ABSTRACT The benefit of exercise in the prevention and treatment of type 2 diabetes mellitus has a strong body of evidence. The implementation of a cardiac rehabilitation or physiotherapeutic program for appropriate counseling and exercise prescription may support the behavioral change process initiated in general practice settings. This would ostensibly improve outcomes for patients suffering from type 2 diabetes mellitus in the midst of the COVID-19 pandemic. The existence of a support and education system for the self-management of diabetes mellitus based on cardiac rehabilitation teams plays a key role in this regard, so that patients and physicians achieve close coordination to attain the desired success. This article addresses the various aspects of patient-centered care through self-management education for this endocrine-metabolic disease during the COVID-19 pandemic.

RESUMEN El beneficio del ejercicio en la prevención y el tratamiento de la diabetes mellitus tipo 2 tiene una base sólida de evidencia. La derivación a un programa de rehabilitación cardíaca o fisioterapeuta para un adecuado asesoramiento y prescripción de ejercicios puede servir de apoyo en el proceso de cambio de comportamiento iniciado en entornos de práctica general, para mejorar los resultados del paciente que padece esta enfermedad en medio de la pandemia de COVID-19. La existencia de un sistema de apoyo y educación para el autocontrol de la diabetes mellitus basado en equipos de rehabilitación cardíaca desempeña un papel fundamental para ello, de manera tal que pacientes y médicos logren una estrecha coordinación para lograr el éxito deseado. En este artículo se revisan los diversos aspectos de la atención centrada en el paciente a través de la educación para el autocontrol de esta enfermedad endocrino-metabólica durante la pandemia de COVID-19.

RESUMO Objetivo O objetivo desse estudo foi determinar a frequência de obliteração do canal pulpar (OCP) após traumatismo dos dentes decíduos anteriores e investigar sua associação com variáveis relacionadas. Métodos Este estudo retrospectivo foi realizado com base nos prontuários odontológicos de pacientes selecionados da Clínica de Trauma Dentário Pediátrico entre 2006 e 2016. Aqueles que tinham OCP nos dentes decíduos anteriores e tinham entre 0-108 meses no momento do traumatismo foram considerados elegíveis. Dados dos pacientes e dos traumatismos, tais como, sexo, idade da criança no momento do traumatismo, etiologia, dente afetado, idade da criança na época no momento da erupção do sucessor permanente, bem como presença de alteração de cor da coroa foram extraídos dos prontuários. Resultados Dentre as 483 crianças com dentes com traumatismos, 14.9% tinham OCP e a maioria delas apresentava alteração de cor da coroa. A média de idade da criança no momento do traumatismo foi de 38 meses e a etiologia mais comumente associada ao TD foram as quedas. O tempo médio decorrido para o início do processo de OCP foi de 13,5 meses. Não houve associação estatisticamente significativa entre a idade da criança no momento do traumatismo e os tipos de TD, OCP e presença de alteração de cor da coroa. Conclusão A frequência de OCP foi relativamente baixa, embora a presença de alteração da coroa tenha sido considerável. Não foi encontrada associação entre a idade da criança no momento do trauma e as variáveis estudadas.

ABSTRACT Objective The aim of this study was to determine the frequency of pulp canal obliteration (PCO) after traumatic dental injury (TDI) of primary anterior teeth and to investigate its relation with the related variables. Methods This retrospective study has been done with dental records of patients selected from the Paediatric Dental Trauma Clinic between 2006 and 2016. Those who had PCO in the primary anterior teeth and were aged 0-108 months at the time of trauma were considered eligible. Data related to patients and TDI, such as sex, the child’s age at the time of trauma, aetiology, affected teeth, the child’s age at the time of the eruption of the permanent successor as well as the presence of crown discoloration were extracted from the dental records. Results Among the 483 children with traumatised teeth, 14.9% had PCO and the most of them exhibited crown discoloration. The average age of the children at the time of the trauma was 38 months and the most common aetiology of the TDI was falls. The average time for the beginning of the PCO process was 13.5 months. There was no statistically significant association between the child’s age at the time of trauma and the types of TDI, PCO and the presence of crown discoloration. Conclusions The frequency of PCO was relatively low though the presence of crown discoloration was considerable. There was no association between the child’s age at the time of trauma and the studied variable.

ABSTRACT Atrial fibrillation (AF), an expected epidemic in the coming decades, is commonly caused by ischemic heart disease and high blood pressure, and it is also associated with overweight and obesity. Physical exercise (PE) is considered a way to correct cardiovascular risk factors and it is therefore recommended in the prevention of cardiovascular diseases. It is also an integral part of cardiac rehabilitation. Although it has been noted that PE can increase the risk of AF, the cardiovascular benefits of regular physical activity are unquestionable. An improved health status and a longer life expectancy have been proven in endurance athletes. Mild or moderate PE protects against AF, which may be associated with an improved left ventricular systolic and diastolic function, as well as with a decreased arterial stiffness. Cardiac rehabilitation with PE is a currently approved indication in patients with chronic heart failure, with or without AF, which is shown to increase functional capacity and life quality, as well as to reduce overall mortality and hospitalizations.

RESUMEN La fibrilación auricular (FA), epidemia esperada en las próximas décadas, es comúnmente causada por la cardiopatía isquémica y la hipertensión arterial, también se asocia con el sobrepeso y la obesidad. El ejercicio físico (EF) se considera una medida que corrige los factores de riesgo cardiovascular y, por tanto, se recomienda en la prevención de las enfermedades cardiovasculares, y forma parte integral de la rehabilitación cardíaca. Aunque se ha señalado que el EF puede incrementar el riesgo de FA, los beneficios cardiovasculares de la actividad física regular son incuestionables. Se ha comprobado un mejor estado de salud y una mayor expectativa de vida en atletas de resistencia. El EF ligero o moderado protege contra la FA, lo que puede estar asociado a un mejoramiento de las funciones sistólica y diastólica del ventrículo izquierdo, así como a una disminución de la rigidez arterial. La rehabilitación cardíaca con EF, es una indicación aprobada actualmente en pacientes con insuficiencia cardíaca crónica, con FA o sin ella, la cual está demostrado que incrementa la capacidad funcional y la calidad de vida, así como que reduce la mortalidad general y las hospitalizaciones.

Resumen Objetivo: Evaluar la factibilidad y los efectos sobre la capacidad funcional de un programa de entrenamiento físico supervisado, aplicado en pacientes con disfunción sistólica severa del ventrículo izquierdo después de infarto agudo de miocardio. Métodos: Se estudiaron 37 pacientes, de ambos sexos y sin límites de edad, con diagnóstico de disfunción sistólica severa del ventrículo izquierdo, después de haber sufrido un infarto agudo de miocardio, que consecutivamente se incorporaron al programa ambulatorio del Centro de Rehabilitación del Instituto de Cardiología. Se hicieron pruebas de esfuerzo máximas limitadas por síntomas con determinación de consumo de oxígeno, ecocardiogramas en reposo y ventriculografías isotópicas en reposo y esfuerzo a los 2, 8 y 18 meses de evolución, y un tiempo medio de seguimiento clínico de 4,1 años. A todos se les prescribió un régimen de entrenamiento físico moderado o intenso, durante un año como mínimo. Se consideró disfunción sistólica severa cuando la fracción de eyección del ventrículo izquierdo fue menor de 35%. Resultados: Todos los parámetros ergométricos que expresaron capacidad funcional incrementaron significativamente en la evaluación del octavo mes (p< 0,0005), permaneciendo invariables a los 18. La fracción de eyección del ventrículo izquierdo media en reposo inicial fue de 28,3 ± 5,3%, la cual no mostró variaciones significativas con el esfuerzo ni con otros estudios evolutivos. La mortalidad total y la morbilidad de la serie fueron de 10,5% y 47,3%, respectivamente. Conclusión: El entrenamiento físico supervisado en pacientes infartados con disfunción sistólica severa de ventrículo izquierdo fue seguro y efectivo, y mejoró su calidad de vida, sin causar efectos negativos sobre la función ventricular.

Abstract Objective: To evaluate the feasibility and effects on the functional capacity of a supervised physical training programme carried out on patients with severe left ventricular systolic dysfunction after an acute myocardial infarction. Methods: The study included a total of 37 patients, males and females of any age, with a diagnosis of severe left ventricular systolic dysfunction after having suffered an acute myocardial infarction. They were consecutively included into the ambulatory programme of the Institute of Cardiology Rehabilitation Centre. Maximum effort tests, limited by symptoms, were performed to determine oxygen consumption. Echocardiograms were also performed at rest, with isotopic ventriculography at rest and then at 2, 8, and 18 months. The mean clinical follow-up was 4.1 years. They were all prescribed to a moderate or intense training programme for at least one year. Severe left ventricular systolic dysfunction was considered when the left ventricular ejection fraction was less than 35%. Results: All the ergometric parameters that expressed functional capacity increased significantly in the evaluation at 8 months (P< .0005), and remained at 18 months. The initial mean left ventricular ejection fraction at rest was 28.3 ± 5.3%, which showed no significant changes with effort or in the other evaluation times. The overall mortality and morbidity of the series was 10.5% and 47.3%, respectively. Conclusion: Supervised physical training in patients after an acute myocardial infarction and with severe left ventricular systolic dysfunction was safe and effective, and improved the quality of life, without causing negative effects on ventricular function.

RESUMO Objetivos Investigar de forma retrospectiva os tipos de traumatismo alveolodentário ocorridos em um atendimento de saúde bucal durante um período de dez anos e relatar os tipos de superfícies contra as quais os traumatismos ocorreram. Métodos Foram selecionados prontuários de crianças atendidas na Clínica de Traumatismo Dentário na Faculdade de Odontologia da Universidade Estadual do Rio de Janeiro, entre os anos de 2006 e 2016. Os prontuários considerados elegíveis para esse estudo foram os das crianças que possuíam algum tipo de traumatismo em dentes anteriores na dentição decídua (incisivos e caninos) e tinham de 0-96 meses de idade. Resultados Foram incluídas no estudo 483 prontuários com um total de 786 dentes acometidos por traumatismos. A média de idade em que os traumatismos ocorram foi de 37,25 meses (±18.62). As fraturas de esmalte (32,8%) e as luxações intrusivas (45,6%) foram os tipos de trauma mais prevalentes. A maioria dos traumatismos ocorreu contra superfícies de cerâmica (34%). A luxação lateral foi o único tipo de traumatismo que apresentou associação com a superfície de impacto, no caso a cerâmica (p=0.014; Teste U de Mann-Whitney). De acordo com o presente estudo o tipo mais prevalente de trauma no tecido dentário e polpa foi a fratura de esmalte e no tecido periodontal foi a luxação intrusiva. A maioria dos traumatismos alveolodentarios ocorreu devido a quedas em suas próprias residências e contra superfícies de cerâmica. Conclusão Os resultados demonstraram que a alta frequência de luxações laterais está associada ao impacto do traumatismo contra superfícies de cerâmica.

ABSTRACT Objectives The aims of this retrospective study were to investigate the types of traumatic dental injury recorded in an oral health service within a ten-year period and to report the type of surface against which the traumatic dental injury occurred. Methods Dental records from children assisted in the Dental Trauma Clinic at the Rio de Janeiro State University’s School of Dentistry, between 2006 and 2016, were analyzed. Only those records who had registered some type of trauma in the primary anterior teeth (incisors and canines) and aged 0-96 months at the time of trauma were considered eligible for the study. Results Four hundred and eighty-three dental records were included, totalizing 786 traumatized teeth. The average age when traumatic dental injury occurred was 37.25 months (±18.62). Enamel fractures (32.8%) and intrusive luxations (45.6%) were the most prevalent types of trauma. The majority of traumas occurred against ceramic surfaces (34%). The greatest number of teeth with lateral luxation were the ones that hit against a ceramic surface (p=0.014; U Mann-Whitney test). According to this study, the most prevalent type of trauma in the dental tissue and pulp was enamel fracture and in the periodontal tissue was intrusive luxation. The majority of traumas occurred due to falls, at home and against ceramic surfaces. Conclusion The results showed that a high frequency of the lateral luxation was associated to a traumatic impact against ceramic surfaces.

Foi avaliada neste estudo a presença de caspase-3-clivada no coração de ratos irradiados durante o declínio da função ventricular. Ratas Wistar foram irradiadas com uma dose única de radiação (15 Gy) diretamente no coração e as análises molecular, histológica e fisiológica foram realizadas treze meses pós a irradiação dos animais. As expressões de procolágeno tipo I, TGF-ß1 e caspase-3-clivada foram analisadas usando Western blotting. Alterações cardíacas estruturais e funcionais foram investigadas por meio de ecocardiografia e microscopia eletrônica. No grupo irradiado, os níveis de procolágeno tipo I, TGF-ß1 e caspase-3-clivada estão aumentados Alterações histológicas importantes (degeneração do tecido cardíaco e deposição de colágeno) e funcionais (fração de ejeção reduzida) foram observadas. Dados sugerem que o declínio da função cardíaca após a exposição à radiação ionizante está relacionado, em parte, com aumento do colágeno e da caspase-3-clivada.

The caspase-3-cleaved presence was evaluated in this study in the heart of irradiated rats, during the decline of ventricular function. Female Wistar rats were irradiated with a single dose of radiation (15 Gy) delivered directly to the heart and the molecular, histological and physiological evaluations were performed at thirteen months post-irradiation. The expressions of procollagen type I, TGF-ß1 and caspase-3-cleaved were analyzed using Western blotting. Cardiac structural and functional alterations were investigated by echocardiography and electron microscopy. In the irradiated group, the levels of procollagen type I, TGF-ß1 and caspase-3-cleaved are increased. Significant histological changes (degeneration of heart tissue and collagen deposition) and functional (reduced ejection fraction) were observed. Data suggest that the cardiac function decline after exposure to ionizing radiation is related, in part, to increased collagen and increased caspase-3-cleaved.

Este estudo apresenta uma revisão de literatura e um relato de dois casos clínicos sobre retenção prolongada de molares decíduos, com o objetivo de descrever os meios de diagnóstico, a etiologia, as implicações clínicas e o tratamento desta condição. Fatores etiológicos locais, ambientais ou genéticos podem levar à retenção de molares decíduos, interferindo na seqüência normal de erupção dos pré-molares. Nos dois casos clínicos apresentados, os pacientes apresentaram um quadro de erupção dentária incompatível com a idade cronológica. A conduta terapêutica baseou-se na realização de exodontias dos elementos retidos, seguida da manutenção de espaço e controle clínico e radiográfico até a erupção dos sucessores. O diagnóstico e a intervenção precoces são de fundamental importância para evitar danos à oclusão.

This paper consist of a literature review about the prolonged retention of the primary molars and two clinical case reports with the purpose of describing the the diagnosis, etiology, the clinical implication and the recommend treatment for this condition. Local, environmental or genetic etiological factors may lead to over-retention of primary molars, interfering in the normal sequence of the eruption of the premolars. In the two case reports presented the patients'dental eruption showed not to be compatible to their chronological age. The recommended treatment was based on the extraction of the retained elements followed by the space maintenance and by clinical and radiographic control until the eruption of the succedaneous teeth.The early diagnosis and intervention are very important to prevent damages to the occlusion.