RESUMO
Functional compressive bandaging (FCB) is a therapeutic resource used to control lymphedema resulting from the treatment of breast cancer. However, the reliability of the technique is unknown. We evaluated intra- and inter-rater reliability of the spiral technique in the four-layer FCB of the arm and forearm in breast cancer survivors with lymphedema. Forty-five breast cancer survivors with a mean age of 64.88±10.01 years participated in the study. Evaluations were performed by two examiners at different times analyzing the pressure exerted (mmHg) by the spiral FCB in the arm and forearm of the upper limb affected by lymphedema. The intraclass correlation coefficient (ICC2,1) was used to determine intraand inter-examiner reliability, with a 95% confidence interval, minimum detectable change, and standard error of the measurement. Intrarater reliability was considered low to high in the arm and forearm region. Inter-rater reliability in the arm region was considered low and in the forearm region low to moderate. Our results indicate that spiral FCB has low to moderate intra-examiner and inter-examiner reliability.
Assuntos
Neoplasias da Mama , Linfedema , Idoso , Braço , Mama , Neoplasias da Mama/complicações , Neoplasias da Mama/terapia , Feminino , Humanos , Linfedema/diagnóstico , Linfedema/etiologia , Linfedema/terapia , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To compare the efficacy, color stability, and tooth sensitivity (TS) of combined bleaching, using a modified protocol with at-home bleaching. METHODS: Eighty participants were randomized into two groups. In the combined group, a desensitizing gel was applied (10 minutes) prior to in-office bleaching (35% hydrogen peroxide (H2O2), 2×15 minute applications) and at-home bleaching (4% H2O2, 2×30 minutes for 21 days) started the next day. In the at-home group, only the at-home bleaching was performed. Color was recorded at the beginning and postbleaching with two scales (VITA Classical and Bleachedguide) and Easyshade spectrophotometer. The TS was recorded daily with a 0-10 visual analogue scale (VAS) and five-point numeric rating scale (NRS). RESULTS: A 40% lower risk (RR=1.4; 95% CI 1.1-1.9) was observed in the at-home group. Higher color change and intensity of TS [mean difference 2.3 (95% CI 1.3-3.3) in the VAS] was observed in the first week for the combined group. After the end of the protocol, a bleaching degree was detected for both groups, with no significant difference between both groups (p>0.05). CONCLUSION: The combined group produced a slightly higher degree of color change than at-home bleaching but with a higher risk and intensity of TS.
Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Humanos , Peróxido de Hidrogênio/uso terapêutico , Método Simples-Cego , Clareamento Dental/métodos , Clareadores Dentários/uso terapêutico , Resultado do TratamentoRESUMO
INTRODUÇÃO: Fístula de Gerbode é uma comunicação entre o ventrículo esquerdo e o átrio direito (VE-AD). O defeito é raro, pode ser congênito ou adquirido. A forma adquirida é mais frequentemente observada após cirurgia valvar, endocardite ou infarto. Relataremos 2 casos de pacientes com fístula de Gerbode adquirida pós-intervenção valvar. Caso 1: Mulher, 56 anos, com diagnóstico pré-operatório de insuficiência mitral (IM) importante, fibrilação atrial, hipertensão pulmonar (HP) e insuficiência tricúspide (IT) discreta. Foi submetida à plastia mitral, tricuÌspide e exclusaÌo de ambas as auriculetas. Um ano após a cirurgia, paciente assintomática, sem sinais de insuficiência cardíaca (IC), porém foi auscultado um sopro sistólico rude em borda esternal esquerda (BEE). O ecocardiograma transesofágico (ETE) demonstrou presença da fístula com 3,5mm do VE para o AD com gradiente de VE-AD de 95 mmHg, redução da HP (de 50 para 36 mmHg) e função do VD normal. A paciente foi mantido em observação. Caso 2: Homem, 61 anos, diagnóstico pré-operatório de IM importante primária, HP importante (PSAP 116mmHg) e IT moderada. Foi submetido a implante de bioprótese mitral e plastia tricúspide. Evoluiu com melhora sintomática e redução da HP. Foi observado sopro sistólico rude em BEE. O ETE demonstrou uma fístula VE-AD, com gradiente de 92 mmHg. Paciente assintomático, sem repercussão hemodinâmica, mantido em tratamento conservador. DISCUSSÃO: Na literatura, a evolução de casos com a fístula varia desde assintomáticos até desfechos desfavoráveis como insuficiência cardíaca, endocardite e necessidade de oclusão da fístula. Apesar de ser relatado como defeito raro, a incidência está aumentando devido ao maior número de intervenção cirúrgica. O diagnóstico é difícil e muitas vezes necessário complementação com ETE para melhor definição do tamanho e localização do defeito e para melhor programação da correção quando houver indicação. A intervenção pode ser cirúrgica ou percutânea. Em paciente assintomáticos, defeitos pequenos e sem sobrecarga de VD podem ser mantidos em conduta conservadora desde que com acompanhamento frequente. CONCLUSÃO: Foram relatados dois casos de fiÌstula de Gerbode (comunicação entre o VE e o AD) adquiridas após cirurgia de correção valvar. Ambos os pacientes relatados foram tratados clinicamente, estão em CF I, sem alterações das câmaras cardíacas.
Assuntos
Comunicação Interatrial , Comunicação Interventricular , Fibrilação Atrial , Hipertensão Pulmonar , Insuficiência da Valva MitralRESUMO
O monkeypox virus (MPXV) infecta várias espécies animais incluindo primatas. Vários surtos de MPXV ocorreram no continente Africano nas últimas décadas. A infecção em humanos resulta do contato com animais infectados, porém a transmissão entre humanos tem sido pouco frequente. Em 2017 ocorreu um novo surto de MPXV na Nigéria com alta transmissão entre humanos indicando alterações na epidemiologia da infecção e possível manutenção endêmica do vírus na população local. Em 2022 o MPXV foi diagnosticado fora do continente Africano com notável transmissão entre humanos e em poucos meses atingiu proporções globais envolvendo mais de 100 países em vários continentes. A transmissão do MPXV de humanos para cães também foi observada. A infecção e rápida disseminação do MPXV em humanos exige mais esforços no sentido de diagnosticar, monitorar e desenvolver medidas de profilaxia para infecções virais oriundas de espécies animais.
The monkeypox virus (MPXV) infects several animal species including primates. In the last decades, several outbreaks of MPXV have been reported in Africa mainland; in most cases, human infection occurred due to the contact with wild animals and transmission amongst humans has been unusual. A large outbreak of MPXV occurred in Nigeria in 2017 with notable human-to-human transmission indicating changes on viral epidemiology. In 2022, outbreaks of MPXV were reported in several non-African countries and within few months the virus spread globally to more than 100 countries in several continents. Human-to-dog transmission was reported in at least one case. The infection and rapid spread of MPXV within humans calls for more efforts to diagnose and to monitor outbreaks of animal-derived viral infections.
Assuntos
Humanos , Animais , Surtos de Doenças/veterinária , Eliminação de Partículas Virais , Mpox/epidemiologiaRESUMO
OBJECTIVES: To conduct a systematic review and meta-analysis to evaluate the risk and intensity of tooth sensitivity (TS) after topical application of desensitizers containing potassium nitrate before dental bleaching. METHODS: We searched PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE. We also surveyed gray literature without restrictions. We meta-analyzed the data using the random-effects model to compare potassium nitrate and placebo in terms of risk and intensity of TS and color change (∆SGU or ∆E). The quality of the evidence was rated using the GRADE approach. The risk of bias (RoB) of the included studies was analyzed using the Cochrane RoB tool. RESULTS: After the database screening, 24 articles remained. A significant 12% lower risk for the groups where desensitizing agents were applied (p = 0.02), with a risk ratio of 0.88 (95% CI 0.78 to 0.98). About the intensity of TS, a significant average mean difference of - 0.77 units of VAS units (95%CI - 1.34 to - 0.19; p = 0.01) in favor of the desensitizer group. In the NRS scale, a significant average mean difference of - 0.36 (95% CI - 0.61 to - 0.12; p value = 0.004) in favor of the desensitizer group. No significant difference was observed in color change (p > 0.28) in ∆SGU and ∆E. CONCLUSIONS: Although a significant reduction in the risk and intensity of TS was observed in groups treated with a potassium nitrate at some point during the bleaching, the clinical significance of this reduction is subtle and clinically questionable. Color change is not affected by the use of agents. CLINICAL RELEVANCE: The reduction in the risk and intensity of TS with the topical application of potassium nitrate-based desensitizing agents in dental bleaching is subtle and maybe clinically questionable.
Assuntos
Sensibilidade da Dentina , Clareadores Dentários , Clareamento Dental , Sensibilidade da Dentina/tratamento farmacológico , Sensibilidade da Dentina/prevenção & controle , Humanos , Peróxido de Hidrogênio , Nitratos , Compostos de PotássioRESUMO
Objective: The primary aim was to quantify the improvements on function and pain of patients with knee osteoarthritis (KOA), short education and low income by a two-day self-management program. Secondary aims were verifying if the program improves clinically relevant measures of weight and strength. Design: A prospective randomized clinical trial was conducted in a tertiary hospital in Brazil with 191 patients with Kellgren & Lawrence grades II and III KOA who were allocated to two groups: control (usual care- CG) and intervention (usual care and two days of an OA self-management program with a multiprofessional team - IG). Western Ontario and McMaster Universities Index (WOMAC), weight, body mass index (BMI), Timed up and go (TUG) and five Times Sit to Stand Test (FTSST) were assessed at baseline, six, 12 and 24 months. Results: Groups were similar at baseline (p â> â0.05). Both groups exhibited improved WOMAC total and subsets scores throughout the study (p â< â0.001). However, only IG improved WOMAC total and subsets in all follow-ups above 20% (minimally clinically important difference), with differences in WOMAC pain, function and total scores (p â= â0.001, p â< â0.001, and p â< â0.001, respectively) and best effect sizes at 1 year (0.355, 0.651 and 0.770, respectively). IG group lost weight (p â< â0.001) and BMI (p â< â0.01). Both groups exhibited improvements in TUG and FTSST (p â< â0.001) that remained in all evaluations. FTSST results favored the IG, p â= â0.032. Conclusions: An educational program to patients with KOA, short schooling and low income improves clinically important measures of pain and function.
RESUMO
Este estudo teve o objetivo de comparar o perfil bioquímico sérico de machos e fêmeas da linhagem pesada de frango de corte, nas idades de quatro, 12 e 20 semanas, em uma unidade de produção industrial, no município de Uberlândia-MG. Após a pesagem das aves, foram coletadas amostras de sangue de 15 aves de cada sexo de cada faixa etária. Os soros obtidos foram avaliados em analisador automático para os seguintes parâmetros bioquímicos: proteína total, albumina, globulinas, ácido úrico, colesterol, triglicérides, gamaglutamiltransferase, aspartato aminotransferase, alanina aminotransferase, creatina quinase, fosfatase alcalina, cálcio e fósforo. Imediatamente após a coleta de cada amostra, avaliou-se a glicemia no sangue total, utilizando-se um glicosímetro. As alterações fisiológicas e metabólicas que as aves apresentaram na fase de recria refletiram na variação dos níveis bioquímicos séricos na maioria dos constituintes avaliados, os quais exibiram diferenças significativas (P<0,05), comparando-se sexo e idade.(AU)
This study aimed to compare the levels of glucose in the blood and serum´s metabolites enzymes and minerals of poultry of heavy lineage of chicken at the age of four, twelve and twenty weeks in an industrial production unit in the city of Uberlândia-MG. After weighing the birds, blood samples were collected from 15 birds of each gender in the three ages. The serum obtained was evaluated in an automatic biochemical analyzer for the following parameters: total protein, albumin, globulin, uric acid, cholesterol, triglycerides, alkaline phosphatase, gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, creatine kinase, calcium and phosphorus. Immediately after the collection of each sample, we evaluated glucose levels by means of a glycosimeter. The physiological and metabolic changes that birds present in the rearing age reflected in the variation of serum biochemical levels in most constituents evaluated, showing significant differences (P< 0.05) comparing age and gender.(AU)
Assuntos
Animais , Fenômenos Bioquímicos , Testes Sorológicos/veterinária , Galinhas/fisiologia , Galinhas/sangueRESUMO
Este estudo teve o objetivo de comparar o perfil bioquímico sérico de machos e fêmeas da linhagem pesada de frango de corte, nas idades de quatro, 12 e 20 semanas, em uma unidade de produção industrial, no município de Uberlândia-MG. Após a pesagem das aves, foram coletadas amostras de sangue de 15 aves de cada sexo de cada faixa etária. Os soros obtidos foram avaliados em analisador automático para os seguintes parâmetros bioquímicos: proteína total, albumina, globulinas, ácido úrico, colesterol, triglicérides, gamaglutamiltransferase, aspartato aminotransferase, alanina aminotransferase, creatina quinase, fosfatase alcalina, cálcio e fósforo. Imediatamente após a coleta de cada amostra, avaliou-se a glicemia no sangue total, utilizando-se um glicosímetro. As alterações fisiológicas e metabólicas que as aves apresentaram na fase de recria refletiram na variação dos níveis bioquímicos séricos na maioria dos constituintes avaliados, os quais exibiram diferenças significativas (P<0,05), comparando-se sexo e idade.(AU)
This study aimed to compare the levels of glucose in the blood and serum´s metabolites enzymes and minerals of poultry of heavy lineage of chicken at the age of four, twelve and twenty weeks in an industrial production unit in the city of Uberlândia-MG. After weighing the birds, blood samples were collected from 15 birds of each gender in the three ages. The serum obtained was evaluated in an automatic biochemical analyzer for the following parameters: total protein, albumin, globulin, uric acid, cholesterol, triglycerides, alkaline phosphatase, gamma-glutamyl transferase, aspartate aminotransferase, alanine aminotransferase, creatine kinase, calcium and phosphorus. Immediately after the collection of each sample, we evaluated glucose levels by means of a glycosimeter. The physiological and metabolic changes that birds present in the rearing age reflected in the variation of serum biochemical levels in most constituents evaluated, showing significant differences (P< 0.05) comparing age and gender.(AU)
Assuntos
Animais , Fenômenos Bioquímicos , Testes Sorológicos/veterinária , Galinhas/fisiologia , Galinhas/sangueRESUMO
Polyacrylonitrile (PAN) was solubilized in N,N-dimethyl formamide (DMF) and the electrospinning process has been employed to obtain PAN nanofibers (PF). Multiwalled carbon nanotubes (MWCNT) were dispersed with the aid of Triton X-100 surfactant and subsequently centrifugated. Buckypapers (BP/PF) were prepared by vacuum filtration procedure of MWCNT suspension supernatant stacking four PF layers over a nylon membrane. The PF removal was carried out by immersing the BP/PF system in DMF and removal periods of 10 and 30 min were evaluated. Scanning electron microscopy (SEM) has not shown any PAN residue in the MWCNT network resulting in highly porous BP. However, by Fourier transform infrared spectroscopy (FT-IR) a PAN band was found around of 2243 cm-1 corresponding to nitrile group (C≡N). Besides, PAN leftover was evidenced by thermogravimetric analysis (TGA), high-resolution transmission electron microscopy (HR-TEM), electrical characterization through four-point probe, nitrogen adsorption at 77 K, and X-ray diffraction (XRD).
RESUMO
OBJECTIVES:: A systematic review and meta-analysis were performed to evaluate the risk and intensity of tooth sensitivity (TS) after dental bleaching with a desensitizer-containing and a desensitizer-free bleaching gel in adult patients. Color change and risk of gingival sensitivity was also evaluated. METHODS:: A comprehensive search was performed MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), EMBASE and Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions to identify randomized clinical trials. Abstracts from the annual conference of the International Association for Dental Research (1990-2016), unpublished and ongoing trials registries, dissertations, and theses were also searched. The quality of the evidence was rated using the Grading of Recommendations: Assessment, Development and Evaluation (GRADE) approach. DATA:: After duplicates were removed, 1352 articles were identified. After title and abstract screening, only 47 studies remained for qualitative evaluation. Most of the studies had unclear risk of bias. No difference between groups were observed for the risk ratio of TS (risk ratio = 0.99; 95% confidence interval [CI] = 0.74-1.33); intensity of TS (standardized difference in means [SMD] = 0.04; 95% CI = 0.79-0.70); color change in shade guide units (SMD - 0.04; 95% CI = 0.50-0.42); color change in ΔE* (SMD = 0.41 (95% CI = 0.07-0.89); and risk ratio of gingival irritation (SMD = 1.05; 95% CI = 0.81-1.36). Except for the risk of TS, graded as moderate quality of evidence, all other outcomes were rated as low and very low quality. CONCLUSIONS:: Incorporating desensitizers in the bleaching gel did not reduce the risk of TS, and the quality of this evidence was considered moderate. On the other hand, the intensity of TS, color change, and risk of gingival irritation was similar between groups, but the quality of the evidence for these outcomes was graded as low or very low, thus reducing the level of confidence in these outcomes.