Monitoramento do perfil microbiológico de dentes com infecção endodôntica primária durante terapia com diferentes medicações intracanal

Pós-graduação em Odontologia Restauradora - ICT

Conduta no tratamento de gengivite ulcerativa necrosante (GUN) em serviço de urgência

Necrotizing ulcerative gingivitis is a periodontal disease which suddenly appears and presents an acute clinical course, characterized by patients' pain, discomfort and halitosis. Ulceration on papilla and marginal gingiva can be observed. For this reason, patients presenting this condition may seek dental assistance in Health Units or Graduation Institutions, being the dentist responsible for the adoption of a clinical treatment that minimizes symptomatology. The purpose of this case report is to expose and discuss aspects of clinical treatment for this disease applied to the reality of this service.

Conduta de tratamento de gengivite ulcerativa necrosante (GUN) em serviço de urgência

Necrotizing ulcerative gingivitis is a periodontal disease which suddenly appears and presents an acute clinical course, characterized by patients' pain, discomfort and halitosis. Ulceration on papilla and marginal gingiva can be observed. For this reason, patients presenting this condition may seek dental assistance in Health Units or Graduation Institutions, being the dentist responsible for the adoption of a clinical treatment that minimizes symptomatology. The purpose of this case report is to expose and discuss aspects of clinical treatment for this disease applied to the reality of this service.

Uso de plasma rico em plaquetas em úlceras de córnea em cães

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

Avaliação da produção de citocinas, expressão gênica e análise funcional de células SHED expostas ao LTA bacteriano

Pós-graduação em Odontologia Restauradora - ICT

Tratamento cirúrgico comparado ao tratamento clínico na miastenia gravis: revisão sistemática e matanálise

Pós-graduação em Bases Gerais da Cirurgia - FMB

Estudo comparativo de cápsulas contendo amoxicilina obtidas de algumas farmácias magistrais

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

Acidose láctica ruminal aguda induzida experimentalmente em ovinos: estudo clínico e laboratorial

Pós-graduação em Medicina Veterinária - FCAV

Diagnosis and management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

Uso de plasma rico em plaquetas em úlceras de córnea em cães

This study aims to clinically and macroscopically evaluate the adjuvant therapy with platelet-rich plasma in the form of eyedrops or clot, for corneal ulcers in dogs treated at the Veterinary Ophthalmology Service. We analyzed 20 eyes diagnosed with ulcerative keratitis, divided into two experimental groups. The eyedrop group (GC) was composed of eyes treated topically with eyedrops of autologous plateletrich plasma (PRP), and the clot group (GT) was composed of eyes treated with a platelet-rich clot and covered with a third eyelid for retention of the clot. The groups were evaluated by clinical and macroscopic analysis and by the analysis of epithelial defect reduction, at different times, at three, five, ten, 15 and 30 days, except for the third day in GT. The coverage of the third eyelid was removed on the fifth day. In both groups the inflammation signs reduced, there was an improvement in ocular sensibility and proper repair of epithelial defect. All GT eyes and 70% GC eyes showed complete healing on the fifth day, the remainder of GC completed healing on the tenth day. PRP in the form of eyedrops and clot is an excellent adjuvant therapy to be instituted in the clinical treatment for corneal ulcer in dogs, because it decreases the inflammatory signs and the ocular pain and it potentially assists in healing epithelial defects.

Características socioeconômicas e demográficas associadas à perda de excesso de peso em pacientes submetidos à cirurga bariátrica

Pós-graduação em Saúde Coletiva - FMB

Quantitative comparison of mobility and gross motor function in Brazilian children with cerebral palsy

Background: Cerebral palsy (CP) presents changes in posture and movement as a core characteristic, which requires therapeutic monitoring during the habilitation or rehabilitation of children. Besides clinical treatment, it is fundamental that professionals use systems of evaluation to quantify the difficulties presented to the individual and assist in the organization of a therapeutic program. The aim of this study was to quantitatively verify the performance of children with spastic di-paresia type CP. Methods: The Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Classification System (GMFM) tests were used and classification made through the GMFCS in the assessment of 7 patients with CP, 4 females and 3 males, average age of 9 years old. Results: According to GMFCS scales, 17% (n=1) were level II and 83% (n=6) were level III. The PEDI test and 88 GMFM items were used in the area of mobility. We observed that there was high correlation between mobility and gross motor function with Pearson's correlation coefficient =0.929) showing the likely impact of these areas in the functional skills and the quality of life of these patients. Conclusion: We suggest the impact of the limitation of the areas in functional skills and quality of life of these patients.

Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

This study was conducted to investigate the relationship among radiographic features observed on panoramic radiographs of sickle cell disease patients and analyze their relationship with history of systemic severity of the disease. Panoramic radiographs of 71 subjects with sickle cell disease were evaluated for the presence of the following radiographic bony alterations: radiopaque areas, increased spacing of bony trabeculae, horizontal arrangement of bony trabeculae and corticalization of mandibular canal. History of clinical systemic severity was assessed through direct questioning about the frequency of vaso-occlusive crisis, history of stroke, clinical jaundice, femur head necrosis, and leg ulceration. Chi-square or Fisher's exact test were applied in order to analyze possible associations between radiographic features and history of complications, with < 0.05 significance level. Increased spacing of bony trabeculae was statistically associated with absence of corticalization of mandibular canal ( < 0.01) and horizontal arrangement of bony trabeculae ( = 0.04). Statistically significant associations were demonstrated between history of clinical jaundice and presence of increased spacing of bony trabeculae ( = 0.02) and between history of stroke and presence of horizontal arrangement of bony trabeculae ( = 0.04). Based on the results of the current study, maxillofacial radiographic features may be associated with clinical parameters of systemic complications in sickle cell disease patients. The relationship between radiographic features and history of complications associated with clinical severity of sickle cell disease has not been demonstrated in the literature. Acknowledgment of such possible association may help establish prognosis and influence clinical treatment of systemic and oral complications.

Exercise training program based on minimum weekly frequencies: effects on blood pressure and physical fitness in elderly hypertensive patients

Background: Exercise training (ET) can reduce blood pressure (BP) and prevent functional disability. However, the effects of low volumes of training have been poorly studied, especially in elderly hypertensive patients. Objectives: To investigate the effects of a multi-component ET program (aerobic training, strength, flexibility, and balance) on BP, physical fitness, and functional ability of elderly hypertensive patients. Methods: Thirty-six elderly hypertensive patients with optimal clinical treatment underwent a multi-component ET program: two 60-minute sessions a week for 12 weeks at a Basic Health Unit. Results: Compared to pre-training values, systolic and diastolic BP were reduced by 3.6% and 1.2%, respectively (p < 0.001), body mass index was reduced by 1.1% (p < 0.001), and peripheral blood glucose was reduced by 2.5% (p= 0.002). There were improvements in all physical fitness domains: muscle strength (chair-stand test and elbow flexor test; p < 0.001), static balance test (unipedal stance test; p < 0.029), aerobic capacity (stationary gait test; p < 0.001), except for flexibility (sit and reach test). Moreover, there was a reduction in the time required to perform two functional ability tests: "put on sock" and "sit down, stand up, and move around the house" (p < 0.001). Conclusions: Lower volumes of ET improved BP, metabolic parameters, and physical fitness and reflected in the functional ability of elderly hypertensive patients. Trial Registration RBR-2xgjh3.

HER-2, p53, p21 and hormonal receptors proteins expression as predictive factors of response and prognosis in locally advanced breast cancer treated with neoadjuvant docetaxel plus epirubicin combination

Abstract Background Neoadjuvant chemotherapy has been considered the standard care in locally advanced breast cancer. However, about 20% of the patients do not benefit from this clinical treatment and, predictive factors of response were not defined yet. This study was designed to evaluate the importance of biological markers to predict response and prognosis in stage II and III breast cancer patients treated with taxane and anthracycline combination as neoadjuvant setting. Methods Sixty patients received preoperative docetaxel (75 mg/m2) in combination with epirubicin (50 mg/m2) in i.v. infusion in D1 every 3 weeks after incisional biopsy. They received adjuvant chemotherapy with CMF or FEC, attaining axillary status following definitive breast surgery. Clinical and pathologic response rates were measured after preoperative therapy. We evaluated the response rate to neoadjuvant chemotherapy and the prognostic significance of clinicopathological and immunohistochemical parameters (ER, PR, p51, p21 and HER-2 protein expression). The median patient age was 50.5 years with a median follow up time 48 months after the time of diagnosis. Results Preoperative treatment achieved clinical response in 76.6% of patients and complete pathologic response in 5%. The clinical, pathological and immunohistochemical parameters were not able to predict response to therapy and, only HER2 protein overexpression was associated with a decrease in disease free and overall survival (P = 0.0007 and P = 0.003) as shown by multivariate analysis. Conclusion Immunohistochemical phenotypes were not able to predict response to neoadjuvant chemotherapy. Clinical response is inversely correlated with a risk of death in patients submitted to neoadjuvant chemotherapy and HER2 overexpression is the major prognostic factor in stage II and III breast cancer patients treated with a neoadjuvant docetaxel and epirubicin combination.