Em dezembro de 2019, foi descoberto um novo vírus, denominado SARS-CoV-2, que causa a doença COVID-19, assim denominada pela Organização Mundial da Saúde (OMS). O SARS-CoV-2 surgiu inicialmente na cidade de Wuhan, na China, e se espalhou rapidamente por todo o mundo. Já em 30 de janeiro de 2020, a OMS reconheceu o surto dessa nova doença como uma emergência de saúde pública de importância internacional, que é considerado o maior nível de alerta. Posteriormente, no dia 11 de março de 2020, a OMS caracterizou a COVID-19 como uma pandemia 1. Até o dia 08 de julho de 2020, no mundo, foram registrados 11.994.182 casos da COVID-19 e 547.931 óbitos. No Brasil, nessa mesma data, já haviam sido confirmados 1.716.196 casos da doença e 68.055 óbitos. O vírus é transmitido através de gotículas respiratórias, do contato direto ou objetos e de superfícies contaminadas. Ou seja, a doença possui múltiplas vias de transmissão, fato que justifica a grande necessidade de distanciamento social 1. Com o distanciamento social, medida profilática mais efetiva contra a doença, houve a necessidade de reavaliação do processo de ensino-aprendizagem, visto que o distanciamento social obrigou estudantes de medicina do mundo inteiro a adotar tecnologias da informação e comunicação (TIC) para continuar com a rotina de estudos. Assim, as TICs e a internet têm sido cada vez mais utilizadas pelas instituições de ensino superior para suprir essa ausência nas salas de aulas. No entanto, devemos questionar se esse novo método de ensinar e aprender, denominado homeschooling, pode influenciar na formação de estudantes de medicina. Com o advento da pandemia, as estratégias de ensino remoto são importantes meios de contenção dos efeitos do distanciamento social; no entanto, as evidências sugerem que inúmeras lacunas serão criadas sem a interação professor-estudante de medicina. Nesse sentido, para o pós-pandemia, é indispensável que as instituições de ensino planejem um robusto conjunto de ações para garantir o contato do estudante de medicina com pacientes, sejam em hospitais, ambulatórios ou na atenção primária em saúde. Além das estratégias de ensino utilizadas por instituições de educação, é necessária uma regulamentação do Ministério da Educação (MEC) e demais órgãos regulamentadores. Assim, em 28 de abril, o Conselho Nacional de Educação (CNE) aprovou por unanimidade a resolução com diretrizes para orientação sobre aulas remotas durante a pandemia. A Portaria Nº 343, de 17 de março de 2020, dispõe sobre a substituição das aulas presenciais por aulas remotas enquanto durar a pandemia da COVID-19. A Portaria veta a substituição de aulas práticas e estágios no curso de medicina. Já em 16 de junho de 2020, o MEC publica a Portaria Nº 544, autorizando a substituição de estágio e práticas por aulas remotas no curso de medicina. Seguindo as recomendações do MEC, as faculdades de medicina do país podem interromper esse contato prático durante a pandemia, o que certamente poderá comprometer o processo de formação de estudantes de medicina, uma vez que o co...

The present study aimed to evaluate the erosive potential of four most commonly prescribed syrup medicaments for respiratory diseases. Attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy combined with multivariate statistical analysis and micro-energy-dispersive X-ray fluorescence spectrometry (μ-EDXRF) mapping was performed. Fifty-five root dentin fragments obtained from the buccal surface of 30 bovine teeth were prepared and divided into five experimental groups (n = 10): control-artificial saliva (S), acebrofilin hydrochloride (AC), ambroxol hydrochloride (AM), bromhexine hydrochloride (BR), and salbutamol sulfate (SS). The S group was stored only in artificial saliva and the other groups were treated with the medicaments (immersed for 1 min in 3 mL of the medication, three times daily, with 1-h intervals between the immersion cycles, during 5 days, 15 immersion cycles). There were a significant decrease in the Ca and P weight percentages (wt%) for dentin after medication treatments, except for AC (p > 0.05). Mineral content of dentin showed a clear gradation with increasing Ca and P wt% reduction in the order S < AC < AM < BR < SS. SS resulted in a significant increase in Ca/P ratio when compared to the control (p < 0.001). ATR-FTIR combined with multivariate, statistical analysis can quickly and reliably indicate extent of dentin erosion. Considering syrups with high-erosive potential should always follow with proper oral hygiene practices or search for an alternative medications void of such detrimental effects. Regular and prolonged use of these medicaments might bear the risk of causing erosion.

Objective The objective of this study was to review the effects of the Matricaria recutita (L.) in the treatment of oral mucositis. Methodology The online search was performed in the period from June 2016 to April 2018 by means of databases LILACS (Latin American and Caribbean Center on Health Sciences Information), SciELO (Scientific Electronic Library Online), and MEDLINE (Medical Literature Analysis and Retrieval System Online). The consultation was restricted to the years 1991 to 2018 with the aim of elucidating the effects of Matricaria recutita in the treatment of oral mucositis. Results The final sample consisted of 21 studies, of which 10 were developed in animals and 11 in humans, published from 1991 to 2017, with a total sample of 644 patients. The total number of patients treated with Matricaria included in 11 studies was 364, while in the control groups the total number was 280. In experimental studies, animal models used were rats and the sample size ranged between 36 and 105 animals submitted to the induction of oral mucositis, where 4 studies used an intraperitoneal injection of 5-fluorouracil, while 7 induced lesion in the mucosa. From the data collected, it should be noted that both studies with humans and with animals showed significant effects. In this way, there is strong evidence for the discussion on the therapy; however, it should be noted that more studies are developed in order to clarify the most appropriate protocol for the prevention and treatment of injuries. Conclusion According to the results found in this study, Matricaria recutita appeared to be a promising alternative for the treatment of oral mucositis. However, due to the great variability in the various types of intervention, more controlled double-blind randomized clinical studies are necessary to ensure the best protocol for treating oral mucositis.

Medicaments essential for alleviation of diseases may sometime adversely affect dental health by eroding the enamel, owing to their acidic nature. It is therefore highly desirable to be able to detect these effects quickly and reliably. In this study, we evaluated the erosive capacity of four most commonly prescribed respiratory disease syrup medicaments on enamel using micro-energy-dispersive X-ray fluorescence spectrometry (µ-EDXRF) and attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). Fifty-five enamel fragments obtained from 30 bovine teeth were treated with artificial saliva (S), acebrofilin hydrochloride (AC), ambroxol hydrochloride (AM), bromhexine hydrochloride (BR), and salbutamol sulfate (SS); by immersing in 3 mL of respective solutions for 1 min, three times a day at intervals of 1 hr, for 5 days. µ-EDXRF analysis of enamel surface did not reveal significant erosion caused by the medications. However, ATR-FTIR showed a detectable shift in the phosphate (PO ) antisymmetric stretching mode (ν ) at ∼985 cm for AM, BR, and SS, indicating erosion. Multivariate statistical analysis showed that AC, AM, SS, and BR could be classified with 70%, 80%, 100%, and 100% efficiency from S (control), further highlighting the ability of ATR-FTIR to identify degree of erosion. This suggests ATR-FTIR may be used to rapidly and nondestructively investigate erosive effects of medicaments.

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The present study aims to evaluate the effect of brushing with fluoride dentifrice on teeth severely affected by erosion due to respiratory medicaments. Enamel (n = 50) and dentin (n = 50) bovine specimens were prepared and treated with artificial saliva (S‐control), acebrofilin hydrochloride (AC), ambroxol hydrochloride (AM), bromhexine hydrochloride (BR), and salbutamol sulfate (SS) and subjected to cycles of demineralization (immersing in 3 mL, 1 min, three times a day at intervals of 1 hr, for 5 days) followed by remineralization (saliva, 37°C, 1 hr). Simulated brushing with fluoridated toothpaste was performed using 810 strokes in a reciprocal‐action brushing simulator. Scanning electron microscopy, micro energy dispersive X‐ray fluorescence (μ‐EDXRF) spectroscopy and attenuated total reflection Fourier transform infrared (ATR FTIR) spectroscopy were then performed. μ‐EDXRF images showed extensive erosion after treatment with all medicaments. SEM images showed enamel erosion in order SS > BR > AC = AM > S after brushing and fluoridation. FTIR results were in agreement. In case of dentin, μ‐EDXRF measurements showed significant difference in mineral content (percent weight of calcium and phosphate) in SS + brushing + fluoridation treated enamel compared to control, while μ‐EDXRF images showed erosive effects in the order SS > AM>BR > AC = S post brushing + fluoridation. SEM images showed erosion in the order SS > AM = BR > AC > S post brushing + fluoridation. Again, FTIR multivariate results were in agreement. Overall, our study shows that proper oral care is critical when taking certain medication. The study also demonstrates the possible use of FTIR for rapid clinical monitoring of tooth erosion in clinics.

Objetivo: Analisar como os estudos científicos descrevem a síndrome de Burnout em profissionais de enfermagem de serviços de urgência e emergência. Métodos: Revisão integrativa de literatura realizada através das bases de dados BDENF, IBECS, LILACS, MEDLINE e SciELO, por meio dos descritores: esgotamento profissional and enfermagem. Das 3087 publicações selecionadas pelos descritores, apenas 11 artigos atenderam os critérios de inclusão e exclusão. Resultados: Dentre os artigos selecionados, 07 tratavam do estresse; 04 falavam da qualidade de vida e lazer; 01 abordava sobre os sintomas somáticos associados ao Burnout e 03 detalhavam sobre a síndrome de Burnout, abordando os fatores preditores e as dimensões sintomatológicas de acordo com o Maslach Burnout Inventory. Conclusão: Esse estudo é importante para que população, profissionais e gestores adquiram conhecimento acerca da síndrome, podendo contribuir para o desenvolvimento de estratégias de enfrentamento, que irão minimizar os riscos de desencadeamento do Burnout. Descritores: Esgotamento profissional, Enfermagem, Síndrome.

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