RESUMO Objetivos: Avaliar a resistência de união dos reparos com resina composta auto-adesiva Vertise Flow (Kerr) e uma resina composta convencional Filtek Z350 (3M ESPE) submetida à diferentes tratamentos de superfície. Métodos: Quarenta amostras foram divididas em quatro grupos: ZV (Filtek Z350 + Vertise Flow, sem tratamento prévio); ZAV (Z350 + Vertise Flow com tratamento prévio com Sistema Adesivo Universal Single Bond (3M ESPE)); ZAZ (Filtek Z350 + Filtek Z350 com tratamento prévio com Sistema Adesivo Universal Single Bond (3M ESPE)); VV (Vertise Flow + Vertise Flow, sem tratamento prévio). Após 15 dias de armazenamento, as amostras foram submetidas ao teste de microtração (Kratos IKCL3-USB, SP, Brasil), com velocidade de 0,5 mm / min e carga de 20kg.Para análise estatística, foram utilizados os testes ANOVA com Tukey (p <5%). Resultados: Os valores médios da resistência de união foram maiores, respectivamente, nos grupos: ZV (36,07 ± 37,63); ZAZ (24,04 ± 28,51); VV (19,39 ± 28,24) e ZAV (16,06 ± 15,66). A resistência de união dos reparos entre os grupos apresentou resultados satisfatórios. Conclusão: A resina composta auto-adesiva Vertise Flow parece ser uma alternativa viável e rápida para reparos em restaurações com resinas compostas.

ABSTRACT Objective: To evaluate the bond strength of repairs with the self-adhering flowable composite Vertise Flow (Kerr) and a conventional composite resin Filtek Z350 (3M ESPE) subjected to different surface treatments. Methods: Forty specimens were divided into four groups: ZV (Filtek Z350 + Vertise Flow, without prior treatment); ZAV (Z350 + Vertise Flow with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); ZAZ (Filtek Z350 + Filtek Z350 with prior treatment with Single Bond Universal Adhesive System (3M ESPE)); VV (Vertise Flow + Vertise Flow, without prior treatment). After 15 days of storage, the specimens were subjected to microtensile tests (Kratos IKCL3-USB, SP, Brazil), with speed of 0.5 mm/min and 20kg load. For statistical analysis, ANOVA with Tukey tests were used (p < 5%). Results: The mean values of the bond strength were highest respectively in the groups: ZV (36.07 ± 37.63); ZAZ (24.04 ± 28.51); VV (19.39 ± 28.24) and ZAV (16.06 ± 15.66). The bond strength of the repairs between the groups presented satisfactory results. Conclusion: The self-adhesive composite resin Vertise Flow seems to be a viable and fast alternative for composite resins repairs.

RESUMO Objetivo: avaliar simetria após a cirurgia conservadora da mama (CCM) para câncer. Métodos: estudo prospectivo de pacientes submetidos à CCM, as quais foram fotografadas segundo os mesmos critérios de avaliação. Os pontos de referência utilizados foram a diferença de altura do mamilo (AM), a distância mamilo-manúbrio (MM), a distância mamilo-esterno (ME) e o ângulo entre o sulco intramamário e o mamilo (ângulo mamilo; AnM). Foi usado o programa ImageJ. Avaliamos três modelos de simetria mamária: excelente/outros (modelo 1), excelente-bom/outros (modelo 2) e outros/ruim (modelo 3). Aplicamos a curva ROC para selecionar os critérios aceitáveis para a avaliação da simetria. Realizamos análise com o modelo de árvore de decisão. Resultados: foram avaliadas 274 mulheres. Os resultados do BCCT.core foram excelentes em 5,8% (16), bons em 24,1% (66), regulares em 46,4% (127) e ruins em 23,7% (65). A diferença de AM (dAM) foi associada a boa área mamária (0,837-0,846); diferenças aceitáveis foram inferiores a 3,1 cm, enquanto os valores inaceitáveis foram superiores a 6,4 cm. As diferenças MM (dMM) foram associadas à área regular das mamas (0,709-0,789); diferença de valor inferior a 4,5 cm foi aceitável, enquanto valores superiores a 6,3 cm foram inaceitáveis. O modelo combinado de árvore de decisão demonstrou resultado bom-excelente para pacientes com diferencial (d) dAM = 1 (0 a 5,30 cm) e dMM ≠ 3 (< 6,28 cm), e resultado ruim/ruim com dMM = 3 (> 6,35 cm). Conclusões: os resultados aqui apresentados são ferramentas simples que podem auxiliar o cirurgião na avaliação da simetria mamária.

ABSTRACT Objective: to evaluate symmetry after breast-conserving surgery (BCS) for cancer. Methods: a prospective study of patients undergoing BCS. These patients were photographed using the same criteria of evaluation. The references points used were the nipple height difference (NH), the nipple-manubrium distances (NM), nipple-sternum distances (NS) and the angle between the intramammary fold and the nipple (nipple angle; NA). ImageJ software was used. Three breast symmetry models were evaluated: excellent/others (model 1), excellent-good/others (model 2) and others/poor (model 3). The ROC curve was used to select acceptable criteria for the evaluation of symmetry. Decision tree model analysis was performed. Results: a total of 274 women were evaluated. The BCCT.core result was excellent in 5.8% (16), good in 24.1% (66), fair in 46.4% (127) and poor in 23.7% (65). The difference in NH was associated with good breast area (0.837-0.846); acceptable differences were below 3.1 cm, while unacceptable values were greater than 6.4 cm. Differences in the NM were associated with average breast area (0.709-0.789); a difference in value of less than 4.5 cm was acceptable, while values greater than 6.3 cm were unacceptable. In the decision tree combined model, a good-excellent outcome for patients with differential (d) dNH = 1 (0 to 5.30 cm) and dNM ≠ 3 (<6.28 cm); and for a poor/poor result, values dNM = 3 (> 6.35). Conclusions: the results presented here are simple tools that can assist the surgeon for breast symmetry evaluation.

RESUMO INTRODUÇÃO: O tratamento conservador da mama (TCM), desde que associado à radioterapia, é seguro. As indicações inicialmente utilizadas para o TCM se elevaram, sendo importante modalidade de tratamento. Novas modalidades, como a oncoplastia associada ao TCM, tornam-se cada vez mais presentes no cotidiano. Pacientes submetidas ao TCM apresentam alguns parâmetros associados a uma melhor qualidade de vida em relação às pacientes mastectomizadas sem reconstrução. Há limitados instrumentos de qualidade de vida a serem utilizados específicamente no TCM, sendo um deles o Breast Cancer Treatment Outcome Scale (BCTOS), questionário este não traduzido e adaptado para a língua portuguesa/Brasil. O BCTOS contém 22 perguntas e quatro domínios (funcional, estético, sensibilidade mamária e oedema). MÉTODOS: Realizamos a tradução e adaptação cultural utilizando a metodologia proposta por Beaton e pelo EORTC. Em resumo, consiste de tradução para o português, resumo da tradução, tradução reversa para o inglês, comitê de especialistas, pré-teste (dez pacientes), revisão do questionário e teste da versão final (seis pacientes). RESULTADOS: As 16 pacientes foram submetidas a quadrantectomia e radioterapia. Linfedema esteve presente em quatro, alteração da força em cinco e alteração da mobilidade em seis pacientes. Avaliando o questionário, a versão de conciliação modificou dois itens. O pré-teste mostrou dificuldades em três pacientes, mas o questionário não se alterou, fato que não se observou no teste final. CONCLUSÃO: A tradução do BCTOS para o português nos ajudará a avaliar a qualidade de vida em pacientes submetidas a tratamento conservador da mama, avaliando as sequelas relacionadas ao tratamento, podendo ser útil na avaliação da cirurgia oncoplástica.

SUMMARY BACKGROUND: Breast conservative treatment (BCT) is safe when it is performed in association with radiotherapy. The number of referral for BCT has increased, and it has become an important treatment modality. Patients who undergo BCT present some characteristics that are associated with better quality of life compared with patients who undergo mastectomy without reconstruction. Instruments that measure the quality of life specifically used in cases of BCT are limited. One of these instruments is the Breast Cancer Treatment Outcome Scale (BCTOS), which has not yet been translated into Brazilian Portuguese. It contains 22 questions and four domains (functional, aesthetic, breast sensitivity and oedema). METHODS: We performed the translation and cultural adaptation process using Beaton's and EORTC translations process. In summary, the translation process is based on Portuguese translation, translation summary, reverse translation into English, expert committee, pre-test (10 patients), questionnaire review and test of the final version (6 patients). RESULTS: All 16 patients were submitted to quadrantectomy and mammary radiotherapy. Lymphedema was present in 4, altered strength in 5, and altered shoulder mobility in 6 patients. Considering the questionnaire, the reconciled version determined change in 2 items. Pre-test evaluation showed difficulties in 3 patients, but the questionnaire did not change. Test evaluation showed no problems. CONCLUSION: The translation of BCTOS into Portuguese will help us to evaluate the quality of life in BCT patients evaluating treatment-related sequelae and may be useful for oncoplastic surgery evaluation.

Abstract This study aimed to evaluate the in vitro antifungal activity of terpinen-4-ol, tyrosol, and β-lapachone against strains of Coccidioides posadasii in filamentous phase (n = 22) and Histoplasma capsulatum in both filamentous (n = 40) and yeast phases (n = 13), using the broth dilution methods as described by the Clinical and Laboratory Standards Institute, to determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of these compounds. The mechanisms of action of these compounds were also investigated by analyzing their effect on cell membrane permeability and ergosterol synthesis. The MIC and MFCf these compounds against C. posadasii, mycelial H. capsulatum, and yeast-like H. capsulatum, were in the following ranges: 350-5720 µg/mL, 20-2860 µg/mL, and 40-1420 µg/mL, respectively for terpinen-4-ol; 250-4000 µg/mL, 30-2000 µg/mL, and 10-1000 µg/mL, respectively, for tyrosol; and 0.48-7.8 µg/mL, 0.25-16 µg/mL, and 0.125-4 µg/mL, respectively for β-lapachone. These compounds showed a decrease in MIC when the samples were subjected to osmotic stress, suggesting that the compounds acted on the fungal membrane. All the compounds were able to reduce the ergosterol content of the fungal strains. Finally, tyrosol was able to cause a leakage of intracellular molecules.

The most highly prevalent inherited disease in Brazil and in the world, sickle cell anemia, is considered a public health problem. Characterized by homozygosis for the hemoglobin S gene, the individual has a range of signs and symptoms that require careful treatment. The sickle cell trait is characterized by heterozygosis for the hemoglobin S gene, however the carrier does not express the disease. In the current study we aimed at verifying the presence of the sickle cell trait in 1000 blood donors of the Hematology and Hemotherapy Center of the State of Piauí (Hemopi) in the period from October 2007 to April 2008. After analysis by alkaline and acid electrophoresis, positive cases were confirmed by molecular biology. We obtained rates of 3.4% for hemoglobin AS and 5% for hemoglobin AC, with a total frequency of 3.9% in the total of 1,000 blood donors.