bluuebunny/crossref_metadata_2025 huggingface dataset:
Ambulatório de apoio ao tabagista no Ceará: perfil dos pacientes e fatores associados ao sucesso terapêutico
Authors: Sales Maria Penha Uchoa , Figueiredo Mara Rúbia Fernandes de , Oliveira Maria Irenilza de , Castro Helano Neiva de
Published: September 2007

OBJETIVO: Avaliar o perfil dos pacientes e fatores associados ao sucesso do tratamento do fumante. MÉTODOS: Estudo retrospectivo dos pacientes que foram atendidos no ambulatório de apoio ao tabagista do Hospital de Messejana, no Ceará, durante o período de outubro de 2002 a abril de 2005. O tratamento foi avaliado considerando-se o perfil do tabagista, tipo de medicação e período de utilização da mesma. RESULTADOS: Do total de 320 pacientes atendidos, 65,6% eram mulheres. A média de idade do início do tratamento foi de 48 anos, sendo 33 anos o tempo médio de uso do tabaco. Acima de 90% deles iniciaram o tabagismo antes dos vinte anos de idade. Daqueles que se encontravam no programa havia pelo menos um ano (258 pessoas), 50,8% atingiram o sucesso terapêutico, 17,8% recaíram e 31,4% não pararam de fumar. Sucesso parcial foi atingido, em média, na quinta semana do tratamento e a recaída foi predominante no quarto mês. Cerca de 60% dos pacientes utilizaram terapia medicamentosa. CONCLUSÃO: A chance de parar de fumar foi associada significativamente ao uso de medicação, independentemente do perfil tabágico avaliado. No segundo ano do programa, observou-se maior associação da bupropiona à terapia de reposição nicotínica, com conseqüente elevação da taxa de sucesso e tendência à redução da recaída.
Impacto de biópsia pulmonar a céu aberto na insuficiência respiratória aguda refratária
Authors: Barbas Carmen Silvia Valente , Capelozzi Vera Luiza , Hoelz Cristiane , Magaldi Ricardo Borges , Souza Rogério de , Sandeville Maria Laura , Campos José Ribas Milanez de , Werebe Eduardo , Andrade Filho Laerte O. , Knobel Elias
Published: September 2007

OBJETIVO: Verificar o impacto dos resultados da biópsia pulmonar a céu aberto nas decisões que determinem mudanças nas estratégias de tratamento de pacientes críticos, com infiltrados pulmonares difusos e insuficiência respiratória aguda refratária, bem como na melhora de seu quadro clínico. MÉTODOS: Foram avaliados 12 pacientes com insuficiência respiratória aguda e sob ventilação mecânica, que foram submetidos à biópsia pulmonar a céu aberto (por toracotomia) após a ausência de resposta clínica ao tratamento padrão. RESULTADOS: A maior causa isolada de insuficiência respiratória aguda foi a infecção viral, identificada em 5 pacientes (40%). A avaliação pré-operatória da causa da insuficiência respiratória foi modificada em 11 pacientes (91,6%), e um diagnóstico específico foi feito em 100% dos casos. A taxa de mortalidade foi de 50%, a despeito das mudanças no regime terapêutico. Seis pacientes (50%) sobreviveram e obtiveram alta hospitalar. Todos os pacientes que obtiveram alta sobreviveram por pelo menos um ano após a biópsia pulmonar a céu aberto, totalizando uma taxa de sobrevida em um ano de 50% dentre os 12 pacientes estudados. Quanto aos pacientes que faleceram no hospital, o tempo de sobrevida após a biópsia pulmonar a céu aberto foi de 14 + 10,8 dias. CONCLUSÃO: Concluímos que a biópsia pulmonar a céu aberto é uma ferramenta útil no controle da insuficiência respiratória aguda quando não se observa melhora clínica após o tratamento padrão, já que pode resultar em um diagnóstico específico que requeira tratamento distinto, provavelmente diminuindo a taxa de mortalidade desses pacientes.
Perfil de sensibilidade e fatores de risco associados à resistência do Mycobacterium tuberculosis, em centro de referência de doenças infecto-contagiosas de Minas Gerais
Authors: Souza Márcia Beatriz de , Antunes Carlos Maurício de Figueiredo , Garcia Guilherme Freire
Published: September 2007

OBJETIVO: Estudar os fatores determinantes da multirresistência do Mycobacterium tuberculosis às drogas tuberculostáticas em centro de referência de doenças infecto-contagiosas do Estado de Minas Gerais, Hospital Eduardo de Menezes. MÉTODOS: Estudo tipo caso-controle, retrospectivo, realizado de setembro de 2000 a janeiro de 2004. Nesse período, 473 culturas com crescimento de M. tuberculosis relativas a 313 pacientes foram analisadas quanto ao perfil de sensibilidade, no Laboratório Central de Minas Gerais. Foram selecionados os casos multirresistentes definidos como resistência a pelo menos rifampicina e isoniazida, depois de pareados com o grupo controle de pacientes com tuberculose sensível a todas as drogas na razão de 1:3. A associação dos dados demográficos e clínicos foi feita por análise estatística uni e multivariada. RESULTADOS: Durante o período de estudo, doze casos de tuberculose multirresistente foram identificados (3,83%). Na análise univariada, a tuberculose multirresistente foi mais comum no sexo masculino, em pacientes com baciloscopia de escarro positiva, pacientes com cavitações maiores que 4 cm de diâmetro e pacientes com um ou mais tratamentos prévios para tuberculose (p = 0,10). Após a análise multivariada somente o tratamento anterior para tuberculose permaneceu estatisticamente significativo (p = 0,0374), com odds ratio de 14,36 (1,96 - 176,46). CONCLUSÃO: O fator de risco que se mostrou independentemente associado ao desenvolvimento de tuberculose multirresistente neste estudo foi a presença de um ou mais tratamentos prévios para tuberculose.
Asma e doença pulmonar obstrutiva crônica: uma comparação entre variáveis de ansiedade e depressão
Authors: Carvalho Neide Suzane , Ribeiro Priscila Robles , Ribeiro Marcos , Nunes Maria do Patrocínio Tenório , Cukier Alberto , Stelmach Rafael
Published: September 2007

OBJETIVO: Avaliar a presença e gravidade de sintomas de ansiedade e depressão entre os portadores de asma e de doença pulmonar obstrutiva crônica. MÉTODOS: Foram usados instrumentos específicos de quantificação de sintomas de ansiedade e depressão, Inventário de Ansiedade Traço-Estado e Beck Depression Inventory, respectivamente, respondidos por pacientes de um ambulatório de asma e doença pulmonar obstrutiva crônica. A população constituiu-se de 189 pacientes pertencentes a três grupos de estudo com objetivos terapêuticos diferentes: 40 asmáticos controlados, 100 asmáticos não controlados e 49 portadores de doença pulmonar obstrutiva crônica, selecionados aleatória e prospectivamente. Entre as variáveis desses estudos constavam sintomas de ansiedade e depressão como parte da metodologia. Os dados obtidos foram comparados levando-se em consideração aspectos demográficos, funcionais e a gravidade dos sintomas de ansiedade e depressão. RESULTADOS: Entre os pacientes asmáticos foi significativamente maior a prevalência de ansiedade moderada e grave quando comparados com aqueles portadores de doença pulmonar obstrutiva crônica (p < 0,001). Em relação à depressão, o grupo de asma não controlada apresentou resultados significativamente maiores quando comparado ao grupo de asma controlada (p < 0,05). CONCLUSÃO: Entre os pacientes asmáticos a freqüência de sintomas de ansiedade e depressão é maior do que em portadores de doença pulmonar obstrutiva crônica, o que pode dificultar o controle clínico.
A espirometria na avaliação pré e pós-transplante de medula óssea
Authors: Mancuzo Eliane Viana , Silva Walace Espada da , Rezende Nilton Alves de
Published: September 2007

OBJETIVO: Analisar os resultados da espirometria de pacientes submetidos a transplante de medula óssea e verificar sua importância na detecção de complicações pulmonares e sua correlação com a evolução dos pacientes. MÉTODOS:Foram analisados retrospectivamente os resultados da espirometria em 120 pacientes, maiores de doze anos, de ambos os sexos, e comparados com o tipo de transplante de medula óssea, doença de base, sorologia para citomegalovírus, fonte de células para o transplante, tabagismo, infecção pulmonar, doença pulmonar prévia, duração da doença hematológica, quimioterapia utilizada, regime de condicionamento, doença do enxerto contra o hospedeiro aguda e crônica e óbito. RESULTADOS: Dezesseis pacientes apresentaram alterações da espirometria antes do transplante, sendo 5% com obstrução pura, 5,8% com restrição pura e 2,5% com obstrução com redução da capacidade vital. Após o transplante 29 pacientes apresentaram alterações desses exames. A chance de alteração da espirometria foi maior nos pacientes com doença do enxerto contra o hospedeiro aguda (p = 0,02), idade menor que 30 anos (p = 0,02), sexo feminino (p = 0,02) e naqueles que receberam células tronco (p = 0,01). As presenças de doença pulmonar prévia e doença do enxerto contra o hospedeiro crônica associaram-se com aumento da mortalidade. Alterações prévias da espirometria não estiveram relacionadas com o óbito pós-transplante. CONCLUSÃO: As alterações detectadas na espirometria não foram capazes de predizer a ocorrência de complicações pulmonares e óbito pós-transplantes. Também não foram determinantes para a não realização do procedimento. A espirometria simples realizada na avaliação desses pacientes parece ter pouca importância prática.
Eventos adversos após vacinação contra o pneumococo
Authors: Donalisio Maria Rita , Rodrigues Somnia Marlene Cadogan Piraggini , Mendes Elisa Teixeira , Krutman Mariana
Published: September 2007

OBJETIVO: Estudar a ocorrência de eventos adversos após aplicação da vacina polissacarídea capsular contra 23 sorotipos do pneumococo em indivíduos com indicação clínica, em Sumaré (SP) (630.000 habitantes). MÉTODOS: Foram investigados prospectivamente 152 indivíduos após vacinação (0,5 mL intramuscular Pneumo23® Aventis Pasteur, Espanha) em um hospital geral. A variável de estudo foi a queixa de pelo menos um sintoma com nexo temporal com a vacina, isto é, nas primeiras 48 h após a aplicação. Os indivíduos foram investigados de cinco a sete dias após a vacinação. As co-variáveis idade, sexo e indicação clínica foram testadas pelo método Qui-quadrado e pelo modelo logístico múltiplo, considerando-se o nível de significância de 5%. RESULTADOS: A idade da população variou de cinco a 86 anos (média de 61,8 anos). A quase totalidade dos indivíduos recebeu a primeira dose na ocasião (99%). Notificou-se a ocorrência de eventos locais em 36 indivíduos (23,7%), entre os quais 68% foram leves, sem repercussão nas atividades diárias. A dor no local da aplicação foi o sintoma mais freqüentemente relatado, por 97,2% dos indivíduos. Eritema e edema local estiveram presentes em 6,3% e 5,1% dos casos, respectivamente. Foram referidos sintomas gerais por 12,8% dos investigados (mal-estar, febre, sonolência, dor no corpo). Nenhuma co-variável relacionou-se estatisticamente com os eventos adversos na análise bivariada (p > 0,20), sendo que a análise múltipla mostrou os mesmos resultados. CONCLUSÃO: A vacina pneumocócica 23-valente é pouco reatogênica na primeira dose, e é ainda pouco indicada na região, mesmo em pacientes de indicação clínica.
Estenose idiopática de traquéia: relato de quatro casos
Authors: Rossi Carolina , Colombari Fernanda , Guembarowsky Alda Losi , Ferreira Filho Olavo Franco , Thomson João Carlos
Published: September 2007

A estenose idiopática de traquéia é incomum. Relatam-se quatro casos com quadro clínico semelhante: história de tratamento de broncoespasmo sem resultado e diagnóstico por broncoscopia. O tratamento em três pacientes foi dilatação e corticóide sistêmico; em um realizou-se traqueoplastia. No quarto, a estenose era mais extensa (2 cm) com redução da luz de 70%, sem possibilidade de dilatação. Realizou-se ressecção laringo-traqueal. Todos apresentaram boa evolução. A estenose idiopática de traquéia deve ser cogitada em casos de "bronquite" mal resolvida com tratamentos convencionais. A broncoscopia e a dilatação têm apresentado bons resultados. Eventualmente, torna-se necessária ressecção laringo-traqueal.
Doença de Castleman ou hiperplasia angiofolicular como nódulo pulmonar solitário: relato de caso
Authors: Krawczun Guilherme Andrade , Garcia Cristiano de Morais , Ito Kazuhiro , Ferreira Filho Olavo Franco , Thomson João Carlos
Published: September 2007

Doença de Castleman é uma doença rara que se manifesta geralmente como nódulo mediastinal, com grande variabilidade de apresentação em relação a idade, manifestações clínicas e evolução. Descreve-se paciente do sexo feminino de 40 anos de idade, com dor torácica incaracterística há alguns anos, com imagem hipotransparente à direita em raio X de tórax. A tomografia computadorizada e a arteriografia pulmonar não elucidaram o diagnóstico. O mesmo só foi possível ao exame anatomopatológico após ressecção cirúrgica do nódulo, que evidenciou características de hiperplasia angiofolicular ou doença de Castleman. O artigo ressalta a importância de se acrescentar esta doença na lista de morbidades para diagnóstico diferencial em nódulos pulmonares solitários.
Linfangiomatose pulmonar: relato de dois casos
Authors: Lima Adma Silva de , Martynychen Mariane Gonçalves , Florêncio Roseni Teresinha , Rabello Lêda Maria , Barros João Adriano de , Escuissato Dante Luis
Published: September 2007

A linfangiomatose, doença rara e de origem controversa, ocorre em indivíduos de todas as faixas etárias, predominando entre os mais jovens, sem predileção por sexo. Comumente cursa com envolvimento torácico, porém órgãos como ossos, baço e fígado podem ser acometidos. Histologicamente, o envolvimento pulmonar cursa com proliferação, anastomoses complexas e dilatação secundária do sistema linfático. Clinicamente, a apresentação é variável. Os achados radiográficos podem ser sugestivos e o diagnóstico é definido pela histologia. Relatamos dois casos da doença; uma das pacientes era oligossintomática e encontra-se em tratamento; na outra, a doença foi mais agressiva e o diagnóstico muito tardio, culminando em óbito.
Fatores associados ao óbito por tuberculose na zona leste da cidade de São Paulo, 2001
Authors: Pelaquin Monica Hid Haddad , Silva Rebeca Souza e , Ribeiro Sandra Aparecida
Published: September 2007

OBJETIVO: Identificar os fatores mais associados à evolução para óbito por tuberculose (TB), comparando casos de TB que evoluíram para óbito com os que evoluíram para cura, entre os casos notificados em 2001, nas subprefeituras de Cidade Tiradentes, Guaianazes, Itaquera e São Mateus, na zona leste do município de São Paulo. MÉTODOS: Foram investigados todos os óbitos (n = 48) que tiveram como causa básica TB, com análise do prontuário hospitalar e posterior visita domiciliar com entrevista do(s) cuidador(es). Paralelamente, investigaram-se 96 casos de TB que tiveram alta cura. Em ambos os grupos, foram excluídos pacientes portadores de HIV. RESULTADOS: A distribuição dos casos curados e óbitos de TB foi igual em ambos os grupos para forma clínica da TB, confirmação laboratorial do diagnóstico e tipo de tratamento. Os casos de óbito tiveram associação estatisticamente significante com sexo masculino, idade maior que 50 anos, escolaridade menor que 3 anos, alcoolismo e desemprego. A regressão logística mostrou que as variáveis de maior significância para evolução para óbito foram: alcoolismo e idade maior que 50 anos, enquanto ser virgem de tratamento e ter ocupação foram fatores de proteção. A associação de alcoolismo, desemprego e idade superior a 50 anos em um mesmo paciente aumentou 25 vezes a chance de evoluir para óbito (IC95%: 6,4397,20). CONCLUSÃO: O treinamento continuado das equipes de saúde, também em nível hospitalar, com prontidão nas ações de vigilância epidemiológica e um adequado funcionamento do sistema de referência/contra-referência em muito melhorarão os indicadores da doença.
Diagnóstico imunológico da tuberculose: problemas e estratégias para o sucesso
Authors: Teixeira Henrique Couto , Abramo Clarice , Munk Martin Emilio
Published: September 2007

A tuberculose continua sendo um grave problema social e de saúde, afetando milhões de pessoas anualmente. A vacina Bacille Calmette-Guerin (BCG), usada no controle profilático, é incapaz de conter a progressão da doença, que usualmente se manifesta através da queda da imunidade celular do indivíduo. O diagnóstico da tuberculose em seus estágios iniciais, aliado à poliquimioterapia, pode contribuir para o controle da disseminação da infecção. Os atuais métodos de diagnóstico apresentam problemas, como: baixa sensibilidade da baciloscopia; longo tempo de realização das culturas microbiológicas; e baixa especificidade do teste cutâneo com o derivado protéico purificado do M. tuberculosis. Novos métodos de diagnóstico que utilizam antígenos específicos (por exemplo, os conhecidos em inglês como o early secreted antigenic target 6-kDa e o culture filtrate protein 10-kDa), estão sendo testados. Os genes que codificam esses antígenos estão localizados na região de diferença 1 do M. tuberculosis, M. africanum e M. bovis, mas estão ausentes no M. bovis (BCG) e na maioria das micobactérias do meio ambiente. Métodos de diagnóstico baseados na produção de interferon-gama por linfócitos T, em resposta a esses antígenos, como o QuantiFERON-TB® e o T SPOT.TB®, estão sendo testados, e superam o teste cutâneo com o derivado protéico purificado nas seguintes características: maior sensibilidade; menor reatividade cruzada devido à vacinação com o BCG ou infecção por micobactérias do meio ambiente; e tempo de execução. A introdução de métodos de diagnóstico mais específicos e sensíveis, assim como um maior entendimento dos mecanismos moleculares e celulares que regulam a interação parasito-hospedeiro, pode contribuir para um eficiente combate à tuberculose.
Amiloidose pulmonar: relato de caso de achado radiológico da apresentação nodular em grande fumante
Authors: Montessi Jorge , Almeida Edmilton Pereira de , Vieira João Paulo , Horta Cândida Maria , Abreu Marcus da Matta , Bolognani Carlos Eduardo Dainezzi , Costa Sandra Márcia Carvalho Ribeiro
Published: September 2007

A amiloidose pulmonar é uma doença rara, caracterizada pelo depósito extracelular de proteínas fibrilares no pulmão. Amiloidose é um termo genérico para grupos heterogêneos de doenças, incluindo doença de Alzheimer e diabetes mellitus tipo II. Apresenta-se no aparelho respiratório sob as formas traqueobrônquica, nodular pulmonar e septal alveolar (parenquimatosa difusa). Relata-se o caso de uma mulher, tabagista (20 anos/maço), portadora de amiloidose nodular pulmonar, diagnosticada através de exames pré-operatórios à realização de colecistectomia videolaparoscópica.
Estudio situacional de siete revistas latinoamericanas de neumología
Authors: Oyarzún Gómez Manuel , Ramírez Venegas Alejandra , Agüero Fernández Adalberto , Martínez José Antônio Baddini , Bermúdez Gómez Mary , Cáneva Jorge O. , Morales Blandir Jaime E. , Pérez-Padilla Rogelio
Published: September 2007

OBJETIVO: Caracterizar la situación de las revistas de neumología publicadas en Latinoamérica. MÉTODOS: Fue realizada una encuesta en reunión organizada por la Sociedad Latinoamericana de Tórax. Cada editor presentó un reporte y respondió a un cuestionario. RESULTADOS: Mejora en la adquisición de informaciones es la principal motivación para las sociedades de neumología para la edición de sus propias revistas, considerando que la diseminación de conocimiento médico y el reporte de experiencias son los principales motivos para que los autores envíen sus trabajos. El error más común en los trabajos enviados es la poca conformidad con las directrices de la revista. Mejorar las relaciones entre autor, editor y revisor sería la mejor estrategia para perfeccionar la calidad de los textos. Algunas sugerencias para mejorar las revistas latinoamericanas: promover profesionales en tareas editoriales; encorajar a los revisores a que sean más meticulosos; y adoptar normas internacionales para la edición de revistas médicas. Fueron reportados los siguientes problemas: falta de periodicidad adecuada y regular de las ediciones; una disminución en la cantidad de trabajos originales que son considerados ejemplares en la especialidad; baja tasa de rechazo de trabajos enviados; alta rotación de editores. CONCLUSIÓN: Podemos hacer las siguientes recomendaciones: a pesar de varias revistas estar en formato electrónico, ellas también deben ser mantenidas en formato impreso; cada revista debe informar su tasa de suscripción, aunque esté incluida en los gastos de inscripción anual; a pesar de cada país de Latinoamérica poder optar por publicar su propia revista, la posibilidad de publicación de una revista multinacional de neumología latinoamericana debe ser explotada.
Study of the areas and thicknesses of mesiobucal root canals prepared by three endodontic techniques
Authors: Constante Isa Geralda Teixeira , Davidowicz Harry , Barletta Fernando Branco , Moura Abilio Albuquerque Maranhão de
Published: September 2007

The purpose of this study was to compare, in vitro, by means of computerized analysis of digital radiographic images, the anatomic alterations produced in the mandibular molar tooth dentinal walls of mesiobucal canals with severe curvature by three different endodontic techniques: Progressive Preparation, Staged and Serial Preparation. A selection was made of 45 extracted, human, mandibular molars, with root curvatures greater than 25°. They were divided into three groups for every technique studied, which were then sub-divided into three sub-groups in accordance with the position of the curvature along the root: cervical, median or apical. After access surgery and tooth length determination, the canals were filled with 100% Barium Sulphate radiological contrast and the teeth were then radiographed with a direct digital radiography system, using a special apparatus capable of keeping the samples in the same spatial position during the different radiographic takes. After the above-mentioned endodontic techniques had been performed, the teeth were again filled with Barium sulphate and were also radiographed under the same previously mentioned conditions. The pre- and post-operative digital images were then analyzed in two computerized programs, AutoCAD 2004 and CorelDraw 10, to assess, respectively, the areas and the horizontal alterations which occurred in the internal and external walls of the root canals. The results indicated that although no significant differences among the techniques were shown in the statistical analysis, in a descriptive analysis the Progressive Preparation technique was shown to be more regular, uniform and effective.
Localization of Bmp-4, Shh and Wnt-5a transcripts during early mice tooth development by in situ hybridization
Authors: Nunes Fábio Daumas , Valenzuela Maria da Graça Silva , Rodini Camila Oliveira , Massironi Silvia Maria Gomes , Ko Gui Mi
Published: September 2007

A comparative nonisotopic in situ hybridization (ISH) analysis was carried out for the detection of Bmp-4, Shh and Wnt-5a transcripts during mice odontogenesis from initiation to cap stage. Bmp-4 was expressed early in the epithelium and then in the underlying mesenchyme. Shh expression was seen in the odontogenic epithelial lining thickening, being stronger in the enamel knot area, during the cap stage. Wnt-5a transcripts were expressed only in the mesenchyme during the initiation, bud and cap stages, with strong expression in the dental mesenchyme during the bud stage. The present results showed that Bmp-4, Shh and Wnt-5a are expressed since the very early stages of tooth development, and they suggest that the Wnt-5a gene is expressed in different cell populations than Bmp-4 and Shh.
Forces in stainless steel, TiMolium® and TMA® intrusion arches, with different bending magnitudes
Authors: Claro Cristiane Aparecida de Assis , Abrão Jorge , Reis Silvia Augusta Braga
Published: September 2007

The present study compared forces in stainless steel, TiMolium® and TMA®, V-bend intrusion arches with different magnitudes of flexion. The sample consisted of rectangular-section wires, caliber .017" x .025", with ten arches of each alloy. All V-bends were made 48 mm from the midline, using the same phantom upper jaw, maintaining the same distance between the tubes fixed to the molars and the midline. Loads necessary to deflect the arches by 5, 10, 15 and 20 mm were measured by means of an Instron dynamometer with a 1 kgf load cell. Calculations for sample size confirmed the suitability of using 10 arches of each alloy. Variance tests (ANOVA) of one factor and three levels, complemented by the Tukey test for multiple comparisons, identified that TMA® intrusion arches required a smaller quantity of load in relation to conventional steel and TiMolium® at all levels of flexion. Furthermore, TiMolium® presented intermediary characteristics between steel and TMA®, and in all alloys increase in distance entailed a significant increase in force between all registered values, and that the increase in load necessary to deflect the arches at the intervals tended to decrease from first to last interval, these differences being more significant in steel, less in TiMolium® and practically non-existent in TMA®.
Prevalence of posterior crossbite among pacifier users: a study in the deciduous dentition
Authors: Scavone-Junior Helio , Ferreira Rívea Inês , Mendes Tadeu Evandro , Ferreira Flávio Vellini
Published: September 2007

The aim of this study was to evaluate the prevalence of posterior crossbite among children whose pacifier-sucking habit persisted until different ages. Children aged 3 to 6 years were randomly selected from public preschools in São Paulo, SP, Brazil. Their mothers were asked to complete a questionnaire on non-nutritive sucking behaviors. The sample consisted of 366 children assigned to 2 groups: control (n = 96) and pacifier users (n = 270). Pacifier users were further assigned to 3 subgroups, according to the age of habit persistence: P1 - until 2 years of age; P2 - between 2 and 4 years of age; and P3 - between 4 and 6 years of age. One dentist assessed the children for occlusal relationships through clinical examination. Associations between the age interval of habit discontinuation and the prevalence of posterior crossbite were analyzed using the chi-square test (p < 0.05). The prevalence of posterior crossbite was significantly higher among pacifier users (20.4%), compared to control children (5.2%), p < 0.01. Unilateral posterior crossbite was more prevalent than bilateral crossbite among pacifier users (9.8% versus 3.6%). Functional posterior crossbites were diagnosed in 3.1% of the control children and 7% of the pacifier users. The frequencies of posterior crossbite were notably high for children in the 3 pacifier subgroups, P1, P2, and P3, corresponding to 17.2%, 16.9%, and 27.3%, respectively. The high prevalence of posterior crossbite may be associated with pacifier-sucking habits that persisted after 2 years of age.
Effect of thickener agents on dental enamel microhardness submitted to at-home bleaching
Authors: Rodrigues José Augusto , Oliveira Glauco Paulo Felício , Amaral Cristiane Mariote
Published: September 2007

Dental bleaching occurs due to an oxidation reaction between the bleaching agents and the macromolecules of pigments in the teeth. This reaction is unspecific and the peroxides can also affect the dental matrix causing mineral loss. On the other hand, recent studies have suggested that the thickener agent carbopol can also cause mineral loss. Thus, the objective of this study was to evaluate in vitro the effect of at-home dental bleaching on dental enamel microhardness after the use of bleaching agents with and without carbopol as a thickener agent. Bovine dental slabs with 3 x 3 x 3 mm were obtained, sequentially polished, and randomly divided into 4 groups according to the experimental treatment: G1: 2% carbopol; G2: 10% carbamide peroxide with carbopol; G3: carbowax; G4: 10% carbamide peroxide with poloxamer. Bleaching was performed daily for 4 weeks, immersed in artificial saliva. Enamel microhardness values were obtained before the treatment (T0) and 7 (T1), 14 (T2), 21 (T3), 28 (T4), and 42 (T5) days after the beginning of the treatment. ANOVA and Tukey's test revealed statistically significant differences only for the factor Time (F = 5.48; p < 0.01). All bleaching and thickener agents caused no alterations on the enamel microhardness.
A prospective randomized trial to reduce oral Candida spp. colonization in patients with hyposalivation
Authors: Torres Sandra Regina , Peixoto Camila Bernardo , Caldas Daniele Manhães , Akiti Tiyomi , Barreiros Maria Glória Carvalho , Uzeda Milton de , Nucci Marcio
Published: September 2007

Low salivary flow rates are associated with higher oral Candida spp. counts, which may predispose to oral candidiasis. The aim of this study was to compare the effect of stimulating salivary flow rates with that of a regimen of chlorhexidine mouth rinse on the intensity of Candida colonization in patients with reduced salivary flow rates. Thirty-one outpatients were randomized to stimulate salivary output (group 1) or to receive chlorhexidine mouth rinses (group 2). Evaluations were performed at baseline (T0), at end of treatment (T1), and 15 days after last day of treatment (T2). Chewing-stimulated whole saliva samples were collected at each visit. Group 1 showed a constant reduction in median cfu counts, although the difference was significant only between T0 and T2 (p = 0.004). Group 2 showed a reduction in median Candida cfu counts between T0 and T1 (p = 0.01), but the counts increased at T2 (p = 0.01), and the difference between T0 and T2 was not significant (p = 0.8). In conclusion, patients who received salivary stimulation showed reductions of Candida cfu counts in saliva and a trend for increasing salivary flow rates between baseline and end of study evaluations. The use of chlorhexidine mouth rinses dramatically reduced Candida cfu counts, but when patients discontinued treatment, intensity of colonization rose again.
Electrochemical behavior and pH stability of artificial salivas for corrosion tests
Authors: Queiroz Gláucia Maria Oliveira de , Silva Leandro Freitas , Ferreira José Tarcísio Lima , Gomes José Antônio da Cunha P. , Sathler Lúcio
Published: September 2007

It is assumed that the compositions of artificial salivas are similar to that of human saliva. However, the use of solutions with different compositions in in vitro corrosion studies can lead dissimilar electrolytes to exhibit dissimilar corrosivity and electrochemical stability. This study evaluated four artificial salivas as regards pH stability with time, redox potentials and the polarization response of an inert platinum electrode. The tested solutions were: SAGF medium, Mondelli artificial saliva, UFRJ artificial saliva (prepared at the School of Pharmacy, Federal University of Rio de Janeiro, RJ, Brazil) and USP-RP artificial saliva (prepared at the School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, SP, Brazil). It was observed that pH variations were less than 1 unit during a 50-hour test. The SAGF medium, and the UFRJ and USP-RP solutions exhibited more oxidizing characteristics, whereas the Mondelli solution presented reducing properties. Anodic polarization revealed oxidation of the evaluated electrolytes at potentials below +600 mV SCE. It was observed that the UFRJ and USP-RP solutions presented more intense oxidation and reduction processes as compared to the Mondelli and SAGF solutions.
Fluoride intake from regular and low fluoride dentifrices by 2-3-year-old children: influence of the dentifrice flavor
Authors: Moraes Samanta Mascarenhas , Pessan Juliano Pelim , Ramires Irene , Buzalaf Marília Afonso Rabelo
Published: September 2007

This study evaluated the fluoride intake from dentifrices with different fluoride concentrations ([F]) by children aged 24-36 months, as well as the influence of the dentifrice flavor in the amount of fluoride ingested during toothbrushing. Thirty-three children were randomly divided into 3 groups, according to the [F] in the dentifrices: G-A (523 µgF/g), G-B (1,062 µgF/g) and G-C (1,373 µgF/g). Dentifrices A and B are marketed for children, while dentifrice C is a regular product. The amount of F ingested was indirectly obtained, subtracting the amount expelled and the amount left on the toothbrush from the amount initially loaded onto the brush. The results were analyzed by ANOVA, Tukey's test and linear regression analysis (p < 0.05). Children ingested around 60% of the dentifrice loaded onto the brush, but no significant differences were seen among the groups (p > 0.05). Mean daily fluoride intake from dentifrice for G-A, G-B and G-C was 0.022ª, 0.032ª and 0.061b mg F/kg body weight, respectively (p < 0.01). There was a strong positive correlation (r = 0.86, p < 0.0001) between the amount of dentifrice used and the amount of fluoride ingested during toothbrushing. The results indicate the need for instructing children's parents and care givers to use a small amount of dentifrice (< 0.3 g) to avoid excessive ingestion of fluoride. The use of low-[F] dentifrices by children younger than 6 years also seems to be a good alternative to minimize fluoride intake. Dentifrice flavor did not influence the percentage of fluoride intake.
Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study
Authors: Chambrone Daniela , Pasin Ivan Munhoz , Conde Marina Clemente , Panutti Claudio , Carneiro Silvia , Lima Luiz Antonio Pugliesi Alves de
Published: September 2007

The objective of this split-mouth, double-blind, randomized controlled trial was to compare the clinical effect of treatment of 2- or 3-wall intrabony defects with open flap debridement (OFD) combined or not with enamel matrix proteins (EMP). Thirteen volunteers were selected with one pair of or more intrabony defects and probing pocket depth (PPD) > 5 mm. All individuals received instructions regarding oral hygiene and were submitted to scaling and root planing. Each participant received the two treatment modalities: test sites were treated with OFD and EMP, and control sites received only OFD. After 6 months, a significant reduction was observed in PPD for the EMP group (from 6.42 ± 1.08 mm to 2.67 ± 1.15 mm) and for the OFD group (from 6.08 ± 1.00 mm to 2.00 ± 0.95 mm) (p < 0.0001), but with no significant difference between groups (p = 0.13). A significant gain in relative attachment level (RAL) was observed in both groups (EMP: from 13.42 ± 1.88 mm to 10.75 ± 2.26 mm, p < 0.001; OFD: from 12.42 ± 1.98 mm to 10.58 ± 2.23 mm, p = 0.013), but with no significant difference between groups (p = 0.85). Gingival recession (GR) was higher in the EMP group (from 1.08 ± 1.50 mm to 2.33 ± 1.43 mm; p = 0.0009) than in the OFD group (from 0.66 ± 1.15 mm to 1.16 ± 1.33 mm; p = 0.16), but this difference was not significant (p = 0.06). In conclusion, the results showed that OFD combined with EMP was not able to improve treatment of intrabony defects compared to OFD alone.
The influence of ovariectomy, simvastatin and sodium alendronate on alveolar bone in rats
Authors: Anbinder Ana Lia , Prado Fernanda de Almeida , Prado Marcela de Almeida , Balducci Ivan , Rocha Rosilene Fernandes da
Published: September 2007

Bisphosphonates are currently used in the treatment of many diseases involving increased bone resorption such as osteoporosis. Statins have been widely used for the treatment of hypercholesterolemia and recent studies have shown that these drugs are also capable of stimulating bone formation. The purpose of this study was to evaluate the influence of an estrogen deficient state and the effects of simvastatin and sodium alendronate therapies on alveolar bone in female rats. Fifty-four rats were either ovariectomized (OVX) or sham operated. A month later, the animals began to receive a daily dose of simvastatin (SIN - 25 mg/kg), sodium alendronate (ALN - 2 mg/kg) or water (control) orally. Thirty-five days after the beginning of the treatment, the rats were sacrificed and their left hemimandibles were removed and radiographed using digital X-ray equipment. The alveolar radiographic density under the first molar was determined with gray-level scaling and the values were submitted to analysis of variance (a = 5%). Ovariectomized rats gained more weight (mean ± standard deviation: 20.06 ± 6.68%) than did the sham operated animals (12.13 ± 5.63%). Alveolar radiographic density values, expressed as gray levels, were lowest in the OVX-water group (183.49 ± 6.47), and differed significantly from those observed for the groups receiving alendronate (sham-ALN: 193.85 ± 3.81; OVX-ALN: 196.06 ± 5.11) and from those of the sham-water group (193.66 ± 4.36). Other comparisons between groups did not show significant differences. It was concluded that the ovariectomy reduced alveolar bone density and that alendronate was efficient for the treatment of this condition.
Dental age in patients with Down syndrome
Authors: Moraes Mari Eli Leonelli de , Bastos Michelle Silva , Santos Luis Roque de Araujo dos , Castilho Julio Cezar de Melo , Moraes Luiz Cesar de , Medici Filho Edmundo
Published: September 2007

The aim of this research was to evaluate dental age in 102 patients with Down Syndrome, using panoramic radiographs. A software program developed by the Discipline of Radiology, School of Dentistry of São José dos Campos, São Paulo State University (UNESP), was used. A table of mineralization chronology of permanent teeth among Brazilians conceived by Nicodemo, Moraes and Medici Filho was used within the software. Statistical analysis of the results showed that 70.91% of the males and 61.21% of the females presented advanced dental age. Only 32.09% of the males and 38.79% of the females presented delayed dental age. Regarding the differences between the dental and chronological ages, two thirds of the males and females presented dental age with differences of up to 12 months, which means that they can be considered to be within normal standards, whereas only 18.87% of the males and 10.21% of the females presented dental age outside normal standards, with differences of over 24 months. In conclusion, the majority of the patients with Down Syndrome were considered to be within the normal standards of mineralization chronology.
Evaluation of some oral postradiotherapy sequelae in patients treated for head and neck tumors
Authors: Rubira Cássia Maria Fischer , Devides Nádia Juliana , Úbeda Liliane Torsani , Bortolucci Jr Antônio Geraldo , Lauris José Roberto , Rubira-Bullen Izabel Regina Fischer , Damante José Humberto
Published: September 2007

The aim of this study was to evaluate the oral sequelae of radiotherapy in patients treated between 1999 and 2003 for head and neck tumors. One-hundred patients (24 women, 76 men) ranging in age from 30 to 83 years (mean 59.2 years) were examined. Time since radiotherapy ranged from 1 to 72 months (mean 28 months). The total mean radiation dose received by the patients was 5,955 cGy. The evaluation protocol included anamnesis, intraoral and extraoral examination, measurement of stimulated salivary flow and salivary pH. Symptoms reported by the patients included dry mouth (68%), dysphagia (38%), and dysgeusia (30%). In 64% of the patients, the mean stimulated salivary flow rate was less than 0.7 ml/min. The mean salivary pH was 6.97 (± 0.714). Stimulated salivary flow increased with increasing postradiotherapy time (p < 0.05). The prevalence of mucositis was associated with higher radiation doses (p < 0.05), and the prevalence of atrophic candidiasis was related to a longer post-treatment period (p < 0.05). Two cases of recurrence of the primary tumor were detected during the study. The main effect of radiotheraphy in the head and neck region was a reduction of the salivary flow rate, even though our study demonstrated that there was a modest late improvement of the salivary flow.
An Agency-Generated Outcome Measure
Authors: Blakely Thomas J. , Dziadosz Gregory M.
Published: September 2007

This article describes the development of an original outcomes measurement scale titled Psychiatric Well-Being (PWB). The scale is a series of statements that are characteristics of the agency’s product of psychiatric well-being for an adult population of persons with a serious psychiatric disorder, many of whom also have a substance abuse disorder. Validity, reliability, and internal consistency of the PWB scale have been determined. The scale may be adapted directly to measuring outcomes of agencies serving similar populations or its characteristics may be modified for measurement use with other populations.
Gradations of Researchers’ Obligation to Provide Ancillary Care for HIV/AIDS in Developing Countries
Authors: Richardson Henry S.
Published: September 2007

Three principal factors affect the stringency of medical researchers’ obligation to provide antiretroviral treatment to participants in non-HIV/AIDS studies that are conducted in developing countries: (1) the centrality of HIV/AIDS to the study design, (2) the extent of the researcher–participant interaction, and (3) the cost relative to the study budget.

I provide a basis for assessing the comparative stringency of the researchers’ obligation to provide this type of ancillary care. Practically, given the range of possible responses to study participants’ needs, calibrating the researcher’s responsibility to provide ancillary care is a useful step in ethical analysis.

Theoretically, a gradation of obligation suggests how research ethics committees or institutional review boards can take multiple, potentially conflicting ethical factors into account without undertaking spurious efforts to quantify their importance.
Motorcycle Safety and the Repeal of Universal Helmet Laws
Authors: Houston David J. , Richardson Lilliard E.
Published: September 2007

Objectives. We assessed the implications for motorcyclist safety of recent repeals of universal helmet laws in 6 US states.

Methods. We examined cross-sectional time-series data from the 50 states and the District of Columbia for the period 1975 through 2004.

Results. On average, when compared to state experience with no helmet mandate, universal helmet laws were associated with an 11.1% reduction in motorcyclist fatality rates, whereas rates in states with partial coverage statutes were not statistically different from those with no helmet law. Furthermore, in the states in which recent repeals of universal coverage have been instituted, the motorcyclist fatality rate increased by an average of 12.2% over what would have been expected had universal coverage been maintained. Since 1997, an additional 615 motorcyclist fatalities have occurred in these states as a result of these changes in motorcycle helmet laws.

Conclusions. Motorcyclist safety has been compromised in the states that have repealed universal coverage and is likely to be compromised in other states that abandon these statutes.
Acculturation and Cigarette Smoking Among Pregnant Hispanic Women Residing in the United States
Authors: Detjen M. Gabrielle , Nieto F. Javier , Trentham-Dietz Amy , Fleming Michael , Chasan-Taber Lisa
Published: September 2007

Objectives. We explored whether higher levels of acculturation were associated with higher rates of cigarette smoking among pregnant Hispanic women residing in the United States.

Methods. We evaluated data from the Latina Gestational Diabetes Mellitus Study, a prospective study of 1231 Hispanic prenatal care patients conducted from 2000 to 2004 in Massachusetts. Self-reported data on acculturation, cigarette smoking, and covariates were collected by bilingual interviewers using a questionnaire. We conducted logistic regression multivariate analyses to examine the impact of acculturation level on the odds of smoking.

Results. Overall, 21% of women reported smoking during pregnancy. Acculturation was associated with elevated smoking rates in pregnant Hispanic women. US-born Hispanic women who preferred English had more than twice the odds of smoking compared with Puerto Rican or foreign-born Hispanic women who preferred Spanish (odds ratio [OR]=2.76, 95% confidence interval [CI] 1.36, 5.63).

Conclusions. Our findings suggest that higher-acculturated Hispanic women living in the United States are more likely to smoke cigarettes during pregnancy than are less-acculturated Hispanic women. These results will inform interventions aimed at reducing cigarette smoking during pregnancy among US Hispanic women.
The effect of mineral fertilization on nutritive value and biological activity of chokeberry fruit
Authors: SKUPIEN K. , OSZMIANSKI J.
Published: September 2007

The aim of the study was to assess whether an extra fertilization with manganese, commercial fertilizer Alkalin (N, K and Si), and combined treatment (manganese + Alkalin) affect the chemical composition of chokeberry fruits (Aronia melanocarpa (Michx) Elliot), especially sugar content and the quantity and profile of phenolics. Dry weight, soluble solids, titratable acidity, total sugar, reducing sugar, sucrose, vitamin C, total polyphenol (gallic acid equivalents); 2, 2-diphenyl-1-picrylhydrazyl radical scavenging activity; and phenolics profile were measured from the fruits harvested from different treatments. Chokeberries treated with manganese showed high content of non-identified phenolic acids [101.15 mg per 100 g fresh weight (FW), these compounds were not detected in fruit treated with Alkalin and manganese + Alkalin], and the highest content of cyanidin glycosides (813.75 mg per 100 g FW). The fruits treated with Alkalin displayed the highest content of quercetin derivatives (40.88 mg per 100 g FW) and eriodictyol 7-glucuronide (26.43 mg per 100g FW). Chokeberries in control treatments had the highest content of dry weight (30.76% FW), soluble solids (24.1% FW), total sugar (20.92% FW), vitamin C (8.4 mg 100 g1 FW), total polyphenol (2377.1 mg gallic acid equivalents per 100 g FW), the highest 2, 2-diphenyl-1-picrylhydrazyl radical % inhibition (38.1%), highest content of chlorogenic acids (210.38 mg per 100 g FW), (-)epicatechin (32.18 mg per 100 g FW) and the highest degree of procyanidin polimerization (59). The results indicate that applied fertilization exerted differential influence on chemical composition of aronia fruits.;
Effect of NPK fertilization and elemental sulphur on growth and yield of lowbush blueberry
Authors: STARAST M. , KARP K. , VOOL E.
Published: September 2007

The aim of the research was to determine the effect of fertilizers on the pH of former arable soils and on the growth and the yield of the lowbush blueberry (Vaccinium angustifolium Ait.). Lowbush blueberry fertilization experiments were established in 1999 at two locations  at Kärla, Saaremaa, West Estonia and at Vasula, Tartu County, South Estonia. Experimental sites were situated on different soils: soil pHKCl at Kärla was 5.5 and at Vasula 6.2. Elemental sulphur and acidifying fertilizers (ammonium sulfate, potassium sulfate and superphosphate) were used in both plantations. Fertilizers were applied based on nutrient in the soil and sulphur was applied at 100 g m2. Plant growth was recorded in 2001, 2002 and 2003. A positive influence of NPK fertilization on yield was found in both Kärla and Vasula, and yield were 336 g and 41 g higher compared to the control, respectively. The vegetative growth and yield of blueberry depended significantly on soil pH. Elemental sulphur increased soil acidity and on loamy sand soil did not increase plant productivity. The sulphur effect on soil pH began to decrease three years after application. Sulphur can be recommended to increase soil acidity in nutrient-rich soil but, not nutrient poor soil with light texture, where only NPK fertilizers were effective.;