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This study examined the canonical relationships between a set of life skill variables and a set of subjective well-being variables among a national sample of vocational rehabilitation clients in the USA. Self-direction, work tolerance, general employability, and self-care were related to physical, family and social, and financial well-being. This analysis also found that communication skill is related to family and social well-being, while psychological well-being is not related to any life skills in the set. The results showed that vocational rehabilitation services aimed to improve life functioning will lead to an improvement in subjective quality of life. [ABSTRACT FROM AUTHOR]

The evidence-based practice (EBP) movement in medicine has permeated and affected a wide array of health and allied health care disciplines, and the field of rehabilitation is no exception. The purpose of this paper is to provide rehabilitation professionals up-to-date information about the defining characteristics and available resources of EBP for healthcare and rehabilitation practices, the critical issues that surround this movement, and the implications of this movement for the field of rehabilitation. [ABSTRACT FROM AUTHOR]

Social Support in connection with rehabilitation outcomes has been studied extensively in rehabilitation and the social sciences. However, the studies have yet to document clearly the strength of effect social support has on outcomes. This meta-analysis divided social support into three relevant categories; perceived satisfaction, perceived availability, and received social support. It was found that effect sizes for the three categories were .28, .32 and .21 respectively. Overall social support was found to have an effect size of .28 with rehabilitation outcomes. The evidence from theses analyses supports the three dimensions of social support and for the efficacy of social support on rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Polyureas (PURs) are a competitive polymer to their analogs, polyurethanes (PUs). Whereas PUs' main functional group is carbamate (urethane), PURs contain urea. In this revision, a comprehensive overview of PUR properties, from synthesis to technical applications, is displayed. Preparative routes that can be used to obtain PURs using diisocianates or harmless reagents such as CO 2 and NH 3 are explained, and aterials, urea monomers and PURs are discussed; PUR copolymers are included in this discussion as well. Bulk to soft components of PUR, as well as porous materials and meso, micro or nanomaterials are evaluated. Topics of this paper include the general properties of aliphatic and aromatic PUR, followed by practical synthetic pathways, catalyst uses, aggregation, sol-gel formation and mechanical aspects.

Background: Nowadays, in western societies, acupuncture is widely used over the control of pain and this analgesic approach is still the most studied aspect of acupuncture. Several studies have shown that most patients go through a significant pain decrease soon after the first sessions of acupuncture., Objectives: This research has as a goal the evaluation on the effect of acupuncture treatment regarding the relief of pain intensity of different etiologies, through the visual analog scale., Methods: This research constitutes a retrospective, descriptive study, carried out with 449 patients attended in the Institute Hospital de Base of the Federal District, in Brasilia city- Brazil. Every data was gathered from our own form, with detailed clinical history which included age, marital status, work activity, reason for referral to acupuncture, main and secondary complaints, pain intensity evaluated by the Visual Analog Scale (VAS), number of sessions completed and drug therapy. All data was organized in the Microsoft Excel and processed in the Statistical Package for the Social Sciences (SPSS), version 20.0., Results: Regarding the main complaint, the mean pain decreased from 7.3 (initial VAS) to 3.2 (final VAS), a reduction that meant more than 50% relief in pain intensity. This 50% reduction in initial pain was also observed in secondary complaints (initial VAS = 6.5 and final VAS = 3.1)., Conclusions: The results of this research suggest that acupuncture treatment was effective in relieving pain intensity, providing a 50% reduction on the visual analogue scale, in relation to painful complaints of different etiologies., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest related to the material of this manuscript., (Copyright © 2020. Published by Elsevier B.V.)

Background/aim: School is a place with a high frequency of dental trauma, and several studies have shown that teachers' knowledge in how to act during acute dental emergencies is lacking. Therefore, this study aimed to assess the knowledge and actions of a group of Brazilian school teachers relative to dental trauma in permanent teeth., Materials and Methods: A cross-sectional, observational study, from 27, schools randomized by lot was performed. All 205 teachers in the 27 schools answered a structured and self-administered questionnaire. The questionnaire contained questions about the participants' education level, work experience and first-aid training, as well as knowledge about and attitudes towards dental trauma in permanent teeth as well as their experience in dental emergency situations., Results: Of the 205 teachers, 91.2% reported having no knowledge about dental trauma and 16.6% of teachers had seen cases of acute dental trauma. Among the 205 teachers, 23.9% had received first-aid training and 4.1% had been educated in dental trauma. Regarding actions of acute injuries to permanent teeth, the teachers showed a significant error rate. No association was found between the level of education and first-aid training or experience with dental trauma. In relation to the experience of the teacher, association was found when managing trauma to soft tissue., Conclusion: The knowledge and actions of Brazilian schoolteachers in relation to care of acute injuries in permanent teeth were inconsistent and based on unfounded concepts, beliefs and intuition, and lack of training. Continuing education of teachers in oral care due to a dental trauma should be a good plan of action., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: The aim of this study was to investigate the preventive effect of thymol in in vivo muscle inflammation and regeneration on cardiotoxin-induced injury., Methods: Mice were pretreated (p.o.) with thymol (10-100 mg/kg), and after 1 h, cardiotoxin (25 μM, 40 μl) was administrated into the gastrocnemius muscle. The quantification of the areas of inflammation and regeneration of muscle tissue (3, 7 and 10 days) in HE-stained slides as well as the count of total mast cells and different phenotypes of mast cells were made. Sirius red staining was used to analyse total collagen expression., Key Findings: The pretreatment with thymol significantly reduced the area of inflammation (30 and 100 mg/kg) and increased the area of regeneration (100 mg/kg) 3 days after the cardiotoxin injection. Thymol at 30 and 100 mg/kg increased the area of collagen in 3 days and also decreased this area in 7 and 10 days, compared to the injured group. The pretreatment with thymol did not affect the number of total mast cells; however, it was able to change the number of mucosal mast cells within 10 days., Conclusions: This study suggests that thymol ameliorates inflammatory response and accelerates regeneration in cardiotoxin-induced muscle injury., (© 2016 Royal Pharmaceutical Society, Journal of Pharmacy and Pharmacology.)

Introduction: Although urine is considered the gold-standard material for the detection of congenital cytomegalovirus (CMV) infection, it can be difficult to obtain in newborns. The aim of this study was to compare the efficiency of detection of congenital CMV infection in saliva and urine samples., Methods: One thousand newborns were included in the study. Congenital cytomegalovirus deoxyribonucleic acid (DNA) was detected by polymerase chain reaction (PCR)., Results: Saliva samples were obtained from all the newborns, whereas urine collection was successful in only 333 cases. There was no statistically significant difference between the use of saliva alone or saliva and urine collected simultaneously for the detection of CMV infection., Conclusions: Saliva samples can be used in large-scale neonatal screening for CMV infection.

Purpose: The objective of the present study was to realize an indirect morphometric evaluation of bone thickness lateral to the mandibular canal., Material and Methods: In 30 partially or totally edentulous dry jaws, the first and second molar areas were analyzed using computed tomography., Results: The findings indicated that 28.33% of the sites could be considered for the installation of a standard 3.75-mm-diameter implant laterally between the mandibular canal and its bony counterpart., Conclusion: Implant installation in the posterior mandible region, lateral to the mandibular canal, is an alternative to more complex techniques, such as vertical ridge augmentation.

Objectives: To evaluate the effectiveness of a high-pressure sodium bicarbonate spray protocol to decontaminate implant surfaces intentionally inoculated with bacteria., Materials and Methods: Twenty commercially pure titanium implants, 10 with machined surfaces and 10 with rough surfaces, were inoculated with Streptococcus sanguis and then submitted to a decontamination protocol using a high-pressure sodium bicarbonate spray device for 1 minute under aseptic conditions., Results: After the application of the decontamination protocol, all bacterial cells were removed from the tested implants, regardless of surface roughness., Conclusion: The results suggest that regardless of the implant surface roughness, the protocol using high-pressure sodium bicarbonate spray for 1 minute, under aseptic conditions, was effective in removing all the viable bacterial cells.

Purpose: An in vitro model was developed and tested to evaluate the precision of guided implant systems. The accuracy of dental implants placed with a flapless technique was analyzed using a stereolithographic template in vitro. Differences between the virtual and actual positions of the implants were measured., Materials and Methods: Six polyurethane mandibles with artificial silicone gums were fabricated, and each was fitted with an individual computed tomography (CT) guide. Stereolithographic guides were created using computer-aided design/computer-assisted manufacturing technology and virtual planning software. All stereolithographic guides had four holes for stabilization pins and three holes for cylindric implants. After implant placement, the mandibles were subjected to another CT scan to compare the actual implant positions with the planned positions. The pre- and postimplantation CT images were superimposed using digital processing image software to evaluate the linear and angular deviations between the virtual planning data and the surgical results., Results: The mean angular discrepancy between the virtual and actual positions of the 18 placed implants was 2.16 ± 0.92 degrees. Among the placed implants, 66.7% were situated a mean of 0.38 ± 0.03 mm apical to the planned vertical position, and 33.3% were situated 0.39 ± 0.03 mm coronal to the planned position., Conclusions: Within the limitations of the present study, this tool showed promising accuracy in virtual implant placement.

This study investigated the effect of bioabsorbable plates and titanium microscrews on the growth of the craniofacial skeleton of rabbits (Oryctolagus cuniculus) in the neonatal period. All animals underwent surgery at seven weeks of age and were killed at twenty-four weeks. In the study group, LactoSorb plate and PROMM titanium microscrews were positioned across the coronal suture. In the control group, only PROMM titanium microscrews were attached to the cranium. Computed tomography was used to obtain morphometric measurements of volume. Results showed no significant intergroup (P < or = 0.05) or intragroup (control group P < or = 0.01; study group P < or = 0.05) differences in craniofacial volume. Under the experimental conditions of this study, bioabsorbable plates did not affect neonatal growth of craniofacial volume in rabbits.

The use of plates for the treatment of fractures can affect craniofacial bone development. This study investigated the effect of bioabsorbable plates and titanium microscrews on the growth of the craniofacial skeleton of rabbits (Oryctolagus cuniculus), in the neonatal period. A LactoSorb plate and PROMM titanium microscrews were positioned across the coronal suture in animals in the study group. In the control group, only PROMM titanium microscrews were attached to the cranium. Anteroposterior linear measurements were obtained using 3 different gauging devices: digital precision caliper, EKG caliper and nylon string. Frontal-nasal (FN) distances were statistically different between the left and right side when the digital caliper (P

Muscle overactivity, one of the cardinal features of spasticity, is a common sequel of cerebral palsy. In this group of patients spasticity is responsible for several limitations that interfere with gait, causing variable functional disability. Drugs such as baclofen, tizanidine, or benzodiazepines, or even definitive treatments such as orthopedics or neurosurgeries are generally prescribed with uncertain results. The use of botulinum toxin type A has been frequently suggested for the treatment of spastic equinus foot in cerebral palsy, but few studies with adequate methodology support this idea. The present paper reviews and summarizes the data of published double-blind, randomized clinical trials to assess, with a meta-analysis, if botulinum toxin type A is an adequate treatment for spasticity caused by cerebral palsy. The results reveal a statistical superiority of botulinum toxin type A over placebo on gait improvement, tested using the Physician Rating Scale and Video Gait Analysis (Peto odds ratio = 3.99, 95% confidence interval = 2.20-7.22) in patients with spastic equinus foot. The botulinum toxin group also presented better results in the subjective assessment than the placebo group (Peto odds ratio = 3.49, 95% confidence interval = 1.50-8.12). Adverse events were more frequently observed after the use of botulinum toxin type A, but they were considered mild and self-limited.

Primary sclerosing cholangitis is a disease usually with a poor prognosis with a mean survival of 10-12 years, starting from the time of diagnosis. Among the different populations studied, males predominate in a ratio 2:1 with ages ranging from 20-78 (mean 42 years). This article describes four patients with this syndrome, a child of eight and three adolescents, thirteen and fourteen years old. It is possibly of autoimmune etiology, characterized by stenosis, dilatation and fibrosis involving the intrahepatic and extrahepatic biliary tree. We analyzed laboratory assays, clinical, immunological, laboratory assays, histological and cholangiographic aspects. In conclusion, in this age group perhaps of the small population sample there was no sex predominance, and 50% progressed without jaundice and without hepatomegaly. The serum levels of gamma glutamyltransferases and especially alkaline phosphatase were elevated compared to aminotransferases without increase of the serum auto antibodies. Only one patients displayed the typical histological appearance of primary sclerosing cholangitis. The diagnosis in al was confirmed by typical cholangiographic signs, restricted only to the intrahepatic biliary tree, identified in all those included in this study.

Hepatorenal syndrome was observed in 25% of the patients with end stage liver disease. In this situation they stayed longer time in intensive unit treatment, hemodialysis. This evolution was observed in 67% of them with this complication after surgery. In this report we describe three patients with hepatorenal syndrome reversible after liver transplant. We define the form of management of these patients after surgery, regard treatment with cyclosporine A, only 72 h after surgery, without administration of aminoglycosides and amphoterycin. This good evaluation also depends of absence of arterial hypotension or infection episodes during and after surgery. It also depends of the good conditions of the implanted liver.

Minimally invasive percutaneous procedures has an important place in internal medicine. In this concept is included a transjugular intrahepatic portosystemic shunts (TIPS). In this pilot study we describe the indication of this therapeutic modality in three cirrhotic patients with hemorrhagic congestive gastropathy unresponsive to infusion of drugs that reduce the portal pressure. All of them were treated by TIPS and control of gastric bleeding occurred in all. One of these showed partial stenosis of the wallstent, treated by prosthesis dilatation. Another developed portosystemic encephalopathy controlled by usual therapeutic measures in the other we implanted two TIPS to obtain a low pressure level of the hepatic-portal gradient. They had no further necessity of blood transfusion, with better hemodynamic conditions and biochemical tests with reduction of the values of the GHP. We conclude that TIPS may be useful to treat hemorrhagic congestive gastropathy acting like a bridge for subsequent elective liver transplantation under good clinical and hemodynamic conditions.

The authors report two rare pancreatic tumor cases (Frantz's tumor), which were in different evolutionary stages, emphasizing the complexity of a precise anatomopathologic diagnosis and an aggressive surgical approach, whenever possible because the excellent prognosis. They also discuss the clinical manifestation and histological origin, as well as the prognosis factors and a new approach for the liver metastasis.

Transjugular intrahepatic portosystemic shunts (TIPS) represents a new surgical technique minimally invasive utilized in the treatment of portal hypertension. Such technique avoid the risks of general anesthesia, and major surgery like portocava anastomosis, reducing the hepatic-portal gradient, and help bleeding esophagogastric varices, hemorrhagic congestive gastropathy and refractary ascites. Certainly diminishes the intensity of intraperitoneal colorectal circulation and the necessity of blood transfusion during surgery for liver transplantation. In this report we reported the first case in Brazil of the implant of TIPS like preparation for liver transplantation in cirrhotic alcoholic patient. We made consideration about techniques aspects and surgery evolution. This new interesting technique applied for this type of patients is indicated as a bridge for candidates for liver transplantation.

In the most of the cases, the diagnosis of focal solid hepatic lesions are performed by ultrasonography, computed tomography, magnetic resonance and hepatic angiography imagig. However, the distinction between benign and malignant neoplasias, sometimes is made after liver biopsy. This report is about 32 of these lesions, diagnosed after guided liver biopsy by ultrasonography. The efficacy of this propedeutic method, minimally invasive, is defined emphasizing that there are no mortality and low levels of morbidity.

During the past 20 years, several authors have reported increased prevalence of cholelithiasis in liver cirrhosis. This biliary disease has been implicated with the deterioration of liver function, liver disease of alcoholic origin or even the presence of hypersplenism in this patient population. This study analyzes the incidence and possible factors which are responsible for promoting cholelithiasis in cirrhosis. The study included 110 cirrhotic patients of a private center specialized in treating liver diseases. The incidence of cholelithiasis was 27.3% (25.3% in males and 33.3% in females). There was no correlation between liver function defined by Child's classification or through the laboratory examinations (AST, ALT, AP, GGT, PT, Alb, TB, DB, PA) and the presence of gallstones. No evidence was found that the etiology of cirrhosis or the presence/absence of hypersplenism affected the prevalence of cholelithiasis in this population. In conclusion, an increased prevalence of cholelithiasis was verified in this population of cirrhotics but the pathogenesis is still obscure.

Hemangiomas are the most common benign vascular tumor found in the liver. In this study, 103 cases of hepatic hemangiomas were analysed in a retrospective manner. Image aspects such as those seen in ultrassonography, computed tomography, nuclear magnetic resonance and arteriography are discussed. The incidence was higher amongst the female sex, between individuals from 40 to 60 years old, which presented predominantly without symptoms (66%) and localized mainly in the right hepatic lobe (74%). The meaning of those aspects, when adopted, permits the clinicians to differentiate benign from malignant nodular lesions in the liver.