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Objective: To assess the systemic and oral health status of geriatric patients hospitalized in an intensive care unit (ICU). Methods: A cross-sectional descriptive study of a convenience sample of 78 older ICU inpatients. A single calibrated examiner collected demographic and clinical data by analyzing patients' records and assessing their oral cavities. Descriptive data analysis was performed to a 5.00% significance level. All patients provided informed consent and were conscious during the oral health assessment. Results: The mean age was 77.69 years and 51.28% of the sample were male. The main reasons patients were admitted to the ICU investigated were postoperative conditions (23.08%) and cardiac abnormalities (20.51%). Systemic arterial hypertension (69.23%) was the most prevalent comorbidity and patients were being treated with anticoagulants (57.69%) and antimicrobials (53.85%). Most patients did not receive oral care (64.10%), while 29.49% of them received it only once, and 57.69% were denture users. The mean decayed, missing, and filled teeth index was 23.74 (17.44 missing teeth, on average) and majorities had tongue biofilm (71.79%) and unsatisfactory oral hygiene during their time in hospital (84.62%). Conclusion: The oral status of hospitalized geriatric patients was characterized by poor hygiene and edentulism

Objetivos: Avaliar o estado de saúde sistêmica e oral de pacientes geriátricos internados em uma unidade de terapia intensiva (UTI). Metodologia: Estudo transversal descritivo, com amostra de conveniência de 78 idosos internados na UTI. Um único examinador calibrado coletou dados demográficos e clínicos, analisando os registros dos pacientes e avaliando as suas cavidades orais. A análise descritiva dos dados foi realizada com nível de significância de 5,00%. Todos os pacientes forneceram consentimento informado e estavam conscientes durante a avaliação da saúde oral. Resultados: A média de idade foi de 77,69 anos e 51,28% da amostra era do sexo masculino. Os principais motivos de internação dos pacientes na UTI investigados foram condições pósoperatórias (23,08%) e alterações cardíacas (20,51%). A hipertensão arterial sistêmica (69,23%) foi a comorbidade mais prevalente, e os pacientes estavam sendo tratados com anticoagulantes (57,69%) e antimicrobianos (53,85%). A maioria dos pacientes não recebeu cuidados orais (64,10%), enquanto 29,49% deles os receberam apenas uma vez e 57,69% eram usuários de próteses dentárias. O índice médio de dentes cariados, perdidos e obturados foi de 23,74 (17,44 dentes ausentes, em média) e a maioria apresentou biofilme lingual (71,79%) e higiene oral insatisfatória durante a internação (84,62%). Conclusão: A condição oral dos pacientes geriátricos hospitalizados foi caracterizada por má higiene e edentulismo.

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ABSTRACT Objective: ssess quantitatively and qualitatively tongue coating microbiota in ICU patients. Methods: Analytical observational study, convenience sample comprising 65 patients was included for medical report analysis and collection of general data, tongue coating assessment through visual inspection and microbiological sample collection for further laboratory analysis. The collection was performed by a single examiner using a sterile swab introduced and rubbing the posterior portion of the tongue close to the oropharynx. Results: Most patients (60%) belonged to the female sex, at mean age of 74.2 years. The main reasons for hospitalization were lung issues (26.2%) - prevailing associated comorbidities were diabetes (43.1%) and high blood pressure (66.2%). The mean length of stay in the ICU was one day. All patients presented tongue dorsum coating. There were Candida albicans (37%), Streptococcus parasanguinis (26.1%) and Streptococcus mitis (32.6%) in 1/3 of lingual extension. Streptococcus mitis (p=0,0265) was the most prevalent species. Conclusion: There was no significance between the amount of coating and number of observed species, although all assessed patients had presented coating. The most prevalent microorganisms were Candida albicans, Streptococcus parasanguinis and Streptococcus mitis.

RESUMO Objetivo: Avaliar quantitativa e qualitativamente a microbiota da saburra lingual em pacientes internados em UTI. Métodos: Estudo observacional analítico, amostra de conveniência composta por 65 pacientes para análise de laudo médico e coleta de dados gerais, avaliação da saburra lingual por inspeção visual e coleta de amostra microbiológica para posterior análise laboratorial. A coleta foi realizada por um único examinador por meio de swab estéril introduzida e fricção na porção posterior de língua próxima à orofaringe. Resultados: A maioria dos pacientes (60%) pertencia ao sexo feminino, com média de idade de 74,2 anos. Os principais motivos de internação foram problemas pulmonares (26,2%) - as comorbidades associadas predominantes foram diabetes (43,1%) e hipertensão arterial (66,2%). O tempo de internação médio na UTI foi de um dia. Todos os pacientes apresentavam saburra do dorso da língua. Havia Candida albicans (37%), Streptococcus parasanguinis (26,1%) e Streptococcus mitis (32,6%) em 1/3 da extensão lingual. Streptococcus mitis (p=0,0265) foi a espécie mais prevalente. Conclusões: Não houve significância entre a quantidade de recobrimento e o número de espécies observadas, embora todos os pacientes avaliados tenham apresentado recobrimento. Os microrganismos mais prevalentes foram Candida albicans, Streptococcus parasanguinis e Streptococcus mitis.

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Since May 2022, the number of monkeypox virus infections has sharply increased in countries where the disease has not been previously endemic. At present, most reports refer to low-severity cases. Herein, we present a severe case of the disease with disseminated skin lesions that progressed to death in an immunosuppressed patient in Belo Horizonte, Minas Gerais, Brazil.

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ABSTRACT Since May 2022, the number of monkeypox virus infections has sharply increased in countries where the disease has not been previously endemic. At present, most reports refer to low-severity cases. Herein, we present a severe case of the disease with disseminated skin lesions that progressed to death in an immunosuppressed patient in Belo Horizonte, Minas Gerais, Brazil.

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O presente artigo tem como finalidade abordar orientações e sugestões para o atendimento odontológico de pacientes com necessidades especiais(pessoas com deficiência)e idosos nas clínicas de graduação, considerando as implicações daCOVID-19.A partir da publicação de orientações nacionais e internacionais de biossegurança, cuidados em saúde bucal e condutas odontológicas, foram elaboradasdiretrizespara esta abordagem clínica.Espera-se a disseminação do conhecimento, informações e adaptações necessárias no ensino para uma melhor assistência e contribuição educacional aos graduandos, além da realização das atividades práticas de maneira segura no ambiente universitário (AU).

The aim of the currentarticle is toaddress the guidelines and suggestions for dental care of patients with special needs (people with disabilities) and elderly in undergraduate dental clinicsbytaking into account the impacts caused bythe COVID-19 pandemic. Guidelines for the Special Care Dentistry clinical approach were developed based on the publication of national and international guidelines on biosafety, oral health care,and dental procedures. Knowledgeandinformationpromotion,and the necessary adaptations in teaching areexpected to allowbetter assistance and educational contribution to undergraduate students, in addition to performingpractical activities ina safer wayin collegeenvironment (AU).

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O envelhecimento populacional desafia a sociedade em compreensões mais amplas sobre o processo de envelhecer. O objetivo deste estudo foi descrever possíveis associações entre parâmetros de estado nutricional, bucal, psicológico e cognitivo em idosos. Trata-se de uma pesquisa transversal e exploratória que avaliou 15 idosos (M=69 anos; DP=±6,97) residentes na comunidade e participantes de um grupo de intervenções cognitivas. Na análise estatística, optou-se pelo teste Qui-Quadrado para variáveis categóricas e Mann-Whitney ou Kruskal-Wallis para variáveis quantitativas discretas (p≤0,005). Observou-se correlação positiva entre circunferência da panturrilha e desempenho cognitivo global, e correlações negativas entre circunferência de panturrilha e sintomas depressivos, assim como entre qualidade de vida e número de dentes perdidos. Conclui-se destacando a relevância de estudos como estes que avaliam diferentes parâmetros para uma compreensão mais ampla da saúde dos idosos.

Population aging challenges society in broader understandings of the aging process. This study aimed to describe possible associations between parameters of nutritional, oral, psychological and cognitive status in the elderly. This is a cross-sectional and exploratory study that evaluated 15 elderly (M = 69 years; SD = ± 6.97) community residents and participants in a group of cognitive interventions. In the statistical analysis, we chose the Chi-Square test for categorical variables and Mann-Whitney or Kruskal-Wallis for discrete quantitative variables (p≤0.005). There was a positive correlation between calf circumference and global cognitive performance, and negative correlations between calf circumference and depressive symptoms; also, between the quality of life and number of missing teeth. It is concluded highlighting the relevance of studies like these that evaluate different parameters for a broader understanding of the health of the elderly.

El envejecimiento de la población desafía a la sociedad en una comprensión más amplia del proceso de envejecimiento. El objetivo de este estudio fue describir posibles asociaciones entre parámetros de estado nutricional, oral, psicológico y cognitivo en ancianos. Este es un estudio transversal y exploratorio que evaluó a 15 personas mayores (M = 69 años; DE = ± 6,97) residentes de la comunidad y participantes en un grupo de intervenciones cognitivas. En el análisis estadístico, elegimos la prueba de Chi-Cuadrado para variables categóricas y Mann-Whitney o Kruskal-Wallis para variables cuantitativas discretas (p≤0.005). Hubo correlación positiva entre la circunferencia de la pantorrilla y el rendimiento cognitivo global, y correlaciones negativas entre la circunferencia de la pantorrilla y los síntomas depresivos, así como entre calidad de vida y número de dientes faltantes. Se concluye destacando la relevancia de estudios como estos que evalúan diferentes parámetros para una comprensión más amplia de la salud de los ancianos.

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OBJECTIVES: The phenomenon of population aging and the remarkable inclusion of older adults in the economically active population has increased their participation in injuries and accidents, including facial trauma. The purpose of this study was to analyze the prevalence, etiology, and treatment of facial trauma in the older population of the Brazilian Federal District, as well as the gender, etiology, type of trauma, and treatment strategy regarding different age groups (60­69 years, 70­79 years, and 80 years or older). METHODS: This is a retrospective quantitative descriptive study using electronic medical records (Trackcare system) of older patients (aged ≥ 60 years) assisted at the Emergency Department of a tertiary hospital of the Federal District between 2016 and 2017 due to facial trauma. RESULTS: Out of 2382 records of patients with facial trauma, 139 (5.8%) were aged over 60 years. The main causes of facial trauma were falls, both in male and female patients. Facial contusion was the main diagnosis of facial trauma (25.2%), followed by fractures of the jaw (16.5%) and zygomatic complex (15.8%). Conservative treatment was the most common strategy adopted in the Emergency Department of Oral and Maxillofacial Surgery and Traumatology. CONCLUSIONS: This study showed a high prevalence of facial trauma in the geriatric population. Etiological factors such as falls and car accidents were highlighted in the studied groups. Conservative treatment and local guidelines were the preferred therapeutic approaches. Owing to the growth trend of the older population in the upcoming decades, exposure to risk factors for facial trauma tends to grow, thus requiring greater attention and specific knowledge from health professionals.

OBJETIVO: O envelhecimento da população e a inclusão marcante dos idosos na parcela economicamente ativa vêm aumentando a participação deles em traumatismos e acidentes, incluindo os que ocorrem na face. O objetivo deste trabalho foi analisar a prevalência, a etiologia e o tratamento do traumatismo de face na população idosa do Distrito Federal, assim como nas diferentes faixas etárias (60 ­ 69, 70 ­ 79 e 80 e mais), em relação a sexo, etiologia, tipo de trauma e tratamento. METODOLOGIA: Trata-se de estudo retrospectivo descritivo quantitativo, que utilizou prontuários eletrônicos (Sistema Trackcare) de pacientes idosos (≥ 60 anos) atendidos no pronto-socorro de hospital terciário do Distrito Federal, durante os anos de 2016 e 2017, por traumatismo de face. RESULTADOS: Do total de 2.382 prontuários de pacientes com traumatismo de face, 139 (5,8%) foram de idosos. O principal fator responsável pelo traumatismo na face foi a queda, tanto no sexo masculino como no feminino. A contusão na face foi o principal diagnóstico de traumatismo nessa região (25,2%), seguido por fratura de mandíbula (16,5%) e fratura do complexo zigomático (15,8%). O tratamento conservador foi o mais adotado no serviço de pronto-socorro de Cirurgia e Traumatologia Bucomaxilofacial. CONCLUSÕES: O presente estudo evidenciou uma elevada prevalência de traumas de face na população geriátrica. Fatores etiológicos como quedas e acidentes automobilísticos tiveram destaques nos grupos estudados. O tratamento conservador e orientações locais foram as condutas terapêuticas adotadas preferencialmente. Devido à tendência de crescimento da população idosa nas próximas décadas, bem como o perfil ativo que os idosos estão assumindo, a exposição a fatores de risco para traumas faciais tende a crescer, exigindo-se assim maior atenção e conhecimento específico por parte dos profissionais de saúde..

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Introduction: In Brazil, dental trauma (DT) is considered a public health problem. However, few studies in the literature report the prevalence of DT in disabled persons (DP). Objective: The aim of this study was to assess the prevalence of DT among DP seen at the Dental Clinic for Special-Needs Patients (COPE) of the Catholic University of Brasília. Material and method: A retrospective, descriptive study analyzing 73 medical charts of DP seen at the COPE between 2014 and 2016 was conducted. Clinical and sociodemographic data were collected. The t-test was used to check for significant differences between the categories of the variables analyzed. The Statistical Package for Social Sciences (SPSS), version 23.0 (IBM Corporation, Armonk, NY, USA) was used for all statistical analyses (p < 0.05). Result: A DT prevalence of 33/73 (45.2%) was found among DP. The predominant type of fracture was crown fracture (26/33-78.8%). The majority of patients were over 20 years old (63/73 - 86.3%), at a proportion significantly higher than those for the other age categories (p < 0.008). The patients in the sample had a variety of diseases, predominantly in the following categories: mental (22/73- 30.1%), multiple (19/73-26%), and systemic (14/73-19.2%). Conclusion: A high prevalence of DT was found in DP, with the majority of cases being related to mental and multiple diseases. Further research is needed to assess the prevalence of DT in this patient group throughout the Federal District.

Introdução: No Brasil, o traumatismo dentário (TD) é considerado um problema de saúde pública. No entanto, poucos estudos na literatura relatam a prevalência de TD em pessoas com deficiência (PD). Objetivo: O objetivo deste trabalho foi avaliar a prevalência de TD em PD atendidas na Clínica de Pacientes Especiais da Universidade Católica de Brasília (COPE). Material e método: Este estudo seguiu um delineamento descritivo e retrospectivo, e foi realizado por meio da análise de 73 prontuários de PD atendidas na COPE entre 2014 e 2016. Foram coletados dados sociodemográficos e clínicos. O teste t foi utilizado entre as proporções para determinar se houve diferenças significativas entre as categorias das variáveis analisadas. O programa "Statistical Package for Social Sciences" (SPSS), versão 23.0 (IBM Corporation, Armonk, NY, EUA) foi utilizado nas análises (p<0,05). Resultado: Encontrou-se uma prevalência de TD de 33/73 (45,2%) entre os PD. A fratura predominante foi a do tipo coronária, com uma frequência de 26/33 (78,8%). A maioria dos pacientes tinha acima de 20 anos, com uma frequência de 63/73 (86,3%), significativamente maior do que as frequências das outras categorias (p < 0,008). Os pacientes da amostra apresentavam doenças variadas, sendo as mais prevalentes as das categorias mental, com frequência de 22/73 (30,1%), múltipla com 19/73 (26%), e sistêmica com 14/73 (19,2%). Conclusão: Foi encontrada uma alta prevalência de TD em PD, sendo a maioria dos casos relacionados a doenças mentais e múltiplas. Futuras pesquisas são necessárias para avaliar a prevalência de TD nesse grupo de pacientes em todo o Distrito Federal.

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ABSTRACT Purpose: To evaluate if late hormonal replacement is able to recover the prostatic tissue modified by androgenic deprivation. Materials and Methods: 24 rats were assigned into a Sham group; an androgen deficient group, submitted to bilateral orchiectomy (Orch); and a group submitted to bilateral orchiectomy followed by testosterone replacement therapy (Orch+T). After 60 days from surgery blood was collected for determination of testosterone levels and the ventral prostate was collected for quantitative and qualitative microscopic analysis. The acinar epithelium height, the number of mast cells per field, and the densities of collagen fibers and acinar lumen were analyzed by stereological methods under light microscopy. The muscle fibers and types of collagen fibers were qualitatively assessed by scanning electron microscopy and polarization microscopy. Results: Hormone depletion (in group Orch) and return to normal levels (in group Orch+T) were effective as verified by serum testosterone analysis. The androgen deprivation promoted several alterations in the prostate: the acinar epithelium height diminished from 16.58±0.47 to 11.48±0.29μm; the number of mast cells per field presented increased from 0.45±0.07 to 2.83±0.25; collagen fibers density increased from 5.83±0.92 to 24.70±1.56%; and acinar lumen density decreased from 36.78±2.14 to 16.47±1.31%. Smooth muscle was also increased in Orch animals, and type I collagen fibers became more predominant in these animals. With the exception of the densities of collagen fibers and acinar lumen, in animals receiving testosterone replacement therapy all parameters became statistically similar to Sham. Collagen fibers density became lower and acinar lumen density became higher in Orch+T animals, when compared to Sham. This is the first study to demonstrate a relation between mast cells and testosterone levels in the prostate. This cells have been implicated in prostatic cancer and benign hyperplasia, although its specific role is not understood. Conclusion: Testosterone deprivation promotes major changes in the prostate of rats. The hormonal replacement therapy was effective in reversing these alterations.

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PURPOSE: To evaluate if late hormonal replacement is able to recover the prostatic tissue modified by androgenic deprivation. MATERIALS AND METHODS: 24 rats were assigned into a Sham group; an androgen deficient group, submitted to bilateral orchiectomy (Orch); and a group submitted to bilateral orchiectomy followed by testosterone replacement therapy (Orch+T). After 60 days from surgery blood was collected for determination of testosterone levels and the ventral prostate was collected for quantitative and qualitative microscopic analysis. The acinar epithelium height, the number of mast cells per field, and the densities of collagen fibers and acinar lumen were analyzed by stereological methods under light microscopy. The muscle fibers and types of collagen fibers were qualitatively assessed by scanning electron microscopy and polarization microscopy. RESULTS: Hormone depletion (in group Orch) and return to normal levels (in group Orch+T) were effective as verified by serum testosterone analysis. The androgen deprivation promoted several alterations in the prostate: the acinar epithelium height diminished from 16.58±0.47 to 11.48±0.29µm; the number of mast cells per field presented increased from 0.45±0.07 to 2.83±0.25; collagen fibers density increased from 5.83±0.92 to 24.70±1.56%; and acinar lumen density decreased from 36.78±2.14 to 16.47±1.31%. Smooth muscle was also increased in Orch animals, and type I collagen fibers became more predominant in these animals. With the exception of the densities of collagen fibers and acinar lumen, in animals receiving testosterone replacement therapy all parameters became statistically similar to Sham. Collagen fibers density became lower and acinar lumen density became higher in Orch+T animals, when compared to Sham. This is the first study to demonstrate a relation between mast cells and testosterone levels in the prostate. This cells have been implicated in prostatic cancer and benign hyperplasia, although its specific role is not understood. CONCLUSION: Testosterone deprivation promotes major changes in the prostate of rats. The hormonal replacement therapy was effective in reversing these alterations.

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PURPOSE: The purpose of this study was to assess oral microbial colonization before and after the implementation of an oral hygiene protocol in children admitted to a pediatric intensive care unit (PICU) using nonhospitalized healthy children as a control group. METHODS: Two groups were analyzed in this clinical study: Group G1 (dentate children admitted to the PICU); and Group G2 (nonhospitalized, healthy, dentate children). The G1 group underwent oral assessments before (G1i) and after (G1f) a three-day oral hygiene protocol using 0.12 percent chlorhexidine applied at 12-hour intervals. RESULTS: Several pathogenic bacteria were identified in group G1i, which was significantly higher than in group G2 (P<.001). There were significant differences between groups G1i and G1f regarding the presence of pathogenic bacteria (P<.001) and a tongue coat (P<.001). The G1f and G2 groups were comparable concerning the presence of pathogenic bacteria (P=.14). CONCLUSIONS: Pathogenic bacteria were present in the oral cavity of almost all hospitalized children and were significantly decreased after an appropriate oral hygiene protocol was incorporated in their daily care. Therefore, regular oral hygiene protocols are warranted in PICUs.

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OBJECTIVE: To assess the level of knowledge and difficulties concerning hospitalized patients regarding preventive oral health measures among professionals working in Intensive Care Units (ICUs). STUDY POPULATION AND METHODS: A cross-sectional survey was conducted among 71 health professionals working in the ICU. A self-administered questionnaire was used to determine the methods used, frequency, and attitude toward oral care provided to patients in Brazilian ICUs. The variables were analyzed using descriptive statistics (percentages). A one-sample t-test between proportions was used to assess significant differences between percentages. t-statistics were considered statistically significant for P < 0.05. Bonferroni correction was applied to account for multiple testing. RESULTS: Most participants were nursing professionals (80.3%) working 12-h shifts in the ICU (70.4%); about 87.3% and 66.2% reported having knowledge about coated tongue and nosocomial pneumonia, respectively (P < 0.05). Most reported using spatulas, gauze, and toothbrushes (49.3%) or only toothbrushes (28.2%) with 0.12% chlorhexidine (49.3%) to sanitize the oral cavity of ICU patients (P < 0.01). Most professionals felt that adequate time was available to provide oral care to ICU patients and that oral care was a priority for mechanically ventilated patients (80.3% and 83.1%, respectively, P < 0.05). However, most professionals (56.4%) reported feeling that the oral cavity was difficult to clean (P < 0.05). CONCLUSION: The survey results suggest that additional education is necessary to increase awareness among ICU professionals of the association between dental plaque and systemic conditions of patients, to standardize oral care protocols, and to promote the oral health of patients in ICUs.

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A pneumonia nosocomial é uma doença sistêmica que acomete o paciente no ambiente hospitalar após 48 horas da sua admissão, principalmente nas unidades de terapia intensiva (UTIs). O acúmulo de biofilme dentário, saburra lingual e processos inflamatórios decorrentes da presença de doença periodontal podem contribuir para a formação de reserva microbiana associada à pneumonia nosocomial. A prevenção da pneumonia nosocomial é muito importante para garantir a saúde do paciente. O uso de clorexidina 0,12% para a higienização de língua, dentes e mucosas é um grande aliado na redução de bactérias, prevenindo o aparecimento de infecções nos pacientes internados, além do combate das mesmas, como a pneumonia nosocomial. O treinamento da equipe de enfermagem para realização dessas manobras, assim como para entender a importância da relação entre saúde bucal e infecções respiratórias, deve ser reforçado, visto que parece ser deficiente. A presença do cirurgião-dentista em uma equipe multidisciplinar de UTI é indispensável. Sua presença parece ser mais importante na equipe de coordenação, para o treinamento e capacitação dos profissionais ali envolvidos, além da realização de procedimentos mais complexos, como exodontia e raspagem e alisamento coronorradicular.

Nosocomial pneumonia is a systemic disease that affects the inpatient after 48 hours of admission, especially in intensive care units (ICUs). The dental plaque accumulation, tongue coating and inflammatory processes arising from the presence of periodontal disease may contribute to the formation of microbial reservatories associated with nosocomial pneumonia. Prevention of nosocomial pneumonia is very important to ensure the health of the patient. The use of 0.12% chlorhexidine for tongue, teeth and also mucosal cleaning is important to reduce bacteria and to prevent the appearance of infections in hospitalized patients, such as nosocomial pneumonia. The training of nursing staff to perform these procedures, as well as to understand the importance of the relationship between oral health and respiratory infections, should be strengthened, since it appears to be defi cient. The presence of the dentist in multidisciplinary ICU team is indispensable. Because the practitioner can coordinate a team for training and qualification of professionals involved there, in addition to performing more complex procedures such as tooth extraction and scaling and root planning.

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Introducción: El frenillo lingual es una membrana mucosa adherida desde la base de la lengua hasta el reborde alveolar. Esta estructura en el recién nacido tiene una actuación importante en el acto de succión y amamantamiento. Un frenillo lingual corto influencia en la posición de los dientes en los arcos dentarios, en el amamantamiento y dificulta los movimientos de la lengua. Este aspecto patológico se llama anquiloglosia. Reporte de Caso: Este trabajo reporta el caso de una niña, 04 años de edad, que compareció con su padre a la Clínica de Odontopediatría de la Universidad Católica de Brasilia, con la queja de "lengua presa". Tras la anamnesis, se diagnosticó anquiloglosia. La niña presentaba el frenillo lingual adherido a la base de la lengua, presencia de diastema entre los incisivos centrales inferiores, lengua en formato de corazón cuando proyectada y dificultad para articulación de determinados fonemas. Luego de la firma del Formulario de Consentimiento informado por el responsable, se propuso como plan de tratamiento su remoción quirúrgica: Frenectomía. La cirugía fue realizada con éxito, con remoción de la membrana adherida, lo que le posibilitó a la niña una mejora inmediata en su habla. La niña fue encaminada para fonoaudiología para recuperar fonemas que no lograba pronunciar. Conclusión: La frenectomía le devolvió las funciones de la lengua al sistema estomatognático de la paciente, permitiendo la ejecución de sus funciones normales como alimentación, deglución y correcta articulación de palabras.

Introdução: O freio lingual é uma membrana mucosa aderida desde a base da língua até o rebordo alveolar. Esta estrutura no recém-nascido tem uma atuação importante no ato de sucção e amamentação. Um freio lingual curto influência na posição dos dentes nos arcos dentários, na amamentação e dificulta os movimentos da língua. Este aspecto patológico é chamado anquiloglossia. Relato de Caso: O presente trabalho relata o caso de uma criança, gênero feminino, 04 anos de idade, que compareceu com seu pai à Clínica de Odontopediatria da Universidade Católica de Brasília, com a queixa de "língua presa". Após a anamnese, diagnosticou-se anquiloglossia. A criança apresentava o freio lingual aderido à base da língua e presença de diastema entre os incisivos centrais inferiores. Metodologia: Após a assinatura do Termo de Consentimento livre e Esclarecido pelo responsável, foi proposto como plano de tratamento a remoção cirúrgica do mesmo - frenectomia. A cirurgia foi realizada com sucesso, com remoção da membrana aderida, o que possibilitou à criança uma melhora imediata na sua fala. A mesma foi encaminhada para fonoaudiologia para recuperar fonemas que antes não conseguia pronunciar. Conclusão: A frenectomia devolveu as funções da língua ao sistema estomatognático da paciente, permitindo a execução de suas funções normais como transporte de alimentos, deglutição e correta articulação de palavras.

Introduction: The lingual frenulum is a mucous membrane attached from the base of the tongue to the alveolar ridge. This structure in the newborn has an important role in sucking and breastfeeding. A short lingual frenulum influences the position of teeth in the dental arches, breastfeeding and hinders tongue movements. This situation is called ankyloglossia. Case Report: This study reports the case of a child, female, 04 years-old, who attended the Pediatric Dentistry Clinic of the Catholic University of Brasilia with her father, complaining of " tied-tongue". After the interview, was diagnosed with ankyloglossia. The child had the lingual frenulum adhered to the base of the tongue, making it difficult to pronounce certain phonemes. Surgical removal was proposed, and consent was given by parents for the frenectomy. The surgery was successful, allowing the child an immediate improvement in speech. The same was referred for speech therapy to regain phonemes that were absent before the procedure. Conclusion: Frenectomy returned proper functions of the stomatognathic system of the patient, allowing the tongue to perform its duties as oral food transport, swallowing correct articulation of words.

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INTRODUCTION: A surgical approach with plaque incision and graft (PIG) to correct Peyronie's disease is the best method for complex, large deviations. However, the geometric and mechanical consequences of this intervention are poorly understood. AIM: The aim of this study was to analyze the geometric and mechanical consequences of PIG on penile straighten surgery. METHOD: A tridimensional penile simile model with a curvature of 85° was created to test all of the most common PIG techniques. PIG with double-Y, H-shape, and Egydio techniques were used to rectify the curved penile model. MAIN OUTCOME MEASUREMENTS: The results that differed from a rectified cylinder shape were highlighted. RESULTS: All of the analyzed techniques created a geometric distortion that could be linked to poor surgical results. We suggest a new technique to resolve these abnormalities. CONCLUSION: Current techniques designed to correct penile deviation using PIG present geometric and mechanical imperfections with potential consequences to the postoperative success rate. The new technique proposed in this report could be a possible solution to solve the geometric distortion caused by PIG.

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BACKGROUND: laparoscopic rectal surgery has not yet achieved a high penetration rate because of its steep learning curve and its relatively high conversion rate. Robotic rectal resection represents the main indication of the use of the robotic platform in colorectal surgery. The aim of this study was to present an early experience with robotic surgery to treat mid and low rectal cancer focusing on the technique and early postoperative outcomes. METHODS: from December 2012 to October 2013, a total of 16 patients with colorectal diseases were operated on using a four-arm single docking full robotic procedure (daVinci Si Surgical System). The treatment of six consecutive patients who underwent robotic rectal cancer surgery for mid or low rectal adenocarcinoma was prospectively analyzed regarding technique standardization, pathological findings and postoperative outcomes. RESULTS: there were no conversions and one intraoperative complication. The mean operative time was 245 min (180-360 min). The mean console time was 170 min (110-240 min). All patients underwent a standardized totally robotic rectal dissection. There were no mortality or urinary dysfunction and one complication (postoperative ileo-16%). The median length of hospital stay was 6 (4-11 days). The median number of lymph nodes harvested was 22 (7-38), and distal and circumferential resection margins were negative in all specimen. R0 resection was achieved in all cases and complete total mesorectal excision in five specimen and nearly complete in one. CONCLUSION: standardized robotic rectal surgery is a promising alternative to treat patients with mid or low rectal cancer and is expected to overcome the low penetration rate of laparoscopic surgery in this field. This technique was successfully performed in six patients with excellent immediate postoperative and pathological results. Additional studies in a large series of patients are necessary to confirm those advantages. (AU)

INTRODUÇÃO: a utilização da cirurgia videolaparoscópica para o tratamento do câncer do reto ainda não apresentou uma alta penetração devido a longa curva de aprendizado e a uma taxa de conversão relativamente alta. A ressecção retal robótica é a principal indicação para o uso da plataforma robótica na cirurgia colorretal. O objetivo desse estudo é apresentar as técnicas e os resultados pós-operatórios imediatos com o uso da cirurgia robótica para o tratamento do câncer do reto distal. PACIENTES E MÉTODOS: no período de dezembro de 2012 a outubro de 2013 foram operados 16 pacientes com patologias colorretais utilizando o robô daVinci SI Surgical System. O tratamento de 6 consecutivos pacientes portadores de câncer do reto do terço médio e do terço inferior foram prospectivamente avaliados quanto a sistematização técnica, achados patológicos e evolução pós-operatória. RESULTADOS: não houve conversão e ocorreu uma complicação intraoperatória. A duração média das operações foi de 245 minutos (180-360 minutos) e o tempo médio do uso do console foi de 170 minutos (110-240 minutos). Ocorreu uma complicação pós-operatória (Íleo) e não houveram nenhuma disfunção urinária ou mortalidade. A duração média da internação hospitalar foi de 6 dias (4-11 dias). O número médio de linfonodos examinados foi de 22 (7-38) e todas as peças tinham margens distal e circunferencial negativas. Ressecção RO foi observada em todos os casos e o grau de excisão total do mesorreto foi completo em 5 peças e quase completo em uma. CONCLUSÃO: cirurgia robótica sistematizada esta tendo uma crescente aceitação e é uma ótima alternativa para o tratamento dos pacientes com câncer do reto distal. Esta tecnologia foi utilizada em 6 pacientes com excelentes resultados não só na recuperação pós-operatória imediata como também nos achados da avaliação patológica. Grandes series randomizadas são importantes para confirmar as possíveis vantagens dessa nova tecnologia. (AU)

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Introduction: Cerebral palsy is defined as a non-progressive brain disorder of movement and posture. The patient is characterized by mental and motor disabilities, sensory impairments of vision and hearing, besides having seizures and contraction joints. Objective: To address a multidisciplinary dental intervention in a patient, leucoderma, 11 years-old, with cerebral palsy who attended the Special Patients Clinic of the Catholic University of Brasilia, Brazil. Case report: Clinical interventions to promote oral health, emphasizing the responsible guidelines regarding oral hygiene techniques, and surgical procedures such as extractions of deciduous teeth #75, #85, #63 (phase 1) and ulectomy in the region of teeth #24 and #25 (phase 2) were performed. Conclusion: The multidisciplinary assistance targeted to the oral health of the patient with cerebral palsy can be considered as an important strategy for promoting the health and quality of life in this population group.

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O atendimento odontológico domiciliar direcionado aos idosos semi e dependentes é conjunto de ações preventivas e de mínima intervenção que visam promover a saúde bucal e orientar familiares e cuidadores. É considerada uma estratégia educativa e assistencial de saúde cuja finalidade é intervir, de maneira multidisciplinar, no processo saúde-doença de idosos vulneráveis. Este estudo tem como objetivo abordar a prática odontológica domiciliar, enfatizando as principais alterações sistêmicas e possíveis repercussões na cavidade bucal, a necessidade de participação efetiva do cirurgião-dentista e orientações de promoção de saúde bucal que possam auxiliar nas condutas dos familiares, cuidadores e profissionais envolvidos com esse tipo de atendimento. Foram realizadas busca e análise de artigos científicos e bases de dados bibliográficos sobre a prática odontológica domiciliar em idosos. Na estratégia de busca foram empregados os termos: assistência domiciliar, odontogeriatria, odontologia domiciliar, idoso fragilizado e saúde bucal. Adotaram-se como critérios de inclusão: artigos publicados em português; artigos indexados nas bases de dados LILACS e SciELO; artigos publicados no período de 2000 a 2011 e legislação federal sobre o assunto, totalizando 36 referências. Concluiu-se que existe grande necessidade dessa atividade odontológica em domicílio a ser executada de maneira capacitada por odontogeriatras com formação gerontológica que possam contribuir na humanização do atendimento e promoção do bem-estar e qualidade de vida desses idosos.

Home dental service for semi and dependent elderly is a set of preventive actions and minimal intervention aimed at establishing the promotion of oral health and guidance to families and caregivers. It is considered an educational strategy and health care whose purpose is to provide multidisciplinary intervention in the health-disease process of vulnerable elderly. This report aimed to approach home dental practice, emphasizing the main systemic changes and possible repercussions in the oral cavity, the need for effective participation of surgeon-dentist and guidelines to promote oral health that may help family members, caregivers and professionals involved with this type of care. Scientific articles and bibliographic databases on the dental practice-based study in the elderly were searched and analyzed. Search strategy terms were: home care, geriatric dentistry, dental home care, frail elderly, oral health. Inclusion criteria were: published articles in Portuguese; articles indexed in the databases LILACS and SciELO; articles published from 2000 to 2011 and federal laws on the subject, totaling 36 references. It was concluded that there is a great need of home dental activity to be performed by skilled geriatric dentists with geriatric training that can contribute in humanizing care and promote well-being and quality of life for elderly people.

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The objective of the study was to evaluate, through quantitative methods, the structural alterations in the corpora cavernosa of rats submitted to orchiectomy as well as the role of late hormone replacement in overturning the possible structural alterations. Twenty-five male rats were assigned into 5 groups with 5 animals each and treated as follows: ORCHIEC-1 = submitted to orchiectomy and sacrificed after 1 month; C-1 = control group sacrificed after 1 month; ORCHIEC-2 = submitted to orchiectomy and sacrificed after 2 months; C-2 = control group sacrificed after 2 months; and T = submitted to orchiectomy, underwent testosterone replacement with testosterone undecanoate (100 mg/kg) after 1 month, and sacrificed after 1 month of hormonal replacement. Smooth muscle, collagen, and elastic system fibers of penile corpora cavernosa were quantified. There was a significant decrease in the absolute values of smooth muscle, sinusoidal space, and total area of corpora cavernosa after 2 months in the castrated group when compared with controls. Overall, regarding density, no significant differences were observed among the groups. The hormonal replacement with testosterone was able to reverse the alterations observed. The method used for this research allowed demonstrating that absolute values are reliable to quantify the structural alterations of corpora cavernosa structures. The results suggest that hormonal replacement, even when instituted at a late stage, is effective in reversing the corpora cavernosa's structural alterations produced by castration.

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Introduction : The autogenous transplantation or dental autotransplantation is defined as the replacement of an absent or impaired tooth by another transplanted one, usually the third molar. The tooth is transplanted to a prepared or existing tooth socket occupied by the lost tooth, in a same person. This technique is considered a viable method due to its high success rate when properly indicated combined with a relatively low cost.Objective and case report:To report a clinical case study conducted in the Integrated Clinics of the Catholic University of Brasilia in a young melanoderm male patient, 13 years-old, who underwent late tooth transplantation technique, i.e., in two steps: the right upper third molar was transplanted to the socket of the right lower first molar. The case described showed incomplete root formation and radiographic following-up for eight consecutive months. Conclusion:This type of oral rehabilitation contributed to bone formation stimulation at the transplanted site, the maintenance of the masticatory function and the financial costs reduction for the patient, representing a further possible therapy in the dentist's armamentarium.