RESUMO Com melhorias nas exigências estéticas dentárias um número crescente de adultos está em busca de tratamento ortodôntico que, juntamente com estilo de vida atual e hábitos alimentares da população adulta, torna os ortodontistas mais propensos a encontrar pacientes com distúrbios metabólicos como a diabetes mellitus. Especula-se que o paciente diabético durante o tratamento ortodôntico pode não experimentar um processo fisiológico de cura como um paciente saudável. Portanto, o objetivo deste trabalho é apresentar uma revisão atual e contextualizada dos mecanismos pelos quais a diabetes mellitus descontrolada impacta na remodelação óssea e no movimento dentário ortodôntico durante a aplicação de forças ortodônticas. Foram pesquisadas as seguintes bases de dados MEDLINE (via PubMed), Scopus, Web of Science, SciELO, LILACS e open grey com os termos MeSH: “remodelação óssea”, “diabetes mellitus”, “ortodontia” e “movimento dentário”. Cinco artigos permaneceram após a estratégia de busca e foram analisados. Em suma, não foram encontrados estudos clínicos, as evidências foram limitadas a estudos em animais (ratos). Os resultados sugerem que existem diferenças na remodelação óssea e na movimentação dentária durante a aplicação de forças ortodônticas em animais com diabetes mellitus quando comparados a animais saudáveis, especialmente quando a doença está associada à doença periodontal. No entanto, os resultados ainda são controversos e podem ser devido a diferentes protocolos de estudo.

ABSTRACT With improvements in dental aesthetic requirements an increasing number of adults are seeking orthodontic treatment that, along with current lifestyle and eating habits of the adult population, makes orthodontists more likely to encounter patients with metabolic disorders such as diabetes mellitus. Speculated that the diabetic patient during orthodontic treatment may not experience a physiological healing process as a healthy patient. Therefore, the objective of this work is to present a current and contextualized review of the mechanisms by which uncontrolled diabetes mellitus impacts on bone remodeling and orthodontic tooth movement during the application of orthodontic forces. The following databases were searched MEDLINE (via PubMed), Scopus, Web of Science, SciELO, LILACS and open grey with these MeSH “bone remodeling”, “diabetes mellitus”, “orthodontic” and “tooth movement”. Five articles remained after search strategy and were analyzed. In sum, no clinical studies were found, the evidence was limited to animal studies (rats). The results suggest that there are differences in bone remodeling and tooth movement during the application of orthodontic forces in animals with diabetes mellitus when compared to healthy animals, especially when the disease is associated with periodontal disease. However, the results are still controversial and may be due to different study protocols.

Quase todas as informações que temos do cosmos chegaram até nós através de ondas eletromagnéticas de uma forma ou de outra. Para interpretar as informações recebidas, precisamos entender o que acontece com a luz neste caminho. Para isto, analisamos as estruturas causais com intuito de dissolver as dúvidas e mal entendidos com respeito aos horizontes cosmológicos.

Almost all the information we have of the cosmos carne to us through electromagnetic waves in one form or another. To interpret the information received, we must understand what happens to light in this way. For this, we analyzed the causal structures with intent to dissolve the doubts and misunderstandings with respect to the cosmological horizons.

PURPOSE: Death at the beginning of life is tragic but not uncommon in neonatal intensive care units. In Portugal, few studies have examined the circumstances surrounding the final moments of neonates. We evaluated the care given to neonates and their families in terminal situations and the changes that had occurred one decade later. DESIGN AND METHODS: We analyzed 256 charts in a retrospective chart review of neonatal deaths between two periods (1992-1995 and 2002-2005) in a level III neonatal intensive care unit. RESULTS: Our results show differences in the care of dying infants between the two periods. The analysis of the 2002-2005 cohort four years revealed more withholding and withdrawing of therapeutic activities and more effective pain and distress relief; however, on the final day of life, 95.7% of the infants received invasive ventilatory support, 76.3% received antibiotics, 58.1% received inotropics, and 25.8% received no opioid or sedative administration. The 2002-2005 cohort had more spiritual advisor solicitation, a higher number of relatives with permission to freely visit and more clinical meetings with neonatologists. Interventions by parents, healthcare providers and ethics committees during decision-making were not documented in any of the charts. Only eight written orders regarding therapeutic limitations and the adoption of palliative care were documented; seven (87.5%) were from the 2002-2005 cohort. Parental presence during death was more frequent in the latter four years (2002-2005 cohort), but only 21.5% of the parents wanted to be present at that moment. CONCLUSION: Despite an increase in the withholding and withdrawing of therapeutic activities and improvements in pain management and family support, many neonates still receive curative and aggressive practices at the end of life.

Modificações nos níveis de luminosidade, aos quais uma espécie está adaptada, podem condicionar diferentes respostas fisiológicas em suas características bioquímicas, anatômicas e de crescimento. Este trabalho teve como objetivo avaliar o crescimento inicial de plantas de licuri (Syagrus coronata (Mart.) Becc.) submetidas a diferentes condições de luminosidade. Neste estudo foram utilizadas plântulas de licuri com cinco meses de idade, cultivadas em substrato composto de terra + adubo orgânico e mantidas a 30 e 100% de luminosidade. Mensalmente foram tomadas medidas de altura, diâmetro do colo e número de folhas das plantas, durante um período de 12 meses. Ao final do experimento, determinaram-se a massa seca, a área foliar e o teor de clorofila. O maior crescimento em altura, diâmetro do colo, número de folhas emitidas e massa seca total foram verificados nas plantas submetidas a 30% de luz. A proporção de massa seca direcionada para as raízes foi maior à medida que houve aumento da intensidade luminosa. Já a parte aérea, diferentemente do sistema radicular, apresentou uma diminuição com o aumento da luminosidade. Em 100% de luz, as plantas apresentaram maior área foliar total, bem como maior razão das clorofilas a/b, enquanto a área foliar específica mostrou-se inversamente proporcional à intensidade luminosa. Com os resultados obtidos, pode-se inferir que a condição de sombreamento favoreceu o crescimento inicial das plantas de licuri.

Changes in light intensity, to which a species is adapted, may condition different physiological responses in its biochemical, anatomical and growing features. This paper aims at assessing the initial growth of licuri plants (Syagrus coronata (Mart.) Becc.) subjected to different light conditions. Five-month-old licuri plants, grown in substrates of soil + organic fertilizer, were used. Plants were kept in 30% and 100% light intensity. Measurements of height, stem diameter, and number of leaves were taken monthly over a 12-month period. At the end of the experiment, dry mass, foliar area and chlorophyll contents were evaluated. Those plants submitted to 30% light intensity showed improvement in height, stem diameter, number of produced leaves, and total dry mass. Proportion of dry mass directed towards the roots was higher as light intensity increased, however, aerial part, differently from the radicular system, decreased. Under 100% light intensity, the plants showed a larger total leaf area, as well as a higher chlorophyll a/b ratio. Specific leaf area was inversely proportional to the light intensity. With the obtained results, it can be inferred that shade favored initial growth of licuri plants.