Objective
The study aimed to report a case of late mandibular fracture after osteomyelitis associated with post-extraction trauma of an impacted third molar.
Case Report
A male patient, 48 years old, ...sought oral and maxillofacial surgery service after 2 months of extraction with edema on the left side of the face, limited mouth opening, and spontaneous pain. The tomographic examination showed an area of bone resorption at a mandibular angle starting from the alveolus region of the tooth 38. Associating the clinical and imaging characteristics, the diagnosis of osteomyelitis was established. The patient became well due to the drug treatment and did not present any more complaints. Within 12 months after the extraction, the patient returned to the service with a new increase in volume, in the posterior region of the mandible, with mandibular mobility under manipulation, as well as signs of infection. A new CT showed the presence of a pathological fracture in the region, requiring a surgical approach for local debridement and fracture repair with the use of a reconstruction plate.
Conclusion
The case presented is an uncommon late postoperative complication after third molar extraction, which demonstrates the importance of monitoring the patient with osteomyelitis, in order to avoid worsening bone involvement and consequent pathological fracture.
Problem
The use of drugs by street children and adolescents is a problem found in most large cities around the world.
Methods
This is a cross‐sectional study of street children and adolescents living ...in shelters in the Federal District, Brazil. An objective questionnaire was applied to 84 individuals from September 2016 to October 2017; 14 of them participated in the qualitative study.
Findings
Most participants were adolescents (84.5%) and males (64.3%), with a history of abandonment, domestic violence, and family drug abuse. All spent some time on the street; boys had a higher chance of being behind the school level and using drugs than girls. Over 60% had used drugs in the previous year, mainly alcohol and marijuana. Over 70% understand the health consequences of this behavior, but most have never tried or failed to stop. About 40% consider themselves dependent on drugs.
Conclusions
The results showed that street‐life experience, peer pressure, and exposure to drugs within the family had an important impact on respondent's drug use behavior, reinforcing the importance of education programs that focus on the family.
As desigualdades econômicas de gênero têm se manifestado persistentes nos países latino-americanos a despeito dos avanços na legislação trabalhista e nas políticas públicas a elas endereçadas. O ...objetivo deste artigo é investigar a natureza das assimetrias salariais de gênero e as suas aproximações e divergências entre Brasil e Colômbia, a partir dos microdados da PNAD/IBGE para o Brasil e da GEIH/DANE para a Colômbia, em 2019. O mercado de trabalho colombiano evidencia menores desigualdades salariais de sexo, mas desfavoráveis para as colombianas nos níveis inferiores da distribuição salarial. As principais causas das diferenças derivam da discriminação salarial no Brasil e nos quantis mais altos, enquanto na Colômbia vêm dos impactos da valoração dos atributos de gênero pelo mercado e para posição mais baixa da distribuição salarial. Isso reflete o reconhecimento da centralidade dos mercados nacionais latino-americanos, como também a emergência de compromissos regionais para as políticas públicas a favor da equidade de gênero.
Fusarium spp. are non-dermatophytic hyaline moulds distributed worldwide and recovered from the nature as soil saprophytes and plant pathogens. Human infections are usually precipitated by local or ...systemic predisposing factors and disseminated infection is associated with impaired immune responses. We report eight cases of cutaneous lesions caused by Fusarium spp. All patients were immunocompetent. Seven cases with presented onychomycosis and one patient with interdigital intertrigo. It is important to alert the medical community about the relevance of the opportunistic fungi, such as Fusarium spp., which have emerged as human infectious agents, emphasizing the importance of correct etiological identification, allowing for appropriate treatment.
•Prototyping is efficient for surgical zygomatic-orbital correction.•The use of preshaped titanium plates reduces operative time and improves esthetics.•Prototyping provides a better outcome for the ...patient than conventional surgery.
Zygomatic-orbital complex fractures are the most common facial traumas that can result in severe esthetic and functional sequelae. Surgical correction of these fractures is a delicate approach and prototyping is an excellent tool to facilitate this procedure.
A 27-year-old man, a motorcycle accident victim, was hospitalized in the intensive care unit for 30days. After this period, facial fractures were treated surgically, leaving sequelae such as enophthalmos, dystopia and loss of projection of the zygomatic arch. A second intervention was planned after one year for reconstruction of the orbit with the help of prototyping. Better outcomes were achieved than in the first intervention.
This report permits to compare the result of conventional surgery and the use of a prototype in the same patient. Noticeably better outcomes were achieved with the second approach. Prototyping made the surgical procedure more predictable and reduced operative time because of the possibility of using preshaped titanium plates.
Prototyping was found to be an excellent option to overcome the deficiencies of the conventional technique, recovering the functional and esthetic characteristics of the patient’s face and ensuring a markedly satisfactory outcome.
Objetivo: Analisar dados da autorização de internação hospitalar (AIH) consolidados no Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS), referentes ao tratamento cirúrgico da ...ATM, em um período de dez anos (2009-2019). Metodologia: Utilizou-se o registro das AIHs no SIH-SUS processadas por meio do DATASUS e a amostra foi composta pelas internações aprovadas em decorrência da realização de procedimentos cirúrgicos da ATM no período em estudo. Para análise estatística foram empregados os testes T- Student e a ANOVA, com nível de significância fixado em p < 0,05. Resultados: Foram autorizadas 5.458 internações e, destas, a artroplastia foi o procedimento mais executado (58,04%) (p<0,001) e a redução cruenta o menos realizado (3,46%) (p<0,001). Observou-se que o Sudeste brasileiro (45,74%) foi a região na qual teve maior realização dessas cirurgias (p<0,001), sendo o caráter de atendimento eletivo (59,9%) o mais predominante e o tratamento cirúrgico de anquilose demandou mais dias de internação (p = 0,015). Pode-se verificar na avaliação financeira, que a artroplastia necessitou de mais recursos para os serviços profissionais (50,33%) (p=0,043) e o tratamento de cirúrgico de anquilose apresentou, descritivamente, um maior custeio de serviços hospitalares (53,79%). Conclusão: O tratamento cirúrgico de ATM assumiu características epidemiológicas heterogêneas no período estudado. Os achados do presente artigo apresentaram informações em vigilância epidemiológica relacionadas às AIHs para o tratamento cirúrgico da ATM, que poderão nortear a tomada de decisão por gestores em saúde pública quanto à compreensão e a alocação de recursos baseada em evidências.
Fusarium spp. are non-dermatophytic hyaline moulds distributed worldwide and recovered from the nature as soil saprophytes and plant pathogens. Human infections are usually precipitated by local or ...systemic predisposing factors and disseminated infection is associated with impaired immune responses. We report eight cases of cutaneous lesions caused by Fusarium spp. All patients were immunocompetent. Seven cases with presented onychomycosis and one patient with interdigital intertrigo. It is important to alert the medical community about the relevance of the opportunistic fungi, such as Fusarium spp., which have emerged as human infectious agents, emphasizing the importance of correct etiological identification, allowing for appropriate treatment.
Generalized Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life. Cannabidiol (CBD), one major non-psychotomimetic compound of the cannabis sativa ...plant, has shown anxiolytic effects both in humans and in animals. This preliminary study aimed to compare the effects of a simulation public speaking test (SPST) on healthy control (HC) patients and treatment-naïve SAD patients who received a single dose of CBD or placebo. A total of 24 never-treated patients with SAD were allocated to receive either CBD (600 mg; n=12) or placebo (placebo; n=12) in a double-blind randomized design 1 h and a half before the test. The same number of HC (n=12) performed the SPST without receiving any medication. Each volunteer participated in only one experimental session in a double-blind procedure. Subjective ratings on the Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) and physiological measures (blood pressure, heart rate, and skin conductance) were measured at six different time points during the SPST. The results were submitted to a repeated-measures analysis of variance. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group as assessed with the VAMS. The SSPS-N scores evidenced significant increases during the testing of placebo group that was almost abolished in the CBD group. No significant differences were observed between CBD and HC in SSPS-N scores or in the cognitive impairment, discomfort, and alert factors of VAMS. The increase in anxiety induced by the SPST on subjects with SAD was reduced with the use of CBD, resulting in a similar response as the HC.
•Fires are strongly associated with agriculture areas, silt and temperature.•Fire occurrences are higher during the dry season.•Protected areas act as fire barrier.•Random Forest is a high ...performance fire prediction algorithm.•Species Distribution Models can be adequately used in fire prediction.
The Cerrado-Amazon transition (CAT) is located between the two largest biogeographic domains of the Neotropical region, coinciding with the “Arc of Deforestation”, an agricultural frontier that expands towards the Amazon. Fire plays an important role in the landscape changes that have been occurring in this transition. Thus, the objectives of this study were (i) evaluate the accuracy of different algorithms/techniques in predicting fires in the CAT; (ii) investigate the season of highest fire probabilities in the CAT; and (iii) identify, among anthropic, climatic, topographic and soil variables, the main drivers of fires spatial distribution in the CAT. Fire occurrence data (active fire pixels) from the MODIS sensor were used as input data in species distribution models. The SDM allowed the construction of monthly fire probability models for the study area. The model's quality was assessed by R-squared, RMSE, AUC and TSS metrics. In addition, we assessed the weight of variables in building the models. To obtain the fire seasonality, we used the bootstrap technique to calculate the 95% confidence interval (CI) about the mean. As result, we found that all algorithms obtained satisfactory performance, as well as the ensemble model technique used, which obtained an average AUC of 0.812 ± 0.001. The algorithm with the best individual performance was Random Forest, with a mean AUC 0.851 ± 0.002. Similar patterns were found when considering TSS metrics. The predicted and observed fire occurrences showed strong association (R2 = 0.81). The high fire probability area was higher during the dry season (15304.37 ± 41.65), showing a significant difference (p-value ≤ 0.05) from the rainy season. The variables that most explained the fire occurrences along the CAT were 'Silt Fraction', 'Distance from Agriculture' and 'Maximum Temperature'. In addition, ‘Distance from Roads’, ‘Distance from Protected Areas’ and Elevation’ were relevant for the monthly models. Anthropogenic variables were more important during the dry season. The results demonstrate that SDMs can be adequately used in fire prediction. Protected areas have shown an important role in acting as a fire barrier. However, many of these areas are vulnerable, surrounded by high fire probabilities during the dry season, predominantly anthropic, putting the natural dynamics of fire in the region and the local biodiversity at risk. Our approach can be useful in environmental protection and monitoring, in addition to facilitating the understanding about the CAT ecological complexity and the high anthropogenic pressure happening there.