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Objetivo: relatar um caso de alopecia temporária após tratamento endovascular com exposição por fluoroscopia devido a uma malformação arteriovenosa na face. Detalhamento do caso: sexo masculino, 34 anos, com queixa de lesão na asa nasal, lábio superior e lateral da face (direita). O paciente trouxe exame de angioressonância apresentando uma malformação arteriovenosa em face com nutrição pela artéria facial e drenagem pela veia mandibular. Como tratamento foi optado uma arteriografia diagnóstica para melhor avaliação de vascularização da malformação arteriovenosa seguida de embolização com onyx® (mistura de etileno vinil álcool copolímero) que fornece o contraste necessário para a visibilização da mistura sob fluoroscopia. O procedimento foi realizado 14 dias após a 1ª consulta, sem intercorrências indicando sucesso terapêutico. No retorno, terceira semana após o procedimento, apresentou alopecia setorial em região occipitoparietal direita. Não havia manchas em região, bem como outros sintomas associados. Foi realizado como tratamento o uso de Minoxidil tópico e Cilostazol via oral. Após o tratamento houve retorno do crescimento espontâneo em cerca de 2 meses. Considerações finais: a embolização com onyx® mostrou-se uma valiosa opção terapêutica com uma maior conservação das estruturas nobres em malformações arteriovenosas, com baixa taxa de complicações no médio e longo prazo.

Objective: to report a case of temporary alopecia after endovascular treatment with fluoroscopy exposure due to an arteriovenous malformation on the face. Case detail: male, 34 years old, complaining of a lesion on the nasal wing, upper lip and side of the face (right). The patient brought an angioresonance exam showing an arteriovenous malformation in the face with nutrition through the facial artery and drainage through the mandibular vein. As a treatment, a diagnostic arteriography was chosen for a better assessment of the vascularity of the arteriovenous malformation followed by embolization with onyx® (mixture of ethylene vinyl alcohol copolymer), which provides the necessary contrast for visualization of the mixture under fluoroscopy. The procedure was performed 14 days after the 1st consultation, with no intercurrences indicating therapeutic success. On return, third week after the procedure, he presented sectoral alopecia in the right occipitoparietal region. There were no stains in the region, as well as other associated symptoms. The use of topical Minoxidil and oral Cilostazol was carried out as treatment. After treatment there was a return of spontaneous growth in about 2 months. Final considerations: embolization with onyx® proved to be a valuable therapeutic option with greater conservation of noble structures in arteriovenous malformations, with a low rate of complications in the medium and long term.

Objetivo: reportar un caso de alopecia transitoria posterior a tratamiento endovascular con exposición radioscópica debido a una malformación arteriovenosa en la cara. Detalle del caso: varón, 34 años, que se queja de una lesión en el ala nasal, labio superior y lado de la cara (derecha). El paciente trajo un examen de angiorresonancia que mostró una malformación arteriovenosa en la cara con nutrición a través de la arteria facial y drenaje a través de la vena mandibular. Como tratamiento se optó por una arteriografía diagnóstica para una mejor valoración de la vascularización de la malformación arteriovenosa seguida de embolización con onyx® (mezcla de copolímero de etileno alcohol vinílico), que proporciona el contraste necesario para la visualización de la mezcla bajo fluoroscopia. El procedimiento se realizó 14 días después de la 1.ª consulta, sin intercurrencias que indicaran éxito terapéutico. A su regreso, a la tercera semana del procedimiento, presenta alopecia sectorial en región occipitoparietal derecha. No había manchas en la región, así como otros síntomas asociados. Como tratamiento se realizó el uso de Minoxidil tópico y Cilostazol oral. Después del tratamiento hubo un retorno del crecimiento espontáneo en aproximadamente 2 meses. Consideraciones finales: la embolización con onyx® demostró ser una valiosa opción terapéutica con mayor conservación de las estructuras nobles en las malformaciones arteriovenosas, con una baja tasa de complicaciones a medio y largo plazo.

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INTRODUCTION: Multiple myeloma is characterized by proliferation of clonal plasma cells. The identification of prognostics factors to identify patient's risk is important. Among the studied factors, it was identified of relevant importance the lactic dehydrogenase. OBJECTIVES: To evaluate the impact of the value of DHL in combination with the score ISS in the medium patients overall survival (OS). METHODS: It is a retrospective cohort with 252 patients with MM recently-diagnosed that attendance in the institution of the study. RESULTS: To evaluate the association between DHL and ISS, we found 6 new groups to be analyzed: ISS I and normal DHL with medium overall survival not reached, and with DHL loud with medium OS of 69,8 months, ISS II and normal DHL with medium overall survival of 78,8 months and with DHL loud with medium OS of 73,9 months, ISS III and normal DHL with medium overall survival of 46,7 months and with DHL loud with medium OS of 45,5 months. CONCLUSION: Through the association of ISS I and normal DHL, ISS III and high DHL and others combinations, we build a new score with superior impact prognostic in our population treated in real life.

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Abstract Introduction Multiple myeloma is characterized by proliferation of clonal plasma cells. The identification of prognostics factors to identify patient's risk is important. Among the studied factors, it was identified of relevant importance the lactic dehydrogenase. Objectives To evaluate the impact of the value of DHL in combination with the score ISS in the medium patients overall survival (OS). Methods It is a retrospective cohort with 252 patients with MM recently-diagnosed that attendance in the institution of the study. Results To evaluate the association between DHL and ISS, we found 6 new groups to be analyzed: ISS I and normal DHL with medium overall survival not reached, and with DHL loud with medium OS of 69,8 months, ISS II and normal DHL with medium overall survival of 78,8 months and with DHL loud with medium OS of 73,9 months, ISS III and normal DHL with medium overall survival of 46,7 months and with DHL loud with medium OS of 45,5 months. Conclusion Through the association of ISS I and normal DHL, ISS III and high DHL and others combinations, we build a new score with superior impact prognostic in our population treated in real life.

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We encapsulated MSZ in zein nanoparticles (NP-ZN) using a desolvation method followed by drying in a mini spray dryer. These nanoparticles exhibited a size of 266.6 ± 52 nm, IPD of 0.14 ± 1.1 and zeta potential of -36.4 ± 1.5 mV, suggesting colloidal stability. Quantification using HPLC showed a drug-loaded of 43.8 µg/mg. SEM demonstrated a spherical morphology with a size variation from 220 to 400 nm. A FTIR analysis did not show drug spectra in the NPs in relation to the physical mixture, which suggests drug encapsulation without changing its chemical structure. A TGA analysis showed thermal stability up to 300 °C. In vitro release studies demonstrated gastroresistance and a sustained drug release at pH 7.4 (97.67 ± 0.32%) in 120 h. The kinetic model used for the release of MSZ from the NP-ZN in a pH 1.2 medium was the Fickian diffusion, in a pH 6.8 medium it was the Peppas-Sahlin model with the polymeric relaxation mechanism and in a pH 7.4 medium it was the Korsmeyer-Peppas model with the Fickian release mechanism, or "Case I". An in vitro cytotoxicity study in the CT26.WT cell line showed no basal cytotoxicity up to 500 µg/mL. The NP-ZN showed to be a promising vector for the sustained release of MSZ in the colon by oral route.

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(1) Background: Tuberculosis remains a public health problem in the world. This study evaluated the temporal trends, distribution, and spatial associations of drug-resistant tuberculosis in liberty-deprived populations in the state of Paraná, Brazil. (2) Methods: An ecological study was developed using all cases of drug-resistant tuberculosis in penal establishments reported by the Brazilian Notifiable Diseases Information System between 2008 and 2018. For the time trend, the Prais-Winsten method was used. To verify the spatial association, the Getis-Ord Gi* technique was used. (3) Results: During the study period, 653 cases of tuberculosis were reported in the studied population, of which 98 (15%) were drug-resistant. Prais-Winsten autoregression identified an increasing trend, with APC = 15.08% (95% CI: 0.02-0.09) from 2008 to 2018; when analyzed from 2012 to 2018, the trend increased even more, with APC = 23.31% (95% CI: 0.01-0.16). Hotspots were also noted in the north, east, and west macro-regions of the state. (4) Conclusions: The presence of drug-resistant tuberculosis, as well as an increasing trend of these cases, was evidenced in all regions of the state among liberty-deprived populations,. The spatial analysis revealed priority areas for drug-resistant tuberculosis in penal establishments.

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Formar docentes aptos à promoção do ensino preconizado pelas Diretrizes Curriculares Nacionais é fundamental na Odontologia. Este estudo objetivou relatar experiências formativas no estágio docente de alunos de Pós-Graduação em Odontologia, na área de Odontologia em Saúde Coletiva, de uma universidade brasileira, com integração ensino-serviço-comunidade, pelo método da reflexão crítica. As atividades foram conduzidas no eixo da Interação Comunitária, junto a centros de saúde da Secretaria Municipal de Saúde (SMS), e no projeto de extensão "Promoção de Saúde na Comunidade Escolardo Colégio de Aplicaçãoda UFSC". As práticas pedagógicas com graduandos, docentes, preceptores da SMS e pós-graduandos envolveram reuniões de equipes, usuários e conselhos de saúde, atividades intersetoriais, integração comunitária, clínica ampliada, promoção dasaúde bucal, com discussões crítico-reflexivas para significar o processo de trabalho em saúde bucal. Na extensão, realizaram-se parcerias com o Departamento de Odontologia da Universidade, a SMS e a Associação de Pais e Professor;reuniões interdisciplinares entre extensionistas, pós-graduandos e professores do colégio; atividades educacionais com metodologias ativas de ensino-aprendizagem (MAEA); emprego do Índice de Necessidades de Tratamento Odontológico; atividades de prevenção e atendimento clínico aos escolares. Houve aprendizagem pedagógica com conteúdos de epidemiologia, atenção à saúde, educação em saúde, planejamento, gestão e avaliação, controle social e aprendizados transversais. O estágio docente no contexto comunitário e de ensino-pesquisa-extensão favoreceuvínculos e as MAEA mostraram a potência do espaço formador para o futuro docente de Odontologia em Saúde Coletiva, capaz de promover uma formação mais harmônica ao perfil profissional almejado ao cirurgião-dentista (AU).

Training professors who are able to promote teaching based on the Brazilian National Curricular Guidelines is essential in Dentistry.This study aimed at reporting training experiences in the teaching internship for post-graduation students inCollective Health Dentistry in a Brazilian university with teaching-service-community integration bythe critical reflection method. The activities were developed in the Community Interaction axis, at the health centers in the Municipal Health Secretariat (Secretaria Municipal de Saúde-SMS) and in the extension project "Promotion of Health in the School Community of Colégio de Aplicação at UFSC".Pedagogical practices with graduating students, professors, SMS preceptors and post-graduating students includedmeetings with teams, users and health councils, inter-sectoral activities, community integration, expanded clinic, oral health promotion, withcritical-reflective discussions to signify the process of work in oral health. In the extension program, partnerships were developed with the University Department of Dentistry, SMSand the Parents and Teachers Association, inter-disciplinary meetings among the extension students, post-graduation students, and school professors; educating activities with active teaching-learning methodologies (Metodologias Ativas de Ensino-Aprendizagem -MAEA); use of the Dental Treatment Needs Index;activities for the prevention and clinical care forschool children. Pedagogical learning was obtained with content including epidemiology, health care, health education, planning, management and evaluation, social control, and transversal learnings. The internship in the community and teaching-research-extension context favored the bonds and the MAEA, emphasizing the potential of the training space for the future professor in Collective Health Dentistry, which is capable ofpromotinga more harmonious training to the professional profile sought by the dental surgeon (AU).

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Prevention of mother-to-child transmission programs have been one of the hallmarks of success in the fight against HIV/AIDS. In Brazil, access to antiretroviral therapy (ART) during pregnancy has increased, leading to a reduction in new infections among children. Currently, lifelong ART is available to all pregnant, however yet challenges remain in eliminating mother-to-child transmission. In this paper, we focus on the role of near-infrared (NIR) spectroscopy to analyse blood plasma samples of pregnant women with HIV infection to differentiate pregnant women without HIV infection. Seventy-seven samples (39 HIV-infected patient and 38 healthy control samples) were analysed. Multivariate classification of resultant NIR spectra facilitated diagnostic segregation of both sample categories in a fast and non-destructive fashion, generating good accuracy, sensitivity and specificity. This method is simple and low-cost, and can be easily adapted to point-of-care screening, which can be essential to monitor pregnancy risks in remote locations or in the developing world. Therefore, it opens a new perspective to investigate vertical transmission (VT). The approach described here, can be useful for the identification and exploration of VT under various pathophysiological conditions of maternal HIV. These findings demonstrate, for the first time, the potential of NIR spectroscopy combined with multivariate analysis as a screening tool for fast and low-cost HIV detection.

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Purpose: The purpose of this study was to evaluate the prevalence, severity, and distribution of molar incisor hypomineralization (MIH) and its association with socioeconomic characteristics among eight-year-old students from public schools in Petrópolis, Rio de Janeiro, Brazil. Methods: This cross-sectional study evaluated 450 eight-year-old Brazilian children. A questionnaire was used to assess socioeconomic factors (family income, maternal education, and person per household). MIH was diagnosed based on European Academy of Paediatric Dentistry criteria. The severity of MIH was evaluated at patient and tooth levels. The examinations were conducted in school environments. Descriptive analysis, chi-square, Fisher's exact, and Kruskal-Wallis tests were performed. Results: The prevalence of MIH was 28.7 percent. The average of affected molars and incisors was 2.25 (standard deviation [SD] equals 1.03) and 0.84 (1.22 SD). The maxillary molars were the most affected, but mandibular molars showed greater severity. The majority of MIH-children had white-creamy opacities (51.9 percent). There was no association between MIH and socioeconomic factors. MIH was more prevalent in boys (P=0.025). The number of incisors with MIH rose with the increasing number of affected molars (P=0.02). A significant association between severity and the mean number of affected molars was observed (P=0.004). Conclusions: The prevalence of molar incisor hypomineralization was 28.7 percent. MIH severity at the individual level was significantly associated with the number of affected teeth and the occurrence of affected incisors.

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The primary concern for HIV-infected pregnant women is the vertical transmission that can occur during pregnancy, in the intrauterine period, during labour or even breastfeeding. The risk of vertical transmission can be reduced by early diagnosis. Therefore, it is necessary to develop new methods to detect this virus in a quick and low-cost fashion, as colorimetric assays for HIV detection tend to be laborious and costly. Herein, attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy combined with multivariate analysis was employed to distinguish HIV-infected patients from healthy uninfected controls in a total of 120 blood plasma samples. The best sensitivity (83%) and specificity (92%) values were obtained using the genetic algorithm with linear discriminant analysis (GA-LDA). These good classification results in addition to the potential for high analytical frequency, the low cost and reagent-free nature of this method demonstrate its potential as an alternative tool for HIV screening during pregnancy.

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This is an integrative review that aimed to analyze the performance of the oral health team in home care within the Family Health Strategy, after the publication of the National Oral Health Policy Guidelines. Databases PubMed, Lilacs and SciELO were used in the 2004-2018 period. The selected papers (n=17) were organized in Excel sheet with data: author, year of publication, title, objectives, publishing journal, study location, type of study and thematic category. Two categories emerged from the thematic analysis: "Oral health practices in the household context and the work process of the oral health team" (n=11) and "Instruments for the management and evaluation of home care by the oral health team" (n=6). The scientific production showed low frequency of home visits, lack of prioritization and systematization of home care actions and weak interaction with the family health team. The home care protocols and instruments for the prioritization of home visits indicate the potential to overcome the clinical approach restricted to the dental office. Fourteen years into the publication of the National Oral Health Policy guidelines, the household is a territory to be conquered by the oral health team.

Trata-se de uma revisão integrativa com o objetivo de analisar a atuação da equipe de saúde bucal na atenção domiciliar no contexto da Estratégia Saúde da Família, após a publicação das Diretrizes da Política Nacional de Saúde Bucal. Utilizou-se as bases de dados PubMed, Lilacs e SciELO, no período de 2004-2018. Os artigos selecionados (n=17) foram organizados em planilha Excel com os dados: autor, ano de publicação, título, objetivos, periódico de publicação, localização do estudo, tipo de estudo e categoria temática. Da análise temática emergiram duas categorias: "Práticas de saúde bucal no contexto domiciliar e o processo de trabalho da equipe de saúde bucal" (n=11) e "Instrumentos de gestão e avaliação da atenção domiciliar para a equipe de saúde bucal" (n=6). A produção científica evidencia baixa frequência de visita domiciliar, falta de priorização e sistematização das ações de atenção domiciliar e pouca interação com a equipe de saúde da família. Os protocolos de atenção domiciliar e os instrumentos de priorização de visitas domiciliares indicam potenciais caminhos para superar o enfoque clínico restrito ao consultório odontológico. Decorridos 14 anos da publicação das diretrizes da Política Nacional de Saúde Bucal o domicílio configura-se em um território a ser conquistado pela equipe de saúde bucal.

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Resumo Trata-se de uma revisão integrativa com o objetivo de analisar a atuação da equipe de saúde bucal na atenção domiciliar no contexto da Estratégia Saúde da Família, após a publicação das Diretrizes da Política Nacional de Saúde Bucal. Utilizou-se as bases de dados PubMed, Lilacs e SciELO, no período de 2004-2018. Os artigos selecionados (n=17) foram organizados em planilha Excel com os dados: autor, ano de publicação, título, objetivos, periódico de publicação, localização do estudo, tipo de estudo e categoria temática. Da análise temática emergiram duas categorias: "Práticas de saúde bucal no contexto domiciliar e o processo de trabalho da equipe de saúde bucal" (n=11) e "Instrumentos de gestão e avaliação da atenção domiciliar para a equipe de saúde bucal" (n=6). A produção científica evidencia baixa frequência de visita domiciliar, falta de priorização e sistematização das ações de atenção domiciliar e pouca interação com a equipe de saúde da família. Os protocolos de atenção domiciliar e os instrumentos de priorização de visitas domiciliares indicam potenciais caminhos para superar o enfoque clínico restrito ao consultório odontológico. Decorridos 14 anos da publicação das diretrizes da Política Nacional de Saúde Bucal o domicílio configura-se em um território a ser conquistado pela equipe de saúde bucal.

Abstract This is an integrative review that aimed to analyze the performance of the oral health team in home care within the Family Health Strategy, after the publication of the National Oral Health Policy Guidelines. Databases PubMed, Lilacs and SciELO were used in the 2004-2018 period. The selected papers (n=17) were organized in Excel sheet with data: author, year of publication, title, objectives, publishing journal, study location, type of study and thematic category. Two categories emerged from the thematic analysis: "Oral health practices in the household context and the work process of the oral health team" (n=11) and "Instruments for the management and evaluation of home care by the oral health team" (n=6). The scientific production showed low frequency of home visits, lack of prioritization and systematization of home care actions and weak interaction with the family health team. The home care protocols and instruments for the prioritization of home visits indicate the potential to overcome the clinical approach restricted to the dental office. Fourteen years into the publication of the National Oral Health Policy guidelines, the household is a territory to be conquered by the oral health team.

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Phytohormones are natural chemical messengers that play critical roles in the regulation of plant growth and development as well as responses to biotic and abiotic stress factors, maintaining plant homeostasis, and allowing adaptation to environmental changes. The discovery of a new class of phytohormones, the brassinosteroids (BRs), almost 40 years ago opened a new era for the studies of plant growth and development and introduced new perspectives in the regulation of agronomic traits through their use in agriculture. BRs are a group of hormones with significant growth regulatory activity that act independently and in conjunction with other phytohormones to control different BR-regulated activities. Genetic and molecular research has increased our understanding of how BRs and their cross-talk with other phytohormones control several physiological and developmental processes. The present article provides an overview of BRs' discovery as well as recent findings on their interactions with other phytohormones at the transcriptional and post-transcriptional levels, in addition to clarifying how their network works to modulate plant growth, development, and responses to biotic and abiotic stresses.

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INTRODUCTION: The estimated involvement of the central nervous system in patients with multiple myeloma is rare at about 1%. The infiltration can be identified at the time multiple myeloma is diagnosed or during its progression. However, it is more common in refractory disease or during relapse. METHODS: This retrospective cohort study reviewed data from medical records of patients followed up at the Gammopathy Outpatient Clinic of Santa Casa de Misericórdia de São Paulo from January 2008 to December 2016. RESULTS: Twenty patients were included, with a median follow-up of 33.5 months after central nervous system infiltration. The prevalence was 7%. The median age at diagnosis of multiple myeloma was 56.1 years, with 70% of participants being female. Sixteen patients had central nervous system infiltration at diagnosis of multiple myeloma. Seventeen patients had exclusive osteodural lesions and three had infiltrations of the leptomeninge, of which one had exclusive involvement and two had associated osteodural lesions. The median overall survival was 40.3 months after central nervous system involvement. The median overall survival in the group with central nervous system infiltration at relapse was 7.4 months. The patients with leptomeningeal involvement had a median overall survival of 5.8 months. CONCLUSION: Central nervous system infiltration is a rare condition, but it should be considered as a possibility in patients with multiple myeloma and neurological symptoms. The best treatment regimen for this condition remains unknown and, in most cases, the prognosis is unfavorable.

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Abstract Introduction: The estimated involvement of the central nervous system in patients with multiple myeloma is rare at about 1%. The infiltration can be identified at the time multiple myeloma is diagnosed or during its progression. However, it is more common in refractory disease or during relapse. Methods: This retrospective cohort study reviewed data from medical records of patients followed up at the Gammopathy Outpatient Clinic of Santa Casa de Misericórdia de São Paulo from January 2008 to December 2016. Results: Twenty patients were included, with a median follow-up of 33.5 months after central nervous system infiltration. The prevalence was 7%. The median age at diagnosis of multiple myeloma was 56.1 years, with 70% of participants being female. Sixteen patients had central nervous system infiltration at diagnosis of multiple myeloma. Seventeen patients had exclusive osteodural lesions and three had infiltrations of the leptomeninge, of which one had exclusive involvement and two had associated osteodural lesions. The median overall survival was 40.3 months after central nervous system involvement. The median overall survival in the group with central nervous system infiltration at relapse was 7.4 months. The patients with leptomeningeal involvement had a median overall survival of 5.8 months. Conclusion: Central nervous system infiltration is a rare condition, but it should be considered as a possibility in patients with multiple myeloma and neurological symptoms. The best treatment regimen for this condition remains unknown and, in most cases, the prognosis is unfavorable.

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BACKGROUND: Chrysobalanus icaco is a medicinal plant commonly used to treat fungal infections in Brazilian Amazonian region. OBJECTIVE: This work aimed to evaluate the antifungal activity of the hydroalcoholic extract of C. icaco (HECi) against oral clinical isolates of Candida spp. and to determine the pharmacognostic parameters of the herbal drug and the phytochemical characteristics of HECi. MATERIALS AND METHODS: The pharmacognostic characterization was performed using pharmacopoeial techniques. Phytochemical screening, total flavonoid content, and high-performance liquid chromatography (HPLC) analysis were used to investigate the chemical composition of the HECi. A broth microdilution method was used to determine the antifungal activity of the extract against 11 oral clinical isolates of Candida spp. RESULTS: Herbal drug presented parameters which were within the limits set forth in current Brazilian legislation. A high amount of flavonoid content (132,959.33 ± 12,598.23 µg quercetin equivalent/g of extract) was found in HECi. Flavonoids such as myricetin and rutin were detected in the extract by HPLC analyses. HECi showed antifungal activity against oral isolates of Candida albicans and Candida parapsilosis (minimum inhibitory concentrations [MIC] 3.12 and 6.25 mg/mL, respectively), and C. albicans American American Type Culture Collection (MIC <1.56 mg/mL). CONCLUSION: HECi was shown to possess antifungal activity against Candida species with clinical importance in the development of oral candidiasis, and these activities may be related to its chemical composition. The antifungal activity detected for C. icaco against Candida species with clinical importance in the development of oral candidiasis can be attributed to the presence of flavonoids in HECi, characterized by chromatographic and spectroscopic techniques. SUMMARY: Chrysobalanus icaco presents a high amount of flavonoids in its constitutionLC analysis was able to identify the flavonoids myricetin and rutin in C. icaco hydroalcoholic extractThe C. icaco hydroalcoholic extract inhibits the growth of oral clinical isolates of Candida spp. and Candida albicans American Type Culture Collection. Abbreviations Used: HECi: Hydroalcoholic extract of C. icaco; HPLC: High performance liquid chromatography; AlCl3: Aluminum chloride; DMSO: Dimethyl sulfoxide; CH3NOONa: Sodium acetate; MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; ATCC: American Type Culture Collection; EMBRAPA: Brazilian Agricultural Research Corporation - Eastern Amazon; v/v: Volume per volume; SD: Standard deviation; TFC: Total flavonoid content; w/v: Weight per volume; ELSD: Evaporative light scattering detector; DAD: Diode-arrange detector; UFPA: Federal University of Pará; IEC: Evandro Chagas Institute; INCQS-FIOCRUZ: National Institute of Quality Control in Health - Fundação Oswaldo Cruz; SDA: Sabouraud Dextrose Agar; CFU: Colony-forming units; MIC: Minimum inhibitory concentrations; MFC: Minimum fungicidal concentrations.

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BACKGROUND: Immediate breast reconstruction has been increasingly incorporated as part of breast cancer treatment, especially for the psychological benefits. Currently, there are many options for breast reconstruction surgery, but the impact of the different techniques on body posture has not been widely studied. One study demonstrated that immediate breast reconstruction with a Beker-25 prosthesis could help to preserve body posture after mastectomy; however, there is no evidence regarding the effect of surgery on the body posture of women after breast reconstruction when using autologous tissue. PURPOSE: The purpose of this paper is to compare the body postures of women who underwent immediate breast reconstruction using an abdominal flap with those of women who underwent mastectomy alone. DESIGN: This is a cross-sectional study. SUBJECTS: Seventy-six women diagnosed with breast cancer underwent mastectomy, between 1 and 5 years after the diagnosis, are the participants of the study. Two groups were defined: women who underwent mastectomy and immediate breast reconstruction (n = 38) and women who underwent mastectomy alone (n = 38). PROCEDURE: To assess body posture, specific anatomical points for obtaining photographs were located and marked in anterior, posterior and right-side and left-side views. The photographs were analysed using Postural Analysis Software/Software de Análise Postural (PAS/SAPO). RESULTS: In the left lateral view, there was a significant difference in the vertical alignment of the trunk (4.2 vs 3.1; p = 0.05). There were no significant differences between the two groups for the variables in the anterior, posterior or right-side views. CONCLUSION: Women who underwent mastectomy alone, compared with women who underwent immediate breast reconstruction with abdominal flaps, showed differences in the vertical alignment of the trunk, with greater asymmetry between the acromion and greater trochanter, which can mean trunk rotation. No significant differences were found between the two groups in the alignment of the head, shoulders, scapula, or pelvis. Copyright © 2015 John Wiley & Sons, Ltd.

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As Diretrizes da Política Nacional de Saúde Bucal destacam a visita domiciliar (VD) como uma das principais formas de ampliação do acesso aos serviços e criação de vínculo com a população, caracterizando-a como um desafio para as Equipe de Saúde Bucal. A adequação dos cursos de Odontologia às Diretrizes Curriculares Nacionais (DCN) implica em preparar o egresso para essa abordagem, utilizando a VD como estratégia pedagógica. Esse estudo investigou as contribuições da VD na formação odontológica, por meio de uma revisão integrativa da produção científica nacional, no período entre 2004 a 2017, compondo uma síntese qualitativa da literatura. Foram pesquisadas quatro bases de dados por meio dos descritores ("home care" OR "home visits") AND ("dentistry" OR "oral health"). Nove estudos compuseram o corpo de análise desta revisão. Dos resultados emergiram quatro categorias: 1- Formação do cirurgião-dentista no Sistema Único de Saúde; 2- Compreensão ampliada do processo saúde-doença; 3- O trabalho interdisciplinar; 4- Humanização do Cuidado. Como contribuições à formação evidenciou-se que a VD propiciou ao estudante de Odontologia a vivência no território e a interação com usuários e profissionais da equipe de saúde. O contato do estudante com a VD possibilita o aprendizado do cuidado à saúde do usuário em seu contexto de vida, bem como a vivência do trabalho interdisciplinar, valorizando os diferentes saberes profissionais. O domicílio demonstrou-se como espaço singular para o aprendizado de vínculo, acolhimento e humanização, o que favorece a formação odontológica na perspectiva da clínica ampliada (AU).

The National Oral Health Policy Guidelines emphasize home visits (HV) as one of the main ways to increase access to services and engender bonds with population, considering the HV as a challenge for the Oral Health Team. The appropriateness of the Dentistry Courses (2002) to the National Curriculum Guidelines (DCN) involves preparing the former student for this approach, using the HV as a pedagogical strategy. This study investigated the contributions of the HV in dental education, through an integrative review of the national scientific production, between 2004 and 2017, composing a qualitative synthesis of the literature. Four databases were searched through these keywords ("home care" OR "home visits") AND ("dentistry" OR "oral health"). Nine articles composed the analysis of this review. From the results emerged four categories: 1 - Dental Education on Unified Health System (SUS); 2 - Enlargement of the health-disease process understanding; 3 - Interdisciplinary work; 4 - Care Humanization. As contributions to dental education, it was evidenced that the HV allowed the Dentistry student to experience the territory and interact with SUS users and professionals of the health team. The student's contact with the HV makes it possible to learn the health care of the user in their life context, as well as the experience of the interdisciplinary work, valuing the different professional knowledge. The household was shown as a unique space for learning of bond relationship, reception and humanization, which favors dental education from the perspective of the expanded clinic (AU).

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RESUMEN

No contexto do processo de regionalização do Sistema Único de Saúde (SUS) surgiram iniciativas para promover as regiões de saúde e seus municípios circunscritos por meio do apoio, que busca reformular os tradicionais mecanismos de gestão. Propõe-se o conceito de apoio regional, que se iniciou, na cidade do Rio de Janeiro, Brasil, com o objeto deste trabalho: o Projeto Apoiadores Regionais, criado pelo Conselho de Secretários Municipais de Saúde do Estado do Rio de Janeiro (Cosems-RJ) em parceria com o Laboratório de Pesquisas sobre Práticas de Integralidade em Saúde, Universidade do Estado do Rio de Janeiro (Lappis-Uerj). Na análise do projeto, utilizou-se a sistematização da experiência, gerando uma interpretação crítica. Entende-se que houve importante ampliação do papel do Cosems-RJ nos espaços de governança regional, destacando-se os novos instrumentos de gestão criados. Conclui-se com a visão de longo prazo acerca do projeto e suas possíveis consequências para o SUS...

In the context of the Brazilian Health System (SUS) regionalization process, some initiatives have been promoting the health regions and their municipalities through the support, which seeks to reformulate the traditional health management mechanisms. Therefore, it is proposed the concept of rregional support, whose field is the interfederative relations of health regions, started in Rio de Janeiro, as object of this work: the Regional Supporters Project, created by Conselho de Secretários Municipais de Saúde do Estado do Rio de Janeiro (Cosems-RJ) in partnership with Laboratório de Pesquisas sobre Práticas de Integralidade em Saúde, Universidade do Estado do Rio de Janeiro (Lappis-Uerj). To analyze this project, the experience systematization was used, in order to create a critical interpretation of the experiences. It is explained, then, that there was significant expansion of the Cosems-RJ role in regional governance spaces, and the new management tools are presented. Finally, this work concludes with a long-term vision of the project and its possible consequences for the Brazilian health system...

En el proceso de regionalización del Sistema Brasileño de Salud (SUS), iniciativas promoven las regiones de salud y sus municipios por medio del apoyo, que busca reformular mecanismos de gestión tradicionales. Se propone el concepto de apoyo regional, cuyo campo de acción son las relaciones interfederativas de las regiones de salud y comenzó, en Rio de Janeiro, con el Proyecto Apoyadores Regionales, creado por el Conselho de Secretários Municipais de Saúde do Estado do Rio de Janeiro (Cosems-RJ) y el Laboratório de Pesquisas sobre Práticas de Integralidade em Saúde, Universidade do Estado do Rio de Janeiro (Lappis-Uerj). Para analisar el proyecto, se apropió de la sistematización de la experiencia, para generar una interpretación crítica. Se entiende que hubo expansión significativa de la función del Cosems-RJ en los espacios de gobernanza regional y fueron destacadas las nuevas herramientas de gestión creadas. Se concluye con uma visión a largo plazo acerca del proyecto y sus posibles consecuencias para el SUS...

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