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Introduction: Acute pharyngitis is a common diagnosis in primary care. Although viruses are the most common aetiology, antibiotic therapy is frequently prescribed. The inappropriate antibiotic prescription should be avoided to prevent antibiotic resistance. Many national and international guidelines recommend testing for group A streptococcus (GAS) before antibiotic treatment when clinical presentation suggests GAS infection. Aim: This study aims to describe the feasibility of the implementation of the rapid antigen detection test (RADT) in a primary care setting and its impact on antibiotic prescription. Secondary goals include the evaluation of possible associations between symptoms and RADT results. Methods: From October 2019 to March 2020, patients presenting with acute pharyngitis at USF do Parque were eligible. A questionnaire was applied to divide the individuals into four different groups (clearly viral, probably viral, diagnostic doubt, and probably bacterial), and to assess the previous intention to prescribe antibiotics. We applied 136 questionnaires and performed 133 RADT. Nursing staff classified the specimen collection process and result from interpretation according to its difficulty. The proportion of antibiotics avoided was estimated as the number of times physicians changed their intended antibiotic prescription following a negative RADT result. Results: Among the tests performed, 97.7% were easy to interpret. Without RADT, 45 patients were going to be prescribed an antibiotic. After the test result, 27 antibiotic prescriptions were avoided. Tonsil hypertrophy, palatal petechiae, and fever increased the odds of a positive RADT result. Cough was associated with a negative RADT result. Conclusions: This study showed that RADT is easy to implement and contributed to appropriate antibiotic prescription. Tonsil hypertrophy, palatal petechiae, and fever were significantly associated with a positive RADT result, and cough was associated with a negative RADT result. Primary care centers would benefit from having RADT available when there is a strong suspicion or doubt of bacterial pharyngitis.

A recessão gengival é uma condição frequente encontrada tanto pelo cirurgião-dentista quanto pelo paciente. É definido como o deslocamento apical da margem gengival além da junção cemento-esmalte. Provocando diferentes alterações no periodonto, entre as elas podem ser citadas hipersensibilidade dentinária e sensação de dente alongado. Tendo como objetivo relatar um caso clínico de recessão gengival classe III de Miller em uma paciente do sexo feminino, 45 anos, leucoderma, apresentando sensibilidade dentinária nos dentes anteroinferiores sendo proposto a técnica do enxerto gengival livre subepitelial. Considerado uma opção superior em comparação com a técnica do enxerto gengival livre clássico.

Publisher Copyright: © 2021 The Author(s). Erratum: Correction to: Discontinuation of chronic benzodiazepine use in primary care: a nonrandomized intervention (Family Practice. 2022;39(2):241-248). Family Practice. 2022.39(3):563. (WOS: 000788675100001), (PMID:35485949), (Scopus ID: 85131225556). Background: Chronic benzodiazepine use is a challenge in primary care practice. Protocols to support safe discontinuation are still needed, especially in countries with high utilization rates. Objectives: To evaluate the feasibility, effectiveness, and safety of a benzodiazepine discontinuation protocol in primary care setting. Methods: Nonrandomized, single-arm interventional study, at primary care units. Family physicians (FPs) recruited patients (18-85 years-old) with benzodiazepine dependence and chronic daily use ≥3 months. Patients with daily dosages ≥30 mg diazepam-equivalent, taking zolpidem, with a history of other substance abuse or major psychiatric disease were excluded. After the switch to diazepam, the dosage was gradually tapered according to a standardized protocol. Primary endpoint was the percentage of patients who stopped benzodiazepine at the intervention last visit. Dosage reduction, withdrawal symptoms, patients' and FPs' satisfaction with the protocol were evaluated. Results: From 66 enrolled patients (74% female; 66.7% aged >64 years; median time of benzodiazepine use was 120 months), 2 withdrew due to medical reasons and 3 presented protocol deviations. Overall, 59.4% of participants successfully stopped benzodiazepine (60.7% when excluding protocol deviations). Men had higher probability of success (relative risk = 0.51, P = 0.001). A total of 31 patients reported at least 1 withdrawal symptom, most frequently insomnia and anxiety. Most of participating FP considered the clinical protocol useful and feasible in daily practice. Among patients completing the protocol, 77% were satisfied. For the patients who reduced dosage, 85% kept without benzodiazepines after 12 months. Conclusion: The discontinuation protocol with standardized dosage reduction was feasible at primary care and showed long-term effectiveness. publishersversion publishersversion published