bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical evaluation of multisurface ART restorations
Authors: Cefaly Daniela Francisca Gigo , Barata Terezinha de Jesus Esteves , Tapety Celiane Mary Carneiro , Bresciani Eduardo , Navarro Maria Fidela de Lima
Published: January 2006

The aim of this study was to evaluate the performance of two different glass-ionomer cements: a high-density (Ketac Molar - ESPE) and a resin-modified cement (Fuji VIII - GC) using the Atraumatic Restorative Treatment technique to restore multisurface cavities in permanent teeth. A total of 60 ART restorations (30 with each material) were placed in schoolchildren (9-16 years of age) by two operators. After a period of 6 months, two independent examiners evaluated 59 restorations according to the criteria used in previous ART studies. Data were submitted to McNemar and Fischer tests. The success rate of the treatment was 98.3%. One restoration (Ketac Molar) was replaced by another material and was recorded as failure. The success rates of the restorations were 100% and 96.6% for Fuji VIII and Ketac Molar, respectively. There was no statistically significant difference in the restorations success between baseline and 6 months (p>0.05). In the same way, no significant differences were found between materials, cavity types or operators (p>0.05). The ART approach was highly appropriate and effective in restorations involving two or more tooth surfaces, after 6 months. The results showed a promising performance of the ART technique with both materials.
Dental caries and dental fluorosis in 7-12-year-old schoolchildren in Catalão, Goiás, Brazil
Authors: Bardal Priscila Ariede Petinuci , Olympio Kelly Polido Kaneshiro , Buzalaf Marília Afonso Rabelo , Bastos José Roberto de Magalhães
Published: January 2006

INTRODUCTION: Over the last two decades, the prevalence of dental caries in children has decreased and the prevalence of dental fluorosis has increased. Knowledge on the epidemiologic conditions of a population is fundamental for the planning of health programs. OBJECTIVES: To determine the prevalence of dental caries and dental fluorosis among schoolchildren, in Catalão, Goiás, Brazil. METHODS: A random sample of 432 schoolchildren aged 7-12-years old was obtained. WHO (1997) criteria for dental caries and fluorosis diagnosis were used. RESULTS: The DMFT indexes were 0.97; 1.20; 1.80; 1.62; 2.40 and 2.51 for 7, 8, 9, 10, 11 and 12 years old, respectively. Analysis of dental fluorosis for the same ages presented higher prevalence at 12 years old and for the female gender. The percentage of questionable dental fluorosis (Dean's classification) was 34.0%. Only 3% of the sample presented dental fluorosis with scores very mild, mild and moderate. CONCLUSIONS: The prevalence of caries in schoolchildren of Catalão, Goiás, Brazil, was low. In average, private schools showed better results than public schools; however, all schools presented a low DMFT index. In this study, dental fluorosis is not a public health problem and has not damaged dental esthetics.
Comparative analysis of pubertal growth spurt predictors: Martins and Sakima method and Grave and Brown method
Authors: Iguma Karina Emy , Tavano Orivaldo , Carvalho Izabel Maria Marchi de
Published: January 2006

The aim of this study was to evaluate whether Martins and Sakima and Grave and Brown methods are useful for the study of pubertal growth spurt in children with cleft lip and palate. A total of 132 hand-wrist radiographs of patients from HRAC/USP aged 7 to 17 years old were analyzed, including girls and boys. Six radiographs of each age and gender were employed. These methods were applied to evaluating the stages of the hand-wrist ossification and epiphyseal formation, by graphic representation. The Martins and Sakima and the Grave and Brown methods revealed that the initial, peak and final stages of pubertal growth spurt occurred between 9 to 10, 12 and 15 years old, respectively, in the female gender. Similarly, in the male gender, both Martins and Sakima and Grave and Brown methods showed similar mean ages: 12, 14 and 16 years old for initial, peak and final stages of pubertal growth spurt, respectively. The Pearson's correlation test showed high and significant correlation (r = 0.99 and p < 0.001) between the methods investigated. In conclusion, the methods appeared to be highly and significantly correlated as regards the analysis of children with cleft lip and palate. Moreover, based on the literature and present results, it is possible to suggest that the two methods have shown similar pattern and may be used with equal efficiency for assessment of the pubertal growth spurt in children with cleft lip and palate.
Influence of the restoration quality on the success of pulpotomy treatment: a preliminary retrospective study
Authors: Demarco Flávio Fernando , Rosa Márcia Silva , Tarquínio Sandra Beatriz Chaves , Piva Evandro
Published: January 2006

The aim of this study was to evaluate the clinical status of pulpotomy treatment with calcium hydroxide and to correlate it with the quality of restoration of the treated teeth. Patients were retrieved from the files of the Operative Dentistry clinics (FOUFPel) between 1996 and 2000. Twenty-two patients were recalled, which had 23 teeth treated with pulpotomy due to exposure by caries. Seven anterior and 16 posterior teeth composed the evaluated group, being all restored with composite resin. The age varied from 15-50 years (mean 23.9) and the follow-up mean was 34.52 months. Clinical and radiographic examinations were performed to evaluate the clinical status of treatment. The criteria used, clinically favorable and failure, were based on the following clinical exams: pulp vitality; sensitivity; and periapical alterations. The quality of the restorations was based on the USPHS criteria. Pulpotomy treatment was ranked as clinically favorable in 10 teeth (43.5%), 4 in anterior and 6 in posterior teeth. Failure was verified in 13 teeth (56.5%), 4 anterior and 9 posterior. From the group clinically favorable, 90% of the restorations were ranked as clinically satisfactory, while only 10% were unsatisfactory. In the failure group, 77.8% of the restorations were classified was unsatisfactory and 22.2% were ranked as satisfactory. The statistical analysis (Fisher´s exact test) demonstrated that there is a statistically significant association between the clinical status of pulpotomy and restoration quality (p<0.05). Within the limitation of the study, it was verified that the quality of restoration could influence the favorable clinical status of pulpotomized teeth. Randomized clinical trials are required to confirm these preliminary data.
Effect of biomechanical preparation and calcium hydroxide pastes on the antisepsis of root canal systems in dogs
Authors: Soares Janir Alves , Leonardo Mario Roberto , Silva Léa Assed Bezerra da , Tanomaru Filho Mário , Ito Izabel Yoko
Published: January 2006

In the endodontic treatment of root canals with necrotic pulps associated with periapical radiolucent areas, one of the main objectives of treatment consists in eliminating the microorganisms spread throughout the ramifications of the root canal system. The scope of this study was to evaluate the antiseptic efficacy of biomechanical preparation and two calcium hydroxide-based pastes, in dogs' teeth with experimentally induced chronic periapical lesions. After initial microbiological sampling, instrumentation of the root canals was undertaken using the conventional technique, using K type files used in conjunction with a solution of 5.25% sodium hypochlorite. After ninety-six hours, further microbiological sampling was undertaken and Calen/CPMC or Calasept pastes were applied for 15 and 30 days. Ninety six hours after the removal of the medication, the third microbiological sampling was undertaken and finally histomicrobiological analysis followed using Brown & Brenn staining. The results were analyzed using the Kruskall-Wallis test, with a level of significance established at 5% (p<0.05). It was shown that the biomechanical preparation significantly reduced the number of colony forming units of microorganisms in root canals. In contrast, there was no significant difference between the antiseptic action of long-term dressings over two periods of action, although 30 days produced a greater reduction in the quantity of microorganisms and of positive microbiological cultures. In histological sections of the four experimental groups, similar microbiological patterns were shown (p>0.05), characterized by an elevated incidence of cocci, bacilli and filaments, predominantly gram-positive, in root canals, secondary canals and accessories, apical cementoplasts and dentinal tubules, but with a low incidence of microorganisms in areas of cementum resorption and the periapical lesion. The biomechanical preparation and intracanal dressing based on calcium hydroxide were important in the antisepsis of the root canal; however, both procedures did not produce significant changes in the microbiological aspects of the root canal system.
Characterizing ceramics and the interfacial adhesion to resin: II- the relationship of surface treatment, bond strength, interfacial toughness and fractography
Authors: Della-Bona Alvaro
Published: January 2006

The clinical success of resin bonding procedures for indirect ceramic restorations and ceramic repairs depends on the quality and durability of the bond between the ceramic and the resin. The quality of this bond will depend upon the bonding mechanisms that are controlled in part by the surface treatment that promote micromechanical and/or chemical bonding to the substrate. The objective of this review is to correlate interfacial toughness (K A) with fracture surface morphological parameters of the dental ceramic-resin systems as a function of ceramic surface treatment. This analysis is designed to identify mechanisms that promote adhesion of these ceramic-resin systems and an appropriate bond test method to yield relevant adhesion performance data.
The influence of different screw tightening forces on the vertical misfit of implant-supported frameworks
Authors: Vasconcellos Diego Klee de , Bottino Marco Antonio , Nishioka Renato Sussumu , Valandro Luiz Felipe , Costa Elza Maria Valadares da
Published: January 2006

OBJECTIVES: The present in vitro study was designed to compare the differences in the vertical misfit of implant-supported frameworks using three different forces for tightening the bridge locking screws: fastening by hand until first resistance, and using torque drivers with 10 and 20Ncm. METHODS: The investigation was conducted based on the results given by 9 six-unit nickel-chromium (2 abutments/ 4 pontics) screw-retained implant-supported frameworks. The structures were exposed to simulated porcelain firings. The marginal misfit measurements were made using a traveling measuring microscope at selected screw tightening forces: fastening by hand until first resistance, and using torque drivers with 10 and 20Ncm. The results were submitted to one-way ANOVA with repeated measures on one factor, and post hoc pairwise comparisons using Tukey test (5%). RESULTS: The mean marginal misfit of the frameworks, fastening the screws by hand until first resistance, was 41.56µm (SD±12.45µm). The use of torque driver devices caused a significant reduction in marginal opening (p<0.05). With the lowest torque available (10Ncm), the mean marginal discrepancy at the abutment-framework interface was reduced an average of 52% to a mean marginal opening of 19.71µm (SD±2.97µm). After the use of the 20Ncm torque driver, the mean marginal discrepancy of the frameworks was reduced an average of 69% to a mean marginal opening of 12.82µm (SD±4.0µm). Comparing the use of torque drivers with 10 and 20 Ncm torque, the means are not significantly different from one another. CONCLUSION: The seating force has an important effect on the vertical misfit measurements, once it may considerably narrow the vertical misfit gaps at the abutment-framework interface, thus leading to a misjudgment of the real marginal situation.
Influence of different auxiliary agents of biomechanical preparation in the filling of "artificially prepared" lateral canals
Authors: Silva Daniela Ribeiro da , Moraes Ivaldo Gomes de
Published: January 2006

The purpose of the present study was to evaluate the influence of some auxiliary agents of biomechanical preparation of the root canal on the filling of artificial lateral canals in extracted human teeth. A total of eighty single-rooted teeth were employed, which were submitted to preparation of three artificial lateral canals in one of the proximal aspects at the cervical, middle and apical thirds, besides one in the buccal aspect. The main canals were prepared by Profile 0.4 rotary instruments through the crown-down technique and irrigated with the irrigants investigated, as follows: Group A - 1% sodium hypochlorite and final irrigation with trisodium EDTA for 5 minutes; Group B - Endogel (2% chlorhexidine gel); Group C - Endo PTC and Dakin's solution and final irrigation with Tergentol- Furacin; and Group D - File Eze. The root canals were obturated by the Tagger's hybrid technique and then radiographed for assessment of the penetration rate of the filling materials in the lateral canals. Analysis of the results demonstrated no statistically significant difference (p<0.05) between the irrigants both to each other and as regards the location (thirds and aspects) of the artificial lateral canals.
Microscopic and radiographic analysis of the effect of particle size of demineralized bovine cancellous bone matrix on the repair of bone defects in femurs of rabbits
Authors: Carneiro Everdan , Garcia Roberto Brandão , Oliveira Rodrigo Cardoso de , Moraes Fernanda Gomes de , Menezes Renato , Letra Ariadne , Canova Giovana Calichio , Cestari Tania Mary , Granjeiro José Mauro
Published: January 2006

The bone tissue has a great regenerative potential, with ability to completely restore its structure and original functions. In some situations, though, bone defects cannot be self-repaired, thus requiring the use of grafts for a correct treatment and good prognosis. This work aimed at microscopically analyzing the effect of the particle size of demineralized bovine cancellous bone matrix in micro and macrogranular forms on the repair of bone defects in femurs of rabbits, with blood clot used as control. At 1, 3 and 6 months after implantation of the materials, the animals were killed and the anatomic specimens were removed. A foreign body-type granulomatous reaction containing macrophages and multinucleated giant cells in contact with the implanted particles was observed. These results suggest a failure in demineralization and/or interruption of the antigenic potential during production of the biomaterial. It is concluded that the size of the particles did not influence the evolution of the repair process of bone defects, acting only as bone-filler substances, and that the material implanted should be improved by quality control during production, since it may represent a good alternative for bone graft.
Six-month evaluation of ART one-surface restorations in a community with high caries experience in Brazil
Authors: Bresciani Eduardo , Carvalho Wendell Lima de , Pereira Lúcia Coelho Garcia , Barata Terezinha de Jesus Esteves , García-Godoy Franklin , Navarro Maria Fidela de Lima
Published: January 2006

The aim of this study to evaluate the success rate in one-surface ART restorations placed in permanent molars using a glass ionomer cement especially developed for ART in a community with high caries experience; to evaluate the operator influence on its success, post-operative sensitivity and technique acceptance by patients. Prior to placement of the restorations, the Gingival Bleeding Index, Visible Plaque Index, DMFT, dmft indices and treatment needed were assessed. One hundred and fifty five one-surface restorations were placed in permanent molars of school children, according to the WHO ART manual, 1997. After 6 months, the success rate was verified clinically and by slides. At baseline, the mean DMFT was 2.56 (±1.08) and the mean dmft, 2.53 (±2.33). Operators A and B have placed 102 and 53 ART restorations respectively. The mean time of placement was 16 minutes and 25 seconds to operator A and 14 minutes and 43 seconds to operator B. At 6-month follow up, 152 ART restorations were evaluated and 97.3% were assessed to be successful. Two restorations were excluded from the sample because the ART restorations were replaced by amalgam fillings. Only 4 restorations have failed, in which 2 due to caries, 1 due to fistula presence and the other because the restoration was lost. Four patients reported postoperative sensitivity. At this study period, ART treatment seems to be suitable for its purpose. Further evaluations are necessary to the new glass ionomer cements especially developed for ART technique provided good results at 6-month follow up in a community with high DMFT and dmft indices. The success rate for one-surface cavities in permanent molars was 97.3%, and the studied indices seemed to have no influence in this early evolution period.
The genetics of amelogenesis imperfecta: a review of the literature
Authors: Santos Maria Cristina Leme Godoy dos , Line Sergio Roberto Peres
Published: January 2006

A melogenesis imperfecta (AI) is a group of inherited defects of dental enamel formation that show both clinical and genetic heterogeneity. Enamel findings in AI are highly variable, ranging from deficient enamel formation to defects in the mineral and protein content. Enamel formation requires the expression of multiple genes that transcribes matrix proteins and proteinases needed to control the complex process of crystal growth and mineralization. The AI phenotypes depend on the specific gene involved, the location and type of mutation, and the corresponding putative change at the protein level. Different inheritance patterns such as X-linked, autosomal dominant and autosomal recessive types have been reported. Mutations in the amelogenin, enamelin, and kallikrein-4 genes have been demonstrated to result in different types of AI and a number of other genes critical to enamel formation have been identified and proposed as candidates for AI. The aim of this article was to present an evaluation of the literature regarding role of proteins and proteinases important to enamel formation and mutation associated with AI.
Influence of calcium hydroxide on dyes for dentin labeling, anlyzed by means of a new methodology
Authors: Moraes Ivaldo Gomes de , Moraes Fernanda Gomes de , Mori Graziela Garrido , Gonçalves Silvana Beltrami
Published: January 2006

The objective of this study was to evaluate the influence of calcium hydroxide in intracanal dressing on the ability of the dyes rhodamine B and methylene blue to label the dentine. Forty extracted human mandibular premolars had their canals instrumented and were divided into four groups: in two groups, the canals were filled with a calcium hydroxide paste and the others remained in distilled water. After 15 days, in two groups (with and without dressing), the canals were obturated with sealer containing methylene blue, whereas the others contained rhodamine B. For analysis, the roots were transversally sectioned in their cervical, medium and apical thirds, and the labeling was analyzed. The Mann-Whitney test showed statistically significant difference between the dressing/methylene blue group and the others. Based on these results, it was concluded that calcium hydroxide in intracanal dressing negatively interferes with the labeling ability of methylene blue.
Effect of professional cleaning and dental brushing with or without fluoridated dentifrice on enamel remineralization
Authors: Marta Sara Nader , Lima José Eduardo de Oliveira , Vono Bernardo Gonzales , Silva Salete Moura Bonifácio da , Machado Maria Aparecida Andrade Moreira , Pin Maria Ligia Gerdullo
Published: January 2006

An in situ evaluation of the potential rehardening effect of fluoridated and non-fluoridated toothpastes with or without air polishing was conducted. Ten volunteers, using acrylic palatal appliances containing two bovine enamel blocks with artificial carious lesions, took part in this study. Four times a day, after the main meals and at night, the volunteers, in a habitual way, brushed their natural teeth with the dentifrice indicated to the experimental design and after that the appliances were put again into the mouth. They were divided into 4 different groups: G1 - control - non-fluoridated dentifrice; G2 - fluoridated dentifrice; G3 - non-fluoridated dentifrice, but having a previous prophylaxis using air polishing; G4 - fluoridated dentifrice and previous air polishing. The effects of treatments on enamel rehardening were evaluated in the blocks that were assessed by surface microhardness, and the percentage of surface microhardness change (%reh) was calculated in relation to the baseline values. The results showed that %reh was higher in the groups with fluoridated dentifrice, and professional prophylaxis did not have an additional effect in the groups of fluoridated dentifrices (p<0.05). The data suggested that, in the absence of fluoride, removal of dental plaque helped to increase the process of enamel rehardening.
Analysis of the coefficient of variation in shear and tensile bond strength tests
Authors: Romano Fábio Lourenço , Ambrosano Gláucia Maria Bovi , Magnani Maria Beatriz Borges de Araújo , Nouer Darcy Flávio
Published: January 2006

The coefficient of variation is a dispersion measurement that does not depend on the unit scales, thus allowing the comparison of experimental results involving different variables. Its calculation is crucial for the adhesive experiments performed in laboratories because both precision and reliability can be verified. The aim of this study was to evaluate and to suggest a classification of the coefficient variation (CV) for in vitro experiments on shear and tensile strengths. The experiments were performed in laboratory by fifty international and national studies on adhesion materials. Statistical data allowing the estimation of the coefficient of variation was gathered from each scientific article since none of them had such a measurement previously calculated. Excel worksheet was used for organizing the data while the sample normality was tested by using Shapiro Wilk tests (alpha = 0.05) and the Statistical Analysis System software (SAS). A mean value of 6.11 (SD = 1.83) for the coefficient of variation was found by the data analysis and the data had a normal distribution (p>0.05). A range classification was proposed for the coefficient of variation from such data, that is, it should be considered low for a value lesser than 2.44; intermediate for a value between 2.44 and 7.94, high for a value between 7.94 and 9.78, and finally, very high for a value greater than 9.78. Such classification can be used as a guide for experiments on adhesion materials, thus making the planning easier as well as revealing precision and validity concerning the data.
Microhardness evaluation around composite restorations using fluoride-containing adhesive systems
Authors: Magalhães Cláudia Silami de , Hara Anderson Takeo , Turssi Cecilia Pedroso , Serra Mônica Campos , Giannini Marcelo
Published: January 2006

The purpose of this study was to evaluate the microhardness of dental enamel around composite restorations bonded with fluoride-containing adhesive systems (FCAS), after thermo- and pH-cycling protocols. Standardized cylindrical cavities were prepared on enamel surfaces of 175 dental fragments, which were randomly assigned into seven experimental groups (n=25). Four groups used FCAS: Optibond Solo (OS); Prime&Bond 2.1 (PB); Syntac Sprint (SS) and Tenure Quick (TC). Other groups consisted of "Sandwich" technique restoration (STR) (glass ionomer liner + hydrophobic adhesive resin /restorative composite) or used Single Bond with (SB) or without (SBWC) cycling protocols. Adhesive systems were applied according to manufacturers' instructions and cavities were restored with a microfilled composite (Durafill VS). After finishing and polishing, all groups were submitted to 1,000 thermal cycles (5 ºC and 55 ºC) and to demineralization (pH 4.3) and remineralization (pH 7.0) cycling protocols, except for SBWC group. The Knoop microhardness of enamel surfaces were measured around restorations. Indentations were recorded at 150, 300 and 450-mm from the cavity wall. Data were analyzed by two-way ANOVA and Duncan's Test (a=0.05%). Means ± SD of enamel microhardness for the groups were (Kg/mm²): SBWC: 314.50 ± 55.93ª ; SB: 256.78 ± 62.66b; STR: 253.90 ± 83.6b; TQ: 243.93 ± 68.3b; OS: 227.97 ± 67.1c; PB: 213.30 ± 91.3d; SS: 208.73 ± 86.6d. Means ± SD of microhardness for the distances 150, 300, 450mm from the cavity wall were, respectively: 234.46 ± 77.81ª; 240.24 ± 85.12ª; 262.06 ± 79.46b. SBWC group, which was not submitted to thermo- and pH-cycling protocols, showed the highest enamel microhardness mean value and the FCAS resulted in lower microhardness values. At 450 mm from the cavity wall, the enamel microhardness increased significantly.
Macroscopic and microscopic study of tissue response to oral antiseptics and its influence on carcinigenesis
Authors: Cardoso Camila Lopes , Prado Renata Falchete do , Taveira Luís Antônio de Assis
Published: January 2006

Studies have related the action of alcohol on the oral mucosa as a promoter of carcinogenesis, once most oral antiseptics contain alcohol. Its utilization for mouthrinses from 30 to 60 seconds, as indicated on the labels, yields a longer-lasting topical action when compared to the intake of alcoholic beverages. This study aimed at conducting a macroscopic and microscopic analysis of the tissue response of tongue mucosa of hamsters to daily topical applications of antiseptics (Anapyon, Listerine, Oral B) during 13 and 20 weeks, following the methodology for carcinogenesis investigation developed by the Discipline of Pathology of Bauru Dental School, University of São Paulo. After sacrificing the animals, their tongues were removed and fixed on 10% formalin. Macroscopic examination did not reveal significant alterations, and the specimens were processed by routine histotechnical procedures for HE staining. Three serial sections of each tongue were evaluated, and characteristics related to epithelial hyperkeratinization, atrophy, hyperplasia and dysplasia were organized in tables. Despite the observation for moderate dysplasia in one case in the Anapyon 20 week group, the further results were very similar to the control group (saline solution), eliminating the need of comparative statistical tests. By means of such methodology for testing the carcinogenesis-initiating action, it was concluded that oral antiseptics are unable to trigger the development of neoplasms.
Prevalência e gravidade de sintomas relacionados à asma em escolares e adolescentes no município de Duque de Caxias, Rio de Janeiro
Authors: Boechat José Laerte , Rios José Luiz , Sant'Anna Clemax Couto , França Alfeu Tavares
Published: January 2006

INTRODUÇÃO: A asma é considerada a doença crônica mais comum na infância. Entretanto, há poucos estudos sobre sua prevalência em nosso meio. OBJETIVO: Avaliar prevalência e gravidade de sintomas de asma em escolares e adolescentes de Duque de Caxias (RJ). MÉTODO: Estudo transversal utilizando o questionário do International Study of Asthma and Allergies in Childhood. A amostra foi composta por alunos de 6, 7, 13 e 14 anos. RESULTADOS: Foram avaliados 4.040 alunos de 13 e 14 anos e 2.334 de 6 e 7 anos. A freqüência de sibilos nos últimos doze meses foi de 27,7% entre os mais jovens e de 19% entre os adolescentes (p < 0,0001). No primeiro grupo houve predomínio do sexo masculino (29,9% vs 25,6%, p = 0,01) e no segundo do feminino (21,9% vs 15,8%, p < 0,0001). Não existiram diferenças entre as faixas etárias relacionadas ao diagnóstico prévio de asma (cerca de 10%). Sibilância aos exercícios físicos foi mais prevalente entre os adolescentes (21,4% vs 7,8%, p < 0,0001). A gravidade dos sintomas foi maior entre as adolescentes (asma grave: 6,6% vs 4,4%, p = 0,001), não havendo diferenças entre gêneros aos 6 e 7 anos. CONCLUSÃO: A prevalência de asma em Duque de Caxias é alta, comparável à de outros municípios brasileiros e latino-americanos. Os valores são superiores aos 6 e 7 anos, quando os sintomas predominam no sexo masculino. Entre os adolescentes, a prevalência e a gravidade dos sintomas são maiores no gênero feminino, fato de observação recente e que parece representar novo comportamento epidemiológico da asma.
Análise do programa de controle da tuberculose em relação ao tratamento, em Campinas - SP
Authors: Oliveira Helenice Bosco de , Marin-León Leticia , Gardinali Jovana
Published: January 2006

INTRODUÇÃO: A cura da tuberculose depende da adesão ao tratamento. OBJETIVO: analisar o resultado do tratamento para tuberculose nos serviços públicos de saúde de Campinas (SP), em 2002. MÉTODO: Foram investigados 436 pacientes de uma coorte de 484 com diagnóstico de tuberculose. O tipo de encerramento do tratamento foi descrito para pacientes novos e em retratamento, para apresentações pulmonares e para co-morbidade com síndrome da imunodeficiência adquirida (AIDS). RESULTADOS: A taxa de sucesso foi de 68,6%, sendo 72,3% nos pacientes sem AIDS e 57,6% nos com AIDS. Nos casos novos, o grupo sem AIDS teve 2,2 vezes mais chance de resultados favoráveis. No grupo com AIDS, não se observou diferença entre novos e retratamentos. Nos insucessos, apenas a letalidade apresentou diferença, 18,9% nos com AIDS vs 8,0% nos sem AIDS. Nas formas pulmonares, o sucesso foi semelhante entre os inicialmente bacilo álcool-ácido resistente positivos e os demais. CONCLUSÃO: O programa de controle da tuberculose de Campinas apresentou baixa efetividade. Foi superior à da coorte nacional em 2001 para os sem AIDS, e inferior para os com AIDS. O sucesso entre os casos de tuberculose sem AIDS derivou fundamentalmente do tratamento dos casos novos. O perfil desfavorável da tuberculose-AIDS, quanto à elevada letalidade (18,9%) e abandono (15,3%), foi responsável, em parte, pela baixa taxa de sucesso. Destacam-se as elevadas proporções de abandono numa cidade com facilidade de acesso para tratamento. Para melhorar o programa, deve-se investir na capacitação das equipes em tratamento supervisionado, educação em saúde e relacionamento com os pacientes.
Múltiplas metástases pulmonares de meningioma benigno
Authors: Rubin Adalberto Sperb , Pellegrin Liliana Gomes , Porto Nelson da Silva , Geyer Geraldo
Published: January 2006

Os meningiomas representam um sexto de todas as neoplasias primárias do sistema nervoso central e raramente desenvolvem metástases extracranianas. A presença de metástases múltiplas, bem como de sintomas respiratórios, são raros. Relata-se o caso de uma paciente de 67 anos com sintomas respiratórios de início subagudo e sem história de doença pulmonar prévia, que apresentou múltiplas metástases pulmonares originadas de meningioma benigno intracraniano, seis meses após a ressecção do tumor primário.
Prevalência de asma em adolescentes urbanos de Santa Maria (RS): Projeto ISAAC - International Study of Asthma and Allergies in Childhood
Authors: Cassol Vitor Emanuel , Solé Dirceu , Menna-Barreto Sérgio Saldanha , Teche Stefania Pigatto , Rizzato Tiago Moraes , Maldonado Martin , Centenaro Diogo Ferrari , Moraes Eliane Zenir Colpo
Published: January 2006

INTRODUÇÃO: A asma é a doença crônica mais comum entre adolescentes. OBJETIVO: Determinar a prevalência de asma e sintomas relacionados utilizando o protocolo do International Study of Asthma and Allergies in Childhood (ISAAC) em adolescentes de Santa Maria (RS). MÉTODO: Estudo transversal, em que foram avaliados 3.066 escolares urbanos (13-14 anos) de Santa Maria (RS), selecionados por amostragem aleatória, conforme protocolo do ISAAC. Os dados foram coletados de março a junho de 2003 utilizando-se questionário padronizado do ISAAC. O questionário foi respondido pelos adolescentes em sala de aula, na presença dos pesquisadores. RESULTADOS: O número de questionários válidos devolvidos foi de 3.066 (95,5%). A prevalência dos sintomas de asma nos adolescentes foi: sibilos alguma vez na vida em 42,1% dos adolescentes; sibilos nos últimos doze meses em 16,7%; quatro crises ou mais de sibilos nos últimos doze meses em 1,9%; sono perturbado em uma ou mais noites por semana nos últimos doze meses em 3,8%; prejuízo na fala nos últimos doze meses em 3,8%; asma alguma vez na vida em 14,9%; sibilos após exercícios nos últimos doze meses em 19%; tosse seca à noite nos últimos doze meses em 32,4% deles. Houve valores significativamente superiores no sexo feminino. CONCLUSÃO: A prevalência dos sintomas relacionados à asma em adolescentes urbanos de Santa Maria mostrou-se elevada, predominando entre as meninas. Ficou entre a média internacional e foi inferior aos dados observados nas capitais brasileiras. Estes dados reforçam a necessidade de estudos regionais para o melhor entendimento da prevalência da asma no Brasil.
Tuberculose em município de porte médio do Sudeste do Brasil: indicadores de morbidade e mortalidade, de 1985 a 2003
Authors: Vendramini Silvia H. F. , Gazetta Cláudia Eli , Chiaravalotti Netto Francisco , Cury Maria R. , Meirelles Edna B. , Kuyumjian Fátima G. , Villa Tereza C. S.
Published: January 2006

INTRODUÇÃO: A tuberculose é uma doença ligada à pobreza, má distribuição de renda, urbanização, epidemia da síndrome da imunodeficiência adquirida, e multirresistência. OBJETIVO: Analisar indicadores de morbidade e mortalidade por tuberculose de São José do Rio Preto, entre 1985 e 2003, comparados com os do Estado de São Paulo e Brasil. Verificar a relação entre risco de ocorrência da doença e níveis socioeconômicos. MÉTODO: Sistemas de informações utilizados: Mortalidade (SIM), Notificação de Tuberculose (Epi-Tb), Nacional de Agravos de Notificação (SINAN), Departamento de Informação e Informática do Sistema Único de Saúde (DATASUS) e Instituto Brasileiro de Geografia e Estatística (IBGE). Os casos novos notificados em 2003 na área urbana foram geo-referenciados e analisados. Gerou-se um mapa temático dos setores agrupados em três classes socioeconômicas, com os respectivos valores dos coeficientes de incidência de tuberculose. RESULTADOS: Coeficientes de incidência e mortalidade foram semelhantes, para valores totais e segundo o sexo, para o Brasil e Estado de São Paulo. No município os valores foram sempre menores. A proporção de casos com co-infecção tuberculose/vírus da imunodeficiência humana variou entre 29% e 37%. Em 2002, a cobertura do tratamento supervisionado foi, respectivamente, de 65% e 59% entre co-infectados e não co-infectados, com taxa de cura de 81% e de abandono de 1%. O risco de adoecer foi três vezes maior na área com piores níveis socioeconômicos. CONCLUSÃO: A identificação de áreas com diferentes riscos para tuberculose permite que o sistema de saúde municipal trate as distintas realidades e priorize regiões com maiores incidências da doença.
Espondilite tuberculosa em adolescente
Authors: Cabral Marta Maciel Lyra , Azevedo Bruno Canto C. de A. , Montenegro Lílian Maria Lapa , Montenegro Rosana de Albuquerque , Lima Andrea Santos , Schindler Haiana Charifker
Published: January 2006

Relata-se o caso de uma adolescente com tuberculose osteoarticular em coluna lombossacral, uma localização incomum. O seu diagnóstico permanece um desafio por apresentar sintomas gerais inespecíficos e lesões ósseas que podem ser confundidas com outras afecções. A doença é degenerativa e de prognóstico reservado. São discutidos aspectos clínicos, laboratoriais e de imagem, incluindo tomografia computadorizada e ressonância magnética. A reação em cadeia da polimerase, usando o marcador IS 6110 para M. tuberculosis, foi positiva, sugerindo fortemente a presença do patógeno. Este ensaio é particularmente indicado quando se exige um diagnóstico de tuberculose rápido e sensível.
Hemoptise fictícia na síndrome de Munchhausen: uma entidade a ser considerada no diagnóstico diferencial
Authors: Andrade Thamine Lessa Espírito Santo , Pereira-Silva Jorge L.
Published: January 2006

A síndrome de Munchhausen resulta de um distúrbio psiquiátrico, no qual os pacientes conscientemente procuram demonstrar sinais e sintomas de doenças orgânicas graves. Foram encontrados na literatura 23 casos de hemoptise fictícia associada à síndrome de Munchhausen, dois com o mesmo mecanismo aqui descrito. Relata-se o caso de um paciente com diversas admissões hospitalares recentes por escarros sangüíneos, que resultavam em exaustivas investigações diagnósticas inconclusivas. Insistentemente questionado, confessou que aspirava o próprio sangue com uma seringa, armazenando-o na cavidade oral, e eliminando-o para forjar a hemoptise. A síndrome de Munchhausen deve ser considerada em pacientes com hemoptise de etiologia obscura.
Estudo da hiper-responsividade brônquica em pacientes portadores de refluxo gastroesofágico
Authors: Lapa Mônica Silveira , Rodrigues Júnior Roberto , Fiss Elie
Published: January 2006

OBJETIVO: O intuito deste trabalho foi evidenciar a existência desse reflexo vagal, através de uma broncoprovocação, em pacientes portadores de refluxo gastroesofágico. MÉTODOS: Onze pacientes com endoscopia sem evidências de refluxo gastroesofágico ou hérnia hiatal (grupo controle) e dez pacientes com hérnia hiatal ou refluxo gastroesofágico foram submetidos à broncoprovocação com carbacol. RESULTADOS: O teste foi positivo em 5 dos pacientes com hérnia hiatal ou refluxo gastroesofágico (50%), e em 3 do grupo controle (27%) (p = 0,64). CONCLUSÃO: A hipótese de que as vias aéreas de pacientes com refluxo gastroesofágico sem sintomas asmatiformes anteriores possam ser mais responsivas do que as de pacientes sem refluxo gastroesofágico permanece não comprovada.
Escalas de risco de Torrington e Henderson e de Epstein: aplicabilidade e efetividade nas ressecções pulmonares
Authors: Stanzani Fabiana , Oliveira Maria Alenita de , Forte Vicente , Faresin Sonia Maria
Published: January 2006

OBJETIVO: Comparar a incidência de complicações pulmonares e cardiopulmonares estimadas, respectivamente, pelas escalas de Torrington e Henderson e de Epstein, em amostra populacional submetida à ressecção pulmonar para tratamento de câncer de pulmão. MÉTODOS: Dados de doentes submetidos à ressecção de um lobo pulmonar ou mais foram retirados de dois bancos de dados montados de forma prospectiva, oriundos de dois hospitais terciários. As medidas de desfecho analisadas foram complicações pulmonares, cardíacas e óbito. Teste exato de Fisher foi usado para avaliar a concordância das taxas de complicações obtidas com as estimadas previamente. RESULTADOS: A escala de Torrington e Henderson foi aplicada em 50 doentes (12 apresentaram risco leve, 32 moderado e 6 grave) e subestimou a taxa de complicações pulmonares nas categorias leve e moderado (p = 0,0003 e p = 0,0006, respectivamente), porém foi capaz de reconhecer os pacientes com alto risco de desenvolver complicações. A escala de Epstein foi aplicada em 38 doentes (4 apresentaram risco alto e 34 baixo) e também subestimou a taxa de complicações cardiopulmonares pós-operatórias da categoria de risco leve, que continha a maioria dos doentes (p < 0,0001), mas reconheceu, também, os pacientes com chance alta de complicar. CONCLUSÃO: As duas escalas não foram adequadas para estimar ocorrência de complicações pulmonares e cardiopulmonares na maioria dos doentes.
Comprometimento do interstício pulmonar em portadores de esclerose sistêmica progressiva: estudo de uma série de 58 casos
Authors: Jezler Sergio Fernandes de Oliveira , Santiago Mittermayer Barreto , Andrade Thamine Lessa , Araujo Neto César , Braga Helio , Cruz Álvaro Augusto
Published: January 2006

OBJETIVO: Estimar a freqüência de doença intersticial pulmonar em um grupo de indivíduos com esclerose sistêmica progressiva e descrever suas características clínicas, funcionais e radiológicas. MÉTODOS: Após confirmação diagnóstica, 58 pacientes com esclerose sistêmica progressiva foram estudados com tomografia computadorizada de alta resolução, provas de função pulmonar, bem como pesquisa do anti-Scl 70. Foram feitas comparações entre os pacientes com e sem comprometimento intersticial pulmonar e pesquisados possíveis fatores preditivos deste acometimento através de análise multivariada. RESULTADOS: Do total, 51,7% apresentaram evidências de doença intersticial pulmonar na tomografia computadorizada de alta resolução. Dispnéia e tosse foram os sintomas mais relatados, (65,5% e 39,7%, respectivamente). Bronquiolectasias e faveolamento foram as anormalidades tomográficas mais comuns (83,3% e 80,0% respectivamente). Quando comparados com os indivíduos sem doença intersticial pulmonar, os pacientes com este acometimento apresentaram freqüência semelhante de sintomas pulmonares e extrapulmonares, porém apresentaram esclerose sistêmica progressiva de maior duração, estertores crepitantes mais freqüentes, maior positividade de anti-Scl 70, e capacidade vital forçada e pulmonar total reduzidas. Somente uma capacidade vital forçada < 80% apresentou tendência a predizer presença de doença intersticial pulmonar. CONCLUSÃO: Doença intersticial pulmonar foi freqüente neste grupo com esclerose sistêmica progressiva. Não ocorreu associação com sintomas. Houve associação entre doença intersticial pulmonar e presença de estertores crepitantes e anti-Scl 70. Contudo, somente redução da capacidade vital forçada foi preditora de doença intersticial pulmonar.
Estudo fenotípico e genotípico da resistência aos macrolídeos de "Streptococcus pneumoniae" isolados em hospitais de Porto Alegre - RS
Authors: Zettler Fabiana Rowe , Zettler Eduardo Walker , Schmitt Virginia Minghelli , Jahns Marina Tagliaro , Dias Cícero Armídio Gomes , Fritscher Carlos Cezar
Published: January 2006

OBJETIVO: O objetivo deste estudo foi determinar a prevalência do S. pneumoniae resistente aos macrolídeos e identificar suas características fenotípicas e genotípicas. MÉTODOS: Amostras de S. pneumoniae isoladas entre maio de 2002 e agosto de 2004, em Porto Alegre (RS), a partir de materiais clínicos coletados de diferentes sítios anatômicos foram analisadas. Para o teste de difusão em ágar foram utilizados discos de eritromicina, claritromicina, azitromicina e clindamicina. As concentrações inibitórias mínimas de eritromicina foram determinadas nos isolados resistentes aos macrolídeos pelo método de diluição em ágar. Os fenótipos dos isolados resistentes aos macrolídeos foram investigados pelo teste de difusão em ágar e a genotipagem pela reação em cadeia da polimerase. RESULTADOS: Foram avaliados 229 isolados de pneumococos, e 12 mostraram-se resistentes aos macrolídeos (5,2%). Entre estes, 9 apresentaram o fenótipo MLSB (75%) e 3 o fenótipo M (25%). A reação em cadeia da polimerase indicou que 8 isolados com o fenótipo MLSB portavam apenas o gene ermB, enquanto que o gene mefE estava presente em todos os 3 isolados com o fenótipo M. Um isolado com o fenótipo MLSB apresentou ambos os genes. CONCLUSÃO: A resistência aos macrolídeos do S. pneumoniae em Porto Alegre permanece baixa, sendo devida principalmente à presença do gene ermB, com expressão do fenótipo MLSB.
Histoplasmose pulmonar cavitária crônica simulando tuberculose
Authors: Unis Gisela , Severo Luiz Carlos
Published: January 2006

OBJETIVO: Avaliar os casos de histoplasmose pulmonar crônica ocorridos nos últimos anos, atendidos no Complexo Hospitalar Santa Casa de Porto Alegre (RS). MÉTODOS: Foram revisados os casos atendidos nos últimos 25 anos no Complexo Hospitalar Santa Casa de Porto Alegre e descritos quatro casos diagnosticados por cultivo e/ou achado histopatológico, corroborados por teste soromicológico. São comentados os casos da literatura brasileira. RESULTADOS: As manifestações clínicas preponderantes foram tosse produtiva, dispnéia, febre, anorexia e emagrecimento. Nos achados radiológicos pulmonares predominaram enfisema, cavidades cistóides, bronquiectasias e espessamento pleural. Os pacientes apresentaram história epidemiológica de contato com fezes de galinha. Num paciente, houve colonização de cavidade por Aspergillus fumigatus. CONCLUSÃO: A histoplasmose pulmonar crônica deve ser considerada na presença de lesões cavitárias em lobos superiores em pacientes com doença pulmonar obstrutiva crônica, baciloscopia negativa no escarro e não reatores à tubeculina. Hemoptise em vigência de lesões tardias ou doença curada sugerem colonização aspergilar.
Hemangiomatose capilar pulmonar, uma rara causa de hipertensão pulmonar: primeiro caso brasileiro
Authors: Castro Helano Neiva de , Figueiredo Mara Rúbia Fernades de , Santos Norma Selma , Nogueira Teresa Neuma Albuquerque Gomes , Uchoa Maria da Penha , Holanda Marcelo Alcântara
Published: January 2006

A hemangiomatose capilar pulmonar é uma doença rara, caracterizada por proliferação de capilares que invadem o interstício pulmonar e o septo alveolar. Documentamos o primeiro caso brasileiro: um paciente do sexo masculino, de 21 anos, com hipertensão pulmonar grave, que evoluiu para óbito. Na tomografia computadorizada de alta resolução apresentava pequenas opacidades intersticiais nodulares maldefinidas, bilateralmente. Foi realizada biópsia pulmonar post-mortem e encontrada intensa proliferação multifocal de capilares nas paredes alveolares, septos interlobulares e tecido conjuntivo peribrônquico. O diagnóstico de hemangiomatose capilar pulmonar deve ser considerado nos pacientes com hipertensão pulmonar e alterações sugestivas na tomografia computadorizada de alta resolução.
Vasculites pulmonares: quando suspeitar e como fazer o diagnóstico
Authors: Barbas Carmen Sílvia Valente , Borges Eduardo da Rosa , Antunes Telma
Published: January 2006

As vasculites pulmonares primárias são caracterizadas por processo inflamatório na parede dos vasos pulmonares que leva a isquemia e hemorragia pulmonar com as conseqüentes expressões clínicas e radiológicas. As vasculites pulmonares primárias são acompanhadas de expressão sistêmicas cutâneas, em nervos periféricos, rins, seios da face, olhos e ouvidos, além do trato gastrintestinal, e sistemas cardíaco e nervoso central. O diagnóstico é feito através da associação das informações clínicas, radiológicas e anatomopatológicas. O tratamento com corticosteróides e imunossupressores deve ser instituído precocemente e apresenta altas taxas de remissão.
Apresentação anatomopatológica das vasculites pulmonares
Authors: Capelozzi Vera Luiza , Parras Edwin Roger , Ab'Saber Alexandre Muxfeldt
Published: January 2006

A apresentação anatomopatológica das vasculites pulmonares inclui um processo inflamatório da parede dos vasos pulmonares que pode vir acompanhado de granulomas, células gigantes, eosinófilos, necrose e hemorragia pulmonar. O conhecimento dessas manifestações, em associação com o tipo de vaso acometido e reações de imunofluorescência auxiliam no diagnóstico diferencial das vasculites.
Síndrome de Churg-Strauss
Authors: Barros Juliana Monteiro de , Antunes Telma , Barbas Carmen Sílvia Valente
Published: January 2006

A síndrome de Churg-Strauss caracteriza-se por asma, eosinofilia e graus variados de vasculite sistêmica. As formas mais graves com acometimento cardíaco, gastrintestinal, sistema nervoso central e renal requerem ciclofosfamida para seu tratamento.
Outras vasculites pulmonares
Authors: Barbas Carmen Sílvia Valente , Barros Juliana Monteiro de , Santana Alfredo
Published: January 2006

A poliangeíte microscópica, a arterite de Takayasu, a síndrome de Behçet, a púrpura de Henoch-Schönlein e as vasculites associadas às doenças do colágeno incluem-se entre as vasculites pulmonares. Seu diagnóstico é realizado associando-se as manifestações clínicas aos achados radiológicos e anatomopatológicos.
Síndromes hemorrágicas pulmonares
Authors: Borges Eduardo da Rosa , Ab'Saber Alexandre Muxfeldt , Barbas Carmen Sílvia Valente
Published: January 2006

As síndromes hemorrágicas pulmonares caracterizam-se por infiltrado pulmonar bilateral, queda dos níveis de hemoglobina e hipoxemia. Dentre as causas de sangramento estão as infecções, vasculites, coagulopatias e doenças do colágeno. A terapêutica consiste do tratamento da doença causal e suporte ventilatório, podendo ser associada a plasmaferese.