RESUMEN

Rosai-Dorfman Disease (RDD) is a rare non-Langerhans histiocytosis, usually self-limited and presenting with massive, painless, bilateral cervical lymphadenopathy, with or without constitutional symptoms. Extranodal disease is frequently present, and may happen in the absence of lymph node involvement, symptomatology and differential diagnosis will depend on the site affected and fatal cases may occur. The authors present two cases of Rosai-Dorfman disease (RDD), diagnosed through immunohistochemistry, with different progressions, one with complete remission and one culminating in death, highlighting the variety of presentations and the diagnostic difficulty. RDD is a rare condition with clinical presentations similar to several diseases, and should be considered in the differential diagnosis of lymphadenopathy with extranodal lesions.

RESUMEN

OBJECTIVE: Patients with cancer often undergo multiple extended treatments that decrease their quality of life. However, the quality of life of women with breast cancer after they undergo treatment remains underexplored in Brazil. Therefore, this study determined sociodemographic, behavioral, and clinical factors related to the post-treatment quality of life of women with breast cancer. METHODS: This cross-sectional study involved 101 women diagnosed with breast cancer between 2014 and 2016 and treated at a Brazilian Oncology Reference Service. Data were collected from them using face-to-face surveys. Quality of life was evaluated using the European Organization for the Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30) and EORTC Breast Cancer-specific Quality of Life questionnaire (EORTC QLQ-BR23). The data collected were analyzed using Student's t-test and Mann-Whitney U test. RESULTS: The median score on the global health, functional, and symptom scales of the EORTC QLQ-C30 was 75.00 (Interquartile range=33.33), 75.99 (Standard deviation [SD]=19.26), and 19.67 (SD=16.91), respectively. The mean score on the functional and symptom scales of the EORTC QLQ-BR23 was 61.89 (SD=17.21) and 20.12 (SD=16.94), respectively. Furthermore, higher post-treatment quality of life was found to be associated with being aged 50 or more, being Black, having eight or more years of education, having a partner, having a paying job, receiving treatment from the private healthcare system, having a higher income, living in the municipality where healthcare services are availed, engaging in physical activity, not smoking, being more religious, having more social support, not being overweight, having no comorbidities, and undergoing lumpectomy. CONCLUSION: Sociodemographic, behavioral, and clinical factors significantly impact the quality of life of women who undergo breast cancer treatment. Implementing interventions that improve health and reducing inequalities in the access to healthcare services can improve the quality of life of these patients. BACKGROUND: Sociodemographic, clinical, and lifestyle factors impact the quality of life of breast cancer survivors. BACKGROUND: Breast cancer therapy may affect future perspectives and emotional, cognitive, and sexual function. BACKGROUND: Some aspects of quality of life still require attention from health professionals. BACKGROUND: Higher post-treatment quality of life of women with breast cancer is linked to being aged 50 or more, being Black, having 8 or more years of education, having a partner, having a paying job, receiving care from private healthcare, having a high per capita income, residing in the municipality where the service is availed, engaging in physical activity, not smoking, greater religiosity, having more social support, having a normal weight, having no comorbidities, and undergoing lumpectomy.

Asunto(s)

RESUMEN

Scissor bite does not correct spontaneously. It gradually worsens by overeruption, negatively affecting masticatory function. It is intended with this manuscript to evaluate the different treatment strategies to correct this malocclusion in adult patients, exploring treatment with clear aligners, bite ramps, and MS (miniscrews), especially in this case of a patient with unilateral right scissor bite, with high dental compensation in the three planes of space, asymmetrical sagittal dental position, overeruption on the scissor bite condition, and a high mandibular arch constriction and maxillary expansion. A comprehensive literature research was performed from 2002 until March 2023. PubMed and BVS databases were used, with the following keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". Since correcting skeletal asymmetries after the growth completion is challenging, adult patient cases often involve a combined orthodontic-surgical approach. In the present clinical case, the severe limitations to decompensating tooth positions for a surgical treatment, with the necessity to perform lower asymmetric extraction and a must longer orthodontic treatment, were the major reasons to avoid the surgical approach, after the scissor bite correction. In spite of this, the efficiency of the clear aligners and auxiliaries like bite ramps, MS, and elastics in successfully correcting a complex scissor bite in an adult patient was demonstrated, with significant esthetic and functional commitment, demonstrated by the case reliability PAR (peer assessment rating) index.

RESUMEN

ABSTRACT Objective Patients with cancer often undergo multiple extended treatments that decrease their quality of life. However, the quality of life of women with breast cancer after they undergo treatment remains underexplored in Brazil. Therefore, this study determined sociodemographic, behavioral, and clinical factors related to the post-treatment quality of life of women with breast cancer. Methods This cross-sectional study involved 101 women diagnosed with breast cancer between 2014 and 2016 and treated at a Brazilian Oncology Reference Service. Data were collected from them using face-to-face surveys. Quality of life was evaluated using the European Organization for the Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30) and EORTC Breast Cancer-specific Quality of Life questionnaire (EORTC QLQ-BR23). The data collected were analyzed using Student's t-test and Mann-Whitney U test. Results The median score on the global health, functional, and symptom scales of the EORTC QLQ-C30 was 75.00 (Interquartile range=33.33), 75.99 (Standard deviation [SD]=19.26), and 19.67 (SD=16.91), respectively. The mean score on the functional and symptom scales of the EORTC QLQ-BR23 was 61.89 (SD=17.21) and 20.12 (SD=16.94), respectively. Furthermore, higher post-treatment quality of life was found to be associated with being aged 50 or more, being Black, having eight or more years of education, having a partner, having a paying job, receiving treatment from the private healthcare system, having a higher income, living in the municipality where healthcare services are availed, engaging in physical activity, not smoking, being more religious, having more social support, not being overweight, having no comorbidities, and undergoing lumpectomy. Conclusion Sociodemographic, behavioral, and clinical factors significantly impact the quality of life of women who undergo breast cancer treatment. Implementing interventions that improve health and reducing inequalities in the access to healthcare services can improve the quality of life of these patients.

RESUMEN

OBJECTIVES: to construct and validate an educational video storyboard about care for premature newborns at home. METHODS: a methodological study, with the construction of an educational video storyboard, validated with 14 judges. Content was selected from scoping review. For data collection, a validated instrument was used. The criterion for validity was agreement greater than 80%, analyzed using the Content Validity Index. RESULTS: the storyboard construction was guided by the Cognitive Theory of Multimedia Learning theoretical framework. Construction and validity took place from May to December 2020. The storyboard's final version lasted 10 minutes, and was validated in terms of objective, structure, presentation and relevance, with a Content Validity Index of 0.9. CONCLUSIONS: the storyboard of the educational video proved to be valid and adequate for health promotion in developing care for premature newborns at home.

Asunto(s)

RESUMEN

Background: The incidence of breast cancer is increasing globally; however, survival outcomes vary and are lower in developing countries. Methods: We analyzed the 5- and 10-year survival rates for breast cancer according to the type of healthcare insurance (public vs. private) in a referral center for cancer care in the Brazilian southeast region. This hospital-based cohort study included 517 women diagnosed with invasive breast cancer between 2003 and 2005. The Kaplan-Meier method was used to estimate the probability of survival, and the Cox proportional hazards regression model was used to assess prognostic factors. Results: The 5- and 10-year breast cancer survival rates were as follows: private healthcare service survival rate of 80.6% (95% CI 75.0-85.0) and 71.5% (95% CI 65.4-77.1), respectively, and public healthcare service survival rate of 68.5% (95% CI 62.5-73.8) and 58.5% (95% CI 52.1-64.4), respectively. The main factors associated with the worst prognosis were lymph node involvement in both healthcare services and tumor size >2 cm only in public health services. The use of hormone therapy (private) and radiotherapy (public) was associated with the best survival rates. Conclusions: The survival discrepancies found between health services can be explained mainly by the difference in the stage of the disease at the time of diagnosis, indicating inequalities in access to the early detection of breast cancer.

RESUMEN

Scissor bite (SB.) is a rare malocclusion that is challenging to diagnose and is often associated with a retrognathic mandible and a series of functional and structural abnormalities that negatively affect the patient. This article intends to analyze the treatment approaches applied to growing patients younger than 16 years old, comparing the conventional appliances described in the literature and a clinical case treated with clear aligners with mandibular advancement (MA.). SB is primarily related to skeletal Class I and II, according to Angle classification. In the various cases analyzed, it can also be mentioned as a significant number of cases with SB of dental origin (seven of dental and four of skeletal) in young patients. In children and adolescents who still have growth potential, the therapeutic possibilities are numerous. A comprehensive literature search was manually performed from 2002 until January 2023, in PubMed and BVS databases with the following conjugated keywords: "scissor bite OR brodie bite" AND "malocclusion" AND "treatment OR correction OR therapeutics". The present case report on a young patient demonstrated the efficiency of the clear aligners with MA to correct an SB, associated with several functional and structural anomalies such as Class II division 1 with an increased overjet and overbite as well as a severe curve of Spee in a hypodivergent biotype.

RESUMEN

BACKGROUND: Clear aligners (CA) are used 22 h daily, creating a bite-block effect. This work aims to (i) analyze occlusal changes before the beginning of treatment, after the first set of CA and after the use of additional aligners; (ii) compare planned occlusal contacts with the ones obtained after the first set of CA; (iii) analyze the occlusal changes occurred after reaching the orthodontic goals after 3 months of using CA only at night; (iv) evaluate and characterize which tooth movements did not allow the treatment to be completed at the end of the first set of aligners, and finally (v) verify the possible relation between the changes in occlusal contact and areas and parameters such as case complexity and facial biotype. MATERIALS AND METHODS: A quantitative, comparative, and observational longitudinal cohort study design was implemented to evaluate the clinical data and the complexity levels of cases receiving CA. A non-probabilistic and convenience sample of 82 individuals was recruited. The orthodontic malocclusion traits were classified as simple, moderate, or complex corrections based on the basis of the Align® recommendations with the Invisalign® evaluation tool. According to the Invisalign® criteria, patients need only one complex problem for their case to be classified as complex. Meshlab® v. 2022.02, ClinCheck® version Pro 6.0, My-Itero® version 2.7.9.601 5d plus, and IBM® SPSS Statistics software (Statistical Program for Social Sciences), version 27.0 for Windows were the software® used. RESULTS: A statistically significant decrease in area and occlusal contacts number were observed from before the start of orthodontic treatment (T0) to the end of treatment (T1). The changes in the occlusal area (from T0 to T1) were statistically different between hyperdivergent (28.24 [15.51-40.91]) and hypodivergent (16.23 [8.11-24.97]) biotypes (p = 0.031). A significant difference between the hyperdivergent (4.0 [2.0-5.0]) and normodivergent (5.5 [4.0-8.0]) group was found in T1 for the anterior contacts (p = 0.044). Anterior contacts obtained were significantly higher than the planned (p = 0.037) Between T1 and T2 statistically significant increases of occlusal areas, posterior and total contacts were observed. CONCLUSIONS: Occlusal contact and area were decreased, either at the end of the first set or after the use of additional aligners. Anterior occlusal contacts obtained were higher than planned as opposed to posterior occlusal contacts obtained. The hardest tooth movements to achieve to complete the treatment were distalization, rotation, and posterior extrusion. After completing orthodontic treatment (T1) to 3 months after (T2) using additional aligners only at night, posterior occlusal contacts were significantly increased, which could be due to the natural settling of the teeth in this period.

RESUMEN

ABSTRACT Objectives: to construct and validate an educational video storyboard about care for premature newborns at home. Methods: a methodological study, with the construction of an educational video storyboard, validated with 14 judges. Content was selected from scoping review. For data collection, a validated instrument was used. The criterion for validity was agreement greater than 80%, analyzed using the Content Validity Index. Results: the storyboard construction was guided by the Cognitive Theory of Multimedia Learning theoretical framework. Construction and validity took place from May to December 2020. The storyboard's final version lasted 10 minutes, and was validated in terms of objective, structure, presentation and relevance, with a Content Validity Index of 0.9. Conclusions: the storyboard of the educational video proved to be valid and adequate for health promotion in developing care for premature newborns at home.

RESUMEN Objetivos: construir y validar un video storyboard educativo sobre el cuidado del recién nacido prematuro en el domicilio. Métodos: estudio metodológico, con la construcción de un storyboard de video educativo, validado con 14 jueces. El contenido fue seleccionado de la revisión del alcance. Para la recolección de datos se utilizó un instrumento validado. El criterio de validación fue concordancia superior al 80%, analizado mediante el Índice de Validación de Contenido. Resultados: la construcción del storyboard fue guiada por el referencial teórico de la Teoría Cognitiva del Aprendizaje Multimedia. La construcción y validación se llevó a cabo de mayo a diciembre de 2020. La versión final del storyboard tiene una duración de 10 minutos y fue validada en cuanto a objetivos, estructura, presentación y relevancia, con un Índice de Validez de Contenido de 0,9. Conclusiones: el storyboard del video educativo se mostró válido y adecuado para la promoción de la salud en el desarrollo de la atención al recién nacido prematuro en el domicilio.

RESUMO Objetivos: construir e validar storyboard de vídeo educativo acerca dos cuidados com recém-nascido prematuro no domicílio. Métodos: estudo metodológico, com construção de storyboard de vídeo educativo, validado com 14 juízes. Selecionou-se o conteúdo a partir de revisão de escopo. Para coleta dos dados, utilizou-se instrumento validado. O critério para validação foi concordância superior a 80%, analisada por meio do Índice de Validação de Conteúdo. Resultados: a construção do storyboard foi guiada pelo referencial teórico da Teoria Cognitiva da Aprendizagem Multimídia. A construção e a validação ocorreram nos meses de maio a dezembro de 2020. A versão final do storyboard contém duração de 10 minutos, e foi validada quanto aos objetivos, estrutura, apresentação e relevância, com Índice de Validade de Conteúdo de 0,9. Conclusões: o storyboard do vídeo educativo se mostrou válido e adequado para promoção da saúde no desenvolvimento de cuidados ao recém-nascido prematuro no domicílio.

RESUMEN

Objetivo: descrever e analisar criticamente a vertente relativista da Teoria fundamentada nos dados (TFD), incluindo uma abordagem de como utilizar este referencial metodológico nas pesquisas qualitativas em enfermagem. Conteúdo: estudo teórico reflexivo organizado em três tópicos. Primeiramente apresenta a evolução da TFD e o legado straussiano; na sequência as características metodológicas da vertente relativista e, por fim, as contribuições da TFD relativista para as pesquisas em enfermagem brasileira. Considerações finais: trata-se de um referencial apropriado para estudos na enfermagem, por possibilitar a geração de modelos explicativos, a partir da prática de enfermagem, e por fornecer subsídios para os profissionais de saúde refletirem sobre o seu fazer com vistas a otimizar a qualidade do cuidado.

Objective: to describe and critically analyze the relativistic aspect of Grounded Theory (GT), also addressing how to use this methodological framework in qualitative research in Nursing. Content: this reflective, theoretical study was organized into three topics: first, the evolution of GT and the legacy of Strauss; then, the methodological characteristics of the relativistic approach; and, finally, the contributions of relativist GT to Brazilian Nursing research. Final considerations: this framework is appropriate for nursing studies, as it makes it possible to generate explanatory models based on nursing in practice and provides input for health personnel to reflect on their own practice, in order to optimize the quality of care.

Objetivo: describir y analizar críticamente el aspecto relativista de la Teoría fundamentada en los datos (TFD), incluyendo un enfoque sobre cómo utilizar ese marco metodológico en las investigaciones cualitativas en enfermería. Contenido: estudio teórico reflexivo organizado en tres temas. Primero, presenta la evolución de la TDF y el legado straussiano; luego, las características metodológicas de la corriente relativista y, finalmente, las contribuciones de la TDF relativista a las investigaciones en enfermería brasileña. Consideraciones finales: se trata de un marco apropiado para los estudios de enfermería, ya que permite la generación de modelos explicativos, basados en la práctica de enfermería, y que proporciona subsidios para que los profesionales de la salud reflexionen sobre su propia práctica, con el fin de optimizar la calidad del cuidado.

RESUMEN

The increasing demand for more aesthetic/comfortable orthodontic alternatives fostered the utilization of clear aligners in recent years. However, the efficacy of clear aligners for treating complex malocclusions is often treated with scepticism. This case series aims to evaluate the predictability of the Invisalign® First system in moderate and severe cases requiring interceptive orthodontic treatments in mixed dentition. A total of 23 patients with 102 interceptive orthodontic malocclusion traits were selected for orthodontic treatment with Invisalign® First and were examined over 18 months (Phase 1). Clinical assessments included ClinCheck® predictions, cephalometric measurements, and measuring tools commonly used to quantify tooth movement. Measurements taken at the beginning and end of the treatment were compared. The complexity degree of each case was established based on the set of problems presented by each patient. All treatment objectives were achieved within 18 months, except for two Class II cases, with 69% of them solved with the first set of aligners. Additional aligners were used in the remaining cases. Even though these 23 cases suggest that the Invisalign® First (Phase 1) may be effective in most interceptive problems, controlled randomized clinical trials are required to evaluate movement predictability and how this relates to the problem complexity and additional aligners required.

RESUMEN

Abstract Objective The study aimed to characterize the clinical, histological, and immunohistochemical profile of women with invasive breast cancer, according to the risk for Hereditary Predisposition Breast and Ovarian Cancer Syndrome in a Brazilian population. Methods This is a retrospective study performed from a hospital-based cohort of 522 women, diagnosed with breast cancer treated at an oncology referral center in the Southeast region of Brazil, between 2014 and 2016. Results Among the 430 women diagnosed with invasive breast cancer who composed the study population, 127 (29.5%) were classified as at increased risk for hereditary predisposition to breast and ovarian cancer syndrome. There was a lower level of education in patients at increased risk (34.6%) when compared with those at usual risk (46.0%). Regarding tumor characteristics, women at increased risk had higher percentages of the disease diagnosed at an advanced stage (32.3%), and with tumors > 2cm (63.0%), with increased prevalence for both characteristics, when compared with those at usual risk. Furthermore, we found higher percentages of HG3 (43.3%) and Ki-67 ≥ 25% (64.6%) in women at increased risk, with prevalence being about twice as high in this group. The presence of triple-negative tumors was observed as 25.2% in women at increased risk and 6.0% in women at usual risk, with the prevalence of absence of biomarkers being 2.5 times higher among women in the increased risk group. Conclusion From the clinical criteria routinely used in the diagnosis of breast cancer, the care practice of genetic counseling for patients at increased risk of hereditary breast cancer in contexts such as Brazil is still scarce.

Resumo Objetivo O presente estudo buscou caracterizar o perfil clínico, histológico e imunohistoquímico de mulheres com câncer de mama invasivo segundo o risco para a Síndrome de Predisposição Hereditária ao Câncer de Mama e Ovário em uma população brasileira. Métodos Trata-se de um estudo retrospectivo realizado a partir de uma coorte hospitalar composta por 522 mulheres diagnosticadas com câncer de mama entre 2014 e 2016 assistidas em um centro de referência oncológica localizado na região sudeste brasileira. Resultados Entre as 430 mulheres diagnosticadas com câncer de mama invasivo que compuseram a população de estudo, 127 (29,5%) foram classificadas como de risco aumentado para a síndrome de predisposição hereditária ao câncer de mama e ovário. Verificou-se menor nível de escolaridade nas pacientes com risco aumentado (34,6%) quando comparadas àquelas consideradas como de risco habitual (46,0%). Quanto às características do tumor, as mulheres de risco aumentado apresentaram maiores percentuais de doença diagnosticada em estádio avançado (32,3%) e com tumores > 2cm (63,0%), com prevalência aumentada para ambas as características, quando comparadas àquelas de risco habitual. Ainda nas mulheres de risco aumentado, foram encontrados maiores percentuais de GH3 (43,3%) e Ki-67 ≥ 25% (64,6%), com prevalência cerca de duas vezes maior neste grupo. A presença de tumores triplo-negativos foi observada em 25,2% nas mulheres de risco aumentado e 6,0% nas mulheres de risco habitual, com prevalência de ausência de biomarcadores 2,5 vezes maior entre as mulheres do grupo de risco aumentado. Conclusão A partir dos critérios clínicos rotineiramente utilizados no diagnóstico do câncer de mama, a prática assistencial do aconselhamento genético para as pacientes com risco aumentado de câncer de mama hereditário em contextos como o do Brasil ainda é escarça.

Asunto(s)

RESUMEN

OBJECTIVE: To analyze the time to diagnosis and treatment for breast cancer and the associated factors, according to the type of care (public vs. private). METHODOLOGY: Retrospective cohort study with 477 women diagnosed with breast cancer between 2014 and 2016. Data were collected in an oncology service in a municipality in Minas Gerais, in the 2018-2019 period. Analyzes were performed using the Kaplan-Meier method and Cox's proportional regression model. RESULTS: The median time to diagnosis was 70 days, being shorter for women who discovered the disease through screening tests and who were diagnosed in early stages of the disease. The median time for treatment was 32 days, which was shorter for women assisted by private health service, with a high level of education and who were diagnosed in early stages. CONCLUSIONS: Private care and facilitators of access to breast cancer care were associated with shorter waiting times.

Asunto(s)

RESUMEN

OBJECTIVE: The study aimed to characterize the clinical, histological, and immunohistochemical profile of women with invasive breast cancer, according to the risk for Hereditary Predisposition Breast and Ovarian Cancer Syndrome in a Brazilian population. METHODS: This is a retrospective study performed from a hospital-based cohort of 522 women, diagnosed with breast cancer treated at an oncology referral center in the Southeast region of Brazil, between 2014 and 2016. RESULTS: Among the 430 women diagnosed with invasive breast cancer who composed the study population, 127 (29.5%) were classified as at increased risk for hereditary predisposition to breast and ovarian cancer syndrome. There was a lower level of education in patients at increased risk (34.6%) when compared with those at usual risk (46.0%). Regarding tumor characteristics, women at increased risk had higher percentages of the disease diagnosed at an advanced stage (32.3%), and with tumors > 2cm (63.0%), with increased prevalence for both characteristics, when compared with those at usual risk. Furthermore, we found higher percentages of HG3 (43.3%) and Ki-67 ≥ 25% (64.6%) in women at increased risk, with prevalence being about twice as high in this group. The presence of triple-negative tumors was observed as 25.2% in women at increased risk and 6.0% in women at usual risk, with the prevalence of absence of biomarkers being 2.5 times higher among women in the increased risk group. CONCLUSION: From the clinical criteria routinely used in the diagnosis of breast cancer, the care practice of genetic counseling for patients at increased risk of hereditary breast cancer in contexts such as Brazil is still scarce.

OBJETIVO: O presente estudo buscou caracterizar o perfil clínico, histológico e imunohistoquímico de mulheres com câncer de mama invasivo segundo o risco para a Síndrome de Predisposição Hereditária ao Câncer de Mama e Ovário em uma população brasileira. MéTODOS: Trata-se de um estudo retrospectivo realizado a partir de uma coorte hospitalar composta por 522 mulheres diagnosticadas com câncer de mama entre 2014 e 2016 assistidas em um centro de referência oncológica localizado na região sudeste brasileira. RESULTADOS: Entre as 430 mulheres diagnosticadas com câncer de mama invasivo que compuseram a população de estudo, 127 (29,5%) foram classificadas como de risco aumentado para a síndrome de predisposição hereditária ao câncer de mama e ovário. Verificou-se menor nível de escolaridade nas pacientes com risco aumentado (34,6%) quando comparadas àquelas consideradas como de risco habitual (46,0%). Quanto às características do tumor, as mulheres de risco aumentado apresentaram maiores percentuais de doença diagnosticada em estádio avançado (32,3%) e com tumores > 2cm (63,0%), com prevalência aumentada para ambas as características, quando comparadas àquelas de risco habitual. Ainda nas mulheres de risco aumentado, foram encontrados maiores percentuais de GH3 (43,3%) e Ki-67 ≥ 25% (64,6%), com prevalência cerca de duas vezes maior neste grupo. A presença de tumores triplo-negativos foi observada em 25,2% nas mulheres de risco aumentado e 6,0% nas mulheres de risco habitual, com prevalência de ausência de biomarcadores 2,5 vezes maior entre as mulheres do grupo de risco aumentado. CONCLUSãO: A partir dos critérios clínicos rotineiramente utilizados no diagnóstico do câncer de mama, a prática assistencial do aconselhamento genético para as pacientes com risco aumentado de câncer de mama hereditário em contextos como o do Brasil ainda é escarça.

Asunto(s)

RESUMEN

Introduction: There is a growing demand for more aesthetic, comfortable, and faster orthodontic treatments, and clear aligners emerged as a solution to fulfill this need. However, the effectiveness of clear aligners to treat complex malocclusions is yet contentious. The use of acceleration methods could improve the efficacy of clear aligners by stimulating cells' mechanobiology through numerous pathways, but this hypothesis is still poorly explored. Objective: We aimed to monitor the release profile of an inflammatory marker-the interleukin-1ß-and to evaluate its relationship with self-reported pain scores with and without the use of acceleration techniques during an orthodontic treatment requiring difficult tooth movements with clear aligners. Case Report. Here, we report a case of a 46-year-old female patient who presented functional and aesthetic complaints. Intraoral examination revealed a diminished overjet and overbite, rotation of teeth 45 and 24, absence of teeth 25, 35, and 36, buccolingual dislocation of tooth 21, a tendency to a Class III malocclusion, and a 2 mm left deviation of the lower midline. This study is divided into three stimulation phases: no stimulation, mechanical vibration stimulation, and photobiomodulation. Interleukin-1ß levels in gingival crevicular fluid samples from the pressure side of six selected teeth were evaluated at four time points after the orthodontic treatment onset. Pain monitoring in those teeth was performed using a visual analogue scale at the same time points. Results: Interleukin-1ß protein production peaked 24 h after treatment onset. Complex movements were associated with increased self-reported pain. Conclusion: Clear aligners show limitations in solving complex tooth movements, even when combined with acceleration. The development of customized and programmable stimulation microdevices integrated into "smart aligners," which could be designed to specifically stimulate the direction of movement and stimulation parameters and could constitute a solution to optimize the orthodontic tooth movement with clear aligners.

RESUMEN

ABSTRACT An extensive review of primary and secondary occurrence data, including several new records, of the South American native antlion Dimares elegans (Perty) revealed that this species is endemic to regions of stressful water regime (Caatinga, Cerrado, Chaco and temperate fields) and adjacent areas in Amazon rainforest, Atlantic forest and Pampas. Its known distribution is from Santarém, Pará state, northern Brazil to Río Negro, Chimpay, northwestern Argentina. The known distribution of the species in Brazil has been extended, registering several areas above the São Francisco River (former possible northeastern limit). New limits further east were established from new primary records. For the first time the species is registered from the Brazillian states of Maranhão, Piauí, Rio Grande do Norte, Paraíba, Bahia, Goiáis, Tocantins, Minas Gerais, Mato Grosso do Sul, São Paulo and Paraná, Brazil. Historical data of occurrence in Goiás (Cerrado) have been geopolitically rectified (Tocantins) and, present occurrence in Goiás is reported by primary data in two new localities. Antlions are mostly xerofilous species, however with recent data this species might present much wider distribution than restricted to seasonally dry forests.

RESUMEN

ABSTRACT Objective: To analyze the time to diagnosis and treatment for breast cancer and the associated factors, according to the type of care (public vs. private). Methodology: Retrospective cohort study with 477 women diagnosed with breast cancer between 2014 and 2016. Data were collected in an oncology service in a municipality in Minas Gerais, in the 2018-2019 period. Analyzes were performed using the Kaplan-Meier method and Cox's proportional regression model. Results: The median time to diagnosis was 70 days, being shorter for women who discovered the disease through screening tests and who were diagnosed in early stages of the disease. The median time for treatment was 32 days, which was shorter for women assisted by private health service, with a high level of education and who were diagnosed in early stages. Conclusions: Private care and facilitators of access to breast cancer care were associated with shorter waiting times.

RESUMEN Objetivo: Analizar el tiempo de diagnóstico y tratamiento del cáncer de mama y los factores asociados, según el tipo de assistência (pública vs. privada). Metodología: Cohorte retrospectiva con 477 mujeres diagnosticadas de cáncer de mama entre 2014-2016. Los datos fueron recolectados en un servicio de oncología de Minas Gerais, en el período 2018-2019. Los análisis se realizaron mediante el método de Kaplan-Meier y el modelo de regresión de Cox. Resultados: Mediana de tiempo para el diagnóstico fue de 70 días - menor para las que descubrieron la enfermedad mediante pruebas de detección y que fueron diagnosticadas en etapas tempranas. Mediana de tiempo para tratamiento fue de 32 días - menor para las atendidas por la red privada, con alto nivel educativo y diagnosticadas en etapas tempranas. Conclusiones: Asistencia en la red privada y facilitadores de acceso a la atención del cáncer de mama asociados a tiempos de espera más cortos.

RESUMO Objetivo: Analisar o tempo para o diagnóstico e tratamento do câncer de mama e os fatores associados, segundo o tipo de assistência (pública vs. privada). Métodos: Coorte retrospectiva com 477 mulheres diagnosticadas com câncer de mama entre 2014-2016. Os dados foram coletados em um serviço de oncologia de um município de Minas Gerais, entre 2018-2019. As análises foram realizadas pelo método de Kaplan-Meier e pelo modelo de regressão de Cox. Resultados: O tempo mediano para diagnóstico foi de 70 dias, sendo menor para aquelas que descobriram a doença por exames de rastreamento e diagnosticadas em estádios iniciais. O tempo mediano para o tratamento foi de 32 dias, sendo menor para as mulheres assistidas pela rede privada, com alta escolaridade e diagnosticadas em estádios iniciais. Conclusões: Assistência na rede privada e facilitadores do acesso ao cuidado do câncer de mama associaram-se a menores tempos de espera.

RESUMEN

Objetivo: Avaliar a prevalência de sepse, em um Centro de Terapia Intensiva, de um hospital de ensino. Metodologia: Estudo descritivo, exploratório, retrospectivo, com abordagem quantitativa, realizado em Centro de Terapia Intensiva de um hospital de referência em Teresina-PI, Brasil, cujos dados foram coletados em 221 prontuários de pacientes internados nesse setor, no ano de 2018. A análise dos dados foi realizada com o Stastistical Package for the Social Sciennces, por meio de estatística descritiva e inferencial. Resultados: A prevalência de sepse no Centro de Terapia Intensiva investigado foi de 20,36% (n=45). A média de permanência neste foi de 10,73 dias (DP ± 15,53) e a maioria evoluiu para óbito 62,2% (n=28). Conclusões: A prevalência de sepse no presente estudo foi baixa, se comparada ao índice mundial que é mais elevado. Trata-se de problema de saúde pública, de alto custo para os serviços e que acarreta mortalidade. (AU)

Objective: To analyze the prevalence of Sepsis in Intensive Care Unit from a teaching hospital. Methods: Descriptive study, exploratory, retrospective with quantitative approach produced at the Intensive Care Unit from a reference hospital in Teresina ­ PI, Brazil, which data were collected from 221 patients records hospitalized in this sector, in 2018. The data analysis was conducted with the Statistical Package for the Social Sciences, by means of descriptive and inferential statistics. Results: The prevalence of Sepsis at the Intensive Care Unit was 20,36 (n=45). The average length was of 10,73 days (SD +- 15,53) and most part of them evolved to death 62,2% (n=28). Conclusion: The prevalence of Sepsis in the present study was low compared to the global index, which are higher. This is a matter of Public Health with high cost services that leads to mortality. (AU)

Objetivo: Evaluar la prevalencia de septicemia en una Unidad de Tratamientos Intensivos de un hospital de enseñaza. Métodos:Estudio descriptivo, explotatório, retrospectivo con abordaje cuantitativa, realizado en la Unidad de Tratamientos Intensivos de un hospital de referencia en Teresina-PI, cuyos datos fueram colectados en 221 historiales médicos de pacientes internados en ese sector en el año de 2018. La análisis de los datos fue hecha con el Stastistical Package for the Social Sciennces por médio de estatística descriptiva e inferencial. Resultados: La prevalencia de septicemia en la Unidad de Tratamientos Intensivos fue de 20,36% (n=45). Los dias medios de permanencia en esta fue de 10,73 días (DP ± 15,53) y la mayoría evolucionó para fallecimiento 62,2% (n=28). Conclusion: La prevalencia de septicemia en el presente estudio fue baja, si comparada a la tasa mundial que son más elevados. Se trata de problema de salud pública, de alto costo para los servicios y que conlleva en mortalidad. (AU)

Asunto(s)

RESUMEN

This study constitutes the most comprehensive effort ever done to assess the faunal diversity of the Macrobrachium genus within two ecoregions that encompass part of the northeastern Brazil: the Northeastern Caatinga Coastal Drainages, and the São Francisco (Lower-middle and Lower portions). Through sampling in several of their hydrographic basins, bibliographic research, and consulting scientific collections, our results reveal the occurrence of five species along these ecoregions: Macrobrachium acanthurus, M. amazonicum, M. carcinus, M. jelskii and M. olfersii. We also provide the first record of these species for several river basins in both ecoregions. Additionally, we confirm the occurrence of M. carcinus from Rio Grande do Norte State and provide updated distribution maps for each species in the studied area. This carcinofauna survey may form the basis for future evaluations of eventual anthropic impacts on biological diversity resulting from projects being implemented in these regions, which involve the São Francisco interbasin water transfer.

Asunto(s)

Asunto(s)