In the three chapters of my dissertation, I analyze the individual behaviors including health (vaccination and preventive care) and consumer (financial literacy) behaviors and the corresponding interventions by nonlinear econometric modeling. In the first chapter, I suggest an appropriate econometric model that investigates the effect of paid sick leave on workers' decision to receive the seasonal flu vaccination. For this investigation, I apply a Bayesian non-linear structural regression model with one-outcome and two-endogenous equations. The results of my estimation indicate that having paid sick leave affects workers' vaccination decisions differently based on their income levels. Low-income workers are willing to be vaccinated because they perceive the high cost of claiming paid sick leave. However, high-income workers are willing to be vaccinated because paid sick leave reduces the cost of vaccination for seasonal flu. In the second chapter, I suggest new econometric regression models that investigate the effect of "Don't Know" or "Refuse" (DK/RF) responses on parameter identification. I estimate the effect of group characteristics and financial education on the level of young respondents' objective financial knowledge and find the actual effects and biases by my suggested models. This study examines six questions about personal finance and selects covariates in the 2015 National Financial Capability Study (NFCS). Because these questions include DK/RF responses, a simple regression model that does not consider DK/RF responses could lead to misleading conclusions, such as gender/income difference and educational effectiveness in schools. In the last chapter, I investigate the effect of three health-related interventions including a doctor's recommendation, information about human papillomavirus (HPV), and HPV vaccination, on the misuse of cervical cancer screening including too-early screening, unnecessary HPV test, annual Pap test, and no Pap smear that are not recommended for women younger than 30 years. I examine the National Health Interview Survey conducted in 2015 and applies binary and multinomial logistic regression models. From the estimation result, I observe that doctor's recommendation plays a significant role in increasing the probability of receiving cervical cancer screening while it induces the too-early screening, unnecessary HPV testing, and overuse of Pap smears. / Ph. D. / In the three chapters of my dissertation, I analyze the individual behaviors including health (vaccination and preventive care) and consumer (financial literacy) behaviors and the corresponding interventions. In the first chapter, I investigate the effect of paid sick leave on workers' decision to receive the seasonal flu vaccination. From this investigation, I observe that low-income workers are willing to be vaccinated because they perceive the high cost of claiming paid sick leave while high-income workers are willing to be vaccinated because paid sick leave reduces the cost of vaccination for seasonal flu. In the second chapter, I investigate the effect of Don't Know or Refuse (DK/RF) responses that are commonly ignored in many studies. From this investigation, I observe the disadvantage of rejecting financial education offers in obtaining proper financial knowledge and the ineffectiveness of formal and informal financial education on the level of objective financial knowledge. In addition, I observe few or no gender, income, and age differences in the level of objective financial knowledge among young adults. In the last chapter, I investigate the effect of a doctor's recommendation, information about human papillomavirus (HPV), and HPV vaccination on the too-early screening, unnecessary HPV test, annual Pap test, and no Pap smear that are not recommended for women younger than 30 years. From this investigation, I observe that doctor's recommendation plays a significant role in increasing the probability of receiving cervical cancer screening while it induces the too-early screening, unnecessary HPV testing, and overuse of Pap smears.

O presente trabalho teve como objetivo avaliar, por meio da microscopia eletrônica de varredura (MEV), a capacidade de remoção da smear layer dos terços médio e apical do canal radicular utilizando soluções quelantes e desmineralizantes e, quantificar, por meio da espectrometria de absorção atômica com chama, a concentração de íons cálcio presentes nessas soluções após suas utilizações. Vinte e cinco caninos superiores foram preparados pela técnica Free Tip Preparation com 4 instrumentos acima do inicial e irrigados com hipoclorito de sódio 1% a cada troca de instrumento. Os dentes foram distribuídos aleatoriamente em 4 grupos, conforme protocolo utilizado para a irrigação final: G1 - EDTA 15%, G2 - quitosana 0,2%, G3 - ácido cítrico 10%, G4 - ácido acético 1%. O grupo controle (G5) não recebeu irrigação. Foram utilizados 5 mL de cada solução por 3 minutos. Após percorrer toda extensão do canal radicular a solução extravasada pelo forame foi coletada e encaminhada para análise espectrométrica. Os espécimes foram seccionados longitudinalmente e preparados para análise em MEV. As fotomicrografias obtidas foram avaliadas qualitativamente por três examinadores, que atribuíram escores às imagens, conforme a quantidade de smear layer. Os dados obtidos pela MEV foram analisados estatisticamente por meio do Teste de Kruskal-Wallis e Dunn. Para avaliação da espectrometria utilizou-se Tukey-Kramer (one-Way ANOVA). Os resultados mostraram que o EDTA 15%, quitosana 0,2% e ácido cítrico 10% removeram a smear layer de forma semelhante entre si e estatisticamente diferente (p<0,05) do ácido ácético 1% e controle. Não houve diferença na capacidade de limpeza das soluções quando os terços médio e apical foram comparados. A maior concentração de íons cálcio foi observada no grupo do EDTA 15% e quitosana 0,2%, sem diferença entre ambos. O grupo do ácido acético 1% apresentou as menores concentrações e o ácido cítrico 10%, concentrações intermediárias e diferentes estatísticamente dos dois grupos (p<0,01). Concluiu-se que as soluções de EDTA 15%, quitosana 0,2% e ácido cítrico 10% foram eficientes na remoção da smear layer do terço médio e apical do canal radicular. As soluções de EDTA 15% e quitosana 0,2% promoveram o maior efeito desmineralizante, seguidas pelo ácido cítrico 10% e acido acético 1%. / This study aimed to evaluate, by scanning electron microscopy (SEM), the ability to remove the smear layer from the apical and middle thirds of the root canal using chelators and demineralizing solutions, and quantify, by atomic absorption spectrophotometry flame, the concentration of calcium ions present in these solutions after their use. Twenty-five canines were prepared by Free Tip Preparation Technique with four instruments above the initial and irrigated with 1% sodium hypochlorite in each change of instrument. The teeth were randomly divided into four groups, according to the protocol used for the final irrigation: G1 - EDTA 15%, G2 - 0.2% chitosan, G3 - citric acid 10%, G4 - 1% acetic acid. The control group (G5) did not receive irrigation. We used 5 mL of each solution for 3 minutes. After irrigating the entire length of the root canal through the apical foramen, the solution was collected and sent to spectrometric analysis. The specimens were sectioned longitudinally and prepared for SEM analysis. The photomicrographs were qualitatively evaluated by three observers, who attributed scores to the images, equivalent to the amount of smear layer removal. The data obtained by SEM was statistically analyzed using the Kruskal-Wallis and Dunn tests. To evaluate the spectrometer, the Tukey-Kramer (one-way ANOVA) was used. The results showed that 15% EDTA, 0.2% chitosan and 10% citric acid had a similar smear layer removal with statistically different (p <0.05) when compared to 1% acetic acid and the control group. There was no difference between the solutions cleaning ability when the middle and apical thirds were compared. The highest concentration of calcium ions was observed in 15% EDTA group and 0.2% chitosan, with no statistical difference between them. The 1% acetic acid group had the lowest concentration and the 10% citric acid intermediate concentrations with statistical difference between each other (p <0.01). It can be concluded that the solutions of 15% EDTA, 0.2% chitosan and 10% citric acid were effective in removing the smear layer of the middle and apical thirds of the root canal. 15% EDTA solutions and 0.2% chitosan promoted the greatest effect on the demineralization, followed by 10% citric acid and 1% acetic acid.

Submitted by Eunice Novais (enovais@uepg.br) on 2018-07-24T14:32:21Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) RENATA TERUMI JITUMORI.pdf: 3093609 bytes, checksum: 92de6bf22e06953ec3a932faaf478f71 (MD5) / Made available in DSpace on 2018-07-24T14:32:21Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) RENATA TERUMI JITUMORI.pdf: 3093609 bytes, checksum: 92de6bf22e06953ec3a932faaf478f71 (MD5) Previous issue date: 2018-02-21 / Avaliou-se o efeito da irrigação prévia na adesão de cimentos resinosos autoadesivos ao canal radicular na cimentação de pinos de fibra de vidro (PFV). Foram utilizados 120 dentes permanentes unirradiculares, os quais tiveram suas coroas removidas e suas raízes tratadas endodonticamente. Após uma semana, foi realizado o preparo padronizado dos condutos para posterior cimentação dos PFV. Nesse momento, as raízes foram divididas aleatoriamente em dez grupos, de acordo com a combinação dos seguintes fatores: cimento resinoso autoadesivo – RelyX U200 (3M ESPE) e Multilink Speed (Ivoclar Vivadent), e agente irrigante aplicado previamente à cimentação dos PFV – água destilada (AD), NaOCl 2,5% (Na), EDTA 17% (ED), ácido poliacrílico 26% (AP) e associação EDTA 17% + NaOCl 2,5% (EN). Duas raízes de cada agente irrigante foram utilizadas para avaliação do grau de desobliteração dos túbulos dentinários (DeTd) por microscopia eletrônica de varredura (MEV). Após a cimentação dos PFV, sete raízes por grupo foram avaliadas em resistência de união (RU) pelo teste de push-out, quatro em nanoinfiltração (NI) por MEV e microdureza Vickers (VHN); para esse propósito cada raiz foi seccionada transversalmente em seis fatias. Os dados obtidos da DeTd foram submetidos a Kruskall Wallis e Student-Newman-Keuls (α=0,05) e dos testes de RU, NI e VHN a ANOVA dois fatores e Tukey (α=0,05). Na avaliação da DeTd, os agentes que promoveram maior abertura dos tubúlos dentinários foram ED, AP e EN. Para o cimento RelyX U200, o Na, AD e ED obtiveram os maiores valores de RU e VHN; enquanto que para o Multilink Speed esses valores foram superiores no grupo irrigado com AD. Para ambos os cimentos, o AP apresentou valores inferiores e a associação EN valores intermediários de RU e VHN. Não houve diferença estatística significante nos resultados de NI (p>0,05). Pode-se concluir que para cada agente cimentante deve haver um protocolo de irrigação prévia ideal na cimentação de pinos de fibra de vidro ao canal radicular. / It was evaluated the effect of previous irrigation on the adhesion of on the adhesion of self-adhesive resin cements to the root canal in the cementation of glass fiber posts. A total of 120 unirradicular permanent teeth were used, which had their crowns removed and their roots treated endodontically. After one week, the standard preparation of the post space was made for the cementation of the GFP. At this time, the roots were randomly divided into ten groups, according to the combination of the following factors: self-adhesive resin cement - RelyX U200 (3M ESPE) and Multilink Speed (Ivoclar Vivadent), and irrigating agent applied prior to GFP cementation - distilled water (DW), 2.5% NaOCl (Na), 17% EDTA (ED), 26% polyacrylic acid (PA) and 17% EDTA followed by 2.5% NaOCl (EN). Two roots of each irrigating agent were used for evaluation the degree of open dentinal tubules (ODeT) by scanning electron microscopy (SEM). After the cementation of the GFP, seven roots per group were evaluated in bond strength (BS) by the push-out test, four in nanoleakage (NL) by SEM and in Vickers microhardness (VHN); for this propose each root was sectioned transversely into six slices. The data obtained from ODeT were submitted to Kruskall Wallis and Student-Newman-Keuls (α=0.05) and from the tests of BS, NL and VHN to ANOVA two-way and Tukey (α=0.05). In the evaluation of the ODeT, the agents that promoted greater opening of the dentin tubules were ED, PA and EN. For RelyX U200 cement, the Na, DW and ED obtained the highest values of BS and VHN; while for Multilink Speed these values were higher in the group irrigated with DW. For both cements, the PA presented lower values and the association EN intermediate values of BS and VHN. There was no statistically significant difference in NL results (p>0.05). It can be concluded that for each cementing agent there must be an optimal prior irrigation protocol for the cementation of glass fiber posts to the root canal.

O presente trabalho teve como objetivo avaliar, por meio da microscopia eletrônica de varredura (MEV), a capacidade de remoção da smear layer dos terços médio e apical do canal radicular utilizando soluções quelantes e desmineralizantes e, quantificar, por meio da espectrometria de absorção atômica com chama, a concentração de íons cálcio presentes nessas soluções após suas utilizações. Vinte e cinco caninos superiores foram preparados pela técnica Free Tip Preparation com 4 instrumentos acima do inicial e irrigados com hipoclorito de sódio 1% a cada troca de instrumento. Os dentes foram distribuídos aleatoriamente em 4 grupos, conforme protocolo utilizado para a irrigação final: G1 - EDTA 15%, G2 - quitosana 0,2%, G3 - ácido cítrico 10%, G4 - ácido acético 1%. O grupo controle (G5) não recebeu irrigação. Foram utilizados 5 mL de cada solução por 3 minutos. Após percorrer toda extensão do canal radicular a solução extravasada pelo forame foi coletada e encaminhada para análise espectrométrica. Os espécimes foram seccionados longitudinalmente e preparados para análise em MEV. As fotomicrografias obtidas foram avaliadas qualitativamente por três examinadores, que atribuíram escores às imagens, conforme a quantidade de smear layer. Os dados obtidos pela MEV foram analisados estatisticamente por meio do Teste de Kruskal-Wallis e Dunn. Para avaliação da espectrometria utilizou-se Tukey-Kramer (one-Way ANOVA). Os resultados mostraram que o EDTA 15%, quitosana 0,2% e ácido cítrico 10% removeram a smear layer de forma semelhante entre si e estatisticamente diferente (p<0,05) do ácido ácético 1% e controle. Não houve diferença na capacidade de limpeza das soluções quando os terços médio e apical foram comparados. A maior concentração de íons cálcio foi observada no grupo do EDTA 15% e quitosana 0,2%, sem diferença entre ambos. O grupo do ácido acético 1% apresentou as menores concentrações e o ácido cítrico 10%, concentrações intermediárias e diferentes estatísticamente dos dois grupos (p<0,01). Concluiu-se que as soluções de EDTA 15%, quitosana 0,2% e ácido cítrico 10% foram eficientes na remoção da smear layer do terço médio e apical do canal radicular. As soluções de EDTA 15% e quitosana 0,2% promoveram o maior efeito desmineralizante, seguidas pelo ácido cítrico 10% e acido acético 1%. / This study aimed to evaluate, by scanning electron microscopy (SEM), the ability to remove the smear layer from the apical and middle thirds of the root canal using chelators and demineralizing solutions, and quantify, by atomic absorption spectrophotometry flame, the concentration of calcium ions present in these solutions after their use. Twenty-five canines were prepared by Free Tip Preparation Technique with four instruments above the initial and irrigated with 1% sodium hypochlorite in each change of instrument. The teeth were randomly divided into four groups, according to the protocol used for the final irrigation: G1 - EDTA 15%, G2 - 0.2% chitosan, G3 - citric acid 10%, G4 - 1% acetic acid. The control group (G5) did not receive irrigation. We used 5 mL of each solution for 3 minutes. After irrigating the entire length of the root canal through the apical foramen, the solution was collected and sent to spectrometric analysis. The specimens were sectioned longitudinally and prepared for SEM analysis. The photomicrographs were qualitatively evaluated by three observers, who attributed scores to the images, equivalent to the amount of smear layer removal. The data obtained by SEM was statistically analyzed using the Kruskal-Wallis and Dunn tests. To evaluate the spectrometer, the Tukey-Kramer (one-way ANOVA) was used. The results showed that 15% EDTA, 0.2% chitosan and 10% citric acid had a similar smear layer removal with statistically different (p <0.05) when compared to 1% acetic acid and the control group. There was no difference between the solutions cleaning ability when the middle and apical thirds were compared. The highest concentration of calcium ions was observed in 15% EDTA group and 0.2% chitosan, with no statistical difference between them. The 1% acetic acid group had the lowest concentration and the 10% citric acid intermediate concentrations with statistical difference between each other (p <0.01). It can be concluded that the solutions of 15% EDTA, 0.2% chitosan and 10% citric acid were effective in removing the smear layer of the middle and apical thirds of the root canal. 15% EDTA solutions and 0.2% chitosan promoted the greatest effect on the demineralization, followed by 10% citric acid and 1% acetic acid.

A qualidade final do preparo do canal destaca-se, dentre outras condições, pela ausência de magma dentinário e pelo aumento da permeabilidade dentinária, de modo a permitir pela primeira, a falta de substrato para desenvolvimento de microbiota e melhor adaptação do material obturador e, pelo segundo a possibilidade de alcançar na maior profundidade do túbulo dentinário as sujidades ali eventualmente presentes e fazer com que a medicação intracanal atue plenamente no sistema endodôntico. Metodologias experimentais de avaliação dessas qualidades aferem isoladamente cada uma delas dificultando a percepção de que a interação de ambas poderia permitir compreender o seu real papel no êxito da terapia endodôntica. O objetivo deste estudo consistiu-se em criar um procedimento capaz de, no mesmo espécime dental, avaliar a presença de magma e o quanto de permeabilidade dentinária radicular se alcança após o preparo químico-cirúrgico e a irrigação-aspiração final com diferentes irrigantes. Quarenta dentes unirradiculares humanos foram preparados com instrumentos rotatórios e Endo-PTC + NaOCl a 1% e divididos em quatro grupos (n=10) no momento da irrigação-aspiração final de acordo com o irrigante a ser empregado: G I (controle) - NaOCl a 1%; G II - EDTA a 17%; G III - EDTA-T a 17% e G IV - MTAD®. Os canais foram preenchidos com azul de metileno a 0,5% e mantidos em frascos por 48 h. Decorrido este tempo, as coroas foram removidas e as raízes foram clivadas no sentido transversal obtendose fragmentos do terço cervical, médio e apical. Os espécimes foram fotografados e analisados no programa ImageLab quanto à penetração do corante. Após esta análise, os fragmentos foram novamente clivados no sentido longitudinal e preparados para MEV. As eletromicrografias foram analisadas por três diferentes avaliadores e qualificadas por escores. As substâncias irrigadoras utilizadas, quando comparadas entre si, tiveram efeitos semelhantes sobre a permeabilidade dentinária, considerando as raízes por inteiras e pelos seus terços. Na avaliação individual das substâncias irrigadoras, as diferenças de permeabilidade entre os terços radiculares não foram estatisticamente significantes, exceto para o EDTA-T cujo terço apical teve menor penetração do corante. Quando a substância irrigadora com ação quelante/desmineralizante foi empregada para irrigação-aspiração final do canal radicular, o magma dentinário foi eficientemente removido enquanto a irrigação somente com NaOCl não foi suficiente para remover o magma. Os três terços do canal radicular apresentaram o mesmo grau de limpeza das paredes da dentina radicular, exceto para o EDTA-T, cujo terço apical apresentou maior quantidade de magma quando comparado aos terços cervical e médio. A vinculação dos resultados estatísticos da permeabilidade dentinária com a remoção do magma dentinário não mostrou a mesma relação uniforme para as substâncias irrigadoras avaliadas, quer na sua totalidade quer nos seus terços, deduzindo-se que maior ou menor permeabilidade necessariamente não corresponde a menor ou maior presença de magma dentinário. As análises da permeabilidade dentinária e da remoção do magma dentinário, com aplicação inicial do corante seguido de processamento para MEV, mostraram-se viáveis nos mesmos espécimes radiculares. / After root canal preparation and removal of smear layer, penetration of intracanal dressing deep in dentinal tubules to reduce microbial growth is enhanced. Removal of smear layer also permits a more effective cleaning of organic tissue and bacteria from within the dentinal tubules and allows a better adaptation of obturation material along root canal walls. Other studies have evaluated smear layer removal and dentinal permeability in isolation on different specimens, making it difficult to interpret the interaction between smear layer and dentin permeability and their real roles in root canal treatment. The aim of this study was to create a procedure to evaluate the presence of smear layer and what its influence is on root dentin permeability after chemomechanical root canal preparation and final irrigation-aspiration with different chemicals using the same specimen. Forty single root human teeth were instrumented with rotary instruments and Endo-PTC + 1% NaOCl and ramdomly divided into four groups (n=10) at the final rinse step, according to the irrigant used: G I (control) - 1% NaOCl; G II - 17% EDTA; G III - 17% EDTA-T and G IV - MTAD®. The root canals were filled with 0.5% methylene blue and maintained in bottles for 48 h. After this time, the crowns were cut off and the roots were transversally split resulting in three fragments: coronal, middle and apical. The specimens were analyzed using ImageLab software to evaluate dye penetration. After this analysis, the fragments were then axially split and prepared for SEM. The photomicrographs were analyzed by three different evaluators and qualified by scores. When the whole roots were analyzed and the irrigants used were compared among themselves, the same effect on dentin permeability was observed. Individual evaluation of the irrigants showed, the differences in the permeability levels for all 3 root canal thirds were not statistically significant, except for the apical third of the EDTA-T irrigation group which exhibited less dye penetration. When a decalcifying irrigant was used for final rinse, the smear layer was efficiently removed. In contrast a final rinse with NaOCl was not enough to remove this layer. In all irrigation experimental groups the three different thirds of the root canals showed the same amount of smear layer removal, except for the EDTA-T group, which exhibited higher amounts of smear layer removal in the apical third compared to coronal and middle thirds. The results of both studies (dentin permeability and smear layer removal) did not show an even relationship for the irrigants evaluated, neither on their smear layer in the entire canal nor was it observed in each root canal thirds evaluated. This inferres that higher or lower dentinal permeability does not necessarily correspond to a higher or lower amount of smear layer presence. The Pearson correlation test supports these statements. The analysis of dentin permeability with initial introduction of a dye followed by the smear layer removal analysis under SEM, was shown to be a feasible procedure using the same root specimen.

Perception of cervical cancer screening among Immigrant African women residing in Houston, Texas Esther I. Orji M.Ed., University of Lagos, 2002 B. Ed, Abia State University, 1998 A.C. E. University of Benin, 1990 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2016 Disparities in cervical cancer screening participation still exist especially among immigrant and minority women compared to non immigrant populations. Research investigators through multiple studies have explored reasons for non participation in cervical cancer screening among immigrant and minority women. However, there was limited research specifically on how immigrant women of African descent could be empowered to overcome barriers associated with cervical cancer screening in Houston Texas. The purpose of this study was to explore and understand the perceptions of factors which are barriers to perform cervical cancer screening tests among immigrant women of African descent, as well as their beliefs on preventive medicine, and how immigrant women could be empowered in order to overcome barriers associated with cervical cancer screening. The theoretical framework was based on the health belief model. The participants for the study were 20 immigrant women of African descent aged 21-65. A semi-structured interview schedule which comprised of open ended questions was used to collect data on the perspectives of immigrant women towards cervical cancer screening. Data was transcribed verbatim and analyzed thematically. The social change implications of the study can be that immigrant women could be more encouraged to seek access to the appropriate state of the art in cervical cancer screening which could contribute in reducing mortality, morbidity rate, and costs associated with cervical cancer.

Most epidemiologic studies of sexually transmitted diseases (STD) are based on patients seeking help or advice at various health care settings. Because many STD:s are subclinical, epidemiologic surveys can be strengthened by a population-based approach. The aims of the present study were to investigate the prevalence and incidence of STDs in a population of young women, and to assess associations between STDs and social background, education, previous genital infections, sexual behaviour, contraceptive use and reproductive experience. All women belonging to the 19-, 21-, 23- and 25-year age cohorts and living in the catchment area of a community health center, were invited by mail to participate in the study. In the presence of the investigator, participants answered a structured questionaire regarding their social background, education, previous genital infections, sexual behaviour, contraceptive use and reproductive experience. A gynecologic examination was performed. Cervical scrapes for human papillomavirus (HPV) DNA, as well as samples for wet smear, cervical pap smear, and Chlamydia trachomatis (CT) culture were taken. The presence of genital warts was noted, and a colposcopy was performed 2-5 minutes after application of 5% acetic acid on the cervix and vulva. Acetowhite changes were then assessed. A serologic test for CT and herpes simplex virus type 2 (HSV-2) antibodies were performed. Of the 816 women available, 611 (75%) participated in the study. One out of four women reported symptoms from the lower genital tract. The most common were itching, followed by discharge and soreness. There was a significant correlation between the womens" complaint of vaginal discharge, and previous CT infection, lack of lactobacilli and the presence of leucocytosis in wet smear. Twenty-two percent of the women were HPV DNA positive and acetowhitening at the cervix was observed in 16% of the women. The sensitivity of detection of HPV infection by acetowhitening of the cervix was 22% (95%CI 18%, 26%), and the specificity was 90% (95% Cl 87%, 93%). C.trachomatis culture positivity was found in 2.7% of the women and the seroprevalence of CT was 24.7 %. Atypical cytology was found in 3.4% of the women and 6.6% was HSV-2 seropositiv. Of the women studied 23.6% reported having had at least one STD previously and the laboratory analysis showed 45.4% to have had at least one STD. Multivariate logistic regression analysis showed that the number of sexual partners, age at first coitus, history of therapeutic abortion, and previous pelvic inflammatory disease (PID) was independently correlated with CT seropositivity. Lifetime number of sexual partners was the only independent risk factor for HPV. Multivariate analysis showed that increasing age, early sexual debut, and a history of spontaneous abortion were independently related to the presence of HSV-2 antibodies. The lifetime number of sexual partners and coitus on first date were independently associated with a previous STD. Conclusion, We found that one out of four women had some kind of lower genital tract complaint, almost every other women had at sometime in their life an STD, and STDs were often asymptomatic. Acetowhitening of the cervix and vulva has low sensitivity, to low to warrant its use as a predictor of subclinical HPV infection. The pattern of risk factors differed between STDs. / <p>Härtill 6 uppsatser</p> / digitalisering@umu

Orientador: José Eduardo Cezar Sampaio / Banca: Silvana Regina Perez Orrico / Banca: Joni Augusto Cirelli / Banca: Enilson Antônio Sallum / Banca: Márcio Zafallon Casati / Resumo: O objetivo do presente estudo foi avaliar, por meio da Microscopia Eletrônica de Varredura (MEV), a eficácia do condicionamento químico com o gel de EDTA 24% na remoção de "smear layer" e exposição de fibras colágenas, avaliando-se diferentes marcas comerciais, modos e tempos de aplicação. Dentes humanos extraídos foram desgastados com fresa diamantada para remoção do cemento e raspados com curetas de Gracey 5-6 para formação de "smear layer". Após o seccionamento dentário, as 225 amostras obtidas foram divididas em 5 grupos: I) Soro Fisiológico; II) EDTA 24% (Farmácia Santa Paula); III) EDTA-T 24% (Farmácia Santa Paula); IV) EDTA 24% (Biora); V) EDTA 24% (Biodinâmica). As amostras de cada grupo(n=45) foram divididas em subgrupos (n= 5) e condicionadas nos tempos de 01, 02, 03 minutos e nos modos de aplicação passiva, ativa vigorosa (fricção) e ativa suave (pincel). Após a análise em MEV, as fotomicrografias foram avaliadas um examinador calibrado e cego. A análise estatística (Teste de Kruskal-Wallis e Dunn), revelou que o gel de EDTA 24% da Biodinâmica promoveu inferior remoção "smear layer" em relação aos outros agentes testados. Não houve diferenças estatísticas para os tempos de aplicação. O modo de aplicação ativa suave (pincel) resultou em menor quantidade de "smear layer" residual. Conclui-se que as comerciais testadas do gel de EDTA 24% foram eficientes na remoção de "smear layer" e exposição de fibras colágenas, nos modos de aplicação ativa vigorosa (fricção) e ativa suave (pincel), independentes do tempo de aplicação. No entanto, a marca comercial Biodinâmica promoveu inferior remoção de "smear layer" e exposição de fibras colágenas em relação às outras marcas comerciais testadas. / Abstract: The aim of this study was to evaluate in vitro the conditioning efficacy with 24% EDTA gel from different trade marks times and application ways using scanning electron microscope. Extracted human teeth were submitted to cementum removal by means of diamond bur in high rotation speed, followed by scaling and root planning with Gracey 5-6 curette in order to further smear layer formation. The 225 samples were randomly assigned to 5 groups: I) control (sterile saline application); II) 24% EDTA (Santa Paula Pharmacy); III) 24% EDTA -T (Santa Paula Pharmacy); IV) 24% EDTA (Biora); V) 24% EDTA (Biodynamic). For each experimental group the application times were 1, 2 or 3 minutes. Substances were applied in 3 different ways: a) topical application (cotton pellets laid passively on the samples); b) vigorous friction (cotton pellets were scrubbed against samples surface); c) smooth friction (using a brush on dentinal surface). One calibrated examiner analyzed the micrographs. The statistical analysis (Kruskal Wallis Test and Dunn Test) showed that 24% EDTA (Biodynamic) proved to be less effective than others agents, there were no statistical differences between times of application. We conclude that smooth friction (using a brush on dentinal surface) of 24% gel efficiently removed the smear layer and exposed dentin collagen matrix in al times of application. The exception was the Biodynamic gel that did not achieve this result. / Doutor

Made available in DSpace on 2014-06-11T19:31:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-23Bitstream added on 2014-06-13T19:20:24Z : No. of bitstreams: 1 mendonca_aam_dr_arafo.pdf: 4133222 bytes, checksum: f9bc8aa3130de1ab931f42b45220c045 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo do presente estudo foi avaliar a citotoxicidade do cimento de ionômero de vidro modificado por resina (CIVMR) sobre células odontoblastóides MDPC- 23 cultivadas sob discos de dentina com ou sem smear layer de diferentes espessuras. Além disto, o estudo também investigou se a permanência ou a remoção da smear layer poderia interferir na resistência de união do material com o substrato dentinário. Para isto, 40 discos de dentina com espessura de 0,4mm foram obtidos de terceiros molares humanos hígidos. Após limpeza das superfícies dos discos com ácido etilenodiamino tetra-acético (EDTA, pH 7.2), medidas de condutância hidráulica foram realizadas como forma de padronização da permeabilidade entre os discos. Lixas d’água de granulação 180 e 600 foram utilizadas para a formação da smear layer espessa e delgada, respectivamente. Desta forma, a distribuição dos discos de dentina resultou nos seguintes grupos controle e experimentais: G1M - grupo controle; G2M – Smear layer Espessa + CIVMR; G3M – Smear layer Delgada + CIVMR; G4M – Smear layer Espessa Removida + CIV; G5M – Smear layer Delgada Removida + CIVMR. Após divisão e posicionamento dos discos em câmaras pulpares artificiais, 50.000 células odontoblástóides MDPC-23 foram cultivadas sobre sua superfície pulpar. Decorridos 48 horas do cultivo, o CIVMR VitrebondTM foi aplicado sobre a superfície oclusal dos mesmos discos de dentina com ou sem smear layer. Após 24 horas, o metabolismo das células foi determinado através da avaliação da atividade da desidrogenase succínica (MTT assay). A morfologia celular foi analisada em microscopia eletrônica de varredura (MEV). Para avaliação da resistência adesiva, outros 40 terceiros molares com dentina oclusal exposta tiveram o VitrebondTM aplicado dentro das mesmas condições já descritas (com ou sem smear layer). Os grupos experimentais... / The objective of present study was to evaluate the cytotoxicity of a resin-modified glass-ionomer cement (RMGIC) on odontoblast-like cells MDPC-23 plated under dentin discs when smear layer with different thickness was removed or not. In addition, it was also investigated whether presence or not of the smear layer could change in the bond strength of material on dentin substrate. Forty dentin discs with 0.4 mm thickness were obtained from caries and restoration free human third molars. The hydraulic conductance of all dentin discs was evaluated. One hundred eighty and 600-grit silicon carbide paper were employed to created thick and thin smear layer, respectively. Thereby, the distribution of dentin disc revealed the following experimental e control groups: G1M – control group; G2M – thick smear layer + RMGIC; G3M – thin smear layer + RMGIC; G4M – Thick smear layer Removed + RMGIC; G5M – Thin smear layer Removed + RMGIC. After adapting the dentin discs in artificial pulp chambers, the odontoblast like cells MDPC-23 (50.000 cells) were plated on the pulpal surface of these discs and incubated for 48 hours. Then the RMGIC VitrebondTM was applied on the oclusal surface of the dentin discs with or without smear layer. After 24h incubation, the cell metabolism was determined through evaluation of succínic desidrogenase enzime (MTT assay). The cell morphology was investigated by scanning electronic microscopy (SEM). To evaluate bond strength, VitrebondTM was applied on the oclusal dentin surface of 40 human third sound molars treated as previously reported (with or not smear layer of different thickness). The experimental and control groups were determined: G1R – Thick smear layer + EDTA + RMGIC; G2R - Thin smear layer + EDTA + RMGIC; G3R - Thick smear layer + RMGIC; G4R - Thin smear layer + RMGIC. Each specimen characterized by the VitrebondTM applied on the exposed and treated... (Complete abstract click electronic access below)

Made available in DSpace on 2014-06-11T19:28:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-03-10Bitstream added on 2014-06-13T19:57:17Z : No. of bitstreams: 1 leite_frm_me_arafo.pdf: 3458261 bytes, checksum: 24ab9b956cd575d2cc355dd7652fbe26 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Universidade Estadual Paulista (UNESP) / A raspagem gera smear layer que contém microrganismos e toxinas, podendo interferir no reparo periodontal. Por esse motivo, diferentes substâncias têm sido empregadas para remover esta camada e expor fibras colágenas da superfície dental. A adesão de elementos sangüíneos a superfícies radiculares desmineralizadas e a estabilização do colágeno pelas fibras colágenas são de extrema importância no sucesso da cirurgia periodontal. O objetivo deste estudo foi avaliar os diferentes padrões de adsorção e adesão de elementos sangüíneos a superfícies radiculares quimicamente condicionadas. Setenta e cinco dentes foram raspados, eqüitativamente divididos em 5 grupos: irrigação com água destilada (controle), aplicação de solução de ácido cítrico a 25%, solução de citrato de sódio a 30%, gel de EDTA a 24% e solução de cloridrato de tetraciclina a 50 mg/mL. Metade da superfície condicionada foi exposta a sangue fresco e preparada para microscopia eletrônica de varredura. As superfícies radiculares raspadas e condicionadas com EDTA e ácido cítrico apresentaram os melhores resultados em relação ao grupo controle. O ácido cítrico também se mostrou mais efetivo na remoção de smear layer e na adesão de elementos sangüíneos do que o cloridrato de tetraciclina e o citrato de sódio. Além disso, a relação entre exposição de fibras colágenas e adesão de elementos sangüíneos foi positiva. Dessa forma, o emprego de EDTA e ácido cítrico sobre a superfície radicular aumentam a adsorção e adesão de células sangüíneas e a estabilização da rede de fibrina. / Root scaling generates a smear layer which contains microorganisms and toxins that could interfere in periodontal healing. For this reason, different substances have been used to remove it and to expose collagen fibers from tooth surface. Blood elements adhesion to demineralized roots and clot stabilization by collagen fibers are extremely important for the success of periodontal surgery. The aim of this study was to evaluate the different patterns of blood elements adsorption and adhesion to root surfaces chemically conditioned. Seventy five teeth were planed and equitably divided into five groups: irrigation with distilled water (control), application of a 25% citric acid solution, 30% sodium citrate solution, 24% EDTA gel and 50 mg/mL tetracycline hydrochloride. Half of the conditioned surface was exposed to fresh blood and prepared for scanning electron microscopy. Planed root surfaces and conditioned with EDTA and citric acid showed better results when compared to control group. Citric acid was more effective on smear layer removal and blood elements adhesion to root surface than tetracycline and sodium citrate. Also, the relationship between collagen fibers exposure and blood elements adhesion was positive. This way, EDTA and citric acid employment on root surface improve blood element adsorption and adhesion to root surface and fibrin network stabilization.