Técnicas de alongamento coronário

Introdução: O alongamento coronário é um procedimento que pode envolver, ou não, técnicas cirúrgicas, e que tem como principal objetivo aumentar o tamanho da coroa clínica, assim como devolver a estética, a forma e a função às arcadas dentárias. Este procedimento realiza-se, ou por motivos estéticos ou motivos restauradores. Ultimamente, os motivos estéticos têm vindo a ganhar importância e são eles que, muitas da vezes, levam os pacientes às consultas de medicina dentária. O sorriso gengival é um desses motivos, e pode ser causado, entre outras razões por, uma erupção passiva alterada ou/e um excesso vertical maxilar. Estas são as etiologias que serão descritas neste trabalho. O aumento coronário realiza-se, também, quando há a necessidade de reabilitar um dente, quer seja com resinas compostas ou com coroas. Este, deve sempre respeitar os limites biológicos do periodonto, nomeadamente o espaço biológico. A invasão deste espaço pode por em risco a manutenção da saúde do periodonto e a viabilidade do tratamento a longo prazo, por isto, preconiza-se que deve ser deixado um espaço de 3mm, desde a crista óssea até a margem restauradora. As técnicas de alongamento coronário enumeradas e definidas ao longo desta tese são: a gengivectomia, o retalho apicalmente posicionado e a erupção dentária forçada. Cada uma delas possui as suas indicações e contra-inidcaçoes. A gengivectomia é realizada quando não há necessidade de recontorno ósseo, pelo contrário, quando essa necessidade existe opta-se pelo retalho apicalmente posicionado. A erupção forçada é uma alternativa ao alongamento cirúrgico e aplica-se, normalmente a dentes não restauráveis mas com estrutura dentária sã abaixo do da crista óssea. Um ótimo diagnóstico é o essencial para a escolha da técnica de aumento coronário que melhor se adequa a cada caso. Objetivo: O objetivo desta revisão bibliográfica tem por base a pesquisa das técnicas de alongamento coronário, começando por perceber a anatomia do periodonto, as alterações que nele acontecem antes e depois dos procedimentos de alongamento coronário, a descrição e a comparação dos mesmos. Materiais e métodos: Para a realização desta revisão foram utilizados os principais motores de busca de dados científicos como a PubMed, B-on, Medline, Scielo, Google Académico e ainda o repositório on-line da Universidade Fernando Pessoa. Foram utilizadas as seguintes palavras chaves: “altered passive eruption”, “gingivectomy”, “gingivoplasty”, “apically repositioned flap”, “surgical crown lengthening”, “biologic width”, “mucogengival junction”, “forced eruption”, “prostethic dentistry”, “gummy smile”, resultando num pesquisa de 45 artigos e duas obras literarátias de interesse. Conclusões: Foi possível concluir que existem varias técnicas de alongamento coronário, cada uma adequada a cada caso e verificou-se que existem vários motivos pelo qual se realiza essa técnica.

Relação coronal do implante com a crista óssea

Introdução: A reabilitação com implantes nas últimas décadas tem evoluído tendo em vista a obtenção de melhores resultados ao nível mecânico/funcional, mas também a nível estético. A relação coronal dos implantes com crista óssea é um dos pontos que tem sido estudado. Objectivo: Realizar uma revisão sobre a relação coronal dos implantes com a crista óssea, com objectivo de responder à seguinte questão “A posição sub-crestal dos implantes em relação à crista óssea é vantajosa?”. Para tal vão ser estudados alguns dos factores que podem influenciar esta decisão. Metodologia: Realizou-se pesquisa bibliográfica recorrendo às bases de dados da “MEDLINE/Pubmed”, “SciELO”, “Science Direct”, “B-on”, “Google Academic” e repositórios de várias universidades portuguesas e estrangeiras, com as palavras-chave: “Bone Cells” ”Bone remodeling”, “Bone Crest”, “Osseointegration”, “Implant Placement”, “Biologic Width” e “Platform Switching”,”Implant Placement Depth” e “Morse Cone”, tendo sido estas associadas entre si. Também foi realizada pesquisa manual em livros dos vários temas estudados. Conclusão: A colocação de implantes ao nível sub-crestal ainda apresenta alguma controvérsia, mas obedecendo a alguns factores, como a utilização de um implante e pilar específicos, pode tornar- se algo muito vantajoso numa perspectiva futura.

Correção de colapsos da crista alveolar com tecidos duros

Introdução: Uma adequada planificação é condição sine qua non para o êxito do tratamento com implantes. No entanto, nem sempre a colocação dos implantes na posição tridimensional ideal é, logo à partida, viável. Neste contexto, a correção dos colapsos da crista óssea com tecidos duros assume especial importância. Objetivos: O objetivo desta revisão narrativa é avaliar a eficácia dos diversos procedimentos existentes para aumento do rebordo com tecidos duros, de forma a facilitar a escolha do tratamento ideal. Materiais e Métodos: Pesquisou-se nas bases de dados MEDLINE, B-on e Google Académico. As palavras-chave utilizadas foram: “guided bone regeneration”, “ridge augmentation”, “seibert classification”, “alveolar bone splitting”, “horizontal bone augmentation” e “vertical bone augmentation”. Deu-se especial ênfase a revisões sistemáticas e meta-análises. A pesquisa foi limitada a artigos publicados em inglês, espanhol e em português até abril de 2016. Foram ainda consultados os livros “Tratado de Periodontia Clínica e Implantologia Oral” de Lindhe et al. (2005), “Implantes Dentais Contemporâneos” de Misch et al. (2009) e “Reabilitação com implantes endo-ósseos” de Alcoforado et al. (2008). Resultados: De um modo geral, todos os procedimentos analisados obtiveram altas taxas de sobrevivência aquando da reabilitação com implantes. No entanto, não houve diferenças significativas entre as diversas técnicas que possam levar a uma conclusão relevante sobre qual a melhor técnica a utilizar para este tipo de procedimento. Conclusão: Há evidências insuficientes para sugerir qual a técnica que deve ser preferida para o aumento de rebordo com tecidos duros, pelo que mais estudos são necessários.

Morfodinâmica do Banco das Três Marias – Barra do Rio Grande

Dados batimétricos detalhados obtidos na antepraia adjacente ao Molhe Oeste conhecida como banco das Três Marias, evidenciaram a presença de uma fossa junto a extremidade do molhe e um banco na forma de domo a SO da depressão. O banco tem sua base e crista respectivamente nas cotas de 8 e 6 m. A feição é aproximadamente oval, com o eixo maior semiparalelo à costa (sentido NNE – SSO) medindo aproximadamente 1600 m. O eixo menor, quase transversal à costa (sentido L-O), apresenta cerca de 1200 m de extensão. O banco representa o resquício do lobo terminal do delta de maré vazante (barra) da laguna formado durante a fixação de sua desembocadura. A fossa junto ao cabeço do molhe apresenta pendente íngreme, que inicia na isóbata de 8 m e alcança a isóbata dos 17 m, sendo provavelmente formada pela ação da corrente longitudinal de SO para NE. Foram coletadas também amostras de sedimento. Estes dados evidenciaram ao menos três subambientes refletindo diferentes níveis de energia. Do mais enérgico para o menos: o banco, onde o sedimento é mais grosso e melhor selecionado, a antepraia, com o sedimento pouco mais fino e a fossa, onde foi amostrada lama, mal selecionada.

Implantes colocados justa cristal versus implantes sub-cristal

Introdução: A posição da colocação do implante relativamente à crista óssea tem sido discutida na comunidade científica como fator influenciador de sucesso ou insucesso. Por outro lado a perda ou preservação óssea está intrinsecamente relacionado com fatores como a seleção do sistema de implante, o tipo de implante e a sua conexão. Objetivo: Este trabalho teve como objetivo a análise da bibliografia existente que compara a colocação de implantes a nível da crista óssea (justa cristal) com a colocação de implantes abaixo da crista óssea (sub-cristal) em sinergismo com outros fatores, de forma que seja percecionada a eficácia e sucesso na seleção efetuada. Metodologia: Procedeu-se a uma pesquisa bibliográfica através da identificação de artigos publicados em bases de dados eletrónicas internacionais, PubMed, B-on e Science Direct utilizando palavras-chave e critérios de exclusão e inclusão, que permitiram fazer uma seleção prévia dos artigos a incluir ao longo deste trabalho. Resultados: Após a realização da pesquisa bibliográfica obtiveram-se 63 artigos. A partir da amostra encontrada foram excluídos 26 artigos devido à falta de correspondência do seu conteúdo ao tema proposto e 14 por se encontrarem repetidos ou sem dados comparativos. Nos 23 artigos aceites encontram-se incluídos estudos animais, elementos finitos, revisões e estudos clínicos. Conclusão: Os resultados sugerem que a colocação de implantes em sub-cristal apresenta-se como uma melhor solução na preservação da crista óssea, no entanto há que levar em conta outros fatores associados diretamente ao implante, nomeadamente, a geometria, superfície não polida do colo assim como o tipo de conexão do pilar ao implante, onde foi encontrada uma relativa evidência de melhor eficácia no que respeita à conexão do tipo “cone Morse”.

Geologie und Hydrogeologie im Raum Bad Pyrmont unter besonderer Berücksichtigung des Quellensystems

The hydrodynamics and hydrochemistry of salt and fresh water from solid rock aquifer systems in the Pyrmont area are described and interpreted on the basis of recent investigations including geoelectrics, isotope hydrology, soil air analysis. Theories on the source of the springs in this area are developed, which explain the different compositions of the springs and make it possible to protect them. Data from new and re-interpretated drill holes, borehole logs and outcrops suggest a revision of the geological structure of the Pyrmont dome. Bad Pyrmont is situated on a wide dome of Triassic rocks in the southern part of the Lower Saxony uplands. Inversion of the relief has caused the development of an erosional basin surrounded by prominent ridges. Deep faults developed at the crest of the dome as this part of the structure was subjected to the strongest tectonic stress. Subrosion of the Zechstein salts in the western part of the dome has caused the main salt bed to wedge out below the western part of the dome along a N-S striking structure; this structure is refered to as the „Salzhang“ (salt slope). West of the „Salzhang“, where subrosion has removed the salt bed that prevents gas rising from below, carbon dioxide of deep volcanic origin can now rise to the surface. Hydraulic cross sections illustrate the presence of extensive and deep-seated groundwater flow within the entire Pyrmont dome. While groundwater flow is directed vertically downwards in the ridges surrounding the dome, centripetal horizontal flow predominates the intermediate area. In the central part of the dome, groundwater rises to join the River Emmer, which is the main receiving water course in the central part of the eroded basin. The depth of the saltwater/freshwater interface is determinated by the weight of the superimposed freshwater body. Hydrochemical cross sections show the shape and position of the interface and document a certain degree of hydrochemical zonation of the gently mineralized fresh water. Genetic relationships between the two main water types and the hydrochemical zones of the freshwater body are discussed. The knowledge of the hydrogeological relationship in the Bad Pyrmont aquifer systems permits a spatially narrow coexistence of wells withdrawing groundwater for different purposes (medicinal, mineral, drinking and industrial water).

Die Solling-Folge (Mittlerer Buntsandstein) im Grenzgebiet Niedersachsen - Thüringen - Hessen

This paper deals with the lithostratigraphic structure of the Solling sequence (Lower Triassic, Middle Buntsandstein) in the area between the Weser river region in the west and the Thuringian Eichsfeld region in the east. Lithologic profile mapping and the gamma-ray logs of several boreholes and 40 exposures have been used to define the lithostratigraphic Classification of the Solling sequence, to mark the facies zones and to find the connection between Sediments of the Thuringian basin in the east and the Weser fault trough via the crest of the Eichsfeld-Altmark Ridge. Tectonically controlled movements of synsedimentary character are the reason for the extreme convergence within the Solling sequence and the extreme Stratigraphie gap at its base (Hardegsen unconformity, Trusheim 1961) in the region of the swells. The discussion also demonstrates the importance of fault bundles active during Triassic and responsible for the thickness pattem of the Solling sequence between the Weser fault trough and the Eichsfeld-Altmark Ridge. The largest Stratigraphie gap is present at the line Brehme (Ohm Mountains) - Beuren - Treffurt where the Solling sequence covers Av/cn/a-bearing layers of the Volpriehausen sequence. In paiticular the Ridge sequences prove the existence of a further erosion unconformity within the Solling sequence (Solling unconformity, Kunz 1965) below the Thuringian Chirotheriensandstein as found by Rohling (1986) in the North German basin at the Stratigraphie level of the Karlshafen layers.

A joint electromagnetic and seismic study of an active pockmark within the hydrate stability field at the Vestnesa Ridge, West Svalbard margin

We acquired coincident marine controlled-source electromagnetic (CSEM), high-resolution seismic reflection and ocean-bottom seismometer (OBS) data over an active pockmark in the crest of the southern part of the Vestnesa Ridge, to estimate fluid composition within an underlying fluid-migration chimney. Synthetic model studies suggest resistivity obtained from CSEM data can resolve gas or hydrate saturation greater than 5% within the chimney. Acoustic chimneys imaged by seismic reflection data beneath the pockmark and on the ridge flanks, were found to be associated with high-resistivity anomalies (+2-4 m). High-velocity anomalies (+0.3 km/s), within the gas hydrate stability zone (GHSZ) and low-velocity anomalies (-0.2 km/s) underlying the GHSZ, were also observed. Joint analysis of the resistivity and velocity anomaly indicates pore saturation of up to 52% hydrate with 28% free gas, or up to 73% hydrate with 4% free gas, within the chimney beneath the pockmark assuming a non-uniform and uniform fluid distribution respectively. Similarly, we estimate up to 30% hydrate with 4% free gas or 30% hydrate with 2% free gas within the pore space of the GHSZ outside the central chimney assuming a non-uniform and uniform fluid distribution respectively. High levels of free-gas saturation in the top part of the chimney are consistent with episodic gas venting from the pockmark.

Geomorphological constraining of tsunami (?) run-up in the Alcantarilha coastal lowland (Central Algarve, Portugal)

The Alcantarilha lowland, partly barred by a well developed barrier, including foredunes covering Pleistocene-Holocene beachrock and aeolianite, develops across the Alcantarilha infilled estuary, the beach-dune extending further SE until the Salgados lagoon. A topographic and coring survey revealed a peculiar feature at the leeward toe of the dune ridge close to the inlet area: a sandy fan with location, shape and morphology suggesting emplacement by single or multiple overwash of the barrier tip rather than tidal forcing. Its storm or tsunami origin and age are under investigation, and the only time-constrain available at present is that it should post-date ca. 6600 cal BP, the most recent in situ aeolianite (Moura et al., 2007) dated so far. METHODS, DATA SET AND RESULTS The fan boundaries are distinctive in aerial photos and satellite images: it is roughly ellipsoidal, ~200 m wide and ~300 m elongated paralleling the shoreline, rising ~ 0.9-1.2 m above the surrounding floodplain surface. Detailed topography shows that its short axis aligns with SW-NE elongated (though irregular) depressions in the dune crest, which link the beach with the fan. This could have favoured funnelling of, or erosion by, water overtopping the barrier but, in either case, the fan should correspond to extreme and abrupt event(s) of coastal flooding. 18 trenches and cores were performed in the exposed area of the fan and nearby flood plain to obtain samples and data on its sedimentology, lithostratigraphy and geometry. The fan consists of well sorted and rounded sand (Fig. 2). It thins away and wedges out landwards of the apex (located near Alc29T) where it is partly covered by dune sand. Its lower boundary is undulating and marked by textural contrast between sand (fan) and underlying mud (alluvial/lagoonal); an accumulation of marine-sourced perforated pebbles showing limited lateral continuity may pinpoint this boundary near the foredune (core Alc 25, ca. 80 m westward of profile in Fig.1); mud-balls were also observed immediately above this surface in cores and trenches. As the washover was probably emplaced in a barred lagoonal/estuarine floodplain setting, the fan’s northern outer belt is enclosed by low-energy sediments (not shown in Fig. 2).

The pianosa contourite depositional system (northern Tyrrhenian sea): drift morphology and plio-quaternary stratigraphic evolution

The Pianosa Contourite Depositional System (CDS) is located in the Corsica Trough (Northern Tyrrhenian Sea), a confined basin dominated by mass transport and contour currents in the eastern flank and by turbidity currents in the western flank. The morphologic and stratigraphic characterisation of the Pianosa CDS is based on multibeam bathymetry, seismic reflection data (multi-channel high resolution mini GI gun, single-channel sparker and CHIRP), sediment cores and ADCP data. The Pianosa CDS is located at shallow to intermediate water depths (170 to 850 m water depth) and is formed under the influence of the Levantine Intermediate Water (LIW). It is 120 km long, has a maximum width of 10 km and is composed of different types of muddy sediment drifts: plastered drift, separated mounded drift, sigmoid drift and multicrested drift. The reduced tectonic activity in the Corsica Trough since the early Pliocene permits to recover a sedimentary record of the contourite depositional system that is only influenced by climate fluctuations. Contourites started to develop in the Middle-Late Pliocene, but their growth was enhanced since the Middle Pleistocene Transition (0.7–0.9 Ma). Although the general circulation of the LIW, flowing northwards in the Corsica Trough, remained active all along the history of the system, contourite drift formation changed, controlled by sediment influx and bottom current velocity. During periods of sea level fall, fast bottom currents often eroded the drift crest in the middle and upper slope. At that time the proximity of the coast to the shelf edge favoured the formation of bioclastic sand deposits winnowed by bottom currents. Higher sediment accumulation of mud in the drifts occurred during periods of fast bottom currents and high sediment availability (i.e. high activity of turbidity currents), coincident with periods of sea level low-stands. Condensed sections were formed during sea level high-stands, when bottom currents were more sluggish and the turbidite system was disconnected, resulting in a lower sediment influx.

Rôle du facteur de transcription PITX1 dans les pathogenèses de l'ostéoporose et des maladies parodontales

L’ostéoporose est une maladie caractérisée par une faible masse osseuse et une détérioration du tissu osseux. Cette condition entraîne une plus grande fragilité osseuse et des risques de fractures. Plusieurs études ont associé l’ostéoporose à la faible densité osseuse des mandibules, à la perte d’attache parodontale, à l’augmentation de la hauteur de la crête alvéolaire et à la chute des dents. Cette étude vise à comprendre les mécanismes sous-jacents cette perte osseuse. En effet, au cours du développement des souris, PITX1 joue un rôle clé dans l'identité des membres postérieurs et dans le bon développement des mandibules et des dents. Son inactivation complète chez la souris mène à un phénotype squelettique sévère. Tandis que, son inactivation partielle provoque des symptômes apparentés à l'arthrose avec une augmentation de la masse osseuse au niveau de l’os cortical et de l’os trabéculaire. Inversement, une étude antérieure chez des jumelles monozygotiques discordantes pour l’ostéoporose, montrent une augmentation d’environ 8.6 fois du niveau d’expression du gène Pitx1 chez la jumelle ostéoporotique. Collectivement, ces données nous ont poussés à investiguer sur le rôle du facteur de transcription PITX1 dans le métabolisme osseux normal et pathologique. Dans ce contexte, des souris transgéniques Col1α1-Pitx1 sur-exprimant Pitx1 spécifiquement dans le tissu osseux sous le promoteur du collagène de type-I (fragment 2.1kpb) ont été générées et phénotypiquement caractérisées. Ces résultats ont révelé que les souris transgéniques Col1α1-Pitx1 présentaient un phénotype similaire à celui des patients ostéoporotiques accompagné d'une perte de dents et des problèmes dentaires et parodontaux. De plus, cette étude a révélé que la surexpression de Pitx1 induit une altération de l’homéostasie osseuse via l’inactivation de la voie de signalisation Wnt/β-caténine canonique. Cette hypothèse a été appuyée par le fait que le traitement des souris transgéniques Col1α1-Pitx1 avec du chlorure de lithium, un activateur de la voie Wnt canonique, prévient le phénotype ostéoporotique chez ces souris. Finalement, cette étude établit un rôle crucial de PITX1 dans la régulation de la masse osseuse et une implication possible dans l’ostéoporose et les maladies parodontales via l’inactivation de la voie de signalisation Wnt/β-caténine canonique.

Orthopaedic anaesthesia for upper extremity procedures in a Nigerian hospital

Background General anaesthesia and regional anaesthesia have been used successfully for upper extremity orthopaedic procedures. Despite the advantages of regional anaesthesia, there is low utilisation in Nigeria. In this study, we assessed the types of anaesthesia employed for upper extremity surgeries in our centre. Methods After obtaining approval from the institutional ethics committee, all the patients who had upper extremity surgeries from 1 January 2011 to 31 December 2012 were included in this review. Both prospective and retrospective data were gathered. The choice of anaesthesia was at the discretion of the attending anaesthetist. Results A total of 226 patients with a male-to-female ratio of 1.6:1 and median age of 35.0 (range 2 – 89) years, had orthopaedic upper extremity procedures during the study period. Sixty-three cases (27.9%) had general anaesthesia, 5 (2.2%) combined regional and general anaesthesia while 158 (69.9%) had regional blocks. The regional blocks comprised 145 (89%) different approaches to the brachial plexus and 18 (11%) local anaesthetic infiltrations. The arm was the site mostly operated upon; while supraclavicular and axillary brachial plexus blocks were performed in equal amounts. In 14 (6.2%) patients, brachial plexus blocks were performed with spinal anaesthesia because of concomitant iliac crest bone grafts. While the duration of surgery did not differ significantly, regional anaesthesia provided a significantly longer duration of anaesthesia than general anaesthesia (251 ± 70.8 min versus 141.3 ± 65.5 min; p = 0.0000001). Conclusion There is a high use of regional anaesthesia for upper extremity orthopaedic surgeries in our centre, which is a positive development in a resource limited setting.

Comparison of two field methods for estimating body fat in different Spanish Dance disciplines

The purpose of the present study was to investigate percentage body fat (%BF) differences in three Spanish dance disciplines and to compare skinfold and bioelectrical impedance predictions of body fat percentage in the same sample. Seventy-six female dancers, divided into three groups, Classical (n=23), Spanish (n=29) and Flamenco (n=24), were measured using skinfold measurements at four sites: triceps, subscapular, biceps and iliac crest, and whole body multi-frequency bioelectrical impedance (BIA). The skin-fold measures were used to predict body fat percentage via Durnin and Womersley's and Segal, Sun and Yannakoulia equations by BIA. Differences in percent fat mass between groups (Classical, Spanish and Flamenco) were tested by using repeated measures analysis (ANOVA). Also, Pearson's product-moment correlations were performed on the body fat percentage values obtained using both methods. In addition, Bland-Altman plots were used to assess agreement, between anthropometric and BIA methods. Repeated measures analysis of variance did not found differences in %BF between modalities (p<0.05). Fat percentage correlations ranged from r= 0.57 to r=0.97 (all, p<0.001). Bland-Altman analysis revealed differences between BIA Yannakoulia as a reference method with BIA Segal (-0.35 ± 2.32%, 95%CI: -0.89to 0.18, p=0.38), with BIA Sun (-0.73 ± 2.3%, 95%CI: -1.27 to -0.20, p=0.014) and Durnin-Womersley (-2.65 ± 2,48%, 95%CI: -3.22 to -2.07, p<0.0001). It was concluded that body fat percentage estimates by BIA compared with skinfold method were systematically different in young adult female ballet dancers, having a tendency to produce underestimations as %BF increased with Segal and Durnin-Womersley equations compared to Yannakoulia, concluding that these methods are not interchangeable.

Características de la esclerosis sistémica, en pacientes de los hospitales Vicente Corral Moscoso y José Carrasco Arteaga durante el período enero 2008 – junio 2015

Antecedentes: La esclerosis sistémica es una enfermedad crónica del tejido conectivo, de etiología desconocida; caracterizada por presentar vasculopatía, autoinmunidad y fibrosis. Genera importantes repercusiones socio sanitarias y hasta la actualidad no tiene cura. Objetivo: Determinar las características demográficas, clínicas e inmunológicas de la Esclerosis Sistémica en pacientes de los Hospitales Vicente Corral Moscoso y José Carrasco Arteaga. Metodología: Es un estudio cuantitativo, descriptivo y retrospectivo. El universo está constituido por los pacientes diagnosticados de esclerosis sistémica en ambos hospitales. La información se recopiló de las historias clínicas y se analizó en Microsoft Excel 2013 y SPSS 19. Se utilizaron variables cuantitativas y cualitativas, mostrándose a través de frecuencias y porcentajes. Se consideró un nivel de asociación estadística para p<0.05. Resultados: La esclerosis sistémica es más común en mujeres. La forma limitada es la predominante. Las manifestaciones clínicas más comunes son las cutáneas, seguida de las osteomusculares y el Síndrome de Raynaud. El grupo de 50-64 años es el que muestra mayor grado de afectación general; en los más jóvenes las afectaciones cutáneas y osteomusculares son las de mayor frecuencia. Los anticuerpos antinucleares resultaron los de mejor valor diagnóstico, siendo positivos en más del 70% de los pacientes. Los tratamientos más comunes se basan en controlar los síntomas, siendo el paracetamol el más utilizado (80,4%). Conclusiones: La Esclerosis Sistémica afecta más a mujeres que a hombres, el grupo etario más frecuente está entre los 25-64 años. La forma limitada predomina sobre la difusa. Sus principales manifestaciones clínicas son las cutáneas

Surf and turf: music education riding the wave and/or planted firmly in teacher education arts courses across two Australian universities

Tertiary Arts educators are exhorted to offer The Australian Curriculum: The Arts (Dance, Drama, Media Arts, Music and Visual Arts) in their teacher education programs. This paper situates itself across two interstate universities (Deakin in Victoria and Griffith in Queensland) where both authors are music educators at these institutions. They discuss the two different ways that primary Arts education is offered at their universities by focusing on the Bachelor of Primary course (program/degree). The focus at Griffith University is on integrating the Arts whereas at Deakin University, the Arts are taught as a discipline within the unit (subject). Across both universities two teaching units for primary Arts education is core within the four-year program. Drawing on the author’s narrative reflection, observation, student questionnaire data, anecdotal feedback and student end of semester evaluations we discuss two different methods of delivery, assessment and challenges the units present to the authors and students. Though tertiary Arts educators are challenged to be inclusive of a rich and diverse arts curriculum as music educators we question whether the students are merely surfing the crest of the wave or being firmly planted in the ground to effectively implement music education in their future primary classrooms. We invite dialogue with other music educators who face similar situations where the delivery of music education is not located within the Arts and is dependent on staffing, resourcing and time limits and in some situations is almost drowning.