Abstract: The present work aims to identify relevant factors influencing the adoption of business teleworking by collecting the perceptions and attitudes of company managers and supervisors within the context of the COVID-19 pandemic, caused by the Sars-CoV-2 virus. A quantitative study is performed by applying a questionnaire to a sample of 317 employees working in companies from the Maule Region, Chile. A database is built and analyzed in two phases: 1) a descriptive phase for demographic data and 2) an inferential and modeling phase to synthesize employees’ perceptions and to determine possible causalities between variables. The results show eight factors. It is concluded that remote work is perceived as a contribution to the company, that the interviewees have a positive attitude towards remote work, and that technological variables enhance business continuity.

Resumen: El presente trabajo tiene como objetivo identificar las dimensiones relevantes para la implementación del teletrabajo en empresas a través de la recolección de percepciones y actitudes de los directivos y supervisores, dado el contexto de la pandemia COVID-19 causada por el virus Sars-CoV-2. Se desarrolla un estudio cuantitativo mediante la aplicación de un cuestionario a una muestra de 317 empleados de empresas de la Región del Maule, Chile. Se elabora una base de datos que es analizada en dos fases: 1) fase descriptiva para los datos demográficos y 2) fase inferencial y de modelamiento para sintetizar las interpretaciones y determinar causalidades entre las variables estudiadas. Se logra determinar ocho factores. Se concluye que se percibe el trabajo remoto como un aporte para la empresa, que los entrevistados poseen una actitud positiva frente al trabajo a distancia y que las variables tecnológicas permiten la continuidad de las organizaciones.

SUMMARY OBJECTIVE To assess the patient’s understanding of the informed consent form before and after plastic surgery. METHODS This was a prospective analytical descriptive study that utilized a questionnaire on informed consent before and after plastic surgery procedures. RESULTS Comprehension of informed consent was higher before surgery than after surgery (p=0.016; question 15). The higher the scholarity, the higher the comprehension (s=0.151; p=0.045) before surgery (question 4). For the other questions, it was not possible to find a difference in the pattern of understanding and in the association with the educational attainment level after surgery (s=0.180; p=0.046; question 1). CONCLUSIONS: The patients’ level of comprehension of the details, outcomes, possible complications, and postoperative evolutions of surgical procedures, as stated by the informed consent form, is high.

ABSTRACT Background: Consultations for chest pain are common in emergency medical services (EMS). A diagnostic strategy using both objective and subjective pain has not been identified yet. Objective: To evaluate a machine learning classifier as a tool for prediction of the risk of presenting a non-ST segment elevation acute coronary syndrome (ACS) in patients consulting an SEM with chest pain. Methods: 161 patients consulting SEM with chest pain were analyzed. Objective variables of the patient and subjective variables of pain characterization were recorded during the triage stage by means of a machine learning classifier. Results: The mean age was 57.43±12 years, 75% male and 16% had prior cardiovascular disease. 57.8% presented an ACS with an incidence of 29.8%, which 35% required PCI and 9.9% CRM in a 30-day follow-up period. A Random Forest Classifier was used as a classification model. The Random Forest Classifier presented an area under the ROC curve of 0.8991, sensitivity of 0.8552, specificity of 0.8588 and precision of 0.8441. The most strongest predictor variables were weight (p=0.002), age (p=5.011e-07), pain intensity (p=3.0679e-05), systolic blood pressure (p = 0.6068) and subjective pain characteristics (p=1.590e-04). Conclusions: Machine learning classifiers are a useful tool for predicting the risk of acute coronary syndrome at 30 days follow-up period.

RESUMEN Introducción: Las consultas por dolor torácico son frecuentes en los servicios de emergencias médicas (SEM). Aún no se ha identificado una estrategia diagnóstica que utilice tanto los datos objetivos como los subjetivos del dolor. Objetivos: Evaluar un clasificador de machine learning para predecir el riesgo de presentar un síndrome coronario agudo (SCA) sin elevación del segmento ST, en pacientes que consultan a un SEM con dolor torácico. Material y métodos: Se analizaron 161 pacientes que consultaron al SEM con dolor torácico. Se registró mediante un clasificador de machine learning las variables objetivas y subjetivas de caracterización del dolor. Resultados: La edad promedio fue de 57 mas/menos 12, 72,7% masculinos eran de sexo masculino y 17,4 % presentaban evento coronario previo. El 57,8% presentaba un síndrome coronario agudo con una incidencia de IAM de 29,8%, de los cuales requirieron revascularización por ATC el 35%, y CRM el 9,9% en el período de seguimiento a 30 días. Como modelo de clasificación se utilizó un Random Forest Classifier que presentó un área bajo la curva ROC de 0,8991, sensibilidad de 0,8552, especificidad de 0,8588 y una precisión de 0,8441. Las variables predictoras más influyentes fueron peso (p = 0,002), edad (p = 5,011e-07), intensidad del dolor (p = 3,0679e-05), tensión arterial sistólica (p = 0,6068) y características subjetivas del dolor (p = 1,590e-04). Conclusiones: Los clasificadores de machine learning son una herramienta útil a fin de predecir el riesgo de sufrir un síndrome coronario agudo a 30 días de seguimiento.

Abstract: The relationship between the commitment and social norms in the tax compliance intention has been determined. The research has a quantitative approach, with a non-experimental design and a correlational scope. The independent variables are the commitment and social norm and the dependent variable is the tax compliance intention. The sample was built based in a random sample of the micro-business that resides in the city of Guayaquil, Ecuador. It was determined that the relationship between the commitment and the intention of tax compliance is positive and significant, while the relationship between social norm and tax compliance tax compliance intention is positive but no-significant. It was shown that the economic sector moderates the relationship between commitment and the intention of tax compliance, existing a stronger relationship between these variables in the services sector. Based on the results of this study, it is concluded that the commitment influences the intention of the tax compliance of the micro-business, not finding enough evidence that the social norm has any influence on the dependent variable.

Resumen: Se determina la relación entre el compromiso y las normas sociales con la intención del cumplimiento tributario. La investigación se realizó con un enfoque cuantitativo, de diseño no experimental y alcance correlacional. Se identificaron como variables independientes el compromiso y norma social y como dependiente la intención del cumplimiento tributario. Se trabajó con una muestra de microempresas determinada aleatoriamente, localizadas en la ciudad de Guayaquil, Ecuador. Del análisis realizado se pudo determinar que la relación entre el compromiso y la intención del cumplimiento tributario es positiva y significativa, mientras que la relación entre norma social e intención de cumplimiento tributario es positiva pero no-significativa. Se pudo demostrar además, que el sector económico modera la relación entre el compromiso y la intención del cumplimiento tributario, existiendo una relación más fuerte entre estas variables para el sector servicios. Se concluye que el compromiso influye en la intención del cumplimiento tributario de las microempresas, no encontrándose evidencia suficiente de que la norma social tenga influencia significativa.

ABSTRACT Background: The European Society of Cardiology (ESC) recommends an algorithm for the evaluation of chest pain with serial measurement of two high sensitivity troponins separated by one hour. However, the high efficacy and safety of the algorithm has only been estimated according to assumptions based on theoretical models. We tested for the first time its performance in the real world by incorporating it into the daily routine of our center. Methods: This is a prospective, single center study using the ESC 0/1h algorithm with high sensitivity troponin T on unselected patients who presented at the emergency department with suspected non-ST-segment elevation acute myocardial infarction. Efficacy and safety were assessed in terms of the 30-day incidence of acute myocardial infarction, cardiovascular death and the composite of acute myocardial infarction, death or coronary revascularization. Results: A total of 1,351 patients were included in the study. Mean age was 61±14 years, 12.4% were diabetics and 35.8% had previous history of coronary events. The rate of acute myocardial infarction was 11% and the rate of mortality 0.29%. According to the application of the algorithm, 917 patients were catalogued as “rule out” (67%), 270 as “observe” (20%) and 164 as “rule in” (13%). The rate of acute myocardial infarction was 0.3% in “rule out”, 7% in “observe” and 77.4% in “rule in” (p <0.001). Moreover, death or coronary revascularization was 7.7% in “rule out”, 17.7% in “observe” and 80.4% in “rule in” (p <0.001). Conclusions: The 1-hour algorithm showed a good capacity to stratify patients presenting with suspicion of acute myocardial infarction and a high negative predictive value to exclude infarction at 30 days, although this capacity decreases when the event considered is the need for coronary revascularization.

RESUMEN Introducción: La Sociedad Europea de Cardiología recomienda para la evaluación del dolor torácico un algoritmo con medición seriada de dos troponinas de alta sensibilidad separadas por una hora. Sin embargo, la alta eficacia y seguridad solo se han estimado según supuestos basados en modelos teóricos. Probamos por primera vez su desempeño en nuestro medio cuando se integra en la rutina diaria. Métodos: Estudio prospectivo unicéntrico que incluyó a pacientes no seleccionados que presentaban sospecha de infarto sin elevación del ST en el servicio de emergencias, a los que se les practicó el algoritmo SEC 0/1h utilizando troponina T de alta sensiblidad. Se evaluó el comportamiento en términos de incidencia a 30 días de los eventos de infarto agudo de miocardio, muerte cardiovascular y el combinado de infarto agudo de miocardio, muerte o revascularización coronaria. Resultados: Se incluyeron 1351 pacientes con una edad media de 61 ± 14 años, 12,4% de diabéticos y 35,8% de evento coronario previo. La tasa de infarto agudo de miocardio fue del 11% con una mortalidad del 0,29%. De acuerdo con la aplicación del algoritmo, 917 pacientes fueron catalogados como “externar” (67%); 270, como “observar” (20%); y 164, como “internar” (13%). La tasa del evento infarto agudo de miocardio resultó del 0,3% en “externar”; del 7%, en “observar”; y del 77,4%, en “internar” (p < 0,001). Por su lado, la muerte o revascularización coronaria resultó de 7,7% en “externar”; del 17,7%, en “observar”; y del 80,4%, en “internar” (p < 0,001). Conclusiones: El algoritmo de 1 hora presentó una buena capacidad para estratificar a pacientes que consultan con sospecha de infarto agudo de miocardio con un gran valor predictivo negativo para excluir el evento de infarto a los 30 días, aunque dicho valor disminuye cuando el evento considerado es la necesidad de revascularización coronaria.

Abstract The present study analyzes how intrinsic factors such as promotion, rewards and the work itself influence the motivation levels of the workers of an Ecuadorian company of telecommunications. A census that reached 90% of effectiveness was done and a Spector questionnaire (Job Satisfaction Survey) was applied consisting of 40 reagents that include 10 variables with answers in a Likert scale of six points. Descriptive statistic and analysis of Cluster accompanied by standardized values, applying SPSS 22.0 was performed. It was determined that the intrinsic factors influence in the motivation of people, that the factor intrinsic work itself is the main axis of the motivation and that it is necessary to incorporate different motivation plans. Also, it was verified that the factors promotion and rewards are in an intermediate range, and that the rewards for doing a good job should improve.

Resumen El presente estudio analiza cómo los factores intrínsecos de promoción, recompensas y el trabajo en sí, influyen en los niveles de motivación de los trabajadores de una compañía ecuatoriana de telecomunicaciones. Se realizó un censo que alcanzó un 90% de efectividad y se aplicó el cuestionario de Spector (Job Satisfaction Survey), de 40 reactivos que abordan 10 variables con respuestas en escala Likert de seis puntos. Se obtuvo la estadística descriptiva y análisis de Cluster acompañado de valores estandarizados, aplicando SPSS 22.0. Se determinó que los factores intrínsecos influyen en la motivación de las personas, que el factor intrínseco trabajo en sí es el principal eje de la motivación y que se precisa planes de motivación diferenciados. Además, se verificó que los factores promoción y recompensas se encuentran en un rango intermedio, y que las recompensas que se reciben por realizar un buen trabajo deberían mejorar.

The features of the leaders' personality, the perceptions of the followers and the aspects of perception of the organizational culture in the exploration sector and exploitation of non-renewable resources as the gold and other minerals, in a company of the County of Gold of the Ecuador are determined and analyzed. A questionnaire was applied with 45 questions in the Likert scale. Also, were carried out the measures of dependability, KMO and significance coefficients, besides an analysis of factors of main components with varimax rotation. It is concluded that the collaborators trust the leadership, communication exists with their headquarters and they feel the support of their leaders. Also, they value the participation that they are granted, the good working atmosphere and the equitable relationship of their bosses. They appreciate that the personality of their leaders is explained by the high risk activities they perform.

Se determinan y analizan los rasgos de personalidad de los líderes, las percepciones de los seguidores y los aspectos de percepción de la cultura organizacional en el sector de exploración y explotación de recursos no renovables como el oro y otros minerales, en una compañía de la Provincia de El Oro del Ecuador. Se aplicó un cuestionario con 45 preguntas en escala Likert. Se realizaron las medidas de confiabilidad, KMO y coeficientes de significación, además de un análisis de factores de componentes principales con rotación varimax. Se concluye que los colaboradores tienen confianza en el liderazgo, existe comunicación con sus jefaturas y sienten el apoyo de sus líderes. Además, valoran la participación que se les otorga, el buen ambiente de trabajo y la relación igualitaria de sus jefes. Aprecian que la personalidad de sus líderes se explica por tener que enfrentar actividades de alto riesgo.

This study shows the teaching perceptions that characterize professors of three Chilean universities that faced the implementation of a competency-based teaching approach. Free and spontaneous accounts on the teaching practice intelligibility were analyzed in a sample of 97 tenured professors from these universities. The analysis was carried out using qualitative methods of data collection and the content analysis technique to identify categories of words, guiding principles and criteria for identifying the perceptions of the professors. Although there are coincidences of perceptions in the guide and contribute categories, there are differences on how professors relate to the guiding principles. The latter concept depends on the depth and time that the each university has been implementing the competency-based approach. Professors focus on the participation and personalization of teaching, the motivation, the development of self-esteem and interaction. Also, although they internalize the context, in one of the universities globalization is not linked to its activities, focusing on the institutional guidelines and on those of the traditional teaching by objectives.

El presente trabajo determina las percepciones docentes que caracterizan a los profesores de tres Universidades chilenas frente a la implementación de la educación con enfoque en competencias. Se analizaron los relatos libres y espontáneos de inteligibilidad de la práctica docente de una muestra de 97 académicos de planta de dichas universidades. El análisis se realizó mediante métodos cualitativos de recogida de datos y la técnica de análisis de contenido para identificar categorías de palabras, principios orientadores y criterios para caracterizar las percepciones de los profesores. Aunque se observan coincidencias de percepciones en las categorías guiar y aportar, se presentan diferencias en cómo los profesores se relacionan con los principios orientadores. Este último factor depende de la profundidad y tiempo que las respectivas Universidades llevan implementando la enseñanza con enfoque en competencias. Los profesores se enfocan en la participación y personalización de la enseñanza, la motivación, desarrollo de la autoestima e interacción. Además, aunque internalizan el contexto, en una de las universidades no se vincula la globalización a sus actividades, centrándose en los lineamientos institucionales y en los de la enseñanza tradicional por objetivos.

Fire blight, one of the most severe diseases on apples is caused by Erwinia amylovora (Ea), it provokes the death of flower buds and sometimes the whole tree. Antibiotic use is one of the methods employed to manage Ea, however, inappropriate use can lead to bacteria resistance. During 2005 and 2006, oregano (Lippia berlandieri) essential oil (80% carvacrol) was evaluated as an organic alternative to manage Ea. In vitro bactericidal minimum concentration (BMC) was 0.055 to 0.073% (w/v). A concentration of 0.11% was assessed in field and its effect on reducing the damage caused by Ea was determined. Results were compared against Agry-Mycin 100 MR, Cuprimicin 100 MR and Agry-Gent Plus 800MR. During both years, treatments were not statistically different with respect to the control. Time of field applications was determined by detection of Ea epiphytic populations grown in semi-selective media, temperature and humidity, with values of 5%, 16.7°C and 78% respectively for 2005, and 96%, 15.2y 70% for 2006. Identification of Ea and its resistance to streptomycin was performed by growing the bacteria in semi-selective media and results were confirmed by PCR. An Ea strain resistant to streptomycin was detected and isolated. This is the first report of an Ea strain resistant to streptomycin and confirmed by molecular techniques in the most important apple area in the state of Chihuahua, Mexico.

El tizón de fuego causado por Erwinia amylovora (Ea), es una de las enfermedades más severas del manzano, debido a que origina la muerte de yemas florales y en ocasiones del árbol completo. Un método para su manejo es el uso de antibióticos. Sin embargo, el uso inapropiado de éstos puede inducir resistencia en las bacterias. En este trabajo se evaluó el aceite esencial de orégano (Lippia berlandieri) (carvacrol 80%) durante los años 2005 y 2006, como una alternativa orgánica para el manejo de Ea. La concentración mínima bactericida (CMB) encontrada in vitro fue de 0.055 a 0.073% (p/v). Se evaluó una concentración de 0.11% (p/v) en campo y se determinó su efecto en la reducción del daño ocasionado por Ea; estos resultados se compararon con los obtenidos con Agry-Mycin 100MR, Cuprimicin 100MR y Agry-Gent Plus 800MR. Durante ambos años, los tratamientos no presentaron diferencias significativas con respecto al testigo. El momento de la aplicación se basó en la detección de poblaciones epifíticas mediante la impresión de estigmas en medio semi-selectivo, temperatura y humedad con valores de 5%, 16.7°C y 78%, respectivamente para 2005. Por otra parte en el ciclo 2006 estos mismos parámetros fueron de 96%, 15.2°C y 70%, respectivamente. La identificación y resistencia de Ea a estreptomicina, se determinó utilizando medios semi-selectivos, los resultados fueron confirmados por reacción en cadena de la polimerasa (PCR). Se detectó y aisló una cepa de Ea resistente a estreptomicina. Éste es el primer reporte mediante técnicas moleculares de una cepa de Ea resistente a estreptomicina en la zona manzanera de Chihuahua, México.

The aim of this study was to evaluate the influence of a low-viscosity bonding resin applied over a self-etching adhesive system on the microtensile bond strength (µTBS) of indirect restorations. Comparisons were made using One Up Bond F (OB) self-etching adhesive system, Single Bond (SB) one-bottle adhesive system and Scotchbond Multi Purpose Plus (SMP) bonding component. Thirty bovine incisors were extracted and decoronated at the cementoenamel junction. The labial surfaces were ground so that superficial dentin and deep dentin were exposed. The specimens were randomized to three groups (n=10): G1- OB; G2- OB + SMP; G3- SB. In G2, a layer of the SMP bonding was applied over the OB adhesive system. Indirect composite restorations were bonded using dual-cure cement under 500 g load for 5 min. The specimens were serially sectioned with a bonding area of ± 1.0 mm² in 3 regions: enamel (E), superficial dentin (SD) and deep dentin (DD). The sticks were fixed with cyanoacrylate adhesive and submitted to µTBS test at a crosshead speed of 0.5 mm/min in a mechanical testing machine (EMIC DL 2000). The fractured specimens were examined under scanning electron microscopy to determine the failure mode. Data were analyzed by one-way ANOVA followed by Tukey's test (p<0.05). µTBS means (in MPa) were: G1/E: 15.5 ± 3.5b; G1/SD: 22.7 ± 7.6a; G1/DD: 19.4 ± 9.4a; G2/E: 15.9 ± 5.8b; G2/SD: 19.9 ± 6.9a; G2/DD: 15.3 ± 4.9a; G3/E: 23.2 ± 7.3a; G3/SD: 20.4 ± 8.2a; G3/DD: 19.1 ± 8.7a. The results showed that the use of a low viscosity bonding resin did not affect the µTBS means when associated with a self-etching adhesive system. The self-etching adhesive system was significantly more efficient in dentin than in enamel, while the one-bottle system was significantly more efficient in enamel when compared to the self-etching adhesive system.

O objetivo do estudo foi identificar a prevalência de fatores de risco (FR) para doenças crônicas não-transmissíveis (DCNT) em praticantes de futebol society e o impacto de 16 semanas de treinamento futebolístico em índices do estado nutricional e da aptidão física. MÉTODOS: Amostra: 45 indivíduos (38,6 ± 7,4 anos), divididos em dois grupos: Experimental (G1 = 22) e Controle (G2 = 23). O G1 submeteu-se a um programa de treinamento de três sessões semanais em dias alternados com duração de 90 minutos (min). O G2 participou, uma vez por semana, de jogo de futebol, com duração de 90 min. As variáveis de investigação contemplaram FR para DCNT, indicadores antropométricos, análises bioquímicas e da aptidão física. A análise dos dados contou com estatística descritiva e inferencial mediante o SPSS 13.0. RESULTADOS: As maiores prevalências de FR apontaram para o sobrepeso (65,0%), história familiar de câncer (57,5%) e cardiopatias (55,0%) e hipertrigliceridemia (32,5%). O G1 apresentou diminuição na massa corporal (p = 0,007), circunferência abdominal (p = 0,010), índice de massa corpórea (p = 0,007) e percentual de gordura (p = 0,004), fato não observado no G2. Em ambos os grupos, as análises do colesterol total, triglicerídeos e glicose em jejum, não mostraram diminuição significativa durante o período investigado (p > 0,05). O G1 obteve melhores índices de consumo máximo de oxigênio (p = 0,011), resistência muscular (p = 0,000) e flexibilidade (p = 0,000), o que não ocorreu no G2. CONCLUSÃO: Os futebolistas apresentaram alta prevalência de FR para DCNT. Em termos gerais, o G1 obteve mudanças satisfatórias no estado nutricional e na aptidão física durante o período de 16 semanas, condição não identificada no G2.

The study objective is to identify the prevalence of risk factors (RF) to non-transmissible chronic diseases (NTCD) in society soccer practitioners and the impact of 16 weeks of soccer training in the nutritional status (NS) and the physical ability index. METHODS: Sample: 45 individuals (38.6 ± 7.4 years), divided in two groups: experimental (G1 = 22) and control (G2 = 23). The G1 was submitted to a training program of three sessions by week in alternated days with 90 minutes (min) duration. The G2 participated once a week, in soccer game, with 90 min duration. The research variables contemplated RF for NTCD, anthropometric indicators, biochemical analysis and physical ability index. Data analysis counted on descriptive and inferential statistics by SPSS 13.0. RESULTS: The major risk factors prevalence's pointed to: the overweight (65.0%), cancer family history (57.5%) and cardiac disease (55.0%) and hypertriglyceridemia (32.5%). The G1 presented body mass (p = 0.007), waist circumference (p = 0.010), body mass index (p = 0.007) and fat percentage (p = 0.004), reduction, fact no observed in G2. In both of the groups, total cholesterol analysis, triglycerides and fasting glucose, didn't demonstrative significant reduction during the observation period (p > 0.05). G1 got better indexes of maximum oxygen consumption (p = 0.011), muscular resistance (p = 0.000) and flexibility (p = 0.000), what did not happen in G2. CONCLUSION: The soccer players presented high prevalence of RF to NTCD. In general terms, G1 got satisfactory changes in NS and physical ability index during 16 weeks period, conditions that weren't identified in G2.

El objetivo de este estudio ha sido el de identificar la prevalencia de factores de riesgo (FR) en las enfermedades crónicas no transmisibles (DCNT) en practicantes de fútbol society y el impacto de 16 semanas de entrenamiento futbolístico en índices de estado nutricional y de la aptitud física. MÉTODOS: Muestra: 45 individuos (38,6 ± 7,4 años), divididos en dos grupos: Experimental (G1 = 22) y Control (G2 = 23). G1 se sometió a un programa de entrenamiento de tres sesiones semanales en días alternados con duración de 90 minutos (min). G2 participó una vez por semana, de juegos de fútbol, con duración de 90 min. Las variables de investigación contemplaron FR para DCNT, indicadores antropométricos, análisis bioquímicos y de aptitud física. El análisis de los datos contó con la estadística descriptiva y la inferencia estadística mediante el SPSS 13.0. RESULTADOS: Las mayores prevalencias de FR apuntaron para: el sobrepeso (65,0%), historia familiar de cáncer (57,5%) y cardiopatías (55,0%) y hipertrigliceridemia (32,5%). G1 presentó disminución en la masa corporal (p = 0,007), circunferencia abdominal (p = 0,010), índice de masa corpórea (p = 0,007) y porcentaje de grasa (p = 0,004), hecho no observado en G2. En ambos grupos, los análisis del colesterol total, triglicéridos y glicosis en ayuno, no mostraron disminución significativa durante el periodo investigado (p > 0,05). G1 obtuvo mejores índices de consumo máximo de oxígeno (p = 0,011), resistencia muscular (p = 0,000) y flexibilidad (p = 0,000), lo que no ocurrió en G2. CONCLUSIÓN: Los futbolistas presentaron alta prevalencia de FR para DCNT. En términos generales, G1 obtuvo cambios satisfactorios en el estado nutricional y en la aptitud física durante el periodo de 16 semanas, condición no identificada en G2.

A hipersensibilidade dentinária cervical é a queixa mais frequente entre os relatos de odontalgia. Este estudo avaliou a eficácia de dois tipos de lasers, vermelho com 660nm e infravermelho com 830nm de comprimento de onda, como dessensibilizadores dentinários, como também os efeitos terapêuticos imediato e tardio em indivíduos de 25 a 45 anos de idade. Um total de 40 dentes com exposição cervical foram tratados em 4 sessões, divididos em 2 grupos - laser vermelho e infravermelho. A sensibilidade dentinária ao estímulo nociceptivo frio foi avaliada por meio de uma escala numérica de dor, de 0 a 10, antes de cada sessão de tratamento, aos 15 e 30 minutos após a irradiação e num período de seguimento de 15, 30 e 60 dias após o término do tratamento. Níveis significantes de dessensibilização dentinária foram apenas encontrados em pacientes com idade entre 25 a 35 anos. O laser díodo vermelho de 660nm foi mais eficaz comparado com laser infravermelho de 830nm e foi observado um nível mais alto de dessensibilização nas mensurações realizadas aos 15 e 30 minutos após irradiação. O efeito terapêutico imediato e tardio do laser díodo vermelho de 660nm é maior quando comparado com o infravermelho de 830nm em ambas faixas etárias.

Cervical dentine hypersensitivity is the most frequent complaint among reported odontalgias. Thus, this study evaluated the effectiveness of two types of lasers (660 nm wavelength red, and 830 nm wavelength infrared) as dentine desensitizers, as well as both the immediate and late therapeutic effects in individuals 25 to 45 years of age. A total of 40 teeth with cervical exposure were treated in 4 sessions. They were divided into 2 groups according to treatment. A 660 nm wavelength red diode laser and an 830 nm wavelength infrared diode laser were used. Dentine sensitivity to cold nociceptive stimulus was evaluated by means of a pain numeric scale from zero to 10 before each treatment session, at 15 and 30 min after irradiation, and in a follow-up period of 15, 30 and 60 days after the end of treatment. Significant levels of dentinal desensitization were only found in patients ranging in age from 25 to 35 years. The 660 nm red diode laser was more effective than the 830 nm infrared laser and a higher level of desensitization was observed at the 15 and 30 minute post-irradiation examinations. The immediate and late therapeutic effects of the 660 nm red diode laser were more evident in 25-35-year-old patients compared with those of the 830 nm infrared diode laser, in terms of the different age groups.

Os geradores unipolares, unicâmara, ou dupla-câmara podem ser inibidos, ou deflagrados por ação de miopotenciais esqueléticos. Na experiência dos autores, estas complicações ocorrem em mais de 70% dos casos. Os geradores bipolares apresentam o risco potencial de provocar arritmias graves, complicação também observada pelos autores. Preocupados com essa situação, os autores idealizaram um tipo de estimulação com o cátodo ligado ao coração e o ânodo longe do gerador e longe do coração e, por isso, o denominaram "tele-anodo". D. Kormann e J. Pachón tiveram a idéia de posicioná-lo na região esternal. Um dos autores (D. Kormann) idealizou e construiu dois sistemas de tele-anodos esternais e intravasculares. Os esternais podem ser espirais, ou cilíndricos. Na técnica proposta, os autores utilizaram, para estimulação unicâmara, em átrio ou ventrículo, um gerador multiprogramável, bipolar, convencional, com eletrodo unipolar em átrio, ou ventrículo, ligado ao seu polo negativo e o tele-anodo, de preferência esternal, conectado ao polo positivo. Para estimulação dupla-câmara, o mesmo autor idealizou um gerador com três receptáculos. Até março de 1986, foram implantados marcapassos com tele-anodo em 62 pacientes, sendo que 57 receberam tele-anodos esternais (51 espirais e 6 cilíndricos) e 5 tele-anodos intravasculares. Os geradores utilizados foram de vários fabricantes, sendo 35 VII, M, 23 DDD, M, 3 AAI, M e 1 VVI, OB. Em todos os casos, as medidas per e pós-operatórias foram muito semelhantes às convencionais. Não houve nenhuma complicação diretamente relacionada com a técnica proposta. Sessenta e um pacientas com tele-anodo, examinados na clínica de marcapasso, apresentaram condições normais. Concluem os autores que a estimulação cardíaca com tele-anodo diminui, significativamente, as complicações existentes em sistemas unipolares e bipolares.

Unipolar pulse generators, either single or dual chamber, can be inhibited or reverted to the asynchronous mode, by skeletal muscle myopotentials. Dual chamber pacemakers may even stimulate the ventricle at the upper rate limit because of myopotential sensing via the atrial channel. A unipolar anti-tachycardia generator may be triggered by myopotentials to provoke an arrhythmia. During bipolar implanted pacing, episodic ventricular tachycardia has been induced in three patients with Chagasic cardiomyopathy and anodal stimulation has been shown to be the cause. Both unipolar and bipolar stimulation modes present problems. A stimulation mode with the cathode intracardiac and the anode remote from the generator and the patient's heart, called "tele-anode" was developed to be implanted in the presternal area or in venous system and avoid pacemaker triggering and inhibition. The subcutaneous "tele-anode" may be a spiral or a cylinder while an intravascular "tele-anode" may be positioned in the superior or inferior vena cava. Until March, 1986, 62 patients underwent "tele-anode" implantation, 57 at the sternum (51 spiral and 6 cylindrical) and 5 intramuscular. Thirty five generators were single chamber ventricular inhibited, 23 were dual chamber, 3 were atrial inhibited and 1 ventricular anti-tachycardia. In all cases the stimulation thresholds and electrogram characteristics were similar between intracardiac cathode and "tele-anode" and cathode and the puise generator site. Only electromyographic signals were consistently attenuated. One patient with an intravascular "tele-anode" died postoperatively of ventricular arrhythmias and one required ventricular lead repositioning. The 61 living patients, followed from one to twenty-one months, have shown no inhibition, triggering or noise mode reversion at nominal sensitivity setting. The authors conclude that pacemakers implanted with "tele-anode" show a clear evidence of decrease of associated complications, inherent to the conventional unipolar and bipolar cardiac stimulation system.

A presença de granulócitos eosinófilos associados a tumores malignos que acometem o sistema nervoso tem sido raramente comunicada. O propósito deste registro é apresentar o caso de um paciente com 47 anos de idade com tumor cerebral maligno (astrocitoma grau III), cujo estudo citológico do LCR revelou quadro inflamatório com presença de elevada percentagem de granulócitos eosinófilos.

It is presented a case of a patient with a cerebral malignant astrocytoma in which the spinal fluid cytomorphology showed numerous eosinophilic granulocytes.