Background: From a patient's point of view, an 'ideal' doctor could be defined as one having personal qualities for interpersonal relationships, technical skills and good intentions. However, doctors' opinions about what it means to be a 'good' patient have not been systematically investigated. Aim: To explore how patients define the characteristics of a 'good' and a 'bad' doctor, and how doctors define a 'good' and a 'bad' patient. Material and Methods: We surveyed a cohort of 107 consecutive patients attending a community teaching hospital in February 2019, who were asked to define the desirable characteristics of a good/ bad doctor. Additionally, a cohort of 115 physicians working at the same hospital was asked to define the desirable characteristics of a good/bad patient. Responses were subjected to content analysis. Simultaneously, an algorithm in Python was used to automatically categorize responses throughout text-mining. Results: The predominant patients' perspective alluded to desirable personal qualities more importantly than proficiency in knowledge and technical skills. Doctors would be satisfied if patients manifested positive personality characteristics, were prone to avoid decisional and personal conflicts, had a high adherence to treatment, and trusted the doctor. The text-mining algorithm was accurate to classify individuals' opinions. Conclusions: Ideally, fusing the skills of the scientist to the reflective capabilities of the medical humanist will fulfill the archetype of what patients consider to be a 'good' doctor. Doctors' preferences reveal a "paternalistic" style, and his/her opinions should be managed carefully to avoid stigmatizing certain patients' behaviors.
The technique using CTZ paste (chloramphenicol, tetracycline, and zinc oxide-eugenol) in the endodontic treatment of deciduous teeth is easy to perform and requires a single session, which is an advantage with child patients. The inexistence of clinical protocols with the use of CTZ and the multifactorial endodontic repair process in deciduous teeth evidence the need for research on the subject. This study aimed to suggest a clinical protocol model for the systematization and standardization of the endodontic treatment of deciduous teeth using CTZ paste. In the case report presented, after pulp therapy, clinical-radiographical follow-up was conducted after 30, 60, 90 and 180 days. It was concluded that using CTZ paste is a simple, viable, and satisfactory alternative. Future clinical studies are needed regarding CTZ use in child clinic with strong scientific evidence.
Introdução. Hipomineralização molar-incisivo (HMI) é uma patologia de origem sistêmica multifatorial. Pode afetar um ou mais primeiros molares permanentes, assim como os incisivos centrais permanentes. Objetivo. O objetivo do presente estudo é propor tratamento clínico para paciente portador de HMI. Relato de caso. Paciente do sexo feminino, nove anos de idade compareceu à clínica infantil queixando-se de sensibilidade dentária. O diagnóstico de HMI nos molares permanentes em diferentes graus de severidade foi realizado por meio de exame clínico e radiográfico. Como tratamento inicial foi realizado 4 aplicações tópicas semanais de verniz fluoretado e prescrito solução de NaF 0,05% para bochechos diários. Nos elementos dentários 16, 26 e 46 foram realizadas restaurações com resina composta (classe I). No elemento dental 36, optou-se por realizar cimentação de coroa de aço pré-fabricada devido ao alto grau de severidade da HMI. Nos incisivos superiores acometidos foram realizadas 3 sessões de microabrasão. Conclusão. A HMI gera perda de estrutura dentária e grande desconforto quanto à sensibilidade, sendo fundamental buscar alternativas clínicas para promover a qualidade de vida do paciente infantil acometido por HMI.
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