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Photobiomodulation as adjuvant therapy for Bell's palsy: a case series
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Silva, Fernanda Leme

; Rodrigues Manzano, Brena

; Carneiro, Mailon Cury

; Moura, Ludimila Lemes

; Ferreira Santos, Dayanne Simões

; Fischer Rubira, Cássia Maria

; da Silva Santos, Paulo Sérgio

Revista Estomatológica Herediana

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Jul 2024, Volume 34 Nº 3 Páginas 263 - 276

Resumo: Es Pt En | Texto: Es Pt En | PDF: Es | PDF: Pt | PDF: En

RESUMEN Este estudio evaluó la eficacia de la terapia por luz de baja intensidad (LLLT, por sus siglas en inglés) en el tratamiento de tres pacientes con parálisis de Bell (BP) y revisó la literatura relacionada. Un caso involucró a una mujer de 52 años con BP grado V, quien, después de recibir terapia con medicamentos y siete sesiones de LLLT (780 nm; 70 mW; E = 9 J), mejoró al grado II en 21 días. Otro caso, un hombre de 37 años, previamente no receptivo a tratamientos, se sometió a 24 sesiones de LLLT, pasando del grado V al II en 4 meses. Finalmente, un hombre de 40 años tratado con medicamentos y 8 sesiones de LLLT mejoró del grado V al I en 1,5 meses. En esencia, la LLLT mejoró significativamente las funciones faciales, la estética y el bienestar general de los pacientes en un corto período de tiempo.

RESUMO Este estudo avaliou a eficácia da terapia com luz de baixo nível (LLLT) no tratamento de três pacientes com paralisia de Bell (PB) e revisou a literatura relevante. O primeiro caso envolveu uma mulher de 52 anos com PB grau V, que, após receber tratamento farmacológico e realizar sete sessões de LLLT (780 nm; 70 mW; E = 9 J), melhorou para grau II em 21 dias. O segundo caso foi de um homem de 37 anos que, após não ter apresentado resposta ao tratamento anteriormente, recebeu 24 sessões de LLLT e progrediu de grau V para grau II ao longo de 4 meses. O terceiro caso envolveu um homem de 40 anos que, após medicação e oito sessões de LLLT, melhorou de grau V para grau I em 1,5 meses. No geral, a LLLT demonstrou melhorar significativamente a função facial, a estética e o bem-estar geral desses pacientes em um período relativamente curto.

ABSTRACT This study evaluated the efficacy of low-level light therapy (LLLT) in the treatment of three patients with Bell's palsy (BP) and reviewed relevant literature. The first case involved a 52year-old woman with grade V BP, who, after receiving pharmacological treatment and undergoing seven sessions of LLLT (780 nm; 70 mW; E = 9 J), improved to grade II within 21 days. The second case was a 37-year-old man who, having previously shown no response to treatment, received 24 sessions of LLLT and progressed from grade V to grade II over the course of 4 months. The third case involved a 40-year-old man who, following medication and eight sessions of LLLT, improved from grade V to grade I in 1.5 months. Overall, LLLT was found to significantly enhance facial function, aesthetics, and overall well-being in these patients within a relatively short period.

https://doi.org/10.20453/reh.v34i3.5837

Anormalidades Cardíacas nas Síndromes Hipereosinofílicas
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Hotta, Viviane Tiemi

; Nastari, Rafael Ruas

; Oishi, Gardênia da Silva Lobo

; Kayano, Alexandre Eiji

; Oliveira, Juliana Alzira Gonzales

; Rocha, Ruiza Gonçalves Mocumbi, Ana Olga Seguro, Fernanda Salles Krieger, José Eduardo Fernandes, Fábio Salemi, Vera Maria Cury

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 Nº 10 elocation e20240190

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo A Hipereosinofilia (HE) é definida como uma contagem de eosinófilos superior a 1500 células/microL no sangue periférico em dois exames, realizados com intervalo mínimo de um mês e/ou confirmação anatomopatológica de HE, com eosinófilos compreendendo mais de 20% de todas as células nucleadas da medula óssea. A Síndrome hipereosinofílica (SHE) indica a presença de HE com comprometimento de órgãos por ação eosinofílica, podendo ser classificada como primária (ou neoplásica), secundária (ou reativa) e idiopática. O comprometimento cardíaco ocorre em até 5% dos casos na fase aguda e em 20% na fase crônica da doença, variando de casos oligossintomáticos até miocardite aguda fulminante ou cardiomiopatia restritiva crônica (endomiocardite de Loeffler). No entanto, o grau de disfunção cardíaca não se correlaciona diretamente com o grau de eosinofilia. O envolvimento cardíaco na SHE ocorre em três fases: necrótica inicial, trombótica e necrótica final. Pode se manifestar como insuficiência cardíaca, arritmias e fenômenos tromboembólicos. O diagnóstico de cardiopatia é baseado em métodos de imagem multimodalidade, com ênfase na importância do ecocardiograma transtorácico (ETT). Em pacientes com janela acústica limitada, podem ser utilizados agentes de contraste ultrassonográfico, que permitem melhor visualização das bordas endocárdicas e da região ventricular apical. Técnicas para análise da deformação miocárdica podem evidenciar redução do strain em segmentos apicais e preservação nos demais segmentos (reverse apical sparing). A ressonância magnética cardíaca permite a caracterização do realce tardio subendocárdico de gadolínio, e a biópsia endomiocárdica é considerada o padrão ouro no diagnóstico de cardiopatia. O tratamento é baseado na etiologia da SHE.

Abstract Hypereosinophilia (HE) is defined as an eosinophil count exceeding 1500 cells/microL in peripheral blood in two tests, performed with an interval of at least one month and/or anatomopathological confirmation of HE, with eosinophils comprising more than 20% of all nucleated cells in the bone marrow. Hypereosinophilic syndrome (HES) indicates the presence of HE with organ involvement due to eosinophil action, which can be classified as primary (or neoplastic), secondary (or reactive), and idiopathic. Cardiac involvement occurs in up to 5% of cases in the acute phase and 20% of the chronic phase of the disease, ranging from oligosymptomatic cases to fulminant acute myocarditis or chronic restrictive cardiomyopathy (Loeffler endomyocarditis). However, the degree of cardiac dysfunction does not directly correlate with the degree of eosinophilia. The cardiac involvement of HES occurs in three phases: initial necrotic, thrombotic, and finally necrotic. It can manifest as heart failure, arrhythmias, and thromboembolic phenomena. The diagnosis of cardiopathy is based on multimodality imaging, with an emphasis on the importance of echocardiography (echo) as the primary examination. TTE with enhanced ultrasound agents can be used for better visualization, allowing greater accuracy in assessing ventricular apex, and myocardial deformation indices, such as longitudinal strain, may be reduced, especially in the ventricular apex (reverse apical sparing). Cardiac magnetic resonance imaging allows the characterization of subendocardial late gadolinium enhancement, and endomyocardial biopsy is considered the gold standard in diagnosing cardiopathy. Treatment is based on the etiology of HES.

https://doi.org/10.36660/abc.20240190

Avaliação das propriedades psicométricas da versão brasileira do Short Portable Mental Status Questionnaire (SPMSQ) de Pfeiffer SPMSQ (SPMSQ
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Teigão, Fernanda Cury Martins

; Moser, Auristela Duarte de Lima

; Fidalski, Solena Ziemer Kusma

Revista Brasileira de Geriatria e Gerontologia

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2024, Volume 27 elocation e230277

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Objective To evaluate the psychometric properties, including validity, reliability, sensitivity, and specificity of the SPMSQ-BR. Method The analysis was conducted on 93 older adults, assessed with the Brazilian version of the SPMSQ, Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), and Verbal Fluency Test (VFT). Internal consistency was estimated using Cronbach's alpha coefficient. In order to assess intra-rater stability and inter-rater reproducibility, the intraclass correlation coefficient (ICC) with a 95% confidence interval was employed. For concurrent and convergent validity, Spearman's correlation coefficient was utilized. Accuracy in establishing the cutoff point for the SPMSQ-BR to screen sensitivity and specificity was assessed through ROC curve analysis. Result The SPMSQ-BR demonstrated excellent internal consistency (α=0.803), high intra-rater and inter-rater reliability (ICC=0.977 and ICC=0.973), respectively. In terms of concurrent validity, it showed a strong negative linear correlation with the MMSE (-0.799, p<0.001), while moderate correlations were found with the CDT (-0.584, p<0.01) and VFT (-0.569, p<0.01). The SPMSQ-BR proved capable of discriminating cognitive impairment with a cutoff point of 3 errors, following the original scale. The area under the curve (AUC) considering education level was 0.905 (sensitivity=81.3%, specificity=76.9%), and without considering education level, the AUC was 0.927 (sensitivity=87.5%, specificity=80.8%), indicating good sensitivity and specificity in both cases. Conclusion The study demonstrated that the Brazilian version of the SPMSQ, established as a Brief Cognitive Capacity Scale, proved to be stable, reproducible, valid, and reliable for assessing the cognitive capacity of older adults. Furthermore, it showed sensitivity in identifying cognitive impairment. properties validity SPMSQBR. SPMSQBR SPMSQ BR. BR 9 adults MiniMental Mini Mental MMSE, , (MMSE) CDT, (CDT) VFT. . (VFT) Cronbachs Cronbach s intrarater intra rater interrater inter reproducibility ICC (ICC 95 employed Spearmans Spearman utilized α=0.803, α0803 α α=0.803 0 803 (α=0.803) ICC=0.977 ICC0977 977 (ICC=0.97 ICC=0.973, ICC0973 ICC=0.973 973 ICC=0.973) respectively 0.799, 0799 799 (-0.799 p<0.001, p0001 p p<0.001 001 p<0.001) 0.584, 0584 584 (-0.584 p<0.01 p001 01 0.569, 0569 569 (-0.569 p<0.01. errors scale (AUC 0905 905 0.90 sensitivity=81.3%, sensitivity813 81 (sensitivity=81.3% specificity=76.9%, specificity769 specificity=76.9% 76 specificity=76.9%) 0927 927 0.92 sensitivity=87.5%, sensitivity875 87 5 (sensitivity=87.5% specificity=80.8%, specificity808 specificity=80.8% 80 8 specificity=80.8%) cases Scale stable reproducible valid Furthermore (MMSE (CDT (VFT α080 α=0.80 (α=0.803 ICC=0.97 ICC097 97 (ICC=0.9 0.799 079 79 (-0.79 p000 p<0.00 00 0.584 058 58 (-0.58 p<0.0 p00 0.569 056 56 (-0.56 090 90 0.9 sensitivity=81.3% sensitivity81 (sensitivity=81.3 specificity76 specificity=76.9 7 092 92 sensitivity=87.5% sensitivity87 (sensitivity=87.5 specificity80 specificity=80.8 α08 α=0.8 (α=0.80 ICC=0.9 ICC09 (ICC=0. 0.79 07 (-0.7 0.58 05 (-0.5 p<0. p0 0.56 09 0. sensitivity=81.3 sensitivity8 (sensitivity=81. specificity7 specificity=76. sensitivity=87.5 (sensitivity=87. specificity8 specificity=80. α0 α=0. (α=0.8 ICC=0. ICC0 (ICC=0 0.7 (-0. 0.5 p<0 sensitivity=81. (sensitivity=81 specificity=76 sensitivity=87. (sensitivity=87 specificity=80 α=0 (α=0. ICC=0 (ICC= (-0 p< sensitivity=81 (sensitivity=8 specificity=7 sensitivity=87 specificity=8 α= (α=0 ICC= (- sensitivity=8 (sensitivity= specificity= (α= ( sensitivity= (sensitivity (α

Resumo Objetivo Avaliar as propriedades psicométricas, contemplando validade, confiabilidade, sensibilidade e especificidade do SPMSQ-BR. Método A análise foi realizada em 93 idosos, avaliados com a versão brasileira do SPMSQ, Mini-Exame do Estado Mental (MEEM), Teste do Desenho do Relógio (TDR) e Teste de Fluência Verbal (TFV). A consistência interna foi estimada pelo coeficiente alfa de Cronbach. Para avaliar a estabilidade intra-avaliador e a reprodutibilidade inter-avaliador, utilizou-se o coeficiente de correlação intraclasse (CCI) com intervalo de confiança de 95%. Para a validade concorrente e convergente, utilizou-se o coeficiente de correlação de Spearman. A acurácia para estabelecer o ponto de corte do SPMSQ-BR para rastreamento da sensibilidade e especificidade realizou-se através da curva ROC. Resultado: O SPMSQ-BR demonstrou excelente consistência interna (α=0,803), alta confiabilidade intra e inter-avaliador (CCI-0,977) e (CCI-0,973) respectivamente. Na validade concorrente apresentou forte correlação linear com o MEEM (-0,799 p<0,001), já com TDR (-0,584 p<0,01) e TFV (-0,569 p<0,01) foram encontradas correlações moderadas. O SPMSQ-BR mostrou-se capaz de discriminar o comprometimento cognitivo com ponto de corte a partir de 3 erros, conforme a escala original. A área sob a curva considerando a escolaridade foi de AUC=0,905 (S=81,3% e E=76,9%) e sem considerar a escolaridade AUC=0,927 (S=87,5% e E=80,8%) apresentando uma boa sensibilidade e especificidade em ambos os casos. Conclusão O estudo demonstrou que a versão brasileira do SPMSQ estabelecida como Breve Escala de Capacidade Cognitiva apresentou-se estável, reprodutível, válida e confiável para avaliar a capacidade cognitiva de idosos, além de ser sensível na identificação de comprometimento cognitivo. psicométricas SPMSQBR. SPMSQBR BR. BR 9 idosos MiniExame Mini Exame MEEM, , (MEEM) (TDR TFV. . (TFV) Cronbach intraavaliador avaliador interavaliador, interavaliador inter avaliador, utilizouse utilizou se CCI (CCI 95 95% convergente Spearman realizouse realizou ROC Resultado α=0,803, α0803 α α=0,803 0 803 (α=0,803) CCI0,977 CCI0977 0,977 977 (CCI-0,977 CCI0,973 CCI0973 0,973 973 (CCI-0,973 respectivamente 0,799 0799 799 (-0,79 p<0,001, p0001 p p<0,001 001 p<0,001) 0,584 0584 584 (-0,58 p<0,01 p001 01 0,569 0569 569 (-0,56 moderadas mostrouse mostrou erros original AUC0905 AUC 905 AUC=0,90 S=81,3% S813 S 81 (S=81,3 E=76,9% E769 E 76 AUC0927 927 AUC=0,92 S=87,5% S875 87 5 (S=87,5 E=80,8% E808 80 8 casos apresentouse estável reprodutível (MEEM (TFV α080 α=0,80 (α=0,803 CCI0 CCI0,97 CCI097 0977 0,97 97 (CCI-0,97 0973 0,79 079 79 (-0,7 p000 p<0,00 00 0,58 058 58 (-0,5 p<0,0 p00 0,56 056 56 AUC090 90 AUC=0,9 S=81,3 S81 (S=81, E=76,9 E76 7 AUC092 92 S=87,5 S87 (S=87, E=80,8 E80 α08 α=0,8 (α=0,80 CCI0,9 CCI09 097 0,9 (CCI-0,9 0,7 07 (-0, 0,5 05 p<0, p0 AUC09 AUC=0, S=81, S8 (S=81 E=76, E7 S=87, (S=87 E=80, E8 α0 α=0, (α=0,8 CCI0, 09 0, (CCI-0, (-0 p<0 AUC0 AUC=0 S=81 (S=8 E=76 S=87 E=80 α=0 (α=0, (CCI-0 (- p< AUC= S=8 (S= E=7 E=8 α= (α=0 (CCI- ( S= (S E= (α= (α

https://doi.org/10.1590/1981-22562024027.230277.pt

Active surveillance versus immediate surgery in the management of low-risk papillary thyroid microcarcinoma: comparison of long-term costs in Brazil lowrisk low risk microcarcinoma longterm long term
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Faro, Fernanda Nascimento

; Bertelli, Antônio Augusto Tupinambá

; Scalissi, Nilza Maria

; Cury, Adriano Namo

; Padovani, Rosália do Prado

; Ferraz, Carolina

Archives of Endocrinology and Metabolism

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2024, Volume 68 elocation e230349

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective To compare the long-term medical costs of active surveillance (AS), partial thyroidectomy (PT), and total thyroidectomy (TT) in patients with low-risk papillary thyroid microcarcinoma (PTMC) receiving care covered by the Brazilian Public Health System. Materials and methods After reviewing AS cohorts and our own data, we created a model of AS, PT, and TT flow care for low-risk PTMC over 10, 20, and 30 years. The medical costs included those associated with diagnosis, surgery, and follow-up. We considered that 13.3% of the patients on AS would require surgery after a mean of 21.3 months, 4% undergoing TT would develop permanent hypoparathyroidism, and 43% undergoing PT would develop hypothyroidism. Results The most economical alternative was AS. The costs of TT per patient were higher than those of AS by 182.8% over 10 years (866.89 versus 306.49 US dollars [USD], respectively), by 152.9% over 20 years (1,023.66 versus 404.73 USD, respectively), and by 134.7% over 30 years (1,180.42 versus 502.96 USD, respectively). The costs of PT per patient were higher than those of AS by 16.0% over 10 years (355.66 versus 306.49 USD, respectively), by 16.9% over 20 years (473.41 versus 404.73 USD, respectively), and by 17.5% over 30 years (591.17 versus 502.96 USD, respectively). Conclusion The AS approach was less costly than immediate surgery throughout 30 years of follow-up. Hence, the implementation of AS in Brazil should not be hindered by cost considerations. longterm long term , (AS) (PT) (TT lowrisk low risk (PTMC System data 3 diagnosis followup. followup follow up. up follow-up 133 13 13.3 213 21 21. months 4 hypoparathyroidism 43 hypothyroidism 1828 182 8 182.8 1 866.89 86689 866 89 (866.8 30649 306 49 306.4 USD [USD] respectively, respectively respectively) 1529 152 9 152.9 2 1,023.66 102366 023 66 (1,023.6 40473 404 73 404.7 1347 134 7 134.7 1,180.42 118042 180 42 (1,180.4 50296 502 96 502.9 respectively. . 160 16 0 16.0 355.66 35566 355 (355.6 169 16.9 473.41 47341 473 41 (473.4 175 17 5 17.5 591.17 59117 591 (591.1 Hence considerations (AS (PT 13. 18 182. 866.8 8668 86 (866. 3064 306. [USD 15 152. 1,023.6 10236 02 6 (1,023. 4047 40 404. 134. 1,180.4 11804 (1,180. 5029 50 502. 16. 355.6 3556 35 (355. 473.4 4734 47 (473. 17. 591.1 5911 59 (591. 866. (866 1,023. 1023 (1,023 1,180. 1180 (1,180 355. (355 473. (473 591. (591 (86 1,023 102 (1,02 1,180 118 (1,18 (35 (47 (59 (8 1,02 (1,0 1,18 11 (1,1 (3 (4 (5 ( 1,0 (1, 1,1 1, (1

https://doi.org/10.20945/2359-4292-2023-0349

Nas brechas do cotidiano: construindo reflexões sobre práticas e saberes profissionais a partir da comida do território
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MALUF, GIULIA DE ARRUDA

; ALBUQUERQUE, MARIA PAULA DE

; FRUTUOSO, MARIA FERNANDA PETROLI

; CURY, BERNARDO TEIXEIRA

Estudos Avançados

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Dez 2023, Volume 37 Nº 109 Páginas 227 - 242

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Data production in a Continuing Health Education workshop focused on professional practices and knowledge about children and adolescents’ eating in peripheral territories. It acknowledges food as a mediator within territorial networks and short food supply chains. The encounter as an important instance to recognize each other’s work/knowledge, valuing popular knowledge, and subverting the nutritionist’s role as the single authority on food and eating. The workshop as an intentional strategy, as well as other unintentional encounters of daily work, invites health professionals to reflect about their practice, initiating changes in the relationship within the team and the territorial network. This motion does not occur without disputes, and does not have easy answers.

RESUMO A produção de dados em uma oficina de educação permanente em saúde sobre as práticas e saberes profissionais envolvendo a alimentação de crianças e adolescentes em territórios periféricos apontou a potência do encontro para o reconhecimento do próprio saber-fazer e do trabalho/conhecimento do outro no cotidiano do cuidado. Reconheceu o alimento como mediador de redes territoriais que envolvem a cadeia curta de produção-comercialização de alimentos que valorizam o saber popular para além do nutricionista como único detentor do saber sobre alimentação. A oficina convidou ao pensamento sobre as relações da equipe e da rede territorial, que não acontecem sem disputas e nem sempre resultam em respostas rápidas e fáceis.

https://doi.org/10.1590/s0103-4014.2023.37109.014

Prosthetic complications and quality of life among wearers of mandibular overdenture with the Facility-Equator system
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SCHUSTER, Alessandra Julie

; MARCELLO-MACHADO, Raissa Micaella

; BIELEMANN, Amália Machado

; POSSEBON, Anna Paula da Rosa

; DEL BEL CURY, Altair Antoninha

; FAOT, Fernanda

Brazilian Oral Research

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2022, Volume 36 elocation e081

Resumo: En | Texto: En | PDF: En

Abstract This longitudinal study aimed to assess the performance of the Facility-Equator system as mandibular overdenture (MO) retainers from a prosthetic perspective during 2 years of loading and to investigate the oral health-related quality of life (OHRQoL) and whether prosthetic events can affect the OHRQoL. Twenty-four patients (68.1 ± 7.51 years) reported their OHRQoL through the Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-EDENT) questionnaires before MO loading and after 1 and 2 years of usage. Prosthetic occurrences were recorded during this period. Data were analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation coefficients. Of the 127 prosthetic events that occurred in the first year, the most frequent events were prosthesis adjustments (16.5%), dislodgement of the Equator attachment (14.17%), and O-ring replacement (11.8%). Eighty-seven prosthetic events were recorded in the second year, the most frequent events being prosthesis adjustments (27.6%), O-ring replacement (20.7%), and recapturing the female matrix (11.5%). All domains of the GOHAI and OHIP-EDENT questionnaires exhibited a significant difference (p < 0.05) between the baseline and 1- and 2-year evaluations, except in the Social Disability and Psychological Discomfort domains (p > 0.05) of OHIP-EDENT after 1 year. Complications related to prosthetic maintenance, such as fracturing of the prosthesis, Equator dislodgement, prosthesis rebasing, and new overdenture confection, affect the OHRQoL (p < 0.05), primarily the Physical Pain and Discomfort domains, especially in the first year of MO loading.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0081

Evaluation of biofilm formation on acrylic resin surfaces coated with silicon dioxide: an in situ study
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SILVA, Rossano Vinícius Dala Rosa

; JARROS, Isabele Carrilho

; DEL BEL CURY, Altair Antoninha

; SIDHU, Sharanbir Kaur

; SILVA, Sónia

; NEGRI, Melyssa Fernanda Norman

; PASCOTTO, Renata Corrêa

Brazilian Oral Research

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2022, Volume 36 elocation e007

Resumo: En | Texto: En | PDF: En

Abstract Biofilm on acrylic resin dental prostheses may cause gingival inflammation. This study evaluated the influence of a silicon dioxide coating layer applied onto acrylic resin on the adhesion of microorganisms. Blocks (5 x 5 x 3 mm) of acrylic resin were evaluated for surface roughness and divided into two groups: control (CG) and coated with silicon dioxide (LG group). The specimens were evaluated by scanning electron microscopy (n = 1) and by contact angle analysis (n = 3). For the in situ study, 20 volunteers wore acrylic palatal devices containing three samples from each group (n = 60) for 2 days. The biofilm formed was quantified by metabolic activity and total biomass using the crystal violet assay. The results were subjected to Bartlett’s normality test and Gamma model with random effect for the response variable (α = 5%). The mean contact angle of the coated group was significantly lower than that of the uncoated group (p < 0.05). The metabolic activity of microorganisms in the biofilm on the blocks treated with coating was significantly lower than that of control blocks (p = 0.02). Regarding the amount of extracellular matrix produced by the microorganisms, there was no difference between the CG and LG group (p = 0.05). The application of a silicon dioxide coating on acrylic resin reduced the activity of the polymicrobial biofilm formed in situ. This coating may be advantageous for patients with conventional complete dentures or implants made of acrylic resin and who have motor difficulties that prevent them from cleaning their prostheses properly.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0007

Posicionamento Brasileiro sobre o Uso da Multimodalidade de Imagens na Cardio-Oncologia – 2021
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Melo, Marcelo Dantas Tavares de

; Paiva, Marcelo Goulart

; Santos, Maria Verônica Câmara

; Rochitte, Carlos Eduardo

; Moreira, Valéria de Melo

; Saleh, Mohamed Hassan

; Brandão, Simone Cristina Soares

; Gallafrio, Claudia Cosentino

; Goldwasser, Daniel

; Gripp, Eliza de Almeida

; Piveta, Rafael Bonafim

; Silva, Tonnison Oliveira

; Santo, Thais Harada Campos Espirito

; Ferreira, Waldinai Pereira

; Salemi, Vera Maria Cury

; Cauduro, Sanderson A.

; Barberato, Silvio Henrique

; Lopes, Heloísa M. Christovam

; Pena, José Luiz Barros

; Rached, Heron Rhydan Saad

; Miglioranza, Marcelo Haertel

; Pinheiro, Aurélio Carvalho

; Vrandecic, Bárbara Athayde Linhares Martins

; Cruz, Cecilia Beatriz Bittencourt Viana

; Nomura, César Higa

; Cerbino, Fernanda Mello Erthal

; Costa, Isabela Bispo Santos da Silva

; Coelho Filho, Otavio Rizzi

; Carneiro, Adriano Camargo de Castro

; Burgos, Ursula Maria Moreira Costa Fernandes, Juliano Lara Uellendahl, Marly Calado, Eveline Barros Senra, Tiago Assunção, Bruna Leal Freire, Claudia Maria Vilas Martins, Cristiane Nunes Sawamura, Karen Saori Shiraishi Brito, Márcio Miranda Jardim, Maria Fernanda Silva Bernardes, Renata Junqueira Moll Diógenes, Tereza Cristina Vieira, Lucas de Oliveira Mesquita, Claudio Tinoco Lopes, Rafael Willain Segundo Neto, Elry Medeiros Vieira Rigo, Letícia Marin, Valeska Leite Siqueira Santos, Marcelo José Grossman, Gabriel Blacher Quagliato, Priscila Cestari Alcantara, Monica Luiza de Teodoro, José Aldo Ribeiro Albricker, Ana Cristina Lopes Barros, Fanilda Souto Amaral, Salomon Israel do Porto, Carmen Lúcia Lascasas Barros, Marcio Vinícius Lins Santos, Simone Nascimento dos Cantisano, Armando Luís Petisco, Ana Cláudia Gomes Pereira Barbosa, José Eduardo Martins Veloso, Orlando Carlos Glória Spina, Salvador Pignatelli, Ricardo Hajjar, Ludhmilla Abrahão Kalil Filho, Roberto Lopes, Marcelo Antônio Cartaxo Queiroga Vieira, Marcelo Luiz Campos Almeida, André Luiz Cerqueira

Arquivos Brasileiros de Cardiologia

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Out 2021, Volume 117 Nº 4 Páginas 845 - 909

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20200266 103 downloads

Prognostic factors for incomplete response in thyroid microcarcinoma: an analysis of initial response to therapy in 517 patients
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Faro, Fernanda Nascimento

; Simões, Vivian Roberta Ferreira

; Ricardo, Gustavo Piech

; Cabral, Cristal Peters

; Ribeiro, Karina de Cássia Braga

; Scalissi, Nilza Maria

; Cury, Adriano Namo

; Marone, Marília Martins

; Padovani, Rosália do Prado

; Ferraz, Carolina

Archives of Endocrinology and Metabolism

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2021, Volume 65 Nº 5 Páginas 579 - 587

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: Although thyroid microcarcinoma (TMC) usually has a favorable prognosis, some patients present a higher risk of disease recurrence or persistence. Thus, we aimed at identifying possible risk factors associated with an incomplete response to therapy in TMC. Subjects and methods: This was a retrospective study of 517 patients with TMC treated with total thyroidectomy, with or without radioactive iodine (RAI) therapy, reclassified after 1.1 ± 0.4 years according to the response to treatment into “favorable” (excellent/indeterminate) or “unfavorable” (biochemical/structural incomplete) responses. We evaluated participants' age, sex, tumor size, histological variants, multifocality, presence of vascular/lymphatic/perineural invasion, extrathyroidal extension, metastatic lymph nodes (LN), and distant metastasis. The effect of RAI therapy on the response range was analyzed in a given subgroup. Results: The mean age observed was 46.4 ± 12.0 years, and 89.7% were female. We noted 97.5% with papillary carcinoma, 27.8% with multifocality and 11.2% with LN metastasis. Although the majority of patients had a low risk of recurrence/persistence (78%), 75% were submitted to RAI therapy. Incomplete response (20.7%) was associated with multifocality (p=0.041; OR=1.619) and metastatic LN (p=0.041; OR=1.868). These variables were strongly correlated (p=0.000; OR=3.283). No cut-off of tumor size was identified as a predictor of incomplete response by the receiver operating curve analysis. RAI treatment did not influence the response of patients with multifocality or LN metastasis. Conclusion: Multifocality and LN metastasis are independent risk factors for incomplete response in TMC patients and are strongly correlated. Additional RAI therapy was not associated with a more favorable response in these subgroups.

https://doi.org/10.20945/2359-3997000000341 192 downloads

10.

Intermediate-risk thyroid carcinoma: indicators of a poor prognosis
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Faro, Fernanda Nascimento

; Bezerra, Ângela Maria Leal Barros

; Scalissi, Nilza Maria

; Cury, Adriano Namo

; Marone, Marília Martins

; Ferraz, Carolina

; Padovani, Rosália do Prado

Archives of Endocrinology and Metabolism

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Dez 2020, Volume 64 Nº 6 Páginas 764 - 771

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: The intermediate-risk (IR) category includes tumors with different degrees of aggression. We aimed to identify the risk factors associated with unfavorable response to initial treatment and compare the effect of low/high radioactive iodine (RAI) therapy. Subjects and methods: A total of 614 IR patients were selected from a database, during 1972-2015. All patients underwent total thyroidectomy and RAI therapy and were reclassified after 12-18 months into the favorable (complete/indeterminate) response group and the unfavorable (biochemical/incomplete structural) response group. A total of 92 patients were assessed for late response (mean: 9.19 ± 5.73 years). Age, gender, tumor size, histology, multifocality, vascular invasion, extrathyroidal extension, presence and number of lymph node metastasis, and stimulated thyroglobulin at ablation (sTg) were evaluated. Results: Mean age at diagnosis was 41.47 ± 15.81 years, and 83.6% of the patients were female. Within 12-18 months after initial therapy, unfavorable response was detected in 41.2% of the patients and was associated, in multivariate analysis, with lymph node metastasis (p = 0.041; odds ratio [OR] = 1.9), presence of more than five metastatic lymph nodes (p = 0,017; OR = 2.6), and sTg > 10 ng/mL (p = 0.005; OR = 10.0). For patients with a longer follow-up, sTg >10 ng/mL was associated with unfavorable response (p = 0.002; OR = 6.8). A higher RAI dose was not related to better prognosis at the end of the follow-up. Conclusion: A sTg level of >10 ng/mL and lymph node metastasis were associated with an unfavorable response 12-18 months after initial treatment. A RAI dose below 150 mCi was proven sufficient to treat IR patients.

https://doi.org/10.20945/2359-3997000000290 619 downloads

11.

The impact of minimal extrathyroidal extension in the recurrence of papillary thyroid cancer patients
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Almeida, Maria Fernanda Ozorio de

; Couto, Júlia Soares

; Ticly, Ana Luiza Trevizani

; Guardia, Vivian Cenize

; Marone, Marilia Martins Silveira

; Scalissi, Nilza Maria

; Cury, Adriano Namo

; Ferraz, Carolina

; Padovani, Rosália do Prado

Archives of Endocrinology and Metabolism

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Jun 2020, Volume 64 Nº 3 Páginas 251 - 256

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective We aimed to evaluate the impact of minimal extrathyroidal extension (mETE) alone on the risk of recurrence of papillary thyroid carcinoma (PTC). The impact of other factors, including multifocality, age, tumor size, and stimulated thyroglobulin (sTg) values was also assessed. Subjects and methods We retrospectively analyzed 1,108 PTC patients from a medical institution, who presented tumors ≤ 4 cm without any adverse characteristics other than mETE. Patients were classified according to their response to initial treatment 12 to 24 months after surgery as proposed by the 2015 American Thyroid Association (ATA) guideline. Statistical analysis was performed using multivariate logistic regression and receiver operating characteristic (ROC) curve. Results In the multivariate logistic regression analysis, mETE did not have an impact on the response to initial treatment (p = 0.44), similar to multifocality, age, and tumor size. Initial Tg value was the only variable associated with a poor response (p < 0.01, odds ratio = 1.303, 95% confidence interval 1.25-1.36). The ROC analysis revealed that Tg was significant (area under curve = 0.8750); the cutoff value of sTg as a predictor of poor response was 10 ng/mL (sensitivity = 72.2%, specificity = 98.5%). Conclusion For low-risk PTC presenting mETE as the only aggressive feature, the initial sTg value is essential to identify patients who may have a poor response after initial treatment and benefit from further treatment. Arch Endocrinol Metab. 2020;64(3):251-6

https://doi.org/10.20945/2359-3997000000245 778 downloads

12.

Blood components requests at an orthopedic hospital: a critical survey
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Borchardt, Aline Cury

; Azevedo-Silva, Fernanda Amorim Filho, Luiz de Melo

Hematology, Transfusion and Cell Therapy

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Mar 2020, Volume 42 Nº 1 Páginas 25 - 32

Resumo: En | Texto: En | PDF: En

Abstract Introduction The correct completion of the blood components request form is the starting point to ensure good transfusion care. Many guidelines have been developed to search for hemoglobin values that trigger the need for transfusion and show the importance of Patient Blood Management, a scientific evidence-based approach in processes where transfusion is a possibility, such as in elective surgeries. Objective The cross-sectional study aimed to analyze the transfusion requests at a complex orthopedic hospital over a one-year period. Method The completion quality was classified as Good, Regular, Bad or Very Bad, according to the information given by the physician. Transfusion medicine professionals analyzed the transfusion indication reported on the request form and classified it as Correct, Not based on Patient Blood Management (PBM), in accordance or not with the institutional Maximum Surgical Blood Order Schedule, Impossible to evaluate due to lack of information on the form, and Incorrect. Results The study categorized the completion quality of 2011 requests as Good (8.80%), Regular (9.30%), Bad (72.75%) and Very Bad (9.15%). Analysis of the indications revealed that 54.90% of the requests were in accordance with the current blood transfusion recommendations, and on 23.12% of the forms this field had not been filled out. Conclusion The majority of blood components (63%) requests are in tune with current blood transfusion recommendations, despite the great number of incorrectly completed forms; nevertheless, it is mandatory to reach much better appropriateness rates.

https://doi.org/10.1016/j.htct.2019.01.001 224 downloads

13.

Tradução e adaptação transcultural do Short Portable Mental Status Questionnaire (SPMSQ) de Pfeiffer para pessoas idosas brasileiras
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Teigão, Fernanda Cury Martins

; Moser, Auristela Duarte de Lima

; Jerez-Roig, Javier

Revista Brasileira de Geriatria e Gerontologia

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2020, Volume 23 Nº 4 elocation e200128

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Objetivo Adaptar culturalmente o Short Portable Mental Status Questionnaire (SPMSQ) de Pfeiffer para uso no Brasil. Métodos O processo envolveu as seguintes fases: tradução inicial; síntese das traduções; retrotradução; revisão por um comitê de especialistas com experts da área para analisar a validade aparente e de conteúdo, contemplando as equivalências semântica, idiomática, cultural, conceitual e clareza e, por fim, um pré-teste com a população alvo. Resultados Na tradução inicial e na retrotradução ocorreram discordâncias entre os tradutores, em 19 e 7 itens respectivamente, que posteriormente foram discutidos e conciliados pelo comitê. O comitê de especialistas sugeriu modificações desde o layout até adequações de termos técnicos para facilitar a aplicabilidade dos profissionais e para tornar o instrumento final mais claro e compreensível para a população-alvo. No pré-teste, 36,6% dos avaliados demonstraram dificuldades no entendimento de um item do questionário; o item foi substituído, a escala foi reaplicada obtendo 100% de compreensão. Conclusão O estudo demonstrou que a versão brasileira do SPMSQ estabelecida como Breve Escala de Capacidade Cognitiva apresentou-se transculturalmente adaptada, com seus itens considerados claros e compreensíveis pelos especialistas e pela população-alvo. O instrumento adaptado contribui por se tratar de uma ferramenta breve de avaliação disponível para rastrear a capacidade cognitiva dos idosos. É recomendado a análise das propriedades psicométricas, estabelecendo o grau de validade e confiabilidade, o qual já está em desenvolvimento pelos autores deste estudo.

Abstract Objective Culturally adapt Pfeiffer’s Short Portable Mental Status Questionnaire (SPMSQ) for use in Brazil. Methods The process involved the following phases: initial translation; synthesis of translations; back-translation; review by a committee of experts in the field to analyze the apparent and content validity, considering the semantic, idiomatic, cultural, conceptual and clarity equivalences and, finally, a pre-test with the target population. Results In the initial translation and in the back-translation, there were disagreements between the translators, in items 19 and 7 respectively, which were later discussed and reconciled by the committee. The expert committee suggested changes from the layout to adjustments to technical terms to facilitate the applicability of professionals and to make the final instrument clearer and more understandable to the target population. In the pre-test, 36.6% of those evaluated showed difficulties in understanding an item in the questionnaire; the item was replaced, the scale was reapplied obtaining 100% understanding. Conclusion The study demonstrated that the Brazilian version of the SPMSQ established as a Brief Cognitive Capacity Scale was cross-culturally adapted, with its items considered clear and understandable by specialists and the target population. The adapted instrument contributes because it is a brief assessment tool available to track the cognitive ability of old people. The analysis of psychometric properties is recommended, establishing the degree of validity and reliability, which is already under development by the authors of this study.

https://doi.org/10.1590/1981-22562020023.200128 320 downloads

14.

Capnocytophaga sputigena bloodstream infection in hematopoietic stem cell transplantations: two cases report and review of the literature
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Mendes, Fernanda Rodrigues

; Bruniera, Felipe Ribeiro Schmidt, Jayir Cury, Ana Paula Rizeck, Camila Higashino, Hermes Oliveira, Fernando Nivaldo Rossi, Flavia Rocha, Vanderson Costa, Silvia Figueiredo

Revista do Instituto de Medicina Tropical de São Paulo

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2020, Volume 62 elocation e48

Resumo: En | Texto: En | PDF: En

ABSTRACT Capnocytophaga is a group of facultative anaerobic gram-negative bacteria present in the oral cavity of humans, dogs and cats, as part of their normal oral flora. Here, we described two cases of bloodstream infections (BSI) caused by Capnocytophaga in neutropenic autologous hematopoietic stem cell transplantation (auto-HSCT) patients with mucositis (Grade I and Grade III) identified by Maldi-Tof. They were successfully treated with β-lactam (meropenem and piperacillin-tazobactam). The species C. sputigena was confirmed by 16S rRNA gene sequencing in one patient. The review of literature showed that C. ochraceae was the most frequent species causing BSI in auto-HSCT patients and that the patients usually presented mucositis and were neutropenic at the onset of the infection.

https://doi.org/10.1590/s1678-9946202062048 788 downloads

15.

Influence of Abutment Collar Height and Implant Length on Stress Distribution in Single Crowns
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Bordin, Dimorvan

; Cury, Altair Antoninha Del Bel

; Faot, Fernanda

Brazilian Dental Journal

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Jun 2019, Volume 30 Nº 3 Páginas 238 - 243

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Este estudo avaliou a influência da altura da porção transmucosa do pilar protético com junção cone morse e do comprimento dos implantes no comportamento biomecânico coroas unitárias com diferentes proporção coroa-implante. Seis modelos virtuais (S11, M11, L11, S13, M13 e L13) foram construídos combinando pilares protéticos com transmucoso considerado: curto (S: 2,5 mm), médio (M: 3,5 mm) ou longo (L: 4,5 mm) com diferentes comprimentos de implantes (11 ou 13 mm). Um incisivo central superior de 11 mm de altura foi construído para cada pilar. Cada conjunto foi posicionado em um modelo de osso virtual e exportado para análise matemática. Uma malha de 0,60 mm foi criada após análise de convergência e uma carga de 49 N foi aplicada ao cíngulo da coroa em um ângulo de 45°. A distribuição de estresse gerada por carga foi analisada nos componentes protéticos de acordo com o critério de tensão de von Mises (σvM) e no osso cortical e medular por meio da tensão de cisalhamento (εmax). O uso de pilares com porção transmucosa mais longa (L11) aumentou a tensão no pilar protético em 250%, e resultou em tensões 40% maiores no parafuso e 92% no osso cortical em relação aos pilares com transmucoso curto (S11). O aumento do comprimento do implante produziu uma ligeira redução da tensão de cisalhamento no osso cortical. O osso medular não foi afetado pela relação coroa-implante. Pilares protéticos com porção transmucosa mais longa concentram tensões no implante e no osso cortical, quando a proporção coroa-implante é aumentada.

Abstract This in silico study evaluated the influence of the abutment collar height and implants length on the biomechanical behavior of morse taper single dental implants with different crown-to-implant ratio. Six virtual models were constructed (S11, M11, L11, S13, M13 and L13) by combining short (S: 2.5 mm), medium (M: 3.5 mm) or long (L: 4.5 mm) abutment collar heights with different implant lengths (11 or 13-mm). An upper central incisor of 11-mm height was constructed on top of each abutment. Each set was positioned in a virtual bone model and exported to analyze mathematically. A 0.60-mm mesh was created after convergence analysis and a 49 N load was applied to the cingulum of the crown at an angle of 45°. Load-generated stress distribution was analyzed in the prosthetic components according to von Mises stress criteria (σvM) and in the cortical and cancellous bone by means of shear stress (εmax). The use of longer collar abutments (L11) increased the stress on the abutment by 250% and resulted in 40% higher stresses on the screw and 92% higher cortical shear stresses compared to short collared abutments (S11). Increasing the implant length produced a slight stress reduction on cortical bone. Cancellous bone was not affected by the crown-to-implant ratio. Longer abutment collars concentrate stresses at the implant level and cortical bone by increasing the crown-to-implant ratio.

https://doi.org/10.1590/0103-6440201902533 1870 downloads

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