RESUMO

BACKGROUND: The clinical activities developed by pharmacists in a hospital environment can improve health outcomes and generate savings for hospitals. However, to determine whether pharmaceutical interventions are cost effective, it is essential to define a method according to which cost-effectiveness is intended to be measured. In addition, the quality of economic assessments and the amount of information present in systematic reviews in the literature make it difficult to analyze the effects of this intervention. OBJECTIVE: This paper aims to provide an overview of systematic reviews on the pharmacoeconomic impact of the performance of pharmaceutical care in hospitals. METHODS: A systematic search of the Cochrane Library databases, PubMed or MEDLINE, LILACS, Scopus, Web of Science, Google Scholar, and Open Thesis will be performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The search will involve the use of keywords determined using the Medical Subject Headings database to define the search terms and include the following terms: "pharmacoeconomics," "pharmaceutical care," and "hospital." The study designs to be included will be systematic reviews of good quality. Studies will be included that address pharmacoeconomics; studies that evaluated pharmaceutical care in hospitals; and studies published in Portuguese, English, or Spanish. The primary outcome sought in the systematic reviews will be the cost ratio in monetary units and the outcomes in monetary or natural units. The secondary economic outcomes considered will be determined based on factors associated with the drugs and translated into benefit, efficacy, or utility. RESULTS: It is intended to start this overview in January 2023. Thus far, only previous searches have been carried out to contextualize the theme and build the protocol. CONCLUSIONS: This overview will determine the pharmacoeconomic impact of pharmaceutical care interventions in the hospital environment. In addition, this study will point out which clinical outcomes in natural units are impacted by the performance of pharmaceutical care and the strengths and limitations of each approach. It will also identify gaps in the literature and areas for future work. TRIAL REGISTRATION: PROSPERO CRD42019140665; https://tinyurl.com/bddwnz43.

RESUMO

Objetivo: Describir la experiencia del equipo de cirugía maxilofacial del Hospital del Trabajador en el manejo de las fracturas de órbita. Materiales y Método: Estudio retrospectivo de 42 pacientes consecutivos operados por fractura de órbita en el Servicio de Cirugía Maxilofacial del Hospital del Trabajador entre enero de 2016 y diciembre de 2017. Se tabularon datos demográficos, información del trauma, tipo de fractura, fracturas asociadas, tratamiento y seguimiento. Resultado: De los 42 pacientes, la mayoría eran hombres (73,8%) con edad promedio de 40 ± 12,24 años. Los principales síntomas al ingreso fueron equimosis (64,3%), edema periocular (54,8%), hemorragia subconjuntival (33,3%) y diplopía (26,2%). La pared orbitaria más frecuentemente afectada fue el piso de la órbita (85,7%). Las fracturas se presentaron de forma aislada en 35,7% de los casos y asociada a otra fractura de la cara en 64,3%. Post cirugía, la tasa de complicación fue de 16,7%, producto de diplopía y enoftalmos leves que solo requirieron tratamientos conservadores para su resolución. Discusión: La baja tasa de complicaciones se debe a la experiencia del equipo médico con un seguimiento a largo plazo, la medición de volúmenes orbitarios, imagenología intraoperatoria, utilización de malla prefabricada y asistencia endoscópica. Conclusiones: Un adecuado diagnóstico y evaluación son fundamentales para el tratamiento de la fractura de órbita. Los datos demográficos, las características de las fracturas y las complicaciones descritas fueron muy similares a lo reportado por otras experiencias, mientras que la tasa de complicaciones fue menor.

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Aim: To describe the experience of the Maxillofacial Surgical team of Hospital del Trabajador de Santiago in the management of orbital fractures. Materials and Methods: Retrospective study of 42 patients operated consecutively between January of 2016 and November of 2017 at Hospital del Trabajador de Santiago by the Maxillofacial Surgery team due to orbital fracture. The demographic data was tabulated and then a comparison between isolated and combined orbital fractures was made. Results: Of 42 patients most were men (73.8%) with an average age of 40±12.24 years. At admission the main symptoms were ecchymosis (64.3%), periorbital edema (54.8%), subconjunctival hemorrhage (33.3%) and diplopia (26.2%). The most frequently affected orbital wall was the floor (85.7%). Isolated fractures accounted for 35.7% of the cases and those associated with other facial fractures for 64.3%. The postoperative complication rate was 16.7% due to diplopia and enophthalmos. Both complications were mild and only required conservative management. Discussion: The low complication rate might be due to the experience of the surgical team in the management of orbital fractures, long-term following, orbital volume measurements, intraoperative imaging, the use of prefabricated mesh and endoscopic guidance. Conclusión: An adequate diagnosis and evaluation are fundamental for orbital fracture treatment. Demographic data, fracture characteristics and the complications described were similar to those reported by other studies, while the rate of complications was lower than those experiences.

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PURPOSES: This study aimed to assess the current status of cone-beam computed tomography (CBCT) education in Brazilian undergraduate Endodontic programs. METHODS: One hundred program directors were emailed. The questionnaire asked whether the CBCT topic was included in the program, the availability of a CBCT machine, and, the total length of the dental program. For the group that does not teach, seven questions discussed the reasons for not teaching and whether another subject included this topic. For the programs that included CBCT, seven questions discussed the number of hours included, and the impression of the program directors with the quality of the teaching. The chi-square test was used for the correlation between the availability of the CBCT machine and the length of the dental program with the inclusion of the topic. RESULTS: Thirty-five program directors replied to the questionnaire. Twenty-six (74.3%) reported that the topic of CBCT is not included in their programs. There was no impact of the availability of a CBCT machine on the inclusion of the topic (p > 0.05). The increased length of the dental program decreased the inclusion of the topic (p < 0.05). Fifty percent of the directors replied that lack of time is the reason for not including the topic. Among the programs that include CBCT, the majority (55.6%) deliver 3-5 h of lectures. The practical activities range from 1 to 5 h or more. The majority (77.8%) of the directors are satisfied with the content delivered and 44.4% understand that the students are competent in the interpretation of CBCT images. CONCLUSIONS: The majority of the Endodontic undergraduate programs in Brazil do not include CBCT in the program. The availability of a CBCT machine does not impact the inclusion of the topic, the increased duration of the dental program decreases the inclusion of the CBCT topic.

Assuntos

Endodontia , Estudantes , Humanos , Brasil , Tomografia Computadorizada de Feixe Cônico , Inquéritos e Questionários , Internet , Endodontia/educação

RESUMO

OBJECTIVES: To evaluate the fracture incidence of Reciproc R25 instruments (VDW) used during non-surgical root canal retreatments performed by students in a postgraduate endodontic program. MATERIALS AND METHODS: From the analysis of clinical record cards and periapical radiographs of root canal retreatments performed by postgraduate students using the Reciproc R25, a total of 1,016 teeth (2,544 root canals) were selected. The instruments were discarded after a single use. The general incidence of instrument fractures and its frequency was analyzed considering the group of teeth and the root thirds where the fractures occurred. Statistical analysis was performed using the χ2 test (p < 0.01). RESULTS: Seven instruments were separated during the procedures. The percentage of fracture in relation to the number of instrumented canals was 0.27% and 0.68% in relation to the number of instrumented teeth. Four fractures occurred in maxillary molars, 1 in a mandibular molar, 1 in a mandibular premolar and 1 in a maxillary incisor. A greater number of fractures was observed in molars when compared with the number of fractures observed in the other dental groups (p < 0.01). Considering all of the instrument fractures, 71.43% were located in the apical third and 28.57% in the middle third (p < 0.01). One instrument fragment was removed, one bypassed, while in 5 cases, the instrument fragment remained inside the root canal. CONCLUSIONS: The use of Reciproc R25 instruments in root canal retreatments carried out by postgraduate students was associated with a low incidence of fractures.

RESUMO

Purpose: The purpose of this study is to evaluate surgical outcomes of facial fractures after the introduction of intraoperative radiology. Methods: An historic cohort of patients without intraoperative fluoroscopy (IOF) was compared with a prospective cohort of patients with IOF. Main outcomes were postoperative complications and reoperation rate. Results: There were 51 in the non-IOF group and 49 in the IOF group. In the group with IOF 10 patients required intraoperative revisions (20.46%). Overall postoperative complication rate was higher in the non-IOF group (25.49% vs. 6.12%) due to the significantly higher bone-related complication rate (15.69% vs. 2.04%). Reoperation rate was also higher in the non-IOF group (11.76% vs. 0%). Conclusion: This study demonstrates that IOF reduces bone-related complication and reoperation rate by allowing correction of surgical errors immediately during surgery.

Assuntos

Traumatismos Faciais/cirurgia , Fluoroscopia , Fixação de Fratura , Cuidados Intraoperatórios/métodos , Complicações Pós-Operatórias/prevenção & controle , Reoperação/estatística & dados numéricos , Fraturas Cranianas/cirurgia , Adulto , Idoso , Traumatismos Faciais/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Erros Médicos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Fraturas Cranianas/diagnóstico por imagem , Resultado do Tratamento

RESUMO

BACKGROUND: Memory gaps in intensive care unit (ICU) survivors are associated with psychiatric disorders. The ICU diaries improve the patient's factual memory of the ICU, but it is not clear if they reduce the incidence of psychiatric disorders in patients and relatives after hospital discharge. The aim of this study is to evaluate the literature on the effect of ICU diaries for patients admitted in ICU and their relatives. METHODS: Two authors independently searched the online databases PubMed, OVID, Embase, EBSCO host, and PsycINFO from inception to July 2019. Studies were included if the intervention group (ICU diary) was compared with a group with no diaries and the sample was comprised patients ≥ 18 years old admitted in the ICU for more than 24 h and their relatives. Randomized clinical trials, observational studies, letter with original data, and abstracts were included, irrespective of the language. The search was not limited by any specific outcome. Review articles, commentaries, editorials, and studies without a control group were excluded. Structured tools were used to assess the methodological quality ("Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I)" for cohort studies and the "Cochrane Risk of Bias tool" for included RCTs and before/after studies). A random-effects model was employed considering the anticipated variability between the studies. RESULTS: Seven hundred eighty-five titles were identified for screening. Two additional studies were selected after a reference search, and after a full-text review, a total of 12 studies were included. When pooling the results, ICU diary was associated with lower risk of depression (RR 0.41, 95% CI 0.23-0.75) and better quality of life (10.3 points higher in SF-36 general health score, 95% CI 0.79-19.8), without a decrease in anxiety or post-traumatic stress disorder (PTSD). For the relatives receiving an ICU diary, there was no difference in the incidence of PTSD, anxiety, or depression. CONCLUSION AND RELEVANCE: This systematic review and meta-analysis supports the use of ICU diaries to reduce the risk of depression and preserve the quality of life of patients after ICU admission. ICU diaries do not seem to have any beneficial effect on the relatives of the patients. TRIAL REGISTRATION: PROSPERO, CRD42019136639.

Assuntos

Diários como Assunto , Família/psicologia , Unidades de Terapia Intensiva/organização & administração , Avaliação de Resultados em Cuidados de Saúde/normas , Pacientes/psicologia , Estado Terminal/psicologia , Humanos , Transtornos da Memória/complicações , Transtornos da Memória/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia

RESUMO

The Juarez Valley is an important agricultural region in northern Mexico, conveniently organized into three modules (I to III). For decades, their soils have been exposed to organochlorine pesticides (OCPs) and also have been irrigated with wastewaters, which may contain heavy metals. Nowadays, there is very limited information regarding the presence of OCPs and heavy metals in these soils. Thus, the aim of this study was to diagnose these soils for OCPs and heavy metal content by using gas chromatography coupled with electron micro-capture detector and atomic absorption spectrometry, respectively. The results indicated that 4,4'-dichlorodiphenyldichloroethylene and 4,4'-dichlorodiphenyltrichloroethane were primarily disseminated across the three modules since they were found in 100% and 97% of the analyzed soils, respectively. According to international regulations, none of the determined OCP concentrations are out of the limits. Additionally, the Cu, Zn, Fe, Pb, and Mn were found in all sampled soils from the three modules. The highest concentration of Fe was found in module II (1902.7 ± 332.2 mg kg-1), followed by Mn in module III (392.43 ± 74.43 mg kg-1), Zn in module I (38.36 ± 26.57 mg kg-1), Pb in module II (23.48 ± 6.48 mg kg-1), and Cu in module I (11.04 ± 3.83 mg kg-1) (p ≤ 0.05). These values did not exceed the limits proposed by international standards. The Cd was detected in most of the analyzed soils and all their values, with an average of 2 mg kg-1, surpassed the Mexican standards (0.35 mg kg-1). This study has mapped the main OCPs and heavy metals in the Juarez Valley and can serve as a starting point to further monitor the behave of xenobiotics. Since these recalcitrant compounds might be bio-accumulated in biological systems, further analytical methods, as well as remediation techniques, should be developed.

Assuntos

Monitoramento Ambiental/métodos , Hidrocarbonetos Clorados/análise , Metais Pesados/análise , Praguicidas/análise , Poluentes do Solo/análise , Solo/química , Irrigação Agrícola , Agricultura , Cromatografia Gasosa-Espectrometria de Massas , México , Espectrofotometria Atômica , Águas Residuárias/química

RESUMO

The Paso del Norte region is characterized by its dynamic industries and active agriculture. Throughout the years, urban and agricultural soils from this region have been exposed to xenobiotics, heavy metals, and excess of hydrocarbons. In this study, samples of urban [domestic workshops (DW)] and agricultural-intended (AI) soils from different sites of Ciudad Juárez, Mexico were evaluated for their fertility, element content, and microbial diversity. Chemical analyses showed that nitrites, nitrates, P, K, Mg, and Mn were predominantly higher in AI soils, compared to DW soils (p ≤ 0.05). The composition of soil microbial communities showed that Proteobacteria phylum was the most abundant in both soils (67%, p ≤ 0.05). In AI soils, Paracoccus denitrificans was reduced (p ≤ 0.05), concurring with an increment in nitrates, while the content of nitrogen was negatively correlated with the rhizobium group (r2 = -0.65, p ≤ 0.05). In DW soils, the Firmicutes phylum represented up to ~25%, and the relative abundance of Proteobacteria strongly correlated with a higher Cu content (r2 = 0.99, p ≤ 0.0001). The monotypic genus Sulfuricurvum was found only in oil-contaminated soil samples. Finally, all samples showed the presence of the recently created phylum Candidatus saccharibacteria. These results describe the productivity parameters of AI soils and its correlation to the microbial diversity, which are very important to understand and potentiate the productivity of soils. The data also suggest that soils impacted with hydrocarbons and metal(oid)s allow the reproduction of microorganisms with the potential to alleviate contaminated sites.

Assuntos

Microbiota , Microbiologia do Solo , Poluentes do Solo/toxicidade , Solo/química , Agricultura , Bactérias/classificação , Poluição Ambiental , Hidrocarbonetos/toxicidade , Metagenômica , Metais Pesados/toxicidade , México , Nitrogênio/análise , Análise Espectral

RESUMO

Anthropogenic activities can deteriorate the quality of groundwater destined for human use and consumption due to the fact that human activities cause changes in groundwater chemistry. The changes are induced by chemical species coming from industrial waste, which interacts with rocks and minerals. These trigger agents (phosphorus and nitrogen nutrients) which can incorporate trace elements (As, Fe, Mn, Pb, Cd, Ni, Zn). The main objective of the present work was to study the phosphate ions' and nitrogenous species' effects on the incorporation of trace elements into groundwater used for human consumption and to determine the physicochemical processes that participate in the incorporation of trace elements. The physicochemical analysis and elemental analysis by ICP of the groundwater that supplies the study area showed that the phosphorus (P) activity contributes in the incorporation of trace elements into the water. Significant correlations between the activities of P and Fe (0.516), Mn (0.553), Pb (0.756), and As (- 0.747) as well as the correlation of NH4+ with As indicate that the presence of chemical species such as PO43- (2.50-32.20 mg L-1), NO3- (0.89-30.80 mg L-1), and NH4+ (0.2-12.70 mg L-1) are triggering agents that favor the dissolution and mobility of As (0.014-0.020 mg L-1), Fe (0.020-1.14 mg L-1), Mn (0.007-0.254 mg L-1), Ni (0.002-0.0141 mg L-1), Zn (0.009-0.459 mg L-1), and Pb (0.009-0.0170 mg L-1), species with adverse health effects because they are considered carcinogenic. Adequate control of the nitrogenous and phosphated material prevents the dissolution and mobility of trace elements into the water.

Assuntos

Monitoramento Ambiental , Água Subterrânea/química , Nitrogênio/análise , Fósforo/análise , Poluentes Químicos da Água/análise , Humanos , Metais Pesados/análise , México , Fosfatos/análise , Oligoelementos/análise

RESUMO

OBJECTIVE: This review aimed to evaluate clinical studies that assessed separated NiTi rotary and reciprocating instruments. DESIGN AND METHODS: This review assessed clinical studies involving treatments performed by undergraduate students, graduate students, and endodontic specialists. This review evaluated studies using rotary instruments, reciprocating instruments, and hybrid techniques. The number of uses of the different NiTi rotary and reciprocating systems was also assessed. RESULTS: The incidence of separation for rotary instruments ranged from 0% to 23%. Rotary instruments were used from 1 to 50 times depending on the instrument and tooth type. The lowest rate of incidence separation for rotary instruments was obtained by undergraduate students, using a hybrid technique. The separation incidence for reciprocating instruments ranged from 0% to 1.71%. Reciprocating instruments were mostly single-used; one study reported their use up to 3 times. Separation rate in reciprocating instruments was similar in single-use or in multiple uses 0.2%. CONCLUSIONS: Separation of instruments has dropped recently and seems to be a minor problem in current Endodontics. Multiple uses of NiTi rotary instruments are a possibility without significantly increasing the risk of instrument separation. Single and multiple uses of NiTi reciprocating instruments are also associated with low incidence of separation. Attempting to remove separated instruments should be carefully evaluated.

RESUMO

Bulk Cu compounds such as Cu(OH)2 are extensively used as pesticides in agriculture. Recent investigations suggest that Cu-based nanomaterials can replace bulk materials reducing the environmental impacts of Cu. In this study, stress responses of alfalfa (Medicago sativa L.) seedlings to Cu(OH)2 nanoparticle or compounds were evaluated. Seeds were immersed in suspension/solutions of a Cu(OH)2 nanoform, bulk Cu(OH)2, CuSO4, and Cu(NO3)2 at 25 and 75 mg/L. Six days later, the germination, seedling growth, and the physiological and biochemical responses of sprouts were evaluated. All Cu treatments significantly reduced root elongation (average = 63%). The ionic compounds at 25 and 75 mg/L caused a reduction in all elements analyzed (Ca, K, Mg, P, Zn, and Mn), excepting for S, Fe and Mo. The bulk-Cu(OH)2 treatment reduced K (48%) and P (52%) at 75 mg/L, but increased Zn at 25 (18%) and 75 (21%) mg/L. The nano-Cu(OH)2 reduced K (46%) and P (48%) at 75 mg/L, and also P (37%) at 25 mg/L, compared with control. Confocal microscopy images showed that all Cu compounds, at 75 mg/L, significantly reduced nitric oxide, concurring with the reduction in root growth. Nano Cu(OH)2 at 25 mg/L upregulated the expression of the Cu/Zn superoxide dismutase gene (1.92-fold), while ionic treatments at 75 mg/L upregulated (∼10-fold) metallothionein (MT) transcripts. Results demonstrated that nano and bulk Cu(OH)2 compounds caused less physiological impairments in comparison to the ionic ones in alfalfa seedlings.

Assuntos

Cobre/toxicidade , Germinação/efeitos dos fármacos , Hidróxidos/toxicidade , Medicago sativa/efeitos dos fármacos , Praguicidas/toxicidade , Plântula/crescimento & desenvolvimento , Nanopartículas Metálicas/toxicidade , Óxido Nítrico/metabolismo , Raízes de Plantas/crescimento & desenvolvimento , Sementes/crescimento & desenvolvimento , Superóxido Dismutase/metabolismo

RESUMO

BACKGROUND: Few data exist on regional systems of care for the treatment of ST-segment-elevation myocardial infarction (STEMI) in developing countries. Our objective was to describe temporal trends in 30-day mortality and identify predictors of mortality among STEMI patients enrolled in a prospective registry in Brazil. METHODS AND RESULTS: From January 2011 to June 2013, 520 patients who received initial STEMI care at 23 nonspecialized public health units or hospitals, some of whom were transferred to a public cardiology referral center, were identified through a regional STEMI network supported by telemedicine and the local prehospital emergency medical service. We stratified patients into five 6-month periods based on presentation date. Mean age (±SD) of patients was 62.0 (±12.2) years, and 55.6% were men. The mean Global Registry of Acute Coronary Events (GRACE) score was 145 (±34). Overall mortality at 30 days was 15.0%. Use of dual antiplatelet therapy and statins increased significantly from baseline (January 2011) to period 5 (June 2013): 61.8% to 93.6% (P<0.001) and 60.4% to 79.7% (P<0.001), respectively. Rates of primary reperfusion also increased (29.1%-53.8%; P<0.001), and more patients were transferred to the referral center (44.7%-76.3%; P=0.001). Thirty-day mortality rates decreased from 19.8% to 5.1% (P<0.001). In multivariable analysis, factors independently associated with 30-day mortality were higher GRACE score, history of previous stroke, lack of transfer to the referral center, and lack of use of optimized medical therapy. CONCLUSIONS: Implementation of a regional STEMI system was associated with lower mortality and higher use of evidence-based therapies.

Assuntos

Mortalidade/tendências , Transferência de Pacientes/tendências , Programas Médicos Regionais , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Antagonistas Adrenérgicos beta/uso terapêutico , Idoso , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Aspirina/uso terapêutico , Brasil , Cardiologia , Serviços Médicos de Emergência , Feminino , Fidelidade a Diretrizes , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/tendências , Inibidores da Agregação Plaquetária/uso terapêutico , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Antagonistas do Receptor Purinérgico P2Y/uso terapêutico , Sistema de Registros , Telemedicina , Centros de Atenção Terciária

RESUMO

OBJECTIVES: The aim of this in vivo study was to assess the accuracy of 2 third-generation electronic apex locators (EALs), Propex II (Dentsply Maillefer) and Root ZX II (J. Morita), and radiographic technique for locating the major foramen (MF). MATERIALS AND METHODS: Thirty-two premolars with single canals that required extraction were included. Following anesthesia, access, and initial canal preparation with size 10 and 15 K-flex files and SX and S1 rotary ProTaper files, the canals were irrigated with 2.5% sodium hypochlorite. The length of the root canal was verified 3 times for each tooth using the 2 apex locators and once using the radiographic technique. Teeth were extracted and the actual WL was determined using size 15 K-files under a × 25 magnification. The Biostat 4.0 program (AnalystSoft Inc.) was used for comparing the direct measurements with those obtained using radiographic technique and the apex locators. Pearson's correlation analysis and analysis of variance (ANOVA) were used for statistical analyses. RESULTS: The measurements obtained using the visual method exhibited the strongest correlation with Root ZX II (r = 0.94), followed by Propex II (r = 0.90) and Ingle's technique (r = 0.81; p < 0.001). Descriptive statistics using ANOVA (Tukey's post hoc test) revealed significant differences between the radiographic measurements and both EALs measurements (p < 0.05). CONCLUSIONS: Both EALs presented similar accuracy that was higher than that of the radiographic measurements obtained with Ingle's technique. Our results suggest that the use of these EALs for MF location is more accurate than the use of radiographic measurements.

RESUMO

OBJECTIVE: This study evaluates the efficacy of passive ultrasonic irrigation (PUI) in removing root canal filling material from endodontically treated teeth after using one of two reciprocating systems, Reciproc (VDW, Munich, Germany) or WaveOne (Dentsply Maillefer, Ballaigues, Switzerland), or one nickel-titanium (NiTi) rotary system, ProTaper Universal Retreatment (Dentsply Maillefer). METHODS: One hundred and twenty straight root canals of extracted human maxillary incisors were instrumented and then obturated. The specimens were divided into six groups (n=20) as follows: Group R, Reciproc R25 instrument without PUI; Group W, WaveOne Primary instrument without PUI; Group PT, ProTaper Universal Retreatment system without PUI; Group R-PUI, Reciproc R25 with PUI; Group W-PUI, WaveOne Primary with PUI and Group PT-PUI, ProTaper Universal Retreatment system with PUI. After removing the filling material, the teeth were cleaved longitudinally and photographed. The total canal space and remaining material were quantified with the aid of an imaging software tool. The Kruskal-Wallis test was used to identify significant differences between the groups. RESULTS: No statistically significant differences (P>0.05) in residual filling material were observed between the groups. CONCLUSION: The use of PUI did not improve the removal of filling material from the root canals, regardless of the previously used instrumentation system.

RESUMO

As percepções do usuário sobre seus medicamentos devem ser compreendidas, visto que reflete os aspectos positivos e negativos que o mesmo vivencia ou vivenciou durante a sua farmacoterapia. Assim, o presente estudo visou identificar a percepção das idosas associados a não adesão à farmacoterapia prescrita, no Programa de Assistência Integral à Melhor Idade. Para tanto, foi realizada entrevista audiogravada, com duração média de cinco minutos e realizada análise de conteúdo. Para a análise dos dados, procedeu-se à ordenação das falas. Partes do material foram codificadas e organizadas em unidades de significação. O esquecimento, a falta ou incompletude de informação médica ou não entendimento das instruções profissionais repassadas e acesso aos medicamentos foram apontados pelas pacientes como motivos de baixo grau de adesão. Diante dos relatos apresentados, recomenda-se maior cuidado no desenvolvimento e pesquisa de dispositivos de adesão à farmacoterapia a partir do relato dos pacientes, aprofundando-se na essência e na compreensão tácita das suas falas.

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The user's perceptions about their medications should be understood, since it reflects the positive and negative aspects that the sameone has experienced during their pharmacotherapy. Thus, this study aimed to identify the perception of the elderly associated with non-adherence to prescribed pharmacotherapy, in the Integral Assistance Program to the Golden Age. To do so, the interviews were recorded in audio, with an average duration of five minutes and content analysis. For data analysis, we proceeded to the ordination of speeches. Parts of the material were coded and organized into meaning units. Forgetfulness, the lack or incompleteness of medical information or not understanding of passed professional instruction and access to medicines were mentioned by patients as reasons for low level of compliance. Given the reports presented, it is recommended greater care in the development and research of adherence to pharmacotherapy devices from patients reports, deepening the essence and the tacit understanding of their speeches.

Assuntos

Humanos , Feminino , Idoso , Idoso , Adesão à Medicação , Pesquisa Qualitativa

RESUMO

INTRODUCTION: The maximum removal of root canal filling material is essential for successful endodontic retreatment. The purpose of this study was to assess the efficacy of 2 reciprocating systems (Reciproc [VDW, Munich, Germany] and WaveOne [Dentsply Maillefer, Ballaigues, Switzerland]) compared with a nickel-titanium (NiTi) rotary system (ProTaper Universal Retreatment [Dentsply Maillefer]) in the removal of root canal filling material. METHODS: Sixty root canals of extracted human maxillary incisors were prepared using the NiTi ProTaper rotary system with the complementary use of a #40 K-type file and then obturated. The specimens were divided into 3 groups (n = 20) according to the system used for filling removal: group 1: instrument R25 of the Reciproc system, group 2: primary instrument of the WaveOne system, and group 3: NiTi rotary instruments of the ProTaper Universal Retreatment system. The teeth were cleaved longitudinally and photographed under a dental operating microscope with 5 × magnification. Images were transferred to a computer, and residual filling material was quantified using Image Tool software (University of Texas Health Science Center, San Antonio, TX). Results were compared using 1-way analysis of variance (P < .05). RESULTS: All teeth examined had filling remnants within the canal. No statistically significant difference (P > .05) in residual filling material was observed among the groups, with 4.30% in group 1, 2.98% in group 2, and 3.14% in group 3. CONCLUSIONS: The Reciproc and WaveOne reciprocating systems were as effective as the ProTaper Universal retreatment system for gutta-percha and sealer removal.

Assuntos

Cavidade Pulpar/anatomia & histologia , Guta-Percha/química , Materiais Restauradores do Canal Radicular/química , Preparo de Canal Radicular/instrumentação , Ligas Dentárias/química , Desenho de Equipamento , Humanos , Processamento de Imagem Assistida por Computador/métodos , Teste de Materiais , Níquel/química , Fotografação/métodos , Distribuição Aleatória , Retratamento , Obturação do Canal Radicular/instrumentação , Rotação , Propriedades de Superfície , Titânio/química

RESUMO

Leishamaniasis is a disease that affects more than 2 million people worldwide, whose causative agent is Leishmania spp. The current therapy for leishmaniasis is far from satisfactory. All available drugs, including pentavalent antimony, require parenteral administration and are potentially toxic. Moreover, an increase in clinical resistance to these drugs has been reported. In this scenario, plant essential oils used traditionally in folk medicine are emerging as alternative sources for chemotherapeutic compounds. In this study, in vitro leishmanicidal effects of a thymol- and a carvacrol-rich essential oil from leaves of Lippia sidoides Cham. were investigated. The essential oils were extracted and their constituents were characterized by gas chromatography coupled to mass spectrometry (GC/MS). Both essential oils showed significant activity against promastigote forms of Leishmania chagasi. However, we found that carvacrol-rich essential oil was more effective, with IC50/72 h of 54.8 µg/mL compared to 74.1 µg/mL for thymol-rich oil. Carvacrol also showed lower IC50 than thymol. Our data suggest that L. sidoides essential oils are indeed promising sources of leishmanicidal compounds.

Assuntos

Antiprotozoários/farmacologia , Leishmania/efeitos dos fármacos , Lippia/química , Monoterpenos/farmacologia , Óleos Voláteis/farmacologia , Óleos de Plantas/farmacologia , Timol/farmacologia , Cimenos , Cromatografia Gasosa-Espectrometria de Massas , Concentração Inibidora 50 , Monoterpenos/isolamento & purificação , Folhas de Planta/química , Timol/isolamento & purificação

RESUMO

Leishamaniasis is a disease that affects more than 2 million people worldwide, whose causative agent is Leishmania spp. The current therapy for leishmaniasis is far from satisfactory. All available drugs, including pentavalent antimony, require parenteral administration and are potentially toxic. Moreover, an increase in clinical resistance to these drugs has been reported. In this scenario, plant essential oils used traditionally in folk medicine are emerging as alternative sources for chemotherapeutic compounds. In this study, in vitro leishmanicidal effects of a thymol- and a carvacrol-rich essential oil from leaves of Lippia sidoides Cham. were investigated. The essential oils were extracted and their constituents were characterized by gas chromatography coupled to mass spectrometry (GC/MS). Both essential oils showed significant activity against promastigote forms of Leishmania chagasi. However, we found that carvacrol-rich essential oil was more effective, with IC50/72 h of 54.8 μg/mL compared to 74.1 μg/mL for thymol-rich oil. Carvacrol also showed lower IC50 than thymol. Our data suggest that L. sidoides essential oils are indeed promising sources of leishmanicidal compounds.

Assuntos

Antiprotozoários/farmacologia , Leishmania/efeitos dos fármacos , Lippia/química , Monoterpenos/farmacologia , Óleos Voláteis/farmacologia , Óleos de Plantas/farmacologia , Timol/farmacologia , Cromatografia Gasosa-Espectrometria de Massas , Monoterpenos/isolamento & purificação , Folhas de Planta/química , Timol/isolamento & purificação

RESUMO

GOAL, SCOPE AND BACKGROUND: The retention of lead by a Mexican, clinoptilolite-rich tuff from Oaxaca (Mexico) at different pH values was evaluated and the lead sorption mechanisms on the zeolitic material in this work were discussed. METHODS: Isotherms were determined using lead nitrate solutions (initial pH values between 2 and 5) at 303 K. After the equilibrium was reached, the content of lead in the liquid phases was determined by atomic absorption spectrometry. The elemental composition of the clinoptilolite-rich tuff before and after the lead sorption process was evaluated by electron microscopy. RESULTS: The maximum ion exchange capacity of the Mexican, clinoptilolite-rich tuff for lead was 1.4 meq/g at pH 3, considering an ion exchange mechanism in the absence of any precipitated or hydrolyzed lead species in the sorption process or any change in the zeolite network. Langmuir and Freundlich isotherms were also considered in this work for comparison purposes. DISCUSSION: It is important to consider the nature of the sorption processes before choosing a model to describe the interaction between the metal ions and the sorbent. CONCLUSIONS: The chemical lead speciation, the pH, as well as the characteristics of the clinoptilolite-rich tuff are important factors to be considered on the lead sorption process by natural zeolites. The chemical species involved in that process are Na, from the zeolite and Pb2+ from the aqueous solution at pH 2 and 3, so that the ion exchange mechanism explains the lead sorption processes by the clinoptilolite-rich tuff through the ion exchange isotherms. The sodium, Mexican, clinoptilolite-rich tuff is a potential adsorbent for lead from aqueous solutions. RECOMMENDATIONS AND PERSPECTIVES: The natural zeolite-rich tuffs are very important as ion exchangers for the treatment of polluted water due to their sorption properties and low cost. The sorption behavior of each natural material depends on their composition. Mexican, clinoptilolite-rich tuff from Oaxaca (Mexico) could be used for the treatment of waste water contaminated with lead. It would be important to propose this material as an alternative as waste water treatment, because it shows good selectivity for the removal of heavy metals from water.

Assuntos

Chumbo/química , Nitratos/química , Solo/análise , Zeolitas/química , Substâncias Perigosas , Concentração de Íons de Hidrogênio , México

RESUMO

El presente trabajo demostró las diversas colonias de bacterias y hongos encontrados en los medicamentos caseros inocuos preparados en forma empírica y recetados por médicos inclusive oftalmólogos. Se cultivaron bacterias gram (-), un coco gram (+) y hongos, la recomendación final eliminar de la práctica médica cotidina la utilización de estos medicamentos caseros inocuos

Assuntos

Humanos , Medicina Tradicional , Medicamentos sem Prescrição/administração & dosagem