Factors associated with the desire for orthodontic treatment among Brazilian adolescents and their parents

Background  

In the period of adolescence physical appearance takes on significant importance in the construction of personal identity, including one's relationship with one's own body. A variety of social, cultural, psychological and personal factors influences the self-perception of dental appearance and the decision to undergo orthodontic treatment. Adolescents who seek orthodontic treatment are concerned with improving their appearance and social acceptance. The aim of the present study was to determine factors associated to the desire for orthodontic treatment among Brazilian adolescents and their parents.     

Carbapenem-resistant Acinetobacter baumannii in patients with burn injury: A systematic review and meta-analysis

PurposeIn this study, we aimed reviewed the data about the patterns of antimicrobial susceptibility and resistance determinants among carbapenem-resistant Acinetobacter baumannii (CRAB) from patients with burn injury.MethodsA systematic review was conducted using the PRISMA statement in PUBMED/MEDLINE, Scopus, Scientific Electronic Library Online (SciELO), Biblioteca Virtual de Saúde (BVS) and Cochrane Library. The data referring to enzymatic resistance mechanisms were evaluated by meta-analyses according to random effect.Results17 articles that evaluated 1226 CRAB recovered from patients with burn injury were included in study. The majority of studies are from Iran (12/17; 70.6%), published in 2016 (6/17; 35.3%) and showed prospective design (15/17; 88.2%). The samples were obtained mainly from burn wounds (14/17; 82.3%) and more than half of the studies did not identify if the isolates originated from infected or colonized patients (10/17; 58.8%). Second the meta-analyses, OXA-type carbapenemase was the main mechanism involved in low susceptibility to carbapenems (53.2%; 95% CI = 60, 80.0%, I² = 86.0%), followed by metallo-β-lactamases (MBL) (30.2%; 95% CI = 11, 42.0%, I² = 93.0%), and Klebsiella pneumoniae carbapenemase (KPC) (16.6%; 95% CI = 5, 63.0%, I² = 88.0%). The majority of strains harbored bla_OXA-23-like (12/17; 70.6%) or bla_{OXA-24/40-like} (12/17; 35.3%) genes. The studies included showed that minocycline (69.5%) and colistin (99.9%) susceptibility remains high and is not impacted by carbapenem resistance in these isolates.ConclusionsThe results summarized in this review indicate the importance of a high-quality surveillance program to design suitable and effective interventions to control CRAB infection in burn units worldwide.     

Seven-year follow-up of esthetic alternative for the restoration of peg-shaped incisors: a case study of identical twins

Alterations in tooth shape and size are related to impaired esthetic appearance and facial harmony and can have a negative effect on a patient's self-esteem. Many alternatives for treating peg-shaped teeth are described in the literature. This article presents two clinical cases involving peg-shaped lateral incisors that were transformed with composite resins, addressing aspects related to treatment alternatives and facial esthetics. At a seven-year recall visit, the composite resins were problem-free and the patients remained very happy with the treatment outcome. Composite resin appears to be an adequate alternative to direct treatment options for restoring peg-shaped incisors.     

Effects of sequential artificial tear and cyclosporine emulsion therapy on conjunctival goblet cell density and transforming growth factor-beta2 production

PURPOSE: To evaluate the effects of sequential treatment with artificial tears and cyclosporine emulsion on conjunctival goblet cell density and production of transforming growth factor (TGF)-beta2 in patients with dry eye disease. METHODS: Patients with dry eye disease (N = 6) defined by an Ocular Surface Disease Index symptom score >or=25, Schirmer test 1 <10 mm, and corneal fluorescein and conjunctival lissamine green staining scores >or=3 were treated with artificial tears (Refresh Plus; Allergan, Irvine, CA) 4 times a day for 4 weeks, followed by 0.05% cyclosporine emulsion (Restasis; Allergan) twice a day for 12 weeks. Impression cytology was performed on the bulbar conjunctiva of both eyes at baseline, after artificial tear therapy, and after 6 and 12 weeks of cyclosporine therapy. Goblet cells were counted in 5 representative microscopic fields per membrane in those taken from the temporal and inferior bulbar conjunctiva of the worse eye, and membranes taken from the fellow eye were immunostained for TGF-beta2. RESULTS: There were no differences in mean goblet cell density between baseline and 4 weeks of artificial tears in the temporal and inferior bulbar specimens. After 6 weeks of cyclosporine emulsion, goblet cell density was significantly greater than baseline and artificial tears in the inferior bulbar conjunctiva (P < 0.01). After 12 weeks of cyclosporine emulsion, goblet cell density was significantly greater than baseline and artificial tears in both temporal and inferior bulbar sites (P < 0.01). The number of TGF-beta2-positive goblet cells was also noted to increase after 6 and 12 weeks of cyclosporine therapy (P < 0.001). CONCLUSIONS: Cyclosporine emulsion, but not artificial tears, increases goblet cell density and production of the immunoregulatory factor TGF-beta2 in the bulbar conjunctiva in patients with dry eye.     

The influence of copper, selenium and zinc on the response to the Montenegro skin test in subjects vaccinated against American cutaneous leishmaniasis

We evaluated the relationship between the trace elements copper, zinc and selenium and the response to the Montenegro skin test (MST) in 172 volunteers vaccinated against American cutaneous leishmaniasis. The MST diameter was categorized as negative and in quartiles of positive response, constituting five groups. Trace element serum levels were analyzed by coupled plasma atomic emission spectrometry and hydride generation atomic absorption spectrometry, with study subjects classified into two groups depending on low or high levels of trace elements observed. MST-positive subjects had an MST diameter (mean+/-SD) of 10.35+/-4.64mm, with copper, selenium and zinc serum levels of 1433.7+/-665.7microg/l, 88.6+/-39microg/l and 999.2+/-366microg/l, respectively. The MST diameter was significantly different in the selenium groups only. The selenium levels also differed with the quartiles of the MST diameters of individuals testing positive (P<0.05). Our findings suggest that trace elements, particularly selenium, should be measured in future vaccine trials so that vaccine immunogenicity and response can be assessed and compared between different studies.     

Organization of primary health care in cities belonging to project for expansion and consolidation of the family health strategy in Mato Grosso State, Brazil

This article presents part of the results from the Baseline Study on the PROESF. The objective was to evaluate primary health care in the cities of Cuiabá, Várzea Grande, and Rondonópolis, Mato Grosso State, Brazil, based on the inter-subjectivity in human relations (among health workers, users of health services, and the public at large and within institutionalized levels of social control). A qualitative and quantitative methodology was used, including interviews with key informants; short meetings with managers; focal groups with managers; and interviews with users and health professionals from pre-selected health units. Scores were assigned to all the questions that indicated participatory processes in primary care practices in the various municipalities. Despite the geopolitical identity among the municipalities and their similar access to the same public policies, there was a significant difference in their performance of the functions pertaining to the organization of primary care and the Family Health Program, in terms of portal of entry into the system, longitudinality, comprehensiveness, and coordination. Differences were observed in the type of relations that were established (participatory versus non-participatory), corresponding to the previous difference.