ABSTRACT Purpose To develop and verify the usability of an internet-based system for telemonitoring and guidance of the hearing aid user as well as monitoring the long-term performance in a pilot group. Methods The system “I can hear, but I can’t understand” was developed based on recommendations in the literature regarding layout, design, and content for guidance and advice. Three stages were followed: planning, design and content development, and pilot testing. The sample consisted of 43 adults and older adults with any type and degree of hearing loss, who had been regularly using a hearing aid for at least 30 days and at most 24 months, with reading skills and no evidence of cognitive impairments. The individuals were followed up for 8 to 12 months. The users’ performance was monitored with the Speech, Spatial and Qualities of Hearing Scale. The usability of this material was assessed with the System Usability Scale. Results Improved performance and increased self-reported daily use of the hearing aid were observed after the period of guidance and telemonitoring via the system for all research participants. In all analyzes of the SUS scale, it was possible to observe a performance superior to 70 points, demonstrating good usability of the system. In the analysis of the performance of the SSQ, in the three moments of the research, a positive response was observed in all domains, thus showing progress in the use of hearing aids, with significant data for the domain of Hearing Speech. Conclusion The system “I can hear, but I can’t understand” proved to be an easy-to-use and effective tool to telemonitor hearing aid users.

RESUMO Objetivo Desenvolver e verificar a usabilidade de um sistema baseado na internet para telemonitoramento e orientação do usuário de prótese auditiva bem como monitorar o desempenho de longo prazo em um grupo piloto. Método O sistema Escuto, mas não entendo foi desenvolvido baseado em recomendações de literatura para layout, design e conteúdo de orientação e aconselhamento. Seguimos três etapas: planejamento, elaboração do design e conteúdo e teste piloto. A amostra foi formada por 43 adultos e idosos, com perda auditiva, de qualquer tipo e grau, uso regular de prótese auditiva de no mínimo 30 dias e no máximo 24 meses; com habilidade de leitura e sem evidências de comprometimentos cognitivos. Os indivíduos foram acompanhados por um período de oito a 12 meses. O desempenho dos usuários foi monitorado por meio do questionário Speech Spatial and Qualities of Hearing Scale. A usabilidade deste material foi avaliada com o questionário System Usability Scale. Resultados Foi observada melhora de desempenho e aumento de uso diário autorrelatado das próteses auditivas após o período de orientação e telemonitoramento via sistema para todos os participantes da pesquisa. Em todas as análises da escala SUS foi possível observar o desempenho superior a 70 pontos, demonstrando a boa usabilidade do sistema. Na análise do desempenho do SSQ, nos três momentos da pesquisa, observou-se resposta positiva em todos os domínios, mostrando assim uma evolução com o uso das próteses auditivas, com dados significantes para o domínio Audição para a fala. Conclusão A usabilidade do sistema foi considerada adequada pelos indivíduos participantes do estudo.

Aim This study aimed to investigate whether non-ionizing radiation emitted by smartphones is likely to cause genotoxic effects on oral epithelial cells. Methods Thirty adults were distributed into two groups according to the mobile phone brand used, namely Samsung (Samsung, Seoul, South Korea) and Apple (Apple, California, USA). The material was collected with gentle swabbing of the right and left buccal mucosa using a cervical brush, then the micronucleus test was performed. Results The Mann-Whitney test with a 5% significance level did not reveal statistically significant differences in micronuclei frequency between the exposed and non-exposed sides (p=0.251). The different brands do not seem to cause risks of inducing genetic damage because there were no statistically significant differences between them (p=0.47). Conclusion Therefore, our results suggest no correlations of micronuclei frequency in the exposed buccal cells of mobile phone users at the exposure standard levels observed.

Resumo Objetivos: analisar os fatores sociodemográficos e obstétricos que podem influenciar na ocorrência do baixo peso ao nascer no contexto da gravidez precoce. Métodos: amostra constou de 232 adolescentes grávidas, na faixa etária de 10 a 19 anos, atendidas em uma maternidade pública de Aracaju-SE, Brasil, durante o período de agosto de 2012 a julho de 2016. A coleta de dados foi realizada através de um questionário estruturado. Resultados: observou-se baixo peso em 41,38% dos recém-nascidos e que o nível de escolaridade e o tipo de vínculo com o parceiro tiveram relevância estatística para a ocorrência do baixo peso em recém-nascidos de mães adolescentes, com p=0,0286 e p=0,0247, respectivamente. Conclusões: os fatores socioeconômicos podem contribuir para a ocorrência de baixo peso em recém-nascidos de mães adolescentese que a gravidez nesta faixa etária constitui grave problema de saúde pública de natureza multifatorial.

Abstract Objectives: to analyze sociodemographic and obstetric factors that may influence the occurrence of low birth weight in the context of early pregnancy. Methods: the sample consisted of 232 pregnant teenagers, aged 10-19 years old, were assisted at a public maternity hospital in Aracaju-SE during the period of August 2012 to July 2016. The data collection was conducted through a structured questionnaire. Results: low birth weight was observed in 41.38% of the newborns and there was a statistical association between the educational level and the marital status with the occurrence of low birth weight in newborns among teenage mothers, with p=0.0286 and p=0.0247, respectively. Conclusions: the socioeconomic factors may contribute to the occurrence of low birth weight in newborns of teenage mothers and teenage pregnancy at this age represents a serious public health problem.

ABSTRACT Marine sponges are a rich source of bioactive natural products with multiple pharmacological properties. In this study, the anti-inflammatory and antinociceptive effects of extracts obtained from Aplysina caissara, Haliclona sp. and Dragmacidon reticulatum were evaluated by using the writhing test and formalin-induced mouse paw edema model in mice. All extracts were administered via oral pathway in the doses of 60 and 90 mg/kg. In the writhing test the pre-treatment with all sponges resulted in significant inhibition of the acetic acid-induced response, suggesting an antinociceptive effect. The formalin test showed that the extracts from A. caissara, Haliclona sp. and D. reticulatum, in the tested doses, did not affect the first formalin phase, however, they were effective in the late phase. To assess the potential anti-inflammatory activity of the extracts, the test of formalin-induced paw edema was used. The oral administration of A. caissara, Haliclona sp. and D. reticulatum extracts significantly reduced the formalin-induced paw edema in mice. In conclusion, our data show that marine sponges can be an important source of anti-inflammatory and antinocicpetive products that can be promising therapeutical leads. Furthermore, pharmacological and chemical studies have been developed not only to characterize the mechanism(s) that is/are responsible for the antinociceptive and anti-inflammatory action but also to identify the active principles of sponges.

Resumo Objetivo: Descrever e quantificar as principais alterações na tomografia computadorizada do tórax em pacientes adultos oligossintomáticos com doença falciforme e, secundariamente, avaliar o índice de acerto do radiologista quanto ao tipo de hemoglobinopatia. Materiais e Métodos: Estudo prospectivo em que 44 pacientes adultos com doença falciforme foram submetidos a tomografia computadorizada do tórax tanto em inspiração como em expiração. Foram descritos a frequência dos achados tomográficos e os graus de acometimento. Por meio da análise das alterações pulmonares e do padrão morfológico do baço, foi calculado o índice de acerto do radiologista quanto ao tipo de hemoglobinopatia. Resultados: As alterações encontradas nos exames de tomografia computadorizada, em ordem decrescente de frequência, foram: opacidades reticulares (81,8%), padrão de atenuação em mosaico (56,8%), distorção arquitetural (31,8%), cardiomegalia (25%), redução volumétrica lobar (18,2%) e aumento do calibre de ramos periféricos das artérias pulmonares (9,1%). Na maioria dos achados o grau de acometimento foi considerado leve, com até cinco segmentos pulmonares acometidos. O índice de acerto quanto ao tipo de hemoglobinopatia (grupo HbSS versus grupo não HbSS) foi 72,7%. Conclusão: Em pacientes adultos com doença falciforme os principais achados tomográficos refletem alterações fibróticas. Além do mais, a tomografia computadorizada pode ser útil na diferenciação do tipo de hemoglobinopatia.

Abstract Objective: To describe and quantify the main changes seen on computed tomography of the chest in mildly symptomatic adult patients with sickle cell disease, as well as to evaluate the radiologist accuracy in determining the type of hemoglobinopathy. Materials and Methods: A prospective study involving 44 adult patients with sickle cell disease who underwent inspiration and expiration computed tomography of the chest. The frequency of tomography findings and the extent of involvement are reported. We also calculated radiologist accuracy in determining the type of hemoglobinopathy by analyzing the pulmonary alterations and morphology of the spleen. Results: The changes found on computed tomography scans, in descending order of frequency, were as follows: fibrotic opacities (81.8%); mosaic attenuation (56.8%); architectural distortion (31.8%); cardiomegaly (25.0%); lobar volume reduction (18.2%); and increased caliber of peripheral pulmonary arteries (9.1%). For most of the findings, the involvement was considered mild, five or fewer lung segments being affected. The accuracy in determining the type of hemoglobinopathy (HbSS group versus not HbSS group) was 72.7%. Conclusion: In adult patients with sickle cell disease, the main tomography findings reflect fibrotic changes. In addition, computed tomography can be helpful in differentiating among hemoglobinopathies.

ABSTRACT Objective: To evaluate the association between clinical, pulmonary, and cardiovascular findings in patients with sickle cell disease and, secondarily, to compare these findings between sickle cell anemia patients and those with other sickle cell diseases. Methods: Fifty-nine adults were included in this cross-sectional study; 47 had sickle cell anemia, and 12 had other sickle cell diseases. All patients underwent pulmonary function tests, chest computed tomography, and echocardiography. Results: Abnormalities on computed tomography, echocardiography, and pulmonary function tests were observed in 93.5%, 75.0%; and 70.2% of patients, respectively. A higher frequency of restrictive abnormalities was observed in patients with a history of acute chest syndrome (85% vs. 21.6%; p-value < 0.0001) and among patients with increased left ventricle size (48.2% vs. 22.2%; p-value = 0.036), and a higher frequency of reduced respiratory muscle strength was observed in patients with a ground-glass pattern (33.3% vs. 4.3%; p-value = 0.016). Moreover, a higher frequency of mosaic attenuation was observed in patients with elevated tricuspid regurgitation velocity (61.1% vs. 24%; p-value = 0.014). Compared to patients with other sickle cell diseases, sickle cell anemia patients had suffered increased frequencies of acute pain episodes, and acute chest syndrome, and exhibited mosaic attenuation on computed tomography, and abnormalities on echocardiography. Conclusion: A significant interrelation between abnormalities of the pulmonary and cardiovascular systems was observed in sickle cell disease patients. Furthermore, the severity of the cardiopulmonary parameters among patients with sickle cell anemia was greater than that of patients with other sickle cell diseases.

Hyptis pectinata (L.) Poit., Lamiaceae, is an aromatic, abundant and broadly used plant species in Sergipe to treat oral and gastrointestinal pain and inflammation. The aim of the present study was to analyze the relation between periodontitis and changes in the corporal mass and alveolar bone structure after induction of experimental periodontal disease in rat treated or not treated with H. pectinata gel at 5% (GS5%) and 10% (GS10%), comparing their effects with doxycycline gel at 10% (D10%, positive control), vehicle gel (negative control) and a group with experimental periodontal disease, but non-treated. The gels were locally applied in the gingival region immediately after the experimental periodontal disease induction by ligature (3×/day, 11 days). Bone destruction was determined through clinical exam, histopathological analysis and cone beam computed tomography of the experimental animals (n = 36). After 11 days of periodontitis induction, all groups that received ligature presented a decrease in the corporal mass, except to the naïve group (without experimental periodontal disease) (p < 0.05). Computed tomography results have shown healthy bone structure in the group I and bone resorption for the test groups. Histopathological analysis confirmed the healthy bone structure for naïve group animals, while the test groups exhibited bone loss in several degrees. In particular, the non-treated group animals had an intense inflammatory process. When the periodontium of the animals treated with GS10% was histopathologically analyzed, insertion periodontium was preserved. The results for these groups were significantly different of the vehicle group (p < 0.05). According to the results, the gel based in the aqueous extract of H. pectinata at 10% can prevent bone loss in experimental periodontal disease similarly to doxycycline 10%.

O objetivo deste trabalho foi avaliar o tratamento de água de chuva, de duas regiões industriais de Joinville (SC), por radiação ultravioleta. O reator operou em processo contínuo, de modo que cada partícula permanecesse sob radiação por 60 segundos. As amostras de água foram analisadas em termos de coliformes totais, coliformes termotolerantes e bactérias heterotróficas antes do tratamento por ultravioleta, após o tratamento e após tratadas e armazenadas por 24, 48 e 72 horas. Verificou-se a eficiência da desinfecção de água de chuva direta e de telhado por radiação ultravioleta com a inativação de 100% dos coliformes totais e dos coliformes termotolerantes e o não recrescimento desses micro-organismos em amostras tratadas e estocados por até 72 horas, no entanto, bactérias heterotróficas persistiram e foram identificadas após 24, 48 e 72 horas ao tratamento.

The objective of this study was to evaluate the treatment of rainwater in two industrial regions in Joinville (SC, Brazil) by ultraviolet radiation. The reactor was operating in continuous process with each particle remaining under radiation for 60 seconds. The samples were evaluated in terms of total coliforms, fecal coliform and heterotrophic bacteria prior to ultraviolet treatment, after treatment and further treated and stored for 24, 48 and 72 hours. The efficiency of disinfection of direct rainwater and that collected from roofing by ultraviolet radiation was verified with 100% inactivation of total coliforms and fecal coliform and these microorganisms did not reappear in samples treated and stored for up to 72 hours, however, heterotrophic bacteria persisted and were identified after 24, 48 and 72 hours of treatment.

INTRODUÇÃO: A correção da ptose mamária associada à flacidez de pele e baixa projeção é ainda tema de discussões e controvérsias na literatura. O objetivo deste estudo é descrever a experiência da Disciplina de Cirurgia Plástica da Universidade Estadual de Campinas (Unicamp) com a técnica de mastopexia com implante mamário associado a retalho de sustentação do músculo peitoral maior. MÉTODO: Foi realizado estudo retrospectivo de 20 pacientes com ptose mamária graus II ou III, operadas no período de junho de 2008 a setembro de 2010. RESULTADOS: Após seguimento pós-operatório entre 9 meses e 12 meses, não foram observados casos de deformidades mamárias ou torácicas e nenhuma paciente evoluiu com recidiva da ptose. Foram observados, em todas as pacientes, manutenção de boa projeção da mama e adequado preenchimento do polo superior mamário, gerando resultados duradouros e satisfatórios. CONCLUSÕES: A técnica de mastopexia com uso de implantes associados a retalho de músculo peitoral maior é de fácil realização, com curva de aprendizado relativamente curta, boa reprodutibilidade, e resultados duradouros e satisfatórios.

BACKGROUND: The correction of breast ptosis associated with skin sagging and low projection is still a subject of controversy in the literature. This study aims to describe the experience of the Plastic Surgery Department of Universidade Estadual de Campinas (Unicamp) with the technique of mastopexy with breast implants in a double plane and the pectoralis major muscle flap. METHODS: A retrospective study of 20 patients with grade II or III mammary ptosis, who underwent surgery between June 2008 and September 2010, was performed. RESULTS: A 9- and 12-month follow-up of patients showed neither breast or chest deformities nor recurrence of ptosis. All patients presented with good breast projection and adequate upper pole fill, with long-lasting and satisfactory results. CONCLUSIONS: Mastopexy with breast implants and the pectoralis major muscle flap technique is easy to perform, with a relatively short learning curve, good reproducibility, and satisfactory long-lasting results.

OBJETIVO: Ameloblastoma desmoplásico (AD) é uma rara variante do ameloblastoma, com características clínicas, imaginológicas e histopatológicas específicas. O perfil biológico deste tumor não é totalmente compreendido, devido ao número limitado de casos notificados. O objetivo deste trabalho é relatar um caso de AD simulando uma lesão periapical. DESCRIÇÃO DO CASO: Este tumor apareceu na região anterior da maxila esquerda numa paciente do gênero feminino de 24 anos de idade, entre o incisivo lateral esquerdo e o canino. A lesão era indolor e apresentava apenas um ligeiro inchaço da mucosa do palato duro. Radiograficamente, uma área radiolúcida bem delimitada que promovia a divergência radicular foi observada. O incisivo lateral respondeu negativamente aos testes pulpares. Diagnóstico provisório de cisto radicular versus cisto fissural foi estabelecido e enucleação cirúrgica seguida de curetagem foi realizada. O exame histológico das amostras revelou a proliferação dos ninhos e cordões de epitélio odontogênico comprimidos imersos em um estroma densamente colagenizado, associada a um trabeculado ósseo levemente irregular. CONCLUSÃO: Estas características eram consistentes com AD. A necrose pulpar do incisivo e o aparecimento radiográfico atípico mascararam a real natureza da doença. Apesar das altas taxas de recorrência, nenhum sinal clínico ou radiográfico de recidiva do tumor foi detectado um ano mais tarde.

PURPOSE: Desmoplastic Ameloblastoma (DA) is a rare variant of ameloblastoma, with specific clinical, imaginological and histopathological features. The biologic profile of this tumor is not fully understood because of the limited number of reported cases. The purpose of this paper is to report a case of DA mimicking a periapical lesion. CASE DESCRIPTION: This tumour appeared in the anterior region of the left upper jaw of a 24-year-old female, between left lateral incisor and canine. The lesion was painless and only a slight swelling of the hard palate mucosa was noted. Radiographically, a well-delimited peak-like radiolucent area promoting root divergence was observed. The lateral incisor failed in responding positively to the pulp tests. Provisional diagnosis of radicular cyst versus fissural cyst was established and surgical enucleation followed by curettage was carried out. Histological examination of the specimens revealed proliferation of nests and cords of compressed odontogenic epithelium immersed in a densely collagenized stroma, associated to a few irregular bone trabeculae. CONCLUSION: These features were consistent with DA. The presence of a pulpally necrotic incisor and the atypical radiographic appearance obscured the disease. Despite the high rates of recurrence, no clinical or radiographic sign of reincidence of the tumor was detected one year later.

Os resultados do tratamento do linfoma de Hodgkin (LH) melhoraram substancialmente ao longo das últimas décadas e tornaram o LH uma das neoplasias humanas com maior chance de cura. Entretanto, os dados sobre tratamento em países em desenvolvimento são escassos. Entre 1996 e 2005, 370 pacientes consecutivos com LH tratados em três instituições públicas no Rio de Janeiro foram identificados. Destes, 216 em estádio avançado (IIB-IV) foram selecionados para esta análise. Os pacientes foram tratados com o protocolo ABVD (doxorrubicina, bleomicina, vinblastina e dacarbazina). A mediana do tempo de seguimento dos sobreviventes foi de 6,3 anos (1-11,8). Quinze pacientes morreram durante o tratamento de primeira linha. A probabilidade de sobrevida livre de progressão (SLP) em cinco anos e a probabilidade de sobrevida global (SG) em cinco anos foram de 69% e 83%, respectivamente. A SLP nos grupos de baixo risco e de alto risco, de acordo com o "International Prognostic Score", foi de 81% e 62% (p=0,003), respectivamente. A SG em cinco anos nos grupos de baixo risco e de alto risco foi de 89% e 78% (p=0,02), respectivamente. O presente estudo apresenta uma estimativa representativa dos resultados atuais do tratamento do LH avançado em instituições públicas no Brasil. Fica claro que o tratamento completo pode ser oferecido à grande maioria dos pacientes, embora aqueles com baixo status socioeconômico possam exigir atenção especial. Em vista das dimensões continentais do Brasil, com substancial heterogeneidade interregional, um registro nacional de pacientes com LH está sendo implementado.

The outcome of Hodgkin's lymphoma (HL) has markedly improved over the last few decades, placing HL among the human cancers with highest cure rates. However, data about treatment outcomes in developing countries are scarce. From 1996 to 2005, 370 consecutive patients with HL treated in three public institutions in Rio de Janeiro were identified. A total of 216 patients who presented with advanced stage (IIB-IV) HL were selected for the present analysis. Patients with advanced disease were treated with ABVD, complemented or not by radiation therapy. The median follow-up time of survivors was 6.3 years (1-11.8). Fifteen patients died during first-line treatment. The complete remission rate was 80%. The 5-year progression-free survival (PFS) and the 5-year overall survival (OS) probabilities were 69% and 83%, respectively. The 5-year PFS in low-risk and high-risk patients were 81% and 62% (p=0.003), respectively. The 5-year OS in low-risk and high-risk International Prognostic Score patients were 89% and 78% (p=0.02), respectively. The present study provides a representative estimate of current treatment results for advanced HL in public institutions in an urban area in Brazil. It is clear that full treatment can be given to most patients, although those with very low socio-economic status might require special attention and support. Since Brazil is a large country, with substantial interregional heterogeneity, a nationwide registry of HL patients is currently being implemented.

OBJETIVOS: avaliar os fatores indicativos (parâmetros clínicos e índices de gravidade fisiológicos e anatômicos) da evolução materna e fetal entre gestantes vítimas de trauma abdominal submetidas à laparotomia e discutir as particularidades do atendimento nesta situação. MÉTODOS: análise retrospectiva dos prontuários de 245 mulheres com trauma abdominal e tratamento operatório, atendidas entre 1990 e 2002. Foram identificadas 13 gestantes com lesão abdominal submetidas à laparotomia. Para registro e análise estatística dos dados foram utilizados o protocolo Epi-Info 6.04 e o teste exato de Fisher, com intervalo de confiança de 95%. Foram relacionados com a mortalidade fetal: escore na escala de coma de Glasgow, pressão arterial sistólica, índices de trauma (RTS, ATI, ISS) e lesão uterina. RESULTADOS: a idade variou de 13 a 34 anos (média de 22,5). Seis mulheres (46,2%) estavam no terceiro trimestre de gestação. O trauma penetrante correspondeu a 53,8% das lesões e em seis dessas pacientes o mecanismo de trauma foi ferimento por projétil de arma de fogo. Três pacientes tiveram lesões uterinas, associadas com óbito fetal. Não houve óbito materno e a mortalidade fetal foi de 30,7%. Não houve associação entre os índices de trauma e a mortalidade materna e fetal. A lesão uterina foi o único fator preditivo de risco para perda fetal (p=0,014). CONCLUSÕES: apesar da casuística pequena e de se tratar de estudo retrospectivo de gestantes com trauma grave, os achados deste estudo mostram que não há indicadores com boa acurácia para indicação da evolução materna e fetal.

PURPOSE: to evaluate the predictors (clinical findings and physiological and anatomical scores) of the maternal and fetal outcomes among pregnant women victims of abdominal trauma who were submitted to laparotomy and to discuss particularities of assessment in this situation. METHODS: retrospective analysis of the medical records of 245 women with abdominal trauma and surgical treatment, from 1990 to 2002. Thirteen pregnant women with abdominal injury were identified. All cases were registered in the Epi-Info 6.04 protocol and data were analyzed statistically by the Fisher exact test, with confidence interval of 95%. RESULTS: ages ranged from 13 to 34 years (mean of 22.5). Six women (46.2%) were in the third trimester of pregnancy. Penetrating trauma accounted for 53.8% of injuries and in six of these patients the mechanism of trauma was gunshot wounds. Three patients had uterine injuries associated with fetal death. There were no maternal deaths and fetal mortality was 30.7%. The use of trauma scores was not associated with maternal and fetal mortality. Uterine injury was the only predictive risk factor for fetal loss (p=0.014). CONCLUSIONS: this is a retrospective study analyzing a small number of pregnant women victims of severe trauma. However, the results show that there are no predictive accuracy scores to evaluate maternal and fetal outcomes.