The reassuring role of music associated with the personality traits of children during dental care: a randomized clinical trial.

AIM: The objective of this study was to analyze the reassuring role of music associated with the personality traits of children during dental care. METHOD: The study involved a randomized crossover clinical trial with 34 children, aged from 4 to 6 years, who exhibited two carious lesions on the occlusal surfaces of the molars. The children were divided into two groups: (G1) first tooth restoration intervention session with music, second session without music; and (G2) first tooth restoration intervention session without music, second session with music. The first consultation was to perform a clinical examination, and the second and third to perform modified Atraumatic Restorative Treatment (mART). Symphony No. 40 by Mozart was played via headphones. Pulse rate (PR) was measured using a pulse oximeter. The Brazilian version of the Eysenck Personality Questionnaire-Junior (EPQ-J) was used to measure the children's personality. For statistical analysis, descriptive, Chi-square, and Wilcoxon tests were carried out. RESULTS: The G1 group exhibited a lower PR at the time of the intervention during the second consultation compared to the third consultation (p = 0.012). The G2 group exhibited a lower PR at the time of the intervention during the third consultation compared to the first consultation (p = 0.002). The majority of the children with a low level of extraversion presented with higher PR (p = 0.005). CONCLUSION: Music could reduce the PR among children during dental intervention. Children with low extraversion showed a tendency towards a higher PR without music during dental care.

Reduced CD5(+) CD24(hi) CD38(hi) and interleukin-10(+) regulatory B cells in active anti-neutrophil cytoplasmic autoantibody-associated vasculitis permit increased circulating autoantibodies.

Pathogenesis of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is B cell-dependent, although how particular B cell subsets modulate immunopathogenesis remains unknown. Although their phenotype remains controversial, regulatory B cells (Bregs ), play a role in immunological tolerance via interleukin (IL)-10. Putative CD19(+) CD24(hi) CD38(hi) and CD19(+) CD24(hi) CD27(+) Bregs were evaluated in addition to their CD5(+) subsets in 69 patients with ANCA-associated vasculitis (AAV). B cell IL-10 was verified by flow cytometry following culture with CD40 ligand and cytosine-phosphate-guanosine (CpG) DNA. Patients with active disease had decreased levels of CD5(+) CD24(hi) CD38(hi) B cells and IL-10(+) B cells compared to patients in remission and healthy controls (HCs). As IL-10(+) and CD5(+) CD24(hi) CD38(hi) B cells normalized in remission within an individual, ANCA titres decreased. The CD5(+) subset of CD24(hi) CD38(hi) B cells decreases in active disease and rebounds during remission similarly to IL-10-producing B cells. Moreover, CD5(+) B cells are enriched in the ability to produce IL-10 compared to CD5(neg) B cells. Together these results suggest that CD5 may identify functional IL-10-producing Bregs . The malfunction of Bregs during active disease due to reduced IL-10 expression may thus permit ANCA production.

Clinical significance, angiographic characteristics, and short-term outcomes in 30 patients with early coronary artery graft failure.

BACKGROUND: Despite technical advances in coronary artery bypass grafting (CABG), early postoperative myocardial ischaemia still remains a challenging problem. The aim of this study was to determine the incidence, clinical features, angiographic characteristics, and management of early graft failure in the present CABG era. METHODS: Between January 1997 and December 2002, 1731 patients underwent CABG at our institution. Coronary angiography was performed in patients with clinical evidence of early postoperative ischaemia (

Randomized, controlled, double-blind trial of topical treatment of cutaneous leishmaniasis with paromomycin plus methylbenzethonium chloride ointment in Guatemala.

A double-blind, randomized trial was undertaken in Guatemala to determine the therapeutic efficacy of an ointment for the treatment of cutaneous leishmaniasis that contained 15% paromomycin and 12% methylbenzethonium chloride and that was applied twice a day for 20 days. The treatment group included 35 patients, and the placebo group included 33 patients. The initial clinical response rate (13 weeks after completing the treatment) was 91.4% in the treatment group and 39.4% in the placebo group. The final clinical response rate at the 12-month follow-up examination was 85.7% (31 of 35) in the treatment group and 39.4% (13 of 33) in the placebo group (P < or = 0.001). In general, the treatment was well tolerated and was never interrupted because of adverse effects. The number of adverse effects reported in the placebo group was lower than in the treatment group (16 events versus 30 events). All adverse effects reported by patients disappeared within 1 week of completing the treatment. Our findings show that the combination of paromomycin with methylbenzethonium chloride for 20 days is a good alternative for antimonial treatments of cutaneous leishmaniasis in Guatemala.

The role of interleukin-6 in cases of cardiac myxoma. Clinical features, immunologic abnormalities, and a possible role in recurrence.

We performed this prospective study to evaluate the correlation of interleukin-6 serum levels with preoperative constitutional symptoms and immunologic abnormalities, and the possible role played by this cytokine in tumor recurrence. Eight patients with atrial myxoma were evaluated at our institution from July 1993 to November 1998. We measured their interleukin-6 serum levels by enzyme-linked immunosorbent assay method preoperatively and 1 and 6 months after surgery. Two of the cases involved recurrent tumor, 1 patient had undergone his 1st surgery at a different institution and died during the 2nd procedure, so his data were incomplete. Preoperatively the whole group of patients had elevated interleukin-6 serum levels. Although patients with a 1st occurrence of tumor demonstrated a positive correlation between interleukin-6 serum level and tumor size, the 2 patients with recurrent tumors appeared to have higher interleukin-6 levels regardless of tumor size. Once the tumor was surgically removed, interleukin-6 levels returned to normal values, and this was associated with regression of clinical manifestations and immunologic features. According to our study, the overproduction of interleukin-6 by cardiac myxomas is responsible for the constitutional symptoms and immunologic abnormalities observed in patients with such tumors and might also play a role as a marker of recurrence. This study also suggests that recurrent cardiac myxomas form a subgroup of cardiac myxomas with a highly intrinsic aggressiveness, as implied by their greater interleukin-6 production despite their smaller size. Further studies are needed to confirm these results.

Molecular study of the rat liver NADH: cytochrome c oxidoreductase complex during development and ageing.

The mechanisms involved in ageing are yet to be fully understood but it is thought that changes produced in energy transfer pathways occurring in the mitochondria may be responsible for the lack of energy typical of the later stages of life. The aim of the present investigation was to determine the enzymatic activity of the liver NADH cytochrome c oxidoreductase complex (Complex I-III) in mitochondria isolated from the liver of rats of 3 different age groups: lactating, animals (15-17 days), adult females (3-5 months) and old animals (26-30 months). The activities of the unbound Complexes I and III were also determined. An increase in Complex I-III activity was detected during development (142 +/- 10 vs. 447 +/- 23 micromol cyt. c/mg/min, p < 0.001) ang ageing (447 +/- 23 vs. 713 +/- 45 micromol cyt. c/mg/min, p < 0.001). However, unbound Complex I showed a reduction in activity during the ageing period whilst Complex III activity moderately increased. Immunological studies indicated only a moderate increase in the amount of Complex I-III and studies on the purified complex suggested that the increase in activity was due to effects other than an increase in enzyme quantity. The analysis of protein bands and the quantification of prosthetic groups showed particular reductions in the relative concentrations of Complex I subunits including the 51 kDa unit, which binds FMN, confirmed by a similar reduction in levels of the nucleotide. In contrast, 4 of the 5 subunits which increased during the lifetime of the animals corresponded to those of Complex III. These subunits are responsible for the binding of catalytic groups. The results suggest that, in addition to the increase in the amount of enzyme, binding factors between Complexes I and III may also play an important role in the observed increase in Complex I-III activity.

Evaluation of a standardized leishmanin skin test in Guatemala.

Before recommending the skin-test use at national level in Guatemala of an antigen prepared from Leishmania major (a Leishmania species not found in the New World), we conducted a study in 100 Guatemalans to determine its sensitivity and specificity. The antigen consisted of 0.1 mL of a solution that contained 5 x 10(6) promastigotes of L. major (MRHO/IR/75/VAX). Positive leishmanin skin test (LST) reactions at 48 h were observed in 16 (80%) of 20 patients with proven active cutaneous leishmaniasis (CL), 18 (90%) of 20 with previously treated proven CL, and in 18 (90%) of 20 with a history and compatible scan of previously suspected but unconfirmed CL. None of 20 healthy controls or 20 patients with skin lesions due to causes other than CL had positive reactions to the LST, giving a sensitivity of 85% and specificity of 100%. There were no statistically significant differences in ethnic group, age, duration of the lesion, lesion size or Leishmania species between the 34 persons with true positive reactions. Even though it will be necessary to test this antigen on a larger number of patients, these preliminary results show that this antigen is specific and reasonably sensitive in identifying current or past CL and that it is a reasonable choice for epidemiological studies on CL in Guatemala.

Reduction of fecal contamination of street-vended beverages in Guatemala by a simple system for water purification and storage, handwashing, and beverage storage.

Street-vended foods and beverages, an integral part of urban economies in the developing world, have been implicated in cholera transmission in Latin America. To improve the microbiologic quality of market-vended beverages in Guatemala, we tested a simple system consisting of dilute bleach (4.95% free available chlorine) for water purification, narrow-mouth plastic vessels with spigots for disinfecting and storing water and for preparing and storing beverages, handwashing soap, and education in using the system. We conducted a randomized controlled intervention trial among 41 vendors who received the intervention and 42 control vendors, comparing total and fecal coliform bacteria and Escherichia coli contamination of market-vended beverages, stored water, and vendors' hands. Samples were obtained at baseline and at each of six weekly follow-up visits. At baseline, fecal coliform bacteria were found in 40 (48%) market-vended beverages and E. coli in 14 (17%). When compared with samples from control vendors, a significant decrease in total coliform (P < 0.001) and fecal coliform (P < 0.001) bacteria in samples of stored water and beverages sold by intervention vendors was observed over the course of the study. The vessel system was well accepted by vendors. This simple inexpensive system consisting of hypochlorite disinfectant, plastic vessels, soap, and education can significantly reduce fecal contamination of market-vended beverages.

Electrophoretic analysis of snake venoms.

Electrophoretic analyses were conducted on snake venoms from 21 species representing Elapidae, Crotalidae and Viperidae. Denatured and native venoms were analyzed by polyacrylamide gel electrophoretic (PAGE) methods with sodium dodecyl sulfate (SDS) and without SDS. Both SDS-PAGE and PAGE profiles of venoms from different snake species indicate that some proteins and polypeptide components of these venoms have common electrophoretic characteristics suggesting a genetic relationship. Conversely, the electropherograms also showed the characteristic protein and polypeptide profiles that could differentiate one snake species from another. Therefore, both SDS-PAGE and PAGE profiles suggest that proteins and polypeptides with similar characteristics abound among subspecies or related species, although each venom has a unique profile that differentiates one species from the other.

Abiotic transformations and decomposition kinetics of 4-carbamoyl-2'-[(hydroxyimino)methyl]-1,1'-(oxydimethylene)-bis(pyridin ium chloride) in aqueous phosphate buffers.

The rate of disappearance of 4-carbamoyl-2'-[(hydroxyimino)methyl]-1,1'-(oxydimethylene) bis (pyridinium chloride) (HI-6) from aqueous phosphate buffers (pH 3.0-9.1) was both pH and temperature sensitive. In midrange buffers (pH 6.0-9.1, mu = 0.2 M) at 37, 25, or 4 degrees C the decomposition followed first-order kinetics consistent with hydroxide-promoted decomposition of the un-ionized drug or with hydrolysis of the ionized oxime anion to result in 4-carbamoyl-2'-hydroxy-1,1'-(oxydimethylene)bis(pyridinium) cation (intermediate 1). The subsequent conversion of intermediate 1 to 4-carboxy-2'-hydroxy-1,1'-(oxydimethylene)bis(pyridinium) cation (intermediate 2) followed higher order kinetics which were consistent with either acid- or base-promoted hydrolysis of the B-ring amide functionality. After approximately 138 days in the dark, the sum of the residual HI-6, intermediate 1, and intermediate 2 in the crude decomposition mixture accounted for 89.9 +/- 10.0% of the initial substrate. Minor byproducts included 4-carbamoyl-2'-carboxy-1,1'-(oxydimethylene)bis(pyridinium) cation, 2-pyridinealdoxime, 2-pyridinecarboxaldehyde, 2-hydroxypyridine, isonicotinamide, isonicotinic acid, and traces of cyanide. In addition, 2-cyanopyridine appeared to be a transient intermediate in more alkaline media. In total, this drug resembles other mono- and bis(pyridinium) aldoximes in terms of the decomposition routes in aqueous solutions at intermediate pHs.

Histopathological changes in gastrocnemius muscles of rabbits injected with HI-6 in saline.

The gastrocnemius muscles of rabbits were injected with HI-6 in saline. Macroscopic and histopathological examinations of injection sites and regional lymph nodes revealed that HI-6 in saline produced muscle necrosis. Macroscopic examinations of muscles injected with a low dose of HI-6 (50 mg/kg) showed no lesions on Day 7. However, histopathological examinations disclosed lesions on some animals but with evidence of healing processes by Day 7; lesions disappeared by Day 14. Further macroscopic and histopathological examinations revealed that lesions associated with the high dose (200 mg/kg) were still prominent on Day 14 but with evidence of healing. Similar lesions seen in muscles injected with saline were significantly less persistent than those associated with HI-6.

Hexachlorobenzene residues and effects on esterase activities in pre-weanling rats after a reciprocal transfer between HCB-treated and control dams.

Female Wistar rats were divided into two groups. One group was fed ad libitum powdered rat chow containing 80 ppm hexachlorobenzene (HCB) and the other was fed HCB-free diet 2 weeks before mating until the termination of the experiment. Immediately after parturition, the pups were randomly culled to 10 per litter and 5 pups were reciprocally transferred between HCB and control dams. All pups within same paired litters were sacrificed on the 16th to 17th day and on the 20th to 23rd day after birth. Liver esterase activity toward indophenyl, thiophenyl, and p-nitrophenyl acetates was determined. The liver to body weight ratio, liver esterase activity and HCB residues were significantly higher in pups nursed by HCB-fed dams than in those nursed by control dams. The HCB residue in the liver, kidney, spleen, heart and brain was analyzed by gas-liquid chromatography. At about the weaning time, the HCB residue levels in pups transferred after parturition from HCB fed to control dams were similar to those in pups which remained with the control dams. The results demonstrated that HCB in tissues at about weaning time was obtained largely through milk. In addition, transmission of HCB through milk had greater effects on esterase activities in suckling pups than placental transmission. The pups born to HCB-treated dams and nursed by the control dams were similar to the pups born and nursed by the same control dams.