with the Mann-Whitney test for the frequency and severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%. Results: The normal occlusion group statistically had greater tooth wear on the incisal surfaces of the maxillary lateral incisors and the incisal surfaces of the maxillary canines than did the Class II Division 2 malocclusion group. The malocclusion group showed statistically greater tooth wear on the labial surfaces of the mandibular lateral incisors, the occlusal surfaces of the maxillary premolars and first molars, the occlusal surfaces of the mandibular premolars, the palatal surfaces of the maxillary second premolars, and the buccal surfaces of the mandibular premolars and first molars than did the normal occlusion group. Conclusions: Subjects with normal occlusion and those with complete Class II Division 2 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but, rather, the consequence of different interocclusal arrangements. (Am J Orthod Dentofacial Orthop 2010;137:730.e1-730.e5)

Tooth-wear patterns in subjects with Class II Division 1 malocclusion and normal occlusion

Introduction: The aim of this study was to investigate the prevalence of tooth wear in adolescents with Class II malocclusion, compared with those with normal occlusion. Methods: The sample consisted of dental casts obtained from 310 subjects, divided into 3 groups: group 1, 110 subjects with normal occlusion (mean age, 13.51 years); group 2, 100 complete Class II Division 1 patients (mean age, 13.44 years); and group 3, 100 half-cusp Class II Division 1 patients (mean age, 13.17 years). Dental wear was assessed by using a modified version of the tooth-wear index. The 3 groups were compared by means of the Kruskal-Wallis and Dunn tests, considering the frequency and the severity of wear on each surface of each group of teeth. The level of statistical significance was set at 5%. Results: The normal occlusion group had statistically greater tooth wear on the palatal surfaces of the maxillary central incisors and the incisal surfaces of the maxillary canines than the corresponding surfaces in both Class II malocclusion groups. The complete and half-cusp Class II Division 1 malocclusion groups had statistically greater tooth wear on the occlusal surfaces of the maxillary second premolar and first molar, the occlusal surfaces of the mandibular premolars, and the buccal surfaces of the mandibular posterior teeth compared with the normal occlusion group. The half-cusp Class II Division 1 malocclusion group had significantly greater tooth wear on the incisal surfaces of the mandibular incisors compared with the complete Class II Division 1 malocclusion group. Conclusions: Subjects with normal occlusion and complete or half-cusp Class II Division 1 malocclusions have different tooth-wear patterns. Tooth wear on the malocclusion subjects should not be considered pathologic but rather consequent to the different interocclusal tooth arrangement. (Am J Orthod Dentofacial Orthop 2010; 137: 14. e1-14.e7)

Proportionally balanced designs: Some further results and general constructions

Proportionally balanced designs were introduced by Gray and Matters in response to a need for the allocation of markers of the Queensland Core Skills Test to have a certain property. Put simply, markers were allocated to pairs of units in proportions that reflected the relative numbers of markers allocated in total to each unit. In this paper, the first author extends the theoretical results relating to such designs and provides further instances, and two general constructions, in the case that the design comprises blocks of precisely two sizes.

Evaluation of distances between the mandibular teeth and the alveolar process in Brazilians with normal occlusion

Introduction: The aims of this study were to evaluate the distances between the mandibular permanent teeth and the alveolar process in Brazilians with normal occlusion and to compare them with normal American values. Methods: We used 59 mandibular casts from untreated subjects who had permanent dentition and the 6 keys to normal occlusion. A computer program was used to calculate the distances between the dental reference points and the alveolar process for each tooth. The mean values were then compared to the normal values by applying the Student t test at a significance level of 0.05. Results: The results showed a progressive increase of these distances from the anterior region (incisors) to the posterior region (molars), from 0.00 to 2.49 mm. All measurements had statistically significant differences from the American sample, except for the values for canines and first premolars. Conclusions: Brazilians with normal occlusion have more lingual crown positions for the incisors, second premolars, and molars compared with Americans with normal occlusion. Although these findings were statistically significant, they are unlikely to be clinically significant. (Am J Orthod Dentofacial Orthop 2010; 137: 308.e1-308.e4)

Two-dimensional balanced sampling plans excluding contiguous units

A balanced sampling plan excluding contiguous units (or BSEC for short) was first introduced by Hedayat, Rao and Stufken in 1988. These designs can be used for survey sampling when the units are arranged in one-dimensional ordering and the contiguous units in this ordering provide similar information. In this paper, we generalize the concept of a BSEC to the two-dimensional situation and give constructions of two-dimensional BSECs with block size 3. The existence problem is completely solved in the case where lambda = 1.

Back to (non)-Basics: Recent developments in neutral and charge-balanced glycosidase inhibitors

Certain glycosidase inhibitors possess potent antiviral, antitumour and antidiabetic properties. Glyconic acid lactones, the earliest glycosidase inhibitors identified, have planar anomeric carbons that mimic the transition state of glycoside hydrolysis. Other classes include lactams, glycals, epoxides, halides and sulfonium ions, the latter based on the natural product salacinol from an antidiabetic herb.

Balanced scorecard (BSC): uma vis??o metodol??gica para o acompanhamento de sua implementa????o

A Embrapa, na inten????o de operacionalizar a gest??o dos seus planos estrat??gicos (Plano Diretor da Embrapa ??? PDE e Planos Diretores das Unidades ??? PDUs) desenvolveu a metodologia Mogest para a implementa????o do seu Modelo de Gest??o Estrat??gica (MGE), no ??mbito corporativo e de suas 40 unidades de neg??cio, com base na modifica????o do m??todo Balanced Scorecard ??? BSC, de Kaplan. Posteriormente, ap??s a implementa????o dos MGEs, no per??odo de 1999 at?? os dias atuais, inicia-se e desenvolve-se a fase de acompanhamento por meio da elabora????o do m??todo MGE/Acompanha. Este trabalho aborda, de forma modificada, o uso do diagrama elaborado por Norton, apud Coutinho (2002), para acompanhar/avaliar a implementa????o do BSC para uma organiza????o orientada ?? estrat??gia, inserido no m??todo MGE/Acompanha (2000), elaborado pela Equipe MGE e aplicado em uma das unidades de neg??cio da Embrapa. Os resultados mostraram a efici??ncia do m??todo e proporcionaram a internaliza????o do conceito ???painel de bordo???, desenvolvido no software Oracle BSC (OBSC).

Balanced Scorecard: adequa????o para a gest??o estrat??gica nas organiza????es p??blicas

Os ??rg??os da Administra????o P??blica Federal (APF) ter??o maior ??xito no alcance de seus objetivos estrat??gicos, investindo na implanta????o de um modelo de gest??o estrat??gica, adaptado para o ambiente de governo, mantendo o alinhamento estrat??gico com os ??rg??os normativos e de controle. Este artigo tem como objetivo apresentar um modelo de gest??o estrat??gica, adaptado a partir das perspectivas do Balanced Scorecard (BSC) desenvolvido pelos professores da Harvard Business School, Robert Kaplan e David Norton, em 1992, para ser utilizado pelos ??rg??os da APF; tal modelo mant??m um alinhamento estrat??gico organizacional com as recomenda????es do Tribunal de Contas da Uni??o (TCU). O modelo ir?? permitir a gest??o estrat??gica a partir da identifica????o dos objetivos estrat??gicos, metas, indicadores e a????es referentes ??s perspectivas do Balanced Scorecard, o que permitir?? o equil??brio entre os indicadores de efici??ncia no acompanhamento das metas de cada ??rg??o da APF, colaborando para uma gest??o estrat??gica integrada, que venha a modernizar a gest??o p??blica, agilizando as tomadas de decis??es e a troca de informa????es.

O balanced scorecard e a gestão ambiental: um estudo no sector público e privado português

Os aspectos sociais e ambientais são reconhecidos cada vez mais como estratégicos na organização, na medida que constituem novas oportunidades de criação de valor mediante o desenvolvimento de vantagens competitivas capazes de diferenciar as empresas dos seus concorrentes actuais e potenciais. A adopção e o desenvolvimento de novas tecnologias, estratégias e instrumentos de gestão das questões sociais e ambientais parece ser hoje uma matéria indiscutível. No entanto, são várias as dificuldades encontradas na quantificação económica e financeira das políticas de desenvolvimento sustentável, levando ao desenvolvimento ou adaptação de ferramentas de gestão, como é o caso do Balanced Scorecard (BSC). Assim, no sentido de averiguarmos se as organizações públicas e privadas portuguesas incluem nos seus scorecards indicadores sociais e ambientais e se existe relação entre a utilização do BSC e os sistemas de certificação ambiental enviamos um questionário a 591 organizações públicas e 549 organizações privadas portuguesas, com uma taxa de resposta de 31,3%. Os resultados obtidos permitem concluir que a maioria dos inquiridos inclui indicadores sociais e ambientais nos seus scorecards e que as empresas certificadas em termos ambientais utilizam mais o BSC do que as não certificadas.

O balanced scorecard como ferramenta de gestão estratégica no setor hoteleiro

O setor hoteleiro opera num mercado com transformações acentuadas, ressaltando a necessidade de utilização de técnicas de gestão mais sofisticadas para medir, avaliar e melhorar o seu desempenho. O Balanced Scorecard (BSC) tem sido destacado na literatura como uma poderosa ferramenta de gestão estratégica para enfrentar a forte concorrência sentida nos distintos setores de atividade. A adoção desta ferramenta ainda está relativamente pouco documentada no setor hoteleiro, pelo que se impõe a necessidade de desenvolver investigação sobre esta temática. Assim, este artigo tem como objetivo proporcionar algumas ideias sobre a importância e necessidade da implementação de metodologias de avaliação de desempenho e de gestão estratégica no setor hoteleiro, destacando o caso particular da ferramenta BSC.

O Balanced Scorecard como Ferramenta de Gestão Estratégica da Qualidade

A melhoria do desempenho organizacional tem sido um dos principais objetivos das organizações. A procura da racionalização na gestão dos recursos e a necessidade de melhorar a qualidade dos produtos e serviços prestados motivaram a aplicação nas organizações públicas e privadas da ferramenta de Contabilidade de Gestão Balanced Scorecard (BSC) e do modelo de excelência EFQM (European Foundation for Quality Management). O EFQM e o BSC são dois modelos de gestão amplamente aceitos na gestão empresarial atual para alcançar a inovação, a aprendizagem e a melhoria contínua. Assim, este artigo tem como objetivo proporcionar algumas ideias acerca da importância do desenvolvimento de programas de gestão da qualidade total (TQM), destacando as principais características, as semelhanças e as diferenças entre os modelos BSC e EFQM, bem como apresentar um modelo de integração das duas filosofias de gestão.

O Tableau de Bord e o Balanced Scorecard: Uma Análise Comparativa

As últimas décadas são testemunho de mudanças dramáticas, transformando a concorrência da era industrial na concorrência da era da informação. A tomada de decisões baseada essencialmente em indicadores financeiros de caráter histórico revelou-se insuficiente para responder às necessidades da gestão. Dadas as limitações dos indicadores de gestão tradicionais para avaliar o desempenho das organizações, quer sejam públicas quer sejam privadas, é necessário o desenvolvimento de modelos de indicadores de gestão que traduzam todos os fatores críticos de êxito. Assim, distintos autores sugeriram novos sistemas de avaliação do desempenho e de gestão estratégica das organizações questionando a utilidade dos tradicionais sistemas de gestão. Entre esses modelos destacamos o Tableau de Bord e o Balanced Scorecard, apresentando as suas principais características, semelhanças e diferenças, no sentido de facilitar a sua implementação nas organizações.