Início Osteonecrose maxilar induzida por agentes antirreabsortivos: conceitos, epidemiologia e conhecimento de profissionais...
10 (2022)
Osteonecrose maxilar induzida por agentes antirreabsortivos: conceitos, epidemiologia e conhecimento de profissionais e usuários
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Introduction: Medications called antiresorptives can be used as adjuvants in the treatment of bone and/or bone cancer diseases, with bisphosphonates, RANK-L inhibitors and antiangiogenic agents as the main representatives of the class. Review: The three drug classes have in common the possibility of causing, from their use, a rare adverse effect, but with extreme morbidity called Drug-Induced Maxillary Osteonecrosis (ONMIM). Due to the increasingly widespread use of these drugs for the treatment of different tumor and bone diseases, the knowledge of the medical, dental and also lay people, representing the patients themselves, about the possibility of the occurrence of ONMIM has become increasingly important. Many patients using antiresorptive medications do not have the knowledge or were not instructed by their physicians about the risk of their adverse effects; which can lead to inadvertent dental treatment and the onset of the disease. Discussion: Prevention before the use of medications through a careful assessment of the oral health condition and an elaborate plan of care between the oncology team and dentists, can reduce the risk of developing ONMIM. Final considerations: Health professionals must take responsibility for sharing their knowledge with patients and emphasize the importance of prevention through dental follow-up. And so, knowledge and awareness can minimize the incidence of the disease through preventive care.
Keywords: bone density conservation agents, denosumab, osteonecrosis, bisphosphonate-associated osteonecrosis of the jaw, antirresorptive medication, bisphosphonates.
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Tomografia computadorizada de feixe cônico: novos recursos e softwares para diagnóstico em endodontia
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Abstract: Introduction: Cone-beam computed tomography (CBCT) is the most used in dentistry, due to its speed and low radiation compared to medical tomography; with this, it favored all specialties, especially endodontics. Review: To carry out this work, scientific articles, books, theses, dissertations and monographs related to the use of CBCT were researched, with emphasis on endodontics, especially in relation to current imaging resources. For this, online, national and international databases such as PUBMED, GOOGLE ACADÉMICO, SCIELO, Scopus and Web of Science were used. Discussion: Endodontics is one of the areas that most explores CBCT in dentistry. Visualization software/algorithms developers for image formation have developed resources for root canal measurement, file/instrumentation guides, making endodontic treatment safer and more predictable. For the endodontist, three-dimensional images help to clearly visualize the location of the apical foramen (which may vary), the size of the lesion that is in the periapical area, the presence of cracks/root fractures, whether root resorption can be resolved with treatment, among others. Other difficulties that periapical radiography cannot show, because it is two-dimensional. The transfer from analog to digital dentistry is still happening, prices are becoming affordable, ease and time saving is transforming and making developers have ideas for great innovations. Therefore, this study aimed to review the literature and discuss the new features of tomographic image viewer software. Final considerations: However, CBCT with three-dimensional imaging capability is of utmost importance for the endodontics of the future.
Keywords: endodontics, X-rays, software, cone-beam computed tomography.
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Cirurgia bariátrica e câncer gástrico: uma revisão sistemática
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: Introduction: Studies show that there is a correlation between waist circumference and visceral fat with a higher risk for cancer of the esophageal-gastric junction. The risk of gastric cancer after bariatric surgery has also not been established. The aim of this work is to conduct a systematic literature review to investigate the relation between gastric cancer and bariatric surgery Review: The research was carried out in the SciELO, MEDLINE and Google Scholar databases, using the PubMed search engine. The keywords were: "gastric cancer" AND "bariatric surgery", with selected publications from the last five years (since 2016), English or Portuguese and human trials. Discussion: A total of eight publications were selected, four of which were obtained from the MEDLINE database and four from Google Scholar. It was seen that few studies address the proposed topic, which indicates that the between gastric cancer and bariatric surgery is still little discussed and little is known about whether there is a correlation between them. Most studies suggest that post-bariatric surgery cancer is a rare condition. However, it is known that many cases are not reported or have been poorly studied, which may interfere with epidemiological data. Final considerations: There is a possibility of post-bariatric cancer, which is often not diagnosed due to nonspecific symptoms. There is a need for further studies on this relation, as the number of bariatric surgeries is increasing and at the same time incomplete data or underdiagnosis of cancer in these patients has been reported.
Keywords: gastric cancer, bariatric surgery, obesity.
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Prevalence of Gram-negative rods antibiotic resistance in public Brazilian hospital
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Resumo: Introdução: As bactérias Gram negativas não fermentadoras e as da família Enterobacteriaceae estão intimamente relacionadas às infecções hospitalares, e com diminuição da sensibilidade aos antimicrobianos. Objetivo: Este estudo tem como objetivo avaliar a prevalência de resistência aos carbapenêmicos em Pseudomonas aeruginosa, Acinetobacter baumannii e Enterobacteriaceae. Material e métodos: As amostras e teste de suscetibilidade antimicrobiana recuperados pelo laboratório credenciado pelo hospital, com atendimento exclusivo pelo Sistema Único de Saúde, nos anos de 2013 a 2017. Resultados e discussão: Observou-se que dentre as infecções graves, as pneumonias foram as mais prevalentes tanto em P. aeruginosa, quanto em A. baumannii e Enterobacteriaceae na corrente sanguínea, em homens, acima de 61 anos, em mais da metade do tempo de estudo, predominantemente em UTI. Além disso, o principal fenótipo para os não fermentadores foi MBL e Enterobacteriaceae KPC. Considerações finais: A resistência a múltiplas drogas reflete a combinação de mecanismos de resistência e o uso da vigilância epidemiológica para identificar os problemas e riscos de infecção aliados à prática de medidas de prevenção e controle podem auxiliar na redução das infecções.
Palavras-chave: Acinetobacter baumannii, enterobacteriaceae, infecção hospitalar, Pseudomonas aeruginosa, mecanismos de resistência.
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Preditivos de falha de decanulação em um hospital de referência em trauma na região Norte
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Introduction: Placing a tracheostomy is a procedure commonly performed in intensive care units (ICU), with well-established protocols, so after tracheostomy, it is necessary to discuss and build work instructions that establish safe standards for safe weaning of the patient. tracheostomy (TQT). Objective: Investigate factors and or predictive events of failure in decannulation, using an institutional flowchart. Method: It was an analytical, retrospective, quantitative, and descriptive study, which occurred through the analysis of data available in the operating system of the Metropolitan Hospital of Urgency and Emergency, in which 128 patients admitted from January to December were analyzed 2019 who underwent tracheostomy, all over 18 years of age, in which 36 participants were included within the research criteria, who were considered to have decannulation failure. Results: 36 adults showed failure at some stage of the decannulation process, 12 of which were female and 24 were male, with an average age of 39.9 years. The most common diagnoses were traumatic brain injury (TBI) 29, followed by face trauma 7, spinal trauma (TRM) 5, firearm injury (FAF) 3, stab wound (FAB) 2 and finally 1 patient with burn trauma. Conclusion: The research demonstrated that dysphagia was the most pertinent factor of failure in decannulation among the predictors investigated. Also opening up a discussion about the need to update the decannulation flowchart used in the referred research hospital.
Keywords: Decannulation, Dysphagia, Deglutition, Public health, Tracheostomy.
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Políticas públicas para a saúde do idoso – uma análise acerca das atuais políticas públicas voltadas para o idoso
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This article aims to discuss about public policies that are aimed at the elderly in Brazil. Thus, this discussion is necessary because many elderly people still feel discriminated against in our country, because often the treatment given to them in society does not correspond with their reality. Many elderly people can still contribute a lot to the growth of our society and can also engage in the labor market, with the exception of those who have some pathology. Old age is not a disease, but a natural process of the human being that does not prevent them from thinking and acting in society. Our discussion is based on the Statute of the Elderly and on authors such as Soares (2012), Boneti (1997), among others who are dedicated to the study of the theme.
Keywords: elderly, elderly health, public policies, autonomy.
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Síndrome da apneia obstrutiva do sono e sua relação com a odontologia: Revisão de Literatura
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Introduction: The common need for functioning is a functioning problem during basic sleep functioning. It is because of the total or partial cause of the air passage for ten or more seconds micro-awakening, in addition to the feeling of suffocation. Review and discussion: The work carried out thorough literary review and introduced, according to the authors, growth hyperplasia and growth change in the upper airway are exacerbating factors of the syndrome; Mouth breathing has been proposed as a cause of dental caries and caries. Final considerations: The Dental Surgeon is important to help in the diagnosis by knowing the main disorders of this distraction and offering palliative treatment with intra-oral appliances or orthognathic surgeries, and may also participate in multidisciplinary treatments.
Keywords: obstructive sleep apnea syndrome, sleep disorder.
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A prevalência, anos vividos com incapacidade e óbitos devido a utilização de opioides por diferentes faixas etárias e locais do mundo: um estudo Global Burden of Disease
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Introduction: Pain is an unpleasant sensation with a significant potential to decrease people's quality of life. Chronic pain has a prevalence of almost 30% of Brazilian elderly and reaches 50% in developed countries. Thus, as the process of chronic pain in the world worsens, there is an increase in the use of opioids and, with that, the progressive loss of the functional capacity of these individuals. The objective of the present study was to recognize the prevalence of mortality and disability. Material and Methods: This study was carried out using the Global Health Data Exchange (GHDx) database, which is a database collected and analyzed by a consortium of more than 3,600 researchers in more than 145 countries. Analyzed data from four countries (developed and emerging) in America comparing the periods of 1990 and 2019. Results and Discussion: Comparing the prevalence of opioid use between 1990 and 2019 in Canada, USA, Brazil and Argentina, it is possible to verify a significant increase in values. Regarding mortality, we can observe that in 1990 the mortality in Canada was 352.48 and in 2019 it was 1,866.68, in the USA the value of 4,352.16 in 1990 advances to 47,336.67 in 2019, in Brazil the rate was 37.49 in 1990 and 132.75 in 2019 and in Argentina the value went from 14.45 to 48.16 in 2019. Considerations: This study demonstrated through numerical data the increase in the use of opioids in important countries of America in its various aspects, from its prevalence of use to the number of deaths caused by the abusive and indiscriminate use of these drugs. The study should encourage managers, physicians and patients to adopt new behaviors and care considering the use of opioids.
Keywords: opioids, chronic pain, functional disability.
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Alterações estomatognáticas da microcefalia causada por Zika Vírus: Revisão de Literatura
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Zika Virus is an arbovirus capable of causing fetal brain anomalies associated with maternal infection. These occur in the first two gestational trimesters; among them stands out microcephaly, a neurological disorder whose occiptofrontal perimeter is below the average for race, age and sex. The discovery of Zika as a new etiological factor for microcephaly alerts the health system, due to the epidemic that occurred in Brazil in 2015. The purpose of this study was to perform a literature review on the main stomatognathic alterations in microcephaly by Zika Virus and its importance for dentistry, as well as the benefits of this practice to such patients. A bibliographic survey was performed using scientific articles in English and Portuguese, published in the last 10 years, with the aid of scientific platforms such as Pubmed and Scielo. Although there are few scientific papers addressing Microcephaly by Zika and its orofacial effects, we conclude that the knowledge of this congenital infection and its orofacial alterations by the dental surgeon is indispensable to offer higher quality in the treatment of microcephaly, adapting the clinical conduct to the individual needs, always allying to a multiprofessional approach.
Keywords: Microcephaly, Zika virus, Orofacial abnormalities, Dental care.
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A atuação do enfermeiro no acompanhamento de pacientes oncológicos sob cuidados paliativos
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Introduction: Oncology is the area of cancer-related research. The most advanced stage of cancer can lead to the terminal state, which is a time when the disease becomes "unrecoverable" for the nursing team, heading towards death without anyone being able to do anything to change its destiny, except how it goes spend your final moments. Objective: To analyze the scientific evidence related to nurses' interventions in cancer patients during the terminal phase. Methodology: This is an integrative review. Open access scientific articles published in scientific journals between 2013 and 2021 were categorized. At the end of the evaluation stages, we selected 7 articles that enabled the execution of this study. Results and discussion: Three main pieces of information were identified regarding the work of nurses for palliative care, which are: importance of nursing communication in palliative patient care; the pharmacological and non-pharmacological care procedures performed by nurses; and the main professional difficulties that nurses face in patient care. Conclusion: Communication is the basis of nurses' work in palliative care. The uses of treatments aim to reduce the patient's symptoms and pain, increasing their quality of life during their final moments. And among the challenges, the service overload, the lack of resources and protocols to perform palliative care and the possibility of suffering the impacts of the negative feelings that the patient and family have at that time stand out.
Keywords: palliative care, nursing, Oncology.
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O perfil dos pacientes com acidente vascular encefálico atendidos em um centro especializado em reabilitação e o risco de lesão por pressão
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Introduction: Stroke is the sudden interruption of blood flow to some region of the brain, which causes symptoms such as plegia, dysarthria, syncope, dizziness and headache. It can be classified as ischemic or hemorrhagic. Objective: the study aimed to identify the profile of patients with cerebrovascular accident and risk of pressure injury. Material and methods: This is a quantitative, descriptive, cross-sectional and field study, carried out in a Specialized Center in Rehabilitation of a school clinic, in the extreme south of Santa Catarina. 41 patients with cerebrovascular accident took part in the research. Data were collected during their care at the Specialized Rehabilitation Center, using a closed-ended questionnaire to establish the profile of patients and application of the Braden Scale. Results and discussion: The data revealed more men, most aged over 60 years, white, with complete high school, married, at risk of pressure injury. Final considerations: The prevention of patients with stroke prevents and treats complications, in addition to providing a better quality of life.
Keywords: pressure ulcer, health profile, cerebrovascular stroke.
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Práticas Integrativas no tratamento da ansiedade
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Introduction: Integrative and Complementary Practices (PICS) use therapeutic resources that are based on traditional knowledge, with the aim of preventing various diseases such as anxiety. In the case of Integrative Health Practices (PIS), the focus of this article, they can be understood as technologies that treat the health of the individual in its multidimensionality - physical, emotional, mental, social and spiritual - in order to promote, maintain and recover health. . Review: This article aims to present alternative therapies for the treatment of anxiety, such as aromatherapy, floral therapy, homeopathy and acupuncture. Discussion: They are known as integrative practices and are currently applied with private clinics and by the Unified Health System (SUS). These are technologies that obtain satisfactory results, through a welcoming listening, with a therapeutic bond, which integrates the individual with the environment and society. The PIS have a transversal, transdisciplinary and intersectoral character. Its validation in the SUS occurs through the criterion of the traditionality of its use, as well as through proof of its benefits. Final Considerations: These Integrative and Complementary Health Practices (PICs) were instituted in Brazil in 2006, and are considered by the World Health Organization (WHO) as traditional medicine practices. This means that the knowledge, skills and practices applied in these types of therapies are based on theories, beliefs and experiences from different cultures, with a focus on health maintenance, prevention, diagnosis, improvement or treatment of physical and mental illnesses. The main difference between PICs and traditional medicine is that conventional medicine tends to treat symptoms separately; in the case of the practice of PICs, these are treatments that see the individual as a whole, not just as a set of symptoms.
Keywords: alternative therapies; anxiety; integrative practices; Unified Health System (SUS).
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Relato epidemiológico da resistência de Staphylococcus aureus resistente a meticilina em unidades de atendimento intensivo
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Introduction: S. aureus infections have become common, but with a change in the number of healthcare-associated infections. With the short time of penicillin use, S. aureus adapted, developing resistance to penicillin and, in sequence, resistance to methicillin called MRSA. Objective: This study aims to evaluate the epidemiology of methicillin-resistant Staphylococcus aureus isolates in a medium-sized hospital in the interior of the state of Minas Gerais, for 36 months. Material and methods: 158 samples were recovered, all resistant to methicillin (MRSA), inside and outside the Intensive Care Units (ICU), submitted to the inducible resistance test iMLSB, evaluation of penicillinase production, besides of the resistance test to other antimicrobials. Results and discussion: The main isolates were samples found in patients older than 66 years, men, in the ICUs, producing penicillinases (76.6%) and 10.8% expressing inducible resistance to MLSB. Final considerations: The epidemiological survey can play a fundamental role in the process of adequate treatment of patients with bacterial infections by multidrug-resistant microorganisms, in the actions to contain the spread and the profile of the main affected patients.
Keywords: Staphylococcus aureus, multidrug resistence, penicillinase.
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