A Perda Auditiva Induzida pelo Ruído (PAIR) na formação odontológica: conhecimentos e níveis de exposição

The rationalization of work in the Dentistry has been taking the professional to work for ways and systems based in the ergonomics, turning their work efficient and less tiring. Since their academic formation, the dentists surgeons are concerned with the high productivity in clinic and with the final result of the work, neglecting the way as it is executed, which reduce their work capacity and exhibits them to occupational diseases that could be minimized and/or forewarned. This research had as the main objective to investigate the knowledge of the Dentistry academics of Rio Grande do Norte Federal University concerning the Noise-induced Hearing Loss (NIHL), relating them at the noise levels that they are exposed, as well as to the preventive measures taken during the clinical activities. Was observed that 95% of the individuals know that the dentist surgeon is a professional in risk for NIHL. Among the causes of NIHL, the one that obtained the largest frequency citation was the high-speed handpieces, reminded by 92,4% of the academics. Among the students which enumerated protective measures for NIHL, 92% mentioned the use of the ear plugs, although 97% of the researched have told do not use any kind of preventive measure related to the noise. Was also observed that 96% of the academics notice the noise during the clinical attendance, what inconvenience 28,1% of them. Related the noise levels, the high-speed handpieces of the academics presented a medium value of 80,5 dB varying from 72,3 to 88,3 dB. The average of the ambient noise observed at the Integrated Clinic was about 74,8 dB. In spite of the noise levels in this research were observed below the established limits of tolerance by the legislation, they can provoke damages to the Dentistry professionals' health, or that suggests the need of an intervention and use of immediate preventive measures able to generate a healthy atmosphere of work and less risky

Você conhece esta síndrome?

A síndrome oculoauriculovertebral, mais comumente conhecida como síndrome de Goldenhar, pode ser diagnosticada pelo dermatologista. Achados como hipoplasia/aplasia de pavilhão auricular e alterações vertebrais, e a presença de trago acessório encontrados no paciente são elementos-chave para a suspeita da síndrome. Sua identificação é de suma importância dada a possibilidade de outras alterações sistêmicas, com impacto até no prognóstico do paciente. Após a confirmação diagnóstica, é interessante a abordagem multidisciplinar e integral em função da potencial pluralidade de manifestações que podem ocorrer na síndrome.

The effect of salinization in maintenance of intermittent catheter

O uso de cateter intermitente representa um procedimento muito utilizado em ambiente hospitalar. Este estudo, de natureza experimental, teve como propósito a análise comparativa entre o cateter intermitente, preenchido com solução de heparina 100 U/ml e o preenchido com soro fisiológico 0,9%. Foi realizado um estudo comparativo, avaliando a formação de coágulos e se estes estivessem presentes seriam quantificados. Para tanto, foram utilizados quatro grupos de 7 coelhos, da linhagem Norfolk, sendo realizado acesso venoso em veia auricular conectado ao dispositivo de infusão múltipla. em dois destes grupos, foi usada solução salina; em um grupo, caso fosse encontrada resistência, esta seria forçada; no outro, esta resistência não seria forçada. Nos dois outros grupos, foi usada solução de heparina; em um grupo, caso fosse encontrada resistência, esta seria forçada; no outro esta resistência não seria forçada. O cateter intermitente foi mantido por 72 horas e, a cada 12 horas foi infundida água destilada, simulando a administração de medicamento. Durante o experimento foram observadas as seguintes variáveis: presença da formação de coágulos, comprimento do coágulo, peso fresco do coágulo, peso seco do coágulo, contagem plaquetária e desconforto. Na análise estatística feita pelo método não paramétrico Kruskal-Wallis, com nível de significância de sigma = 5%, não foi encontrada diferença significativa entre os grupos e momentos. Pôde-se constatar a presença de formação de coágulo em todos os grupos independentemente da solução de preenchimento. Concluímos, principalmente, que há necessidade de elaboração de novas normas e rotinas na utilização de cateter intermitente.

Unilateral Facial Paralysis Caused by Ramsay Hunt Syndrome

The Ramsay Hunt syndrome is a rare disease caused by an infection of the geniculate ganglion by the varicella-zoster virus. The main clinical features of the syndrome are as follows: Bell palsy unilateral or bilateral, vesicular eruptions on the ears, ear pain, dizziness, preauricular swelling, tingling, tearing, loss of taste sensation, and nystagmus. We describe a 23-year-old white woman, who presented with facial paralysis on the left side of the face, pain, fever, ear pain, and swelling in the neck and auricular region on the left side. She received appropriate treatment with acyclovir, vitamin B complex, and CMP nucleus. After 30 days after presentation, the patient did not show any signs or symptoms of the syndrome. At follow-up at 1 year, she showed no relapse of the syndrome.

Craniofacial Implants Success in Facial Rehabilitation

The use of craniofacial implants is an effective treatment for patients with deformities, burns, and cancer sequelae. The sites with the most successful implants are the auricular, nasal, and orbital regions. Furthermore, other factors can affect the implant longevity such as irradiated area, surgical technique, bone quality and quantity, macrostructure and microstructure of the implant, maintenance, and systemic factors.

Perfil audiológico de indivíduos portadores da síndrome de Goldenhar

A síndrome de Goldenhar é uma anomalia congênita rara, de etiologia ainda desconhecida e caracterizada por uma tríade clássica de alterações oculares, auriculares e vertebrais. FORMA DE ESTUDO: Estudo de série. MATERIAL E MÉTODO: Este trabalho foi realizado com 30 indivíduos portadores da síndrome de Goldenhar regularmente matriculados no HRAC, de ambos os gêneros, com faixa etária variando de 8 a 34 anos de idade. OBJETIVO: foi caracterizar o perfil audiológico dos indivíduos portadores dessa síndrome, garantindo assim um melhor tratamento e orientação para os mesmos, assim como também estabelecer a freqüência do comprometimento auditivo contralateral nos indivíduos com o clássico envolvimento unilateral. A avaliação audiológica do estudo constou de ATL, timpanometria, EOA-T e BERA. RESULTADO: de acordo com os resultados concluímos que 34% (=10) dos indivíduos apresentaram como característica de seu perfil audiológico perda auditiva do tipo sensório-neural mista com grau variando de moderado a profundo (7 uni e 3 bilaterais); 13% (n=4) apresentaram perda do tipo condutiva (bilateralmente) com grau de leve a severo e 3% (n=1) apresentaram ou perda do tipo sensório-neural profundo unilateral. Encontramos 40% (n=12) com audição normal bilateralmente e em 10% (n=3) não foi possível estabelecer a característica do perfil audiológico por utilizarmos como avaliação apenas o BERA como pesquisa de limiar eletrofisiológico. Dos doze (12) indivíduos com malformação de OE unilateral encontramos apenas dois (02) com comprometimento auditivo na orelha contralateral, sendo um do tipo misto de grau severo e um condutivo de grau moderado. Com relação a variável sexo encontramos predominância maior da síndrome de Goldenhar no gênero feminino (57%) do que no masculino (43%), mas considerado estatisticamente sem significância, assim como também o lado anatomicamente afetado, que foi predominantemente o direito.

Emprego da vídeo-otoscopia no diagnóstico de otites externas de cães

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

Metabolic acidosis in healthy mules under general anaesthesia with halothane

Objective To report the severe metabolic acidosis identified in a group of 11 healthy mules anaesthetized with halothane for castration.Study design Data generated from a prospective study.Animals Eleven mules aged 2.5-8 years, weighing 230-315 kg and 11 horses aged 1.5-3.5 years, weighing 315-480 kg.Methods Animals were anaesthetized for castration as part of an electroencephalographic study. Preanaesthetic medication was acepromazine (0.03 mg kg(-1)) administered through a preplaced jugular venous catheter. Anaesthesia was induced 30-90 minutes later with intravenous thiopental (10 mg kg(-1)). After orotracheal intubation, anaesthesia was maintained with halothane vaporised in oxygen. The animals' lungs were ventilated to maintain the end-tidal CO(2) concentration between 3.9 and 4.5 kPa (29-34 mmHg). Anaesthetic monitoring included invasive blood pressure measurement via the auricular artery (mules) and submandibular branch of the facial artery (horses). Arterial blood gas samples were drawn from these catheters at three time points during surgery and pH, PaCO(2), base excess (ecf) and HCO(3)(-) were measured. Values were compared between groups using a Mann-Whitney test. p was taken as <0.05. Results are reported as median (range).Results PaCO(2) did not differ between groups but pH was significantly lower in mules [7.178 (7.00-7.29)] compared to horses [7.367 (7.24-7.43)] (p = 0.0002). HCO(3)(-) values were significantly lower in the mules [16.6 (13.0-22.3) mM] compared to horses [23.7 (20.9-23.7) mM] (p = 0.0001), whilst base excess (ecf) was significantly more negative in the mules [-11.4 (-1.27 to -16) mM] compared to horses [-1.3 (-5.8 to +2.4) mM] (p = 0.0004).Conclusion and clinical relevance This study demonstrated severe metabolic acidosis in healthy mules, which may have prompted intervention with drug therapies in a clinical arena. It is probable that the acidosis existed prior to anaesthesia and caused by diet, but other possible causes are considered.

Toothache referred from auriculotemporal neuralgia: case report

P>AimTo present a 52-year-old male patient who complained of intense pain of short duration in the region of the left external ear and in the ipsilateral maxillary second molar that was relieved by blockade of the auriculotemporal nerve in the infratemporal fossa.SummaryExtra- and intraoral physical examination revealed a trigger point that reproduced the symptoms upon finger pressure in the ipsilateral auriculotemporal nerve and in the outer auricular pavilion. The patient's medical history was unremarkable. The maxillary left second molar tooth was not responsive to pulp sensitivity testing and there was no pain upon percussion or palpation of the buccal sulcus. Periapical radiographs revealed a satisfactory root filling in the maxillary left second molar. on the basis of the clinical signs and symptoms, the auriculotemporal was blocked with 0.5 mL 2% lidocaine and 0.5 mL of a suspension containing dexamethasone acetate (8 mg mL(-1)) and dexamethasone disodium sulfate (2 mg mL(-1)), with full remission of pain 6 months later. The diagnosis was auriculotemporal neuralgia.Key learning pointAuriculotemporal neuralgia should be considered as a possible cause of nonodontogenic toothache and thus included in the differential diagnoses.The blockade of the auriculotemporal nerve in the infratemporal fossa is diagnostic and therapeutic. It can be achieved with a solution of lidocaine and dexamethasone.

Contribuição para o estudo da proção cervical da veia facial de fetos, recém-nascidos e crianças.

In the study of cervical posterior of the facial vein of the foetus, newborns and children we injected in the veins of the head and neck of 15 corpses, rubber material (Xantopren and or Neoprene Latex). The results showed than the retromandibular and or the facial vein form a venous trunk in 83.3%, what finish always in the intern jugular vein or join the retromandibular vein and casually also with a posterior auricular vein originating the extern jugular vein (16.7%).

Direct and indirect connections between cochlear root neurons and facial motor neurons: Pathways underlying the acoustic pinna reflex in the albino rat

Cochlear root neurons (CRNs) are involved in the acoustic startle reflex, which is widely used in behavioral models of sensorimotor integration. A short-latency component of this reflex, the auricular reflex, promotes pinna movements in response to unexpected loud sounds. However, the pathway involved in the auricular component of the startle reflex is not well understood. We hypothesized that the auricular reflex is mediated by direct and indirect inputs from CRNs to the motoneurons responsible for pinna movement, which are located in the medial subnucleus of the facial motor nucleus (Mot7). To assess whether there is a direct connection between CRNs and auricular motoneurons in the rat, two neuronal tracers were used in conjunction: biotinylated dextran amine, which was injected into the cochlear nerve root, and Fluoro-Gold, which was injected into the levator auris longus muscle. Under light microscopy, close appositions were observed between axon terminals of CRNs and auricular motoneurons. The presence of direct synaptic contact was confirmed at the ultrastructural level. To confirm the indirect connection, biotinylated dextran amine was injected into the auditory-responsive portion of the caudal pontine reticular nucleus, which receives direct input from CRNs. The results confirm that the caudal pontine reticular nucleus also targets the Mot7 and that its terminals are concentrated in the medial subnucleus. Therefore, it is likely that CRNs innervate auricular motoneurons both directly and indirectly, suggesting that these connections participate in the rapid auricular reflex that accompanies the acoustic startle reflex. © 2008 Wiley-Liss, Inc.

Bone regeneration in cranioplasty and clinical complications in rabbits with alloxan-induced diabetes

This research evaluated the bone repair process in surgical defects created on the parietal bones of diabetic rabbits using the guided bone regeneration technique to observe the effects of alloxan in the induction of diabetes mellitus. Twenty-four adult rabbits were divided into three study groups: control (C), diabetic (D) and diabetic associated to polytetrafluoroethylene (PTFE) membrane (D-PTFE). For diabetes induction the animals received one dose of monohydrated alloxan (90 mg/kg) by intravenous administration in the auricular or femoral vein. In group D-PTFE the membrane covered both the floor and the surface of the bone defect. In groups D and C, the bone defect was filled up with blood clot. The specimens were fixed in 10% formol and prepared for histomorphometric analysis. The results showed that the 90 mg/kg dose of monohydrate alloxan was sufficient to promote diabetes mellitus when administered in the auricular vein. Bone regeneration was slower in the diabetic group when compared with the control and diabetic-PTFE groups, but there was no significant statistical difference between the two experimental groups (D and D-PTFE). The oral and general clinical complications among the diabetics were weight loss, polyuria, polyphagia and severe chronic gingivitis.

Efeito do eCG ou benzoato de estradiol associado ao norgestomet na taxa de concepção de vacas de corte submetidas à IATF no pós-parto

This study aimed to compare conception rates at the postpartum period (PPP) in beef cows which were administered either Equine Chorionic Gonadotrophin (eCG) or Estradiol Benzoate (EB) after Norgestomet and submitted to fixed-time artificial insemination (FTAI). The hypothesis was that the administration of eCG or EB enhances the conception rate. Lactating Nelore cows (n=138) and Brangus (n = 63), between 26 and 118 days of post partum period (PPP) were divided into three homogeneous groups, and subdivided in two blocks, inside each group one of them with a PPP d'' 45 days (PPP1; n=107) and another with a PPP > 45 days (PPP2; n=94). All cows received an auricular implant containing 3mg Norgestomet (Crestar®), followed by the administration of 5mg Estradiol Valerate. The auricular implants were kept during 10 days. Cows received 1mL saline solution (n=68, Control Group) or 500IU eCG (Folligon®; n=67; eCG Group) or 1mg Estradiol Benzoate (Index, n=66; EB Group) 24 hours after the removal of the implant. FTAI was made 54 hours after the implant removal. The pregnancy diagnosis was carried through ultrasonography 30 days after FTAI. There was an interaction between treatments and PPP. In the PPP1, the conception rate was higher in the eCG Group than in the EB Group (47.22% vs. 15.38%; Pd''0.01). In the PPP2, the conception rates of the eCG and EB Groups were higher than in the Control Group (41.93%, 44.44% vs. 22.22%: Pd''0.01). It was concluded that in cows up to 45 days of PPP, the eCG associated with Norgestomet enhances the conception rates.

Anatomical study of the retroarticular process in dry human skulls

Introduction: The retroarticular process is a bony prominence formed by the thickening of the lateral border of the mandibular fossa, forming the posterior wall of the temporomandibular joint. Since little is known and discussed about the retroarticular process, our aim was to study its presence, shape and size, relating these findings to the shape of the skulls according to the horizontal cephalic index. Materials and Methods: We used 400 dry human skulls of the Institute of Science and Technology - UNESP Anatomy Laboratory. Each skull was classified in brachycranics, mesocranics or dolichocranics, and then positioned on a craneostat to measure the height of the retroarticular process from its lower extremity to the auriculo-orbital plane. The width was obtained by measuring the base of the process on its longer lateral axis. Results: The retroarticular process was found bilaterally in 397 skulls (99.25%). All the processes were classified into the following shapes: pyramidal (35.55%), tubercular (31.78%), mammilar (20.73%), crest-like (9.05%) and molar shape (2.89%); 254 skulls (63.50%) showed the same type of process at the right and left sides (Kappa=0.496, moderate agreement). The average height and width were 5.28 mm and 12.81 mm, respectively. Conclusion: The retroarticular process was found in almost all the skulls examined. There are no significant evidences about the relationship among the presence, shape and size of the retroarticular process and the shape of the skulls according to the horizontal cephalic index. However, our findings led us to infer that there would be a functional relationship between the process and the temporomandibular joint.

Endaural access to remove the projectile from a firearm

Background: Surgical approaches to temporomandibular region have been the subject of numerous controversies in the literature. Pre-auricular approaches have been used with the observance of high success rate, and during surgery history, various modifications of this approach were conducted in order to reduce irreversible sequelae. Thus, given the relevance of the study, this article proposes to alert the professionals that carry out these surgical approaches in relation to the anatomical structures involved and to describe and emphasise the benefits of endaural approach. Case report: A Caucasian male patient, victim of a firearm injury, sustained a wound on the right pre-auricular region, and at the time of assessment, he complained of pain, mouth opening difficulty and dysphagia. On physical examination, there was oedema and ecchymosis in the right periorbital region. In the radiological examination, a foreign body compatible with a firearm projectile was observed in the right pre-auricular region, being in accordance with the information collected. The endaural incision and divulsion by plans was then made until the projectile. Discussion: For proper exposure of the region, several studies were designed to evaluate the patterns of branching and anastomosis of the facial nerve. As for the best cosmetic result with the different pre-auricular approaches, the endaural approach was described as an approach that offers great cosmetic results because the incision design guides the surgeon in the wound closure and causes a decrease in the tension of flap, unlike that observed by some authors. © 2012 Springer-Verlag Berlin Heidelberg.