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Autism comes from the Greek word auto, which means "self." Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction and communication. Dental treatment in patients with ASD can be challenging due to their behavior. Therefore, this review discusses preventive treatment techniques for pediatric patients with ASD at the dental office, as the prevalence of children with autism is growing. Thus, dentists would face more patients with autism in their daily practice. Regarding treatment protocols, they would require specialized attention in dental management. Information was searched in the following databases: PubMed, SciELO, Redalyc, Elsevier, and the International Association of Paediatric Dentistry (IAPD). The descriptors used were: Pediatric Dentistry, Autism, ASD, Autism Spectrum Disorder, and Management of the autistic patient.

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El mantenimiento preventivo en las instituciones hospitalarias se ejecuta para minimizar las acciones correctivas. Esto trae consigo una disminución de los gastos, una reducción de los riesgos y un aumento de la disponibilidad técnica de los equipos médicos, con la disminución de los tiempos de parada de los servicios, lo cual redunda en la excelencia de los servicios médicos prestados. En el campo de las tecnologías médicas ocurre un gran avance cada día, por lo que los equipos son más sofisticados y costosos. Este artículo tiene el objetivo de exponer la importancia de la capacitación ineludible del personal de Electromedicina en la actividad de gestión de mantenimiento a equipos médicos, a partir de las necesidades que ofrece la interpretación de su inventario. Se brindan pautas básicas sobre la preparación permanente y continuada del electromédico en mantenimiento a equipos médicos y se demuestra lo útil que resulta un inventario para gestionar la capacitación de los recursos humanos, lo cual se debe a la consulta, el análisis-síntesis y la sistematización de múltiples fuentes bibliográficas impresas e insertadas en la web: bases de datos Medline, Scielo, Redalyc y Google Académico. De ellas se revisó el material de 62 y, finalmente, se seleccionaron 24 artículos. Se concluyó que la capacitación en esta temática es fundamental para que las tareas de mantenimiento constituyan en verdad herramientas eficaces, que beneficien no solo a la institución prestadora de servicios de salud, sino al paciente y al personal médico(AU)

Preventive maintenance in hospital institutions is carried out to minimize corrective actions. This brings about a decrease in expenses, a reduction of risks and an increase in the technical availability of medical equipment, with a reduction in the times that services stop, which results in the excellence of the medical services provided. In the field of medical technologies, great advances occur every day, the reason why pieces of equipment are more sophisticated and expensive. This article aims to expose the importance of the unavoidable training of electromedicine personnel in the activity of maintenance management for medical equipment, based on the needs offered by the interpretation of its stock. Basic guidelines are provided about the permanent and continuous training of the electromedicine technologist in maintenance of medical equipment, while it is demonstrated how useful an equipment stock is to manage the training of human resources, which responds to the work developed after consultation, analysis-synthesis and systematization from multiple bibliographic sources printed and inserted on the databases of Medline, Scielo, Redalyc and Google Scholar. Of these sources, the material of 62 was reviewed and, finally, 24 articles were selected. It was concluded that training on this subject is essential for maintenance tasks, which truly constitute effective tools, benefiting not only the institution that provides health services, but also the patient and the medical personnel(AU)

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We propose an index to prioritize preventive maintenance for medical equipment. Our index considers seven variables: type of equipment, equipment function, maintenance requirements, calibration, equipment age, equipment location, and equipment hazards. We developed a mathematical model using these variables, and its result is interpreted as an index of equipment maintenance priority. The numerical output of the index was classified into three categories: high, medium, and low priority. We proposed our index model to technical staff at the Department of Biomedical Engineering of the National Institute of Respiratory Diseases in Mexico as a protocol for scheduling appropriate preventive maintenance for medical equipment during the year. The index was tested in a sample of 16 different medical equipment. Our model provides a guide to define the priority and the number of preventive maintenance routines required for medical equipment per year.

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Abstract Agricultural Machinery as an off-road vehicle is the backbone of the World agricultural industry. Its main function is to operate as a prime mover and support the power requirements to function the various type of draft implements. In this regards, the hydraulic system is an important part and is controlled by the propagated oil which is cleaned by impurities and debris using a filter system. Once it blocks, the bypass opens to avoid any pressure burst of the system, and the particles find their way into the hydraulic system and get lodged in the gears, pumps, valves, and drive train to hinder the performance of the Agricultural Machinery. This research presents an onboard Multiple Signal Classification Algorithm (MUSIC) and pseudo-spectrum analysis as a computational tool used by cellphones to analyze the particle pollution level of the hydraulic filter. This analysis is carried out on the soundtracks recorded from different cell phones in different incremental stages of fluid contamination to the particles until it being choked, based on the standard of ISO4406.

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Objetivo: Relatar um caso clínico envolvendo a abordagem cirúrgica/restauradora e medidas preventivas. Relato do caso: Paciente MEMO, 6 anos e 8 meses de idade, feminino, com alto risco/atividade de cárie, apresentando biofilme visível em superfícies lisas livres, lesões de cárie ativa, perda precoce do dente 85, fístula relacionada com a região do dente 75, mudança de cor do dente 61 e perda significativa de dimensão vertical posterior, apresentou-se para tratamento na Clínica de pós-graduação em Odontopediatria da FOP/Unicamp. O plano de tratamento consistiu na abordagem integral focada na promoção da saúde como desfecho principal, ou seja, mudança de comportamento em relação à saúde bucal, e como desfecho secundário, a abordagem cirúrgica/restauradora. Instrução de higiene bucal foi realizada em todas as sessões. O manejo do comportamento foi conduzido por meio da evidenciação e controle de biofilme, profilaxia e adequação do meio bucal seguido da extração do dente 75, selamento de fossas e fissuras dos dentes 36, 46 e 16 e restaurações no 55 e 65. Mantenedor de espaço removível inferior foi realizado. Conclusões: Após seis meses pôde-se observar ausência de biofilme visível, o índice de placa estava controlado e não havia evidência de novas lesões de cárie. Pode-se concluir que o sucesso obtido neste caso destaca a importância da abordagem integral focada na promoção da saúde na clínica odontopediátrica.

Objective: To report a clinic case involving the surgical/restorative approach and preventive actions. Case report: The patient MEMO, aged 6y and 8mo, female, with high caries risk/activity, presenting visible biofilm on free smooth surfaces, active carious lesions, early loss of the 85 tooth, fistula related with the 75 tooth region, color change on 61 tooth and significant loss of posterior vertical dimension has been driven to Pediatric Dentistry Graduate Clinic at FOP/ Unicamp. Treatment plan consisted on integral approach focused as primary outcome on health promotion, behavior change in relation to oral health, and as secondary outcome, the surgical/ restorative approach. Oral hygiene instruction was conducted in all sessions. The behavior management was conducted by evidence and control of visible dental plaque, prophylaxis and oral environment adequation; extraction of 75 tooth, pit and fissure sealing of the 36, 46, 16 teeth, and restorations in the 55 and 65. Removable lower space maintainer appliance was made. Conclusions: After 6 months it could be observed that there was not visible biofilm, the IP was controlled. In addition, there was no evidence of new caries lesions. It could be concluded that the success obtained on this clinical case bring about the importance of the integral performance focused on healthy promotion in pediatric dentist clinic.

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OBJECTIVE: To determine what factors have a significant influence on the performance of medical device maintenance outsourcing, and to determine how the performance of external governance structures differs depending on whether a hospital is private or public. METHODS: This was a longitudinal study of 590 maintenance transactions at 20 hospitals in Bogotá, Colombia, involving 764 medical devices and 72 maintenance service providers. Maintenance performance data (i.e., turn-around time in hours; TAT) for the service providers (either in-house or outsourced) were primarily collected over a 20-month period, from December 2009-August 2011, by means of a monitoring procedure; then, a hazards model was run. RESULTS: The availability of specific repair parts, in-stock, in the city in which the medical devices were located, had a positive impact on the performance of both internal and external governance structures. Online service also had a positive impact on both, with a stronger positive impact on the performance of internal governance than on that of external governance. For transactions governed by external structures, better performance was seen in private hospitals than in public ones. In public health institutions, internal governance showed better performance than external governance. Both internal and external governance structures showed better performance in private healthcare institutions than in public ones. CONCLUSIONS: In public health institutions, internal governance shows better performance than external governance; this suggests that healthcare managers should reconsider the trend to eliminate in-house maintenance service staff in public healthcare institutions.

OBJETIVO: Establecer los factores que influyen significativamente en el desempeño del mantenimiento de los dispositivos médicos mediante contratación externa, y determinar cómo difiere el desempeño de las estructuras externas de gobernanza según un hospital sea privado o público. MÉTODOS: Se realizó un estudio longitudinal de 590 transacciones de mantenimiento en 20 hospitales de Bogotá (Colombia), que incluyeron 764 dispositivos médicos y 72 proveedores de servicio de mantenimiento. Por medio de un procedimiento de vigilancia, se recopilaron principalmente datos de desempeño del mantenimiento (es decir, el plazo de entrega en horas) por parte de los proveedores del servicio (ya fuera este interno o externalizado) durante un período de 20 meses, desde diciembre del 2009 a agosto del 2011; a continuación, se aplicó un modelo de riesgos. RESULTADOS: La disponibilidad de piezas de repuesto específicas en existencia en la misma ciudad en que se ubicaban los dispositivos médicos tuvo una repercusión positiva sobre el desempeño de ambas estructuras de gobernanza, la interna y la externa. El servicio en línea también tuvo una repercusión positiva en el desempeño de ambas estructuras; pero esta repercusión fue más intensa en el desempeño de la gobernanza interna que en el de la externa. En cuanto a las transacciones regidas por estructuras externas, se observó un mejor desempeño en los hospitales privados que en los públicos. En las instituciones de salud pública, la gobernanza interna mostró un mejor desempeño que la externa. Ambas estructuras de gobernanza mostraron un mejor desempeño en las instituciones de atención de salud privadas que en las públicas. CONCLUSIONES: En las instituciones de salud pública, la gobernanza interna muestra un mejor desempeño que la externa; ello indica que los gerentes de atención de salud deben reconsiderar la tendencia a eliminar al personal de los servicios de mantenimiento interno de las instituciones públicas de atención de salud.

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A Terapia Periodontal de Suporte (TSP) denota a necessidade básica dos procedimentos terapêuticos para que os pacientes, por meio de esforços próprios, possam controlar a infecção periodontal, sendo considerada abordagem que está diretamente relacionada com o sucesso da terapia periodontal como um todo. Inúmeras experiências clínicas sobre os efeitos em longo prazo do tratamento de periodontite têm demonstrado que manutenção profissional cuidadosa pós-terapêutica é parte integrante do tratamento periodontal, constituindo o único meio de garantir a manutenção por longo período dos efeitos benéficos da terapia. Assim, o objetivo desse artigo é revisar alguns aspectos relacionados à TSP, incluindo filosofia e periodicidade do tratamento, índices para controle periodontal, abordagem profissional, recursos e técnicas disponíveis bem como o processo de reavaliação de pacientes. A avaliação desses tópicos permite afirmar que a TSP é pré-requisito indiscutível para garantir resultados benéficos dos tratamentos com manutenção dos níveis de inserção clínica por longos períodos de tempo, mesmo que abordagens em relação à avaliação contínua do risco nos níveis do paciente, dos dentes e dos sítios dos dentes representem desafio para o conceito da TSP.

Supportive Periodontal Therapy (SPT) denotes the basic need of therapeutic procedures in order patients can control periodontal infection through their own efforts, considering the approach that is directly related to the success of the periodontal therapy as a whole. Several clinical experiences on long-term effects of periodontitis treatments have shown that a careful professional post-therapeutic maintenance therapy is part of the periodontal treatment, consisting in the only means of assuring the maintenance of the therapy beneficial effects in long term. This paper aims to review a few aspects related to SPT, including philosophy and frequency of treatment, periodontal control indexes, professional approach, available resources and techniques, as well as the process of reassessing patients. The analysis of those topics allows us to state that SPT is an undeniable prerequisite to ensure beneficial outcomes of periodontal treatment with maintenance of clinical attachment levels for long periods, even though approaches to continuous assessment of the patient?s risk levels, teeth and tooth sites pose a challenge to SPT concept.

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Objetivo: Caracterizar os pacientes atendidos no programa de manutencao preventiva (MP) e relacionar as necessidades de tratamento apresentadas com os intervalos de retorno prescritos. Metodo: Foram coletados dados secundarios de prontuarios de pacientes da MP, no ano de 2008, relativos a idade, genero, e intervalo de tempo decorrido desde a ultima consulta. Registrou-se a presenca ou ausencia de alteracoes sistemicas, uso de medicamentos, dor ou desconforto bucal, desordem oclusal e lesoes de mucosa. Foram comparados os dois ultimos Indices Periodontais Comunitarios (CPI) e Indices de Placa Visivel (IPV). As variaveis necessidade de tratamento e tempo decorrido desde a ultima consulta foram comparadas pelo teste-t, com nivel de significancia de 5%. Resultados: A amostra consisti u de 115 individuos, 60,9% do genero feminino e 39,1% do masculino, com media de idade de 25,40 (ñ13,34) anos. A porcentagem dos que faziam uso regular de medicamentos (22,61%) foi maior que a observada para a presenca de alteracoes sistemicas (19,13%). Dos 67,83% que apresentaram necessidade de tratamento, 52,56% tinham necessidade de atencao primaria, 6,41% somente secundaria e 41,03% em ambos os niveis de atencao. O intervalo medio de tempo decorrido desde a ultima consulta (12,76 ñ 6,62 meses) apresentou baixa correlacao com as variaveis alteracoes sistemicas (r= 0,0174), uso de medicamentos (r= 0,0714), dor e desconforto bucal (r= 0,0357), lesoes de mucosa (r= 0,0357), necessidade de tratamento (r= 0,0368). Nao houve diferenca estatistica significativa entre os intervalos de retorno prescritos para individuos que tinham ou nao necessidade de tratamento (p=0,6958). Conclusao: Existe uma falta de sistematizacao na determinacao de intervalos de MP, ressaltando a necessidade de estudos prospectivos para estabelecer criterios baseados na classificacao de risco individual, que possam ser aplicados ao ensino da disciplina e a pratica profissional.

Objective: To characterize the patients enrolled in a preventive maintenance (PM) program, and to correlate their treatment needs with the prescribed and recall intervals. Method: Secondary data - age, gender and time interval elapsed since the last dental appointment - were collected from the charts of patients attending the PM program in 2008. The presence or absence of systemic alterations, use of medications, oral pain or discomfort, oclusal disorder and mucosal lesions was recorded. The last two Community Periodontal Indexes (CPI) and Visible Plaque Indexs (VPI) were compared. The variables treatment needs and time interval elapsed since the last dental appointment were compared by the t-test at 5% significance level. Results: The sample was composed by 115 individuals, 60.9% were females and 39.1% were males with mean age of 25.40 (ñ 13.34) years. The percentage of those who made regular use of medications (22.61%) was higher than that observed for the presence of systemic alterations (19.13%). From the 67.83% that had treatment needs, 52.56% needed primary attention, 6.41% only secondary attention and 41.03% needed both levels of attention. The mean time interval elapsed since the last appointment (12.76 ñ 6.62 months) had a low correlation with the variables systemic alterations (r= 0.0174), use of medications (r= 0.0714), oral pain and discomfort (r= 0.0357), mucosal lesions (r= 0.0357) and treatment needs (r= 0.0368). There was no statistically significant difference among the recall intervals prescribed for individuals who had or not treatment needs (p=0.6958). Conclusion: There is a lack of systematization in the determination of PM intervals, reinforcing the need for prospective studies to reestablish criteria based on the classification of individual risks that can be applied to the teaching of Integrated Clinic discipline and professional practice.

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Neste artigo é apresentado um procedimento para avaliação e qualificação de medidores potenciométricos de pH, fundamentadoem normas técnicas nacionais, internacionais e normas da qualidade. O objetivo é introduzir um procedimentoque propicie o uso adequado do medidor de pH e leve à padronização da avaliação do equipamento e melhoriana confiabilidade dos resultados obtidos. O procedimento consiste em avaliar o medidor de pH por meio de um formulário cujos quesitos baseiam-se na inspeção do medidor, acessórios, insumos, documentação e testes. Para avaliar a aplicabilidade do método proposto, foram testados medidores de pH pertencentes a laboratórios de Curitiba. Nesses testes constatou-se que o procedimento permite definir critériosadequados de análise, pois abrange todas as fases do processo, o que permite evidenciar não-conformidades em todas elas, desde a seleção do medidor de pH, procedimento de controle e acompanhamento do processo até a emissão do parecer final. Os resultados in situ indicaram que a maioria dos medidores de pH apresentavam não-conformidadescom as normas vigentes. Observou-se a necessidade de manutenção periódica dos medidores e treinamento dos técnicos que realizam os ensaios. Constatou-se também que os profissionais não dedicam a devida atenção ao ensaio de medição de pH por considerá-lo simples, o que certamente contribui para a ocorrência de resultados incorretos.

In this article we describe a procedure for evaluating and qualifyingpotentiometric pH meters based on Brazilian and international technical standards and Brazilian quality standards. The aim of the study was to introduce a procedure that will enable pH meters to be used correctly and lead to a standardized approach to the evaluation of this instrument, as well as allowing more reliable results to be obtained. The procedure involves evaluating the pH meter by using an assessment form that covers inspection of the meter, accessories, supplies, documentation and tests. The feasibility of the proposed method was evaluated by testing pH meters belonging to a number of laboratories in Curitiba (Brazil). As a result of these tests it was found that the procedure allows suitable analytical criteria to be defined, as it covers all phases of the process, from the initial selection of the pH meter, through the procedure for controlling and following up the process, to the release of the final report, and therefore allows any non-compliance to be identified. The in situ results show that most of the meters tested do not comply with the prevailing standards and that regular routine maintenance needs to be carried out as well as training given to the technicians who perform the tests. It was also observed that the staff who use the pH meters do not take enough care when carrying out pH measurements because they believe it is a simple procedure, a fact which undoubtedly contributes to incorrect results.

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O objetivo deste trabalho é propor um protocolo de procedimentos práticos no modelo de promoção de saúde com base na revisão da literatura. O atendimento do paciente é dividido em quatro fases: exame diagnóstico e plano de tratamento; tratamento dos pacientes em atividade de doenças cárie e periodontal; tratamento restaurador e manutenção periódica. Esse protocolo permite a realização de um tratamento mais efetivo, uma vez que possibilita detectar precocemente a atividade das doenças cárie e periodontal intervindo com medidas mais simples e efetivas, ao mesmo tempo que envolve o paciente no processo de manutenção de sua saúde.

The goal of this Project is to propose a protocol of clinical procedures used to promote health care, based in the specific literature. The patient treatment is divided in four steps: diagnostics and a treatment plane; treatment of the caries and periodontal diseases; restoration and maintenance. This protocol allows a more effective treatment, because it detects early caries and periodontal diseases so simpler and less invasive measures can be used; at the same time that it educates and involves the patient on how care for his own health.

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