Management of a multiple dentoalveolar trauma in permanent dentition with avulsion of a canine: A 4-year follow-up

Traumatic dental injuries are relatively frequent accidents that typically involve teeth in the maxillary anterior segment. The emergency treatment and the clinical decisions must be efficiently made at the time of injury, and there is a need for long-term follow-up because of the high incidence of complications. The aim of this article was to present the emergency and rehabilitation treatments of a multiple dentoalveolar trauma in the permanent dentition involving different extensions of enamel-dentin crown fracture, pulp exposure, and the avulsion of a canine. The treatment outcomes are reported up to the 4-year follow-up, and the clinical approaches and their rationale are discussed.

A modified approach for vestibuloplasty in severely resorbed mandible using an implant-retained postoperative stent: a case report

Background. Severely resorbed mandibles often present a short band of keratinized tissue associated with a shallow vestibule. As a result, prominent muscle insertions are present, especially in the mental region of the mandible. This case report describes the deepening of the vestibular sulcus in an atrophic mandible by combining free gingival grafts harvested from the palate and a postoperative acrylic resin stent screwed on osseointegrated implants placed at the anterior region of the mandible. Study design. During the second-stage surgery, a split-thickness labial flap was reflected and apically sutured onto the periosteum. Two free gingival grafts were obtained and then sutured at this recipient site. A previously custom-made acrylic stent was then screwed onto the most distally positioned implants. To document the procedure`s stability over time, a metal ball was placed in the most apical part of the vestibule and standardized cephalometric radiographs were taken before and 6 months after the procedure. Linear measurements of vestibular depths over the observation time were realized using specific software for radiographic analysis. Results. The proposed technique augmented the band of attached masticatory mucosa, deepened the vestibule and prevented the muscle reinsertion. The difference between the 2 measurements of vestibular depths was 9.39 mm (initial 20.88 mm, final 11.49 mm) after a 6-month postoperative period. Conclusion. The technique, in combination with palatal mucosal graft and use of a postoperative stent, decreased the pull of mentalis muscle and provided a peri-implantally stable soft tissue around implants. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: e7-e14)

Quando uma den??ncia an??nima feita ?? Ouvidoria vira amea??a ao denunciante

A Ouvidoria do Ibama recebeu den??ncia sobre venda ilegal de madeiras no Maranh??o. Apesar de a den??ncia ter sido an??nima, por falha dos agentes de fiscaliza????o, os donos da empresa que atuava ilegalmente descobriram que a den??ncia havia partido de cidad??o da comunidade vizinha e come??ou a amea??ar a vizinhan??a. A Ouvidoria recebeu mensagens de rep??dio ao fato de o ??rg??o ter exposto a comunidade a tais amea??as, o que gerou contato com o setor de fiscaliza????o. O caso trata da quest??o da den??ncia an??nima nas ouvidorias e de como ?? preciso atuar para que sejam preservados os cidad??os que colaboram com esses ??rg??os. O estudo pode ser aplicado em cursos com enfoque em quest??es vinculadas ?? ??tica, media????o de conflitos e atendimento ao cidad??o

O processo decis??rio da reforma tribut??ria e da previd??ncia social: per??odo de 1994 a 1998

An??lise da reforma constitucional no governo Fernando Henrique Cardoso a partir dos estudos de caso da reforma tribut??ria e da previd??ncia social, compreendendo tamb??m uma reconstitui????o do processo decis??rio de pol??ticas nestas ??reas desde a era Collor.

Reflex??es para Ibero-Am??rica: avalia????o de programas sociais

A ENAP Escola Nacional de Administra????o P??blica, com o apoio do Minist??rio do Planejamento, Or??amento e Gest??o, da Ag??ncia Brasileira de Coopera????o do Minist??rio das Rela????es Exteriores, do Centro Latino-americano de Administra????o para o Desenvolvimento (Clad) e da Caixa Econ??mica Federal, construiu uma s??rie de atividades de aprendizagem direcionadas a dirigentes e t??cnicos que atuam nas ??reas de planejamento estrat??gico e avalia????o de programas. Esses eventos de aprendizagem permitiram uma intensa troca de experi??ncias entre os 60 dirigentes e t??cnicos representantes de organismos governamentais de 16 pa??ses ibero-americanos ??? Argentina, Bol??via, Brasil, Chile, Col??mbia, Costa Rica, El Salvador, Guatemala, M??xico, Panam??, Paraguai, Peru, Portugal, Rep??blica Dominicana, Uruguai e Venezuela. A consolida????o desse per??odo de rica troca de experi??ncias est?? retratada nesta publica????o, que mostra o avan??o na constru????o de um conhecimento coletivo referente a desafios contempor??neos de nossos governos nas ??reas de planejamento e de avalia????o de programas sociais

Painel 2 - Experi??ncias Setoriais: o Monitoramento nas ??reas da Educa????o e Sa??de

Painel 2 - Experi??ncias Setoriais: o Monitoramento nas ??reas da Educa????o e Sa??de; Palestra 1 - Minist??rio da Educa????o: "Instrumentos para Monitoramento e Avalia????o das Pol??ticas e Programas do Minist??rio da Educa????o", apresentada por Milena Lins Fernandes Soares e ??rica de Oliveira; Palestra 2 - Minist??rio da Sa??de: "O Monitoramento e a Avalia????o na Gest??o do Minist??rio da Sa??de", apresentada por Afonso Teixeira dos Reis

Caf?? com debate: prospec????o de conhecimento no setor p??blico

O Caf?? com Debate recebeu a Presidente do Centro de Gest??o de Estudos Estrat??gicos, L??cia Melo, para abordar o tema: Prospec????o de Conhecimento no Setor P??blico, no dia 27 de abril, na ENAP. A apresenta????o da palestrante destacou que frente ao cen??rio de explos??o do conhecimento aliado aos desafios da inova????o, h?? uma compreens??o crescente sobre a centralidade da gest??o do conhecimento na promo????o do desenvolvimento econ??mico e social. Os processos de decis??o devem ser baseados em informa????o estrat??gica de qualidade, analisada e tratada de acordo com as necessidades. Assim, a import??ncia da prospec????o do conhecimento se justifica pela contribui????o para o desenvolvimento de uma cultura de pensamento estrat??gico e de mais longo prazo entre os tomadores de decis??o. L??cia Melo tamb??m ressaltou o importante papel do CGEE na promo????o e realiza????o de estudos e pesquisas prospectivas de alto n??vel na ??rea de ci??ncia e tecnologia e suas rela????es com os setores produtivos

Enap: manual de uso da marca

A Escola Nacional de Administra????o P??blica (Enap) est?? atualizando sua logomarca. A nova marca est?? alinhada com a comunica????o do Governo Federal. A imagem ?? uma continuidade visual em rela????o ?? anterior, desenvolvida no ano de 1998, pelo designer Francisco In??cio Scaramelli Homem de Melo.

4?? Encontro Nacional de Educa????o a Distancia para a Rede de Escolas de Governo

IV Encontro Nacional de Educa????o ?? Dist??ncia para a Rede de Escolas de Governo, realizado em Fortaleza-CE, no per??odo de 16 a 18 de novembro de 2011.

Pr??-equidade de g??nero: incorporando pol??ticas de a????o afirmativa no mundo do trabalho

A institui????o do Programa Pr??-equidade de G??nero ?? o reconhecimento p??blico da desigualdade de tratamento e de oportunidades, que ainda permanece entre mulheres e homens. A implementa????o ?? consolidada com a coloca????o em pr??tica dos planos de a????es firmados entre a Secretaria Especial de Pol??ticas para as Mulheres (SPM) e as organiza????es aderentes. A pesquisa explorat??ria teve como objetivo apresentar o programa e discuti-lo com base no modelo "policy cycle como aprendizado", de Silva e Melo (2000). Os resultados subsidiar??o pesquisa futura sobre a avalia????o do programa. Dentro da estrat??gia adotada, a coleta de dados ocorreu em documentos institucionais e dados bibliogr??ficos em mar??o de 2009, com o seguinte resultado: a avalia????o n??o trata de forma clara da efetividade e da sustentabilidade do programa. Este trabalho est?? dividido em seis partes: descri????o do m??todo utilizado; apresenta????o do Programa Pro-equidade de G??nero; avalia????o de suas duas primeiras edi????es; breve contextualiza????o das pol??ticas p??blicas no Brasil e o modelo "policy cicle como aprendizado"; rela????es entre o programa e o modelo; e considera????es finais.

Pessoal: o Estado e seus servidores

Retomando o artigo de J. A. de Carvalho e Melo, a RSP Revisitada traz ?? tona temas importantes e recorrentes, at?? os dias de hoje, na rela????o entre o Estado e seus servidores. O texto discorre sobre aspectos distintos: nomea????o, posse e exerc??cio, natureza legal ou contratual do v??nculo entre o funcion??rio p??blico e o Estado, estabilidade e tempo de servi??o, e encerra com reflex??es sobre a Administra????o democr??tica e o seu papel na vida moderna.

Novel neutral iron(II) isocyanide maleonitrile dithiolate [Fe(S2C2(CN)2)(t-BuNC) 4] compound

FeBr2 reacts with the S2C2(CN)22- ion (1:1 ratio) in the presence of an excess of t-BuNC in THF to give the mixed ligand [Fe(S2C2(CN)2)(t-BuNC) 4] compound. This neutral product with a formal oxidation state of two for the iron atom was characterized by conductivity measurements, and, i.r., Mössbauer, 13C and 1H n.m.r. spectroscopy. There is a Fe-C p back-donation strengthened towards isocyanide ligands, according to the data of 13C, 1H n.m.r. and Mössbauer spectroscopy.

Endogenous angiotensin II modulates nNOS expression in renovascular hypertension

Nitric oxide (NO) influences renal blood flow mainly as a result of neuronal nitric oxide synthase (nNOS). Nevertheless, it is unclear how nNOS expression is modulated by endogenous angiotensin II, an inhibitor of NO function. We tested the hypothesis that the angiotensin II AT1 receptor and oxidative stress mediated by NADPH oxidase contribute to the modulation of renal nNOS expression in two-kidney, one-clip (2K1C) hypertensive rats. Experiments were performed on male Wistar rats (150 to 170 g body weight) divided into 2K1C (N = 19) and sham-operated (N = 19) groups. nNOS expression in kidneys of 2K1C hypertensive rats (N = 9) was compared by Western blotting to that of 2K1C rats treated with low doses of the AT1 antagonist losartan (10 mg·kg-1·day-1; N = 5) or the superoxide scavenger tempol (0.2 mmol·kg-1·day-1; N = 5), which still remain hypertensive. After 28 days, nNOS expression was significantly increased by 1.7-fold in the clipped kidneys of 2K1C rats and by 3-fold in the non-clipped kidneys of 2K1C rats compared with sham rats, but was normalized by losartan. With tempol treatment, nNOS expression increased 2-fold in the clipped kidneys and 1.4-fold in the non-clipped kidneys compared with sham rats. The changes in nNOS expression were not followed by changes in the enzyme activity, as measured indirectly by the cGMP method. In conclusion, AT1 receptors and oxidative stress seem to be primary stimuli for increased nNOS expression, but this up-regulation does not result in higher enzyme activity.

Diverse effects of renal denervation on ventricular hypertrophy and blood pressure in DOCA-salt hypertensive rats

Cardiac hypertrophy that accompanies hypertension seems to be a phenomenon of multifactorial origin whose development does not seem to depend on an increased pressure load alone, but also on local growth factors and cardioadrenergic activity. The aim of the present study was to determine if sympathetic renal denervation and its effects on arterial pressure level can prevent cardiac hypertrophy and if it can also delay the onset and attenuate the severity of deoxycorticosterone acetate (DOCA)-salt hypertension. DOCA-salt treatment was initiated in rats seven days after uninephrectomy and contralateral renal denervation or sham renal denervation. DOCA (15 mg/kg, sc) or vehicle (soybean oil, 0.25 ml per animal) was administered twice a week for two weeks. Rats treated with DOCA or vehicle (control) were provided drinking water containing 1% NaCl and 0.03% KCl. At the end of the treatment period, mean arterial pressure (MAP) and heart rate measurements were made in conscious animals. Under ether anesthesia, the heart was removed and the right and left ventricles (including the septum) were separated and weighed. DOCA-salt treatment produced a significant increase in left ventricular weight/body weight (LVW/BW) ratio (2.44 ± 0.09 mg/g) and right ventricular weight/body weight (RVW/BW) ratio (0.53 ± 0.01 mg/g) compared to control (1.92 ± 0.04 and 0.48 ± 0.01 mg/g, respectively) rats. MAP was significantly higher (39%) in DOCA-salt rats. Renal denervation prevented (P>0.05) the development of hypertension in DOCA-salt rats but did not prevent the increase in LVW/BW (2.27 ± 0.03 mg/g) and RVW/BW (0.52 ± 0.01 mg/g). We have shown that the increase in arterial pressure level is not responsible for cardiac hypertrophy, which may be more related to other events associated with DOCA-salt hypertension, such as an increase in cardiac sympathetic activity.

Neural reflex regulation of arterial pressure in pathophysiological conditions : interplay among the baroreflex, the cardiopulmonary reflexes and the chemoreflex

The maintenance of arterial pressure at levels adequate to perfuse the tissues is a basic requirement for the constancy of the internal environment and survival. The objective of the present review was to provide information about the basic reflex mechanisms that are responsible for the moment-to-moment regulation of the cardiovascular system. We demonstrate that this control is largely provided by the action of arterial and non-arterial reflexes that detect and correct changes in arterial pressure (baroreflex), blood volume or chemical composition (mechano- and chemosensitive cardiopulmonary reflexes), and changes in blood-gas composition (chemoreceptor reflex). The importance of the integration of these cardiovascular reflexes is well understood and it is clear that processing mainly occurs in the nucleus tractus solitarii, although the mechanism is poorly understood. There are several indications that the interactions of baroreflex, chemoreflex and Bezold-Jarisch reflex inputs, and the central nervous system control the activity of autonomic preganglionic neurons through parallel afferent and efferent pathways to achieve cardiovascular homeostasis. It is surprising that so little appears in the literature about the integration of these neural reflexes in cardiovascular function. Thus, our purpose was to review the interplay between peripheral neural reflex mechanisms of arterial blood pressure and blood volume regulation in physiological and pathophysiological states. Special emphasis is placed on the experimental model of arterial hypertension induced by N-nitro-L-arginine methyl ester (L-NAME) in which the interplay of these three reflexes is demonstrable.