Abstract Objective To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage. Data sources The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied. Selection of studies Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened. Data collection Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I2 statistic. Data synthesis When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07–0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96–4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52–0.80). No statistically significant differences were observed in the general acceptability of the treatments. Conclusion Misoprostol has been determined as a safe option with good acceptance by patients.

Resumo Objetivo Avaliar a eficácia, segurança e aceitabilidade do misoprostol no tratamento do aborto incompleto. Fontes de dados Os bancos de dados PubMed, Scopus, Embase, Web of Science, Cochrane Library e bancos de dados de Ensaios Clínicos (clinicaltrials.gov) foram pesquisados para os artigos relevantes, e estratégias de busca foram desenvolvidas usando uma combinação de termos temáticos de Medical Subject Headings e palavras de texto. A última pesquisa foi realizada em 4 de julho de 2022. Nenhuma restrição de idioma foi aplicada. Seleção dos estudos Foram incluídos ensaios clínicos randomizados com pacientes com idade gestacional até 6/7 semanas com diagnóstico de aborto incompleto e que foram manejadas com pelo menos um dos três tipos de tratamento estudados. Um total de 8.087 estudos foram selecionados. Coleta de dados Os dados foram sintetizados usando o pacote estatístico Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). Para resultados dicotômicos, o odds ratio (OR, na sigla em inglês) e o intervalo de confiança (IC) de 95% foram derivados para cada estudo. A heterogeneidade entre os resultados do ensaio foi avaliada usando o teste padrão, estatística I2. Síntese dos dados Ao comparar misoprostol com aspiração a vácuo médico (MVA, na sigla em inglês), a taxa de aborto completo foi maior no grupo MVA (OR = 0,16; IC95% = 0,07–0,36). Hemorragia ou sangramento intenso foi mais comum no grupo do misoprostol (OR = 3,00; 95%CI = 1,96–4,59), mas a dor após o tratamento foi mais comum em pacientes tratados com MVA (OR = 0,65; 95%CI = 0,52–0,80). Não foram observadas diferenças estatisticamente significativas na aceitabilidade geral dos tratamentos. Conclusão O misoprostol tem se mostrado uma opção segura e com boa aceitação pelos pacientes.

Resumen Este estudio tuvo como objetivo evaluar el efecto de la inoculación con L. buchneri liofilizado y/o activado sobre las poblaciones de bacterias de ácido láctico en ensilajes de maíz. Los tratamientos experimentales consistieron en ensilaje de maíz sin aditivo y ensilaje con los inoculantes L. buchneri 1 × 10 5 ufc/g, aplicados según las recomendaciones del fabricante (1 g/tonelada de forraje) en las formas de inoculante liofilizado e inoculante preactivado. Se identificaron aislados purificados de ensilajes de maíz con y sin inocu lación, y el 93% de los aislados correspondieron a bacterias de ácido láctico de la especie L. plantarum. Entre los aislados no se detectaron bacterias de la especie L. buchneri. La aplicación de L. buchneri liofilizado o activado en la masa ensilada promueve un aumento considerable de la población de bacterias de ácido lácticas en los ensilajes de maíz durante todo el período de fermentación.

Abstract This study aimed to evaluate the effect of inoculation with lyophilised and/or activated Lactobacillus buchneri on lactic acid bacteria populations in corn silage. Experimental treatments consisted of corn silage without additives or silage with the inoculants of L. buchneri (1 x 10 5 cfu/g) applied according to the manufacturer’s recommendations (1 g/tonne fodder) in the forms of the lyophilised inoculant and pre-activated inoculant. Purified isolates from corn silage with and without the inoculant were identified, and 93% of the isolates corresponded to the lactic acid bacteria of the species Lactobacillus plantarum. Among the isolates, no bacteria of the species L. buchneri were detected. The application of lyophilised or activated L. buchneri improved the microbiological profile and reduced ethanol production in corn silage, even without being identified among the isolates captured 70 days after ensilage.

Resumen El objetivo fue analizar las características estructurales, las funciones y los atributos de los vínculos en las redes sociales de usuarios de un Centro de Atención Psicosocial. Para ello, se desarrolló un estudio cualitativo en el que participaron 16 usuarios de un Centro de Atención Psicosocial. Se realizaron entrevistas en profundidad y semiestructuradas con base en el diagrama del mapa de Red. Se identificaron redes sociales extensas y con concentración de relaciones íntimas, circunscritas a los familiares y a los servicios de salud. Después de la enfermedad, los participantes relataron relaciones familiares fragilizadas. La apropiación de los espacios en la comunidad y en las redes incluye una herramienta de análisis, indicando a la producción del cuidado de salud mental los rumbos para la atención psicosocial.

Abstract The objective was to analyze the structural characteristics, functions and attributes of bonds in the social networks of users of a Psychosocial Care Center. For this purpose, a qualitative study was developed in which 16 users of a Psychosocial Care Center participated. In-depth and semi-structured interviews were carried out based on the Network Map diagram. Extensive social networks were identified, with a concentration of intimate relationships, limited to family members and health services. After the illness, the participants reported fragile family relationships. The appropriation of spaces in the community and in friendship relationships favored the structuring of networks. The analysis of the network map comprises an analysis tool indicating the pathways for psychosocial care to reach the production of mental health care.

Resumo Objetivou-se analisar as características estruturais, as funções e os atributos dos vínculos, nas redes sociais, de usuários de um Centro de Atenção Psicossocial (Caps). Para isso, desenvolveu-se um estudo qualitativo em que participaram 16 usuários de um Caps. Foram realizadas entrevistas em profundidade e semiestruturadas com base no diagrama do Mapa de Redes. Identificaram-se redes sociais extensas e com concentração de relações íntimas, circunscritas aos familiares e aos serviços de saúde. Após o adoecimento, os participantes relataram relações familiares fragilizadas. A apropriação dos espaços na comunidade e nas relações de amizade favoreceu a estruturação das redes. A análise do Mapa de Redes compreende uma ferramenta analisadora indicando, à produção do cuidado em Saúde Mental, os rumos para a Atenção Psicossocial.

RESUMO Objetivo Analisar a percepção de alunos dos cursos de Fonoaudiologia e de Pedagogia a respeito de suas experiências e práticas de leitura e escrita de textos pertencentes ao gênero do discurso na esfera acadêmica. Método Pesquisa de caráter quanti-qualitativo, de corte transversal e do tipo analítico. Para o levantamento dos dados, foi aplicado um questionário com perguntas que abrangiam a relação dos alunos com a leitura e com a escrita de textos pertencentes ao gênero acadêmico e as dificuldades enfrentadas no uso desse gênero do discurso. Resultados Muitos alunos supõem que apresentam alguma dificuldade no uso dos gêneros discursivos usados na universidade, o que pode indicar lacunas no trabalho com a linguagem escrita nos níveis de ensino que antecederam sua entrada no Ensino Superior. Alguns discentes referiram que se sentem culpados por não acompanharem, de forma efetiva, as atividades de leitura e de escrita propostas em seus respectivos cursos universitários, subentendendo que isso se deve a um distúrbio inerente aos mesmos. Conclusão Apesar do aumento do número de alunos no Ensino Superior, muitos ainda sentem-se excluídos da vida acadêmica, especialmente, por não usarem, de maneira proficiente, textos próprios deste nível de ensino. Cabe à Universidade e a todos os atores envolvidos na formação superior promoverem ações que considerem o direito a educação de todos os alunos.

ABSTRACT Purpose to analyze the perception of Speech-Therapy and Education undergraduates regarding their experiences and practices in reading and writing texts from academic discourse genres. Methods It´s a mixed crosscut study, with data collected by the application of a semi-structured questionnaire with open and closed questions about students’ relation towards reading and writing of academic texts, their difficulties in the use of these genres and how they cope with such difficulties. Results The results show that a significant number of the students assume that they have some difficulty in reading and writing these discourse genres in academic settings, which may be an indication of gaps in working with reading and writing during previous educational levels. Some of these students even blame themselves for not effectively following the reading and writing proposals in higher education, implying that this is due to an intrinsic disorder. Conclusion The data allow us to state that, despite the increase in the number of students in higher education, many still feel excluded from academic life, especially for not using academic discourse genres in a proficient way. It is the University responsibility, along with all actors involved in higher education, to promote actions that consider the right to education for all students.

abstract: This paper analyses the behaviour of reinforced concrete beams subjected to progressive loads. Although this topic is addressed in recent works through tri-dimensional finite elements, the present study adopts a simpler alternative, using Euler-Bernoulli’s beam finite element. The evolution of the generalized cracking is addressed by Damage Mechanics theory, and the nonlinear constitutive models of concrete and steel are considered, including plasticity and post-peak ‘. The laminated approach permits not only to ascertain the damage evolution but, in practical aspects, makes easy to define vertically symmetrical transversal sections and to distribute the reinforcement as desired, even if the steel rebars have different lengths. It is highlighted the changing of the neutral axis during the damage evolution process, which is updated automatically by the developed numeric-computational code. To validate the proposed methodology, two examples are detailed, both based on experimental tests found in the literature. The results obtained are close to the experimental ones and confirm the applicability of the proposed approach.

resumo: Este trabalho analisa o comportamento de vigas de concreto armado submetidas a carregamentos progressivos. Embora este tema seja tratado em trabalhos mais recentes através de modelos de elementos finitos tridimensionais, o presente trabalho adota uma alternativa mais simples empregando elementos finitos de viga de Euler-Bernoulli. A evolução da fissuração generalizada é abordada pela teoria da Mecânica do Dano, e são considerados os modelos constitutivos não lineares do concreto e do aço, incluindo a plasticidade e o comportamento pós-pico. A abordagem laminada permite não só verificar a evolução do dano, mas, em aspectos práticos, facilita definir seções transversais verticalmente simétricas e distribuir a armadura conforme desejado, mesmo que as barras de aço tenham comprimentos diferentes. Destaca-se a mudança da linha neutra durante o processo de evolução do dano, que é atualizado automaticamente pelo código numérico-computacional desenvolvido. Para validar a metodologia proposta, são detalhados dois exemplos, ambos baseados em testes experimentais encontrados na literatura. Os resultados obtidos são muito próximos dos experimentais e confirmam a aplicabilidade da abordagem proposta.

Abstract The objective was to analyze the structural characteristics, functions and attributes of bonds in the social networks of users of a Psychosocial Care Center. For this purpose, a qualitative study was developed in which 16 users of a Psychosocial Care Center participated. In-depth and semi-structured interviews were carried out based on the Network Map diagram. Extensive social networks were identified, with a concentration of intimate relationships, limited to family members and health services. After the illness, the participants reported fragile family relationships. The appropriation of spaces in the community and in friendship relationships favored the structuring of networks. The analysis of the network map comprises an analysis tool indicating the pathways for psychosocial care to reach the production of mental health care.

Resumen El objetivo fue analizar las características estructurales, las funciones y los atributos de los vínculos en las redes sociales de usuarios de un Centro de Atención Psicosocial. Para ello, se desarrolló un estudio cualitativo en el que participaron 16 usuarios de un Centro de Atención Psicosocial. Se realizaron entrevistas en profundidad y semiestructuradas con base en el diagrama del mapa de Red. Se identificaron redes sociales extensas y con concentración de relaciones íntimas, circunscritas a los familiares y a los servicios de salud. Después de la enfermedad, los participantes relataron relaciones familiares fragilizadas. La apropiación de los espacios en la comunidad y en las redes incluye una herramienta de análisis, indicando a la producción del cuidado de salud mental los rumbos para la atención psicosocial.

Resumo Objetivou-se analisar as características estruturais, as funções e os atributos dos vínculos, nas redes sociais, de usuários de um Centro de Atenção Psicossocial (Caps). Para isso, desenvolveu-se um estudo qualitativo em que participaram 16 usuários de um Caps. Foram realizadas entrevistas em profundidade e semiestruturadas com base no diagrama do Mapa de Redes. Identificaram-se redes sociais extensas e com concentração de relações íntimas, circunscritas aos familiares e aos serviços de saúde. Após o adoecimento, os participantes relataram relações familiares fragilizadas. A apropriação dos espaços na comunidade e nas relações de amizade favoreceu a estruturação das redes. A análise do Mapa de Redes compreende uma ferramenta analisadora indicando, à produção do cuidado em Saúde Mental, os rumos para a Atenção Psicossocial.

Abstract The objective of this study was to compare the protein profile of the acquired enamel pellicle (AEP) formed in vivo in patients with or without gastroesophageal reflux disease (GERD), and with or without erosive tooth wear (ETW). Twenty-four volunteers were divided into 3 groups: 1) GERD and ETW; 2) GERD without ETW; and 3) control (without GERD). The AEP formed 120 min after prophylaxis was collected from the lingual/palatal surfaces. The samples were subjected to mass spectrometry (nLC-ESI-MS/MS) and label-free quantification by Protein Lynx Global Service software. A total of 213 proteins were identified, or 119, 92 and 106 from each group, respectively. Group 2 showed a high number of phosphorylated and calcium-binding proteins. Twenty-three proteins were found in all the groups, including 14-3-3 protein zeta/delta and 1-phosphatidylinositol. Several intracellular proteins that join saliva after the exfoliation of oral mucosa cells might have the potential to bind hydroxyapatite, or participate in forming supramolecular aggregates that bind to precursor proteins in the AEP. Proteins might play a central role in protecting the dental surface against acid dissolution.

ABSTRACT Metacognition is a fundamental cognitive process for learning and it is related to self-reflection. The objective of this exploratory and qualitative study was to describe children’s perception of their metacognitive strategies based on a metacognition scale. In this way,106 children aged 9 to 12 years old participated, who answered a structured questionnaire. Data analysis followed the semiotic phenomenology criteria. The results revealed five themes: (1) Joy and motivation; (2) Indecision and curiosity; (3) Know more about me; (4) Anxiety; (5) Different from what I do at school. The diversity thematic of children’s perception of their self-reflective process suggests the extent of monitoring their own thoughts, feelings and behaviors and the experience and judgment of internalized contents. It is suggested that self-reflective tasks may be included in school programs, as they allow children to re-signify their role as subjects of their own knowledge process.

RESUMEN La metacognición es un proceso cognitivo fundamental hacia el aprendizaje y está relacionada a la autorreflexión. El objetivo de este estudio, exploratorio y de enfoque cualitativo, fue describir la percepción de niños sobre sus estrategias metacognitivas a partir de una escala de metacognición. Participaron 106 niños de 9 a 12 años, que respondieron a un cuestionario estructurado. El análisis de los datos siguió los criterios de la fenomenología semiótica. Los resultados apuntaron cinco temáticas: (1) Alegría y motivación; (2) Indecisión y curiosidad; (3) Saber más sobre mí; (4) Ansiedad; (5) Diferente de lo que hago en la escuela. La diversidad temática de la percepción de los niños sobre su proceso autorreflexivo sugiere la amplitud de la supervisión de los propios pensamientos, sentimientos y comportamientos y de la experiencia y juzgamiento de contenidos internalizados. Se sugiere que tareas autorreflexivas sean incluidas en los programas escolares, pues propician a los niños la resignificación del papel de sujetos de su propio proceso de conocimiento.

RESUMO A metacognição é um processo cognitivo fundamental para a aprendizagem e está relacionada à autorreflexão. O objetivo deste estudo, exploratório e de enfoque qualitativo, foi descrever a percepção de crianças sobre suas estratégias metacognitivas a partir de uma escala de metacognição. Participaram 106 crianças de 9 a 12 anos de idade, que responderam a um questionário estruturado. A análise dos dados seguiu os critérios da fenomenologia semiótica. Os resultados revelaram cinco temáticas: (1) Alegria e motivação; (2) Indecisão e curiosidade; (3) Saber mais sobre mim; (4) Ansiedade; (5) Diferente do que faço na escola. A diversidade temática da percepção das crianças sobre seu processo autorreflexivo sugere a amplitude do monitoramento dos próprios pensamentos, sentimentos e comportamentos e da experiência e julgamento de conteúdos internalizados. Sugere-se que tarefas autorreflexivas sejam incluídas nos programas escolares, pois propiciam às crianças a ressignificação do papel de sujeitos de seu próprio processo de conhecimento.

Abstract Aims: To describe reference values for the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) and Upper Quarter Y Balance Test (UQYBT) in young adults, and to determine whether there were differences in both tests based on gender and age. Intrarater reliability and measurement error were also assessed. Methods: Test-retest design with a sample of 146 young adults. The CKCUEST (number of touches, normalized score, and power) and the UQYBT (normalized reach in the medial, superolateral, and inferolateral direction, and the composite score) were used. Mean and standard deviation were calculated for both tests. A linear and a mixed regression model were applied to determine significant differences in test scores. Reliability was determined using Intraclass Correlation Coefficient (ICC) and error measurement through Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC). Results: Normative values were established and divided by gender and age. Men presented greater scores regarding the number of touches, power score, superolateral and inferolateral reaches. Good intrarater reliability was found for both tests. In the CKCUEST, the SEM and SDC values were 1 and 3 touches. In the UQYBT, the SEM values ranged from 3 to 7 cm, while the SDC ranged from 8 to 19 cm. Conclusion: Normative data were provided and men presented greater scores than women. Good intrarater reliability was found and values of SEM and SDC were established. Clinicians must use both tests in clinical practice since different aspects of the upper quarter are assessed.

ABSTRACT. This study aimed to evaluate forage yield, tiller population density, canopy height, nutritional value as well as cattle performance in alternate stocking from three tropical forage cultivars. The experiment followed a randomized block design, in a 3 x 3 factorial scheme with three replications. Three forage cultivars (Marandu, Massai and Xaraés) distributed in nine hectares were evaluated in three dry season periods (transition wet/dry, dry, and end of dry season), with repeated measures over time. The following variables were evaluated: canopy height, leaf: stem ratio, forage mass, leaf mass, stem mass and dead material mass. Total digestible nutrients, crude protein and in vitro dry mass digestibility were evaluated regarding forage nutrition. Animal performance, using 36 eleven-month-old animals (half-blood Nelore), was evaluated by the daily average gain and weight gain by area. During pre-grazing, canopy height presented interaction among forage cultivars and the evaluated periods. The average daily gain showed no interaction among cultivars and period of the year the similarity in animal performance among the cultivars Marandu and Massai show that the Massai grass can be used as an alternative for forage diversification under an alternate management system.

Resumo A trombose de veia porta (TVP) é uma doença na qual ocorre trombose desde os ramos intra-hepáticos da veia porta, podendo se estender até a veia esplênica e/ou veia mesentérica superior, estando associada, na maioria das vezes, à cirrose hepática. A TVP não associada a cirrose é rara. O objetivo deste artigo foi relatar dois casos de TVP não associados à cirrose, que foram tratados com anticoagulação e tiveram evolução clínica satisfatória.

Abstract Portal vein thrombosis (PVT) is a disease in which thrombosis occurs from the intrahepatic branches of the portal vein, and may extend to the splenic vein and/or superior mesenteric vein. It is most often associated with liver cirrhosis. PVT not associated with cirrhosis is rare. The aim of this article is to report two cases of PVT in which it was not associated with cirrhosis. Both were treated with anticoagulation and clinical progress afterwards was good.

Abstract Duchenne muscular dystrophy (DMD) is a severe disease with no cure caused by a genetic abnormality, promoting progressive muscle degeneration. Corticosteroids are used drugs in treatment associated with adverse effects. The extract of Miconia ferruginata (Melastomataceae) (MF) has demonstrated potent antioxidant and anti-inflammatory potential in vitro. This study used a DMD model (mdx) to determine the toxic dose of this plant and found a possible non-toxic dose with therapeutic effects. The mdx groups received an intraperitoneal injection of 0 (control group), 50, 100, 200, 300, and 2000 mg kg-1 of the aqueous leaf extract following a single-dose acute toxicity protocol and were observed for 14 days. The range of toxicity of the extract and LD50 were determined. Histopathological analysis, the quantification of fibrosis, and immunohistochemical analysis of the tissues were performed. The results demonstrated that 2000 mg kg-1 was highly toxic, inducing histopathological changes in the tissues evaluated, with 100% mortality in 48 hours. The other doses caused no behavioral changes or signs of toxicity. The MF extract led reduction in histopathological changes, fibrosis, and inflammation, a reduction in HSP70 and an increase in MCL-1 proteins. Doses of 50-200 mg kg-1 demonstrated regenerative tissue and anti-inflammatory potential.

RESUMO As restaurações dentárias que são realizadas com resinas compostas apresentam aspecto estético muito satisfatório, com coloração próxima à do dente e propriedades mecânicas aceitáveis. O grande desafio destas resinas é que tenham o mesmo, ou semelhante, desempenho mecânico que o dente original. O presente trabalho foi desenvolvido com o objetivo de avaliar as partículas inorgânicas do composto Al2O3-0,5B2O3-SiO2, produzidas pela técnica de spray pirólise (USP) para aplicação em resinas compostas dentárias. A síntese das partículas foi realizada empregando o método sol-gel, com os precursores nitrato de alumínio, ácido bórico e tetraetilortosilicato TEOS com pH da solução de 1,5. A fim de verificar as propriedades das partículas realizou-se caraterização físico-química pelo método de adsorção e dessorção de nitrogênio via BET, análise por MEV, FTIR, DRX, DTA-TGA, RMN e ensaio mecânico de tração. As imagens obtidas por MEV indicaram que as partículas eram esféricas de granulometria média de 1,26 ± 0,04 µm, sendo classificadas como microhíbridas. Pelos difratogramas observou-se característica amorfa, confirmando que o método de síntese aplicado é eficiente para a produção de materiais vítreos. Os testes com resina composta experimental apresentaram taxa de polimerização aceitável (16 e 9%), mas baixa resistência à compressão mecânica: entre 9,55 e 13,27 MPa.

ABSTRACT Dental restorations that are performed with composite resins present a very satisfactory aesthetic appearance, with a color close to that of the tooth and acceptable mechanical properties. The great challenge of these resins is that they have the same, or similar, mechanical performance as the original tooth. The present work was developed with the objective of evaluating the inorganic particles of the compound Al2O3-0,5B2O3-SiO2, produced by spray pyrolysis (USP) for application in dental composite resins. The synthesis of the particles was carried out using the sol-gel method, with the precursors aluminum nitrate, boric acid and TEOS tetraethylorthosilicate with a pH of 1.5. In order to verify the properties of the particles, physicochemical characterization was carried out using the nitrogen adsorption and desorption method via BET, analysis by SEM, FTIR, XRD, DTA-TGA, NMR and mechanical tensile testing. The images obtained by SEM indicated that the particles were spherical with a mean granulometry of 1.26 ± 0.04 µm, being classified as microhybrid. From the diffractograms, an amorphous characteristic was observed, confirming that the applied synthesis method is efficient for the production of glassy materials. Tests with experimental composite resin showed an acceptable polymerization rate (16 and 9%), but low mechanical compressive strength: between 9.55 and 13.27 MPa.

RESUMO Este estudo teve como objetivo comparar o desempenho da tomografia computadorizada de feixe cônico (TCFC), sondagem clínica e cirúrgica na avaliação do envolvimento da furca de molares superiores (EF). Defeitos de furca (n= 120) foram avaliados por meio de TCFC, avaliação clínica e intra-cirúrgica (IC). O envolvimento da furca, perda óssea vertical e horizontal foram avaliados através de sondagem clínica, TCFC e sondagem durante IC. Três radiologistas treinados avaliaram as imagens de TCFC e a concordância intra e interobservador foi calculada pelo teste Kappa e Coeficiente de Correlação Intraclasse (ICC). Para comparação da sondagem clínica, IC e CBCT foram utilizados os testes de McNemar e Wilcoxon. A precisão, sensibilidade, especificidade, valores preditivos positivos e negativos foram calculados para a detecção de EF. Os achados clínicos mostraram 61 sítios com EF, sendo 28 Grau I, 25 locais de Grau II e 8 locais de Grau III. Observou-se boa concordância intra- (k = 1,00) e interobservador (k = 0,773). A concordância intraobservador e interobservador para perda óssea horizontal foi moderada, k = 0,485 e k = 0,549, respectivamente. Os achados intra-cirúrgicos mostraram EF grau I em 21 sítios e grau II e grau III em quinze sítios cada. A avaliação clínica mostrou 75% de concordância com IC e 78% com CBCT. A acurácia para detecção clínica de EF foi de 75%, enquanto para avaliação de CBCT variou de 72,5% a 77,5%, considerando os 3 observadores. Diferenças significativas foram encontradas em sítios distais em CBCT (p<0,05). A avaliação clínica e a TCFC mostraram resultados semelhantes para a presença ou ausência de EF. Em relação à perda óssea horizontal e vertical, a TCFC não foi considerada um exame preciso para defeitos ósseos incipientes.

ABSTRACT The aim of this study was to compare the performance of conebeam computed tomography (CBCT), clinical and surgical probing in assessing maxillary molar furcation involvement (FI). Furcation defects (n= 120) were assessed through CBCT, clinical and intra-surgical evaluation (ISE). Furcation Involvement, vertical and horizontal bone loss were assessed through clinical probing, CBCT and probing during ISE. Three trained radiologists evaluated CBCT images and intra- and interobserver agreement were calculated by Kappa test and Intraclass Correlation Coefficient (ICC). McNemar and Wilcoxon tests were used to compare clinical probing, ISE and CBCT. Accuracy, sensitivity, specificity, positive and negative predictive values were calculated to detect FI. Clinical findings showed 28 sites with Degree I, 25 sites with Degree II, and 8 sites with Degree III. Good intra- (k=1.00) and interobserver agreement (k=0.773) were observed. Intraobserver and interobserver agreement for horizontal bone loss were moderate, k=0.485 and k=0.549, respectively. Intra-surgical findings showed Degree I at 21 sites, and Degree II and Degree III FI at fifteen sites each. Clinical evaluation showed 75% agreement with ISE and 78% with CBCT. Accuracy for clinical detection of FI was 75%, while for CBCT evaluation ranged from 72.5% to 77.5%, considering the 3 observers. Significant differences were found at distal sites using CBCT (p<0.05). Clinical evaluation and CBCT showed similar results for the presence or absence of FI. Concerning horizontal and vertical bone loss, CBCT was not considered a precise examination method for incipient bone defects.

RESUMO JUSTIFICATIVA E OBJETIVOS: A abordagem multiprofissional envolve mais de um especialista da área da saúde para obter tratamento mais efetivo do paciente com dor crônica. O objetivo deste estudo foi avaliar se a abordagem multidisciplinar possui eficácia no tratamento de pacientes com dor crônica, assim como analisar a resposta terapêutica destes pacientes com a utilização de escalas para aferição de dor neuropática, intensidade da dor e qualidade de vida. MÉTODOS: Foram avaliados 27 pacientes, com idade média de 56,85±12,17 anos. Permaneceram em acompanhamento com equipe multidisciplinar por 4 meses e foram avaliados no início e ao final do tratamento pela escala analógica visual, Leeds Pain Scale for Neuropathic Signs and Symptoms e o questionário de qualidade de vida Short Form-36. RESULTADOS: Observou-se melhora sintomática dos pacientes, no que diz respeito à redução da intensidade da dor, aperfeiçoamento da capacidade funcional, saúde mental e estado geral de saúde, sendo os valores encontrados pré e pós-intervenção de 30,10% para 58,80% (p=0,004), 33,7% para 57,78% (p<0,001), 43,41% para 67,56% (p=0,002), 40,19% para 65,07% (p=0,001), respectivamente, além da redução da sensação subjetiva de dor aferida pela escala analógica visual com mediana pré-tratamento de 8 e ao final de 2 (p<0,001). CONCLUSÃO: O estudo confirmou que o tratamento realizado por equipe multidisciplinar especializada em dor apresentou melhora e aumento da qualidade de vida dos pacientes.

ABSTRACT BACKGROUND AND OBJECTIVES: The multidisciplinary approach involves more than one specialist in the health field in order to obtain more effective treatment for patients with chronic pain. The aim of this study was to assess whether the multidisciplinary approach is effective in the treatment of patients with chronic pain, as well as to analyze the therapeutic response of these patients using scales for measuring neuropathic pain, pain intensity and quality of life. METHODS: Twenty-seven patients were evaluated, with a mean age of 56.85±12.17 years. They remained in follow-up with a multidisciplinary team for 4 months and were evaluated at the beginning and end of treatment using the visual analog scale, Leeds Pain Scale for Neuropathic Signs and Symptoms and the Short Form-36 quality of life questionnaire. RESULTS: Results showed a symptomatic improvement of the patients, with regard to the reduction of pain intensity, improvement of functional capacity, mental health and general health condition, with the values found before and after intervention from 30.10% to 58.80% (p=0.004), 33.7% to 57.78% (p<0.001), 43.41% to 67.56% (p=0.002), 40.19% to 65.07% (p=0.001), respectively, in addition to the reduction of the subjective pain sensation measured by the visual analog scale with a pre-treatment median of 8 and median at the end of 2 (p<0.001). CONCLUSION: The study confirmed that the treatment performed by a multidisciplinary team improves not only the level of pain, but also directly affects the quality of life of patients.