Acute urticaria in children: from pediatric Emergency Department to allergology consultation at a Central Hospital.

Summary: Background. Acute urticaria is a common condition in the pediatric emergency department (ED) and no data is available in Portugal. Objective. We aimed to characterize the prevalence, etiology and management of acute urticaria in children presenting at an ED of a portuguese central hospital and report the follow-up investigation when drug or food allergy was suspected.Methods. Retrospective study of clinical records from children admitted to the ED with acute urticaria during one year period. Results. 250 children were included, mean age of 7.4 ± 4.9 years (0-17 years). The most frequently suspected etiological factors were infections (22%), foods (12%), insect bites (9%) and drugs (8%), of which, upper respiratory tract infections, seafood and ß-lactam antibiotics were the most frequent. In 44% of cases, the etiology of urticaria was not determined. After ED discharge, of the 50 patients with suggestive drug or food allergy, only 48% were sent to allergological workup and the allergy confirmed in 6 of them (2.4% of the 250 children). Conclusions. These data suggest that allergy is not the main trigger of acute urticaria in ED children, but when suspected, reference to an allergy department to complete allergological workup was insufficient.

Chimarrão, terere and mate-tea in legitimate technology modes of preparation and consume: A comparative study of chemical composition, antioxidant, anti-inflammatory and anti-anxiety properties of the mostly consumed beverages of Ilex paraguariensis St. Hil.

ETHNOPHARMACOLOGICAL RELEVANCE: Ilex paraguariensis St. Hil. (Aquifoliaceae) is a medicinal plant widely used by South American populations for centuries and is popularly attributed to stimulating and detoxifying properties. Nowadays, their consume traditionally occurs through three different beverages: chimarrão, terere and mate-tea. AIM OF THE STUDY: Although its composition and properties are well studied, literature lacks work comparing the potential of their extracts obtained by a legitimate preparation mode of their popular beverages. Therefore, the purpose of this research is to investigate changes in chemical composition, antioxidant activity, anti-inflammatory efficacy and anxiolytic effect from lyophilized aqueous extracts obtained simulating the legitimate popular preparation mode of chimarrão, terere and mate-tea. MATERIALS AND METHODS: In this work, were investigated differences related to preparation technology and dry material used through chemical composition analysis, with the lyophilized aqueous extracts obtained simulating the chimarrão, terere and mate-tea preparation. The chemical composition analysis comprises the total soluble phenolics content, chemical profiles by HPLC-ESI-MS/MS, and quantitative component detection by HPLC-UV/DAD. Moreover, evaluations of comparative antioxidant activity of the extracts (DPPH and ORACFL assays), anti-inflammatory efficacy and anxiolytic effect were performed in vivo. RESULTS: Our results showed that chimarrão extracts presented a richer composition in terms of phenolic compounds and purine alkaloids, and better antioxidant activity when compared to the other extracts. In pleurisy test, all products showed anti-inflammatory properties in the dose of 60 mg/kg. In the anxiolytic evaluation, although all extracts presented some effect, chimarrão and terere were better than mate-tea in general. No sign of toxicity was observed. CONCLUSIONS: Our findings support that the beverage made as chimarrão has the best composition and the most promising properties overall.

Localized Fournier's Gangrene in "End-Stage" Renal Failure: Multidisciplinary Approach and Integration of Palliative Care.

Presentation of the Case. Penile gangrene is a rare entity with significant morbidity and mortality. There are only few case reports of isolated penile Fournier's gangrene in literature. Its rare occurrence, associated with complex and serious comorbidity, poses a major challenge to the attending medical personnel. A 53-year-old Caucasian patient with poorly controlled diabetes, progressive renal insufficiency, and multiple vascular complications presented with progressive necrosis of the penis (localized Fournier's gangrene). Discussion. Fournier's gangrene or necrotizing fasciitis refers to any synergistic necrotizing infection of the external genitalia or perineum and is a hallmark of severe systemic vascular disease. Fournier's gangrene is an absolute emergency because the time interval between diagnosis and treatment significantly influences morbidity and mortality. Despite aggressive management, the estimated mortality rates range from 57 to 71%. Conclusions. Improved integration of palliative care services into the care of such patients is important to improve end-of-life care even though they do not have a malignant disease. The "Palliative Care Indicator Tool" can help identifying people at risk of deteriorating health and is important to improve end-of-life care.

Neonatal hypotonia: is it a diagnostic challenge? / Hipotonia neonatal: entraña un diagnostico dificil?

INTRODUCTION: Hypotonia is a frequent sign of disease in newborns. However, it's a nonspecific clinical finding: may be the presentation form of a systemic or neurological disease. AIMS: To study the main causes of neonatal hypotonia as well as to evaluate the diagnostic accuracy of the anamnesis and physical examination of the hypotonic newborn. PATIENTS AND METHODS: A 22-year retrospective study of hypotonic neonates admitted to the Neonatal Intensive Care Unit was conducted. It was performed an initial blind classification of hypotonia's type (central-CH, peripheral-PH or undetermined hypotonia) based on the clinical history and the recorded data of physical examination. RESULTS: 91 infants were included. 42 (46.2%) had prenatal history abnormalities: polyhydramnios (28.6%), intrauterine growth restriction (21.4%) and pelvic presentation (19.0%). 53 (58.2%) required resuscitation at birth. The main associated symptoms were respiratory distress (65.9%), feeding difficulties (36.5%) and decreased spontaneous movements (22.4%). The final diagnosis was reached in 64 newborns (70.3%): 81.3% with CH, 18.7% with PH. The positive predictive value of the initial classification was 97.9% in CH and 66.7% in PH group. The mortality rate was 8.8% and it was higher in PH group (58.3% vs 1.3%). CONCLUSIONS: Neonatal hypotonia can be associated to an extensive list of disorders. A detailed clinical history associated to a careful neurological evaluation present a high diagnostic predictive value that should guide the etiological investigation.

TITLE: Hipotonia neonatal: entraña un diagnostico dificil?Introduccion. La hipotonia constituye un signo habitual de enfermedad en el neonato. Ahora bien, se trata de un signo inespecifico: puede ser la manifestacion inicial de una enfermedad neurologica o multisistemica. Objetivos. Estudiar las principales causas de la hipotonia neonatal y evaluar la exactitud diagnostica de la anamnesis y la exploracion fisica en el neonato hipotonico. Pacientes y metodos. Estudio retrospectivo de 22 años con recien nacidos afectados por hipotonia e ingresados en la unidad de cuidados intensivos neonatales. A partir de la anamnesis y de los datos recabados durante la exploracion fisica, se hizo una clasificacion inicial en condiciones de enmascaramiento del tipo de hipotonia: central, periferica o indeterminada. Resultados. El numero de pacientes estudiados ascendio a 91. De ellos, 42 (46,2%) presentaban antecedentes de alteraciones prenatales: polihidramnios (28,6%), retraso del crecimiento intrauterino (21,4%) y presentacion de nalgas (19%). Cincuenta y tres (58,2%) habian precisado reanimacion al nacer. Los principales sintomas asociados consistieron en disnea (65,9%), dificultades de alimentacion (36,5%) y escasez de movimientos espontaneos (22,4%). El diagnostico definitivo se obtuvo en 64 neonatos (70,3%): el 81,3% mostraba hipotonia central, y el 18,7%, hipotonia periferica. El valor predictivo positivo de la clasificacion inicial alcanzo el 97,9% en la hipotonia central y el 66,7% en la hipotonia periferica. La tasa de mortalidad fue del 8,8%, y resulto superior en el grupo de hipotonia periferica (58,3% frente a 1,3%). Conclusiones. La hipotonia neonatal aparece vinculada con una larga lista de trastornos. Una anamnesis minuciosa y una valoracion neurologica cuidadosa brindan un alto valor predictivo diagnostico que debe orientar el estudio etiologico.

Can the alendronate dosage be altered when combined with high-frequency loading in osteoporosis treatment?

Alendronate therapy has been associated with serious side effects. Altering the alendronate concentration and combining with high-frequency loading as mechanical intervention was explored in this animal study as a treatment for osteoporosis. The bone anabolic potency of high-frequency loading was overruled by the different alendronate dosages applied in the present study. Further exploration of reduced hormonal therapy associated with mechanical interventions in osteoporosis treatment should be sought. INTRODUCTION: The aim of the present study was to investigate the effect of alendronate (ALN) administration at two different dosages, associated or not with high-frequency (HF) loading, on the bone microstructural response. METHODS: Sixty-four female Wistar rats were used, of which 48 were ovariectomized (OVX) and 16 were sham-operated (shOVX). The OVX animals were divided into three groups: two groups were treated with alendronate, at a dosage of 2 mg/kg (ALN(2)) or at a reduced dosage of 1 mg/kg (ALN(1)) three times per week. A third OVX group did not receive pharmaceutical treatment. All four groups were mechanically stimulated via whole body vibration (WBV) at HF (up to 150 Hz) or left untreated (shWBV). ALN and HF were administered for 6 weeks, starting at 10-week post-(sh)OVX. Tibia bone structural parameters were analyzed using ex vivo microcomputed tomography. RESULTS: Trabecular bone loss and structural deterioration resulting from ovariectomy were partially restored by ALN administration, demonstrated by the improvement of trabecular patter factor (Tb.Pf), trabecular separation (Tb.Sp), and structure model index (SMI) of the ALN groups compared to that of the OVX group, regardless of the applied dosage [ALN(2) or ALN(1)] or mechanical loading regime (shWBV or WBV). However, a significant positive effect of the ALN(1) administration on trabecular (decrease of Tb.Sp and SMI) and cortical bone (increase of cortical thickness) microarchitecture compared to that of the OVX status group was observed for both loading regimes was not seen for ALN(2). Furthermore, HF loading resulted in cortical bone changes, with an increased trabeculary area and endocortical perimeter. Finally, the benefits of a combined therapy of ALN with HF loading could not be discerned in the present experimental conditions. CONCLUSIONS: The bone anabolic potency of HF loading was overruled by the ALN dosages applied in the present study. Further altering the ALN dosage combined with robust mechanical stimuli needs to be considered in osteoporosis research and eventually therapy.

Efeito do período e temperatura de armazenamento de ovos férteis sobre o rendimento de incubação e características de qualidade de codornas neonatas / Effect of period and storage temperature of hatching eggs from breeder quails on hatching results and quality characteristics of neonate quails

Foram estudados parâmetros de incubação e de qualidade física de codornas japonesas neonatas oriundas de ovos submetidos a diferentes condições de armazenamento. Os tratamentos constituíram-se de combinações entre temperaturas e períodos de armazenamento dos ovos férteis. O delineamento foi em blocos casualizados em arranjo fatorial 2x5, temperaturas (ambiente (28±1,5ºC) e refrigerada (14ºC)) x períodos de armazenamento (um, três, seis, nove ou doze dias), totalizando 10 tratamentos com 105 repetições, sendo cada ovo uma unidade experimental. Os ovos foram incubados nas condições de 37,9ºC e 60% de umidade relativa (UR). Houve aumento de perda de peso do ovo com o período de armazenamento, com efeito linear positivo. Observou-se maior taxa de eclosão/ovos férteis para os ovos armazenados sob refrigeração. Houve efeito linear negativo para o período de armazenamento sobre a taxa de eclosão somente para os ovos armazenados em 28ºC. Para o peso da codorna neonata, houve efeito linear negativo, independentemente da temperatura de armazenamento. O comprimento do intestino delgado em temperatura ambiente sofreu influência do período de armazenamento, sendo que o período de 12 dias apresentou pior resultado. O pior escore de qualidade física foi encontrado em codornas neonatas oriundas de ovos armazenados em temperatura ambiente por 12 dias. Pode-se concluir que, para melhorar a eclosão e a qualidade física da progênie, ovos de codorna devem ser armazenados por até nove dias e em temperatura de 14ºC.

Incubation parameters and physical quality of neonate Japanese quails hatched from eggs that were subject to different storage conditions were evaluated. The treatments consisted of a combination of temperatures and storage periods of hatching eggs from breeder quails. The experiments were conducted in a randomized block design in a factorial arrangement 2x5, with two storage temperatures (ambient temperature ± 28°C and refrigerated temperature 14°C) and five storage periods (one, three, six, nine and twelve days), totaling 10 treatments with 105 repetitions, each egg considered to be an experimental unit. The eggs were incubated at 37.9°C with 60% of relative humidity (RH). There was a positive linear effect between egg weight loss and storage period. Higher rates of hatching/fertile eggs were observed for eggs stored in refrigerated conditions. A negative linear effect was observed between storage period and hatching rate when the eggs where stored at a temperature of 28ºC. There was a negative effect for neonate quail weight, independent of storage temperatures. The intestine length was influenced by storage period and 12 days of storage showed the shortest intestine length. Lower scores of physical quality were observed in quails that hatched from eggs stored in ambient temperatures during 12 days. In this context, to improve hatching rates and physical quality of neonate quails the eggs should be stored up to nine days at a temperature of 14°C.

Effect of simulated microwave disinfection on the linear dimensional change, hardness and impact strength of acrylic resins processed by different polymerization cycles.

AIM: This study investigated the effect of simulated microwave disinfection (SMD) on the linear dimensional changes, hardness and impact strength of acrylic resins under different polymerization cycles. METHDOS: Metal dies with referential points were embedded in flasks with dental stone. Samples of Classico and Vipi acrylic resins were made following the manufacturers' recommendations. The assessed polymerization cycles were: A) water bath at 74 ºC for 9 h; B) water bath at 74 ºC for 8 h and temperature increased to 100 ºC for 1 h; C) water bath at 74 ºC for 2 h and temperature increased to 100 ºC for 1 h; and D) water bath at 120 ºC and pressure of 60 pounds. Linear dimensional distances in length and width were measured after SMD and water storage at 37 ºC for 7 and 30 days using an optical microscope. SMD was carried out with the samples immersed in 150 mL of water in an oven (650 W for 3 min). A load of 25 gf for 10 s was used in the hardness test. Charpy impact test was performed with 40 kpcm. Data were submitted to ANOVA and Tukey's test (5%). RESULTS: The Classico resin was dimensionally steady in length in the A and D cycles for all periods, while the Vipi resin was steady in the A, B and C cycles for all periods. The Classico resin was dimensionally steady in width in the C and D cycles for all periods, and the Vipi resin was steady in all cycles and periods. The hardness values for Classico resin were steady in all cycles and periods, while the Vipi resin was steady only in the C cycle for all periods. Impact strength values for Classico resin were steady in the A, C and D cycles for all periods, while Vipi resin was steady in all cycles and periods. CONCLUSION: SMD promoted different effects on the linear dimensional changes, hardness and impact strength of acrylic resins submitted to different polymerization cycles when after SMD and water storage were considered.

Effect of simulated microwave disinfection on the linear dimensional change, hardness and impact strength of acrylic resins processed by different polymerizing cycles.

AIM: This study investigated the effect of simulated microwave disinfection (SMD) on the linear dimensional changes, hardness and impact strength of acrylic resins under different polymerization cycles. METHODS: Metal dies with referential points were embedded in flasks with dental stone. Samples of Classico and Vipi acrylic resins were made following the manufacturers' recommendations. The assessed polymerization cycles were: A-- water bath at 74ºC for 9 h; B-- water bath at 74ºC for 8 h and temperature increased to 100ºC for 1 h; C-- water bath at 74ºC for 2 h and temperature increased to 100ºC for 1 h;; and D-- water bath at 120ºC and pressure of 60 pounds. Linear dimensional distances in length and width were measured after SMD and water storage at 37ºC for 7 and 30 days using an optical microscope. SMD was carried out with the samples immersed in 150 mL of water in an oven (650 W for 3 min). A load of 25 gf for 10 sec was used in the hardness test. Charpy impact test was performed with 40 kpcm. Data were submitted to ANOVA and Tukey's test (5%). RESULTS: The Classico resin was dimensionally steady in length in the A and D cycles for all periods, while the Vipi resin was steady in the A, B and C cycles for all periods. The Classico resin was dimensionally steady in width in the C and D cycles for all periods, and the Vipi resin was steady in all cycles and periods. The hardness values for Classico resin were steady in all cycles and periods, while the Vipi resin was steady only in the C cycle for all periods. Impact strength values for Classico resin were steady in the A, C and D cycles for all periods, while Vipi resin was steady in all cycles and periods. CONCLUSION: SMD promoted different effects on the linear dimensional changes, hardness and impact strength of acrylic resins submitted to different polymerization cycles when after SMD and water storage were considered.

Plantas medicinais no processo de cicatrização de feridas: uma revisão de literatura / Medicinal plants in the wound healing process: a literature review

Uma busca foi realizada na literatura, visando sumarizar as pesquisas realizadas e obter informações acerca da utilização de plantas medicinais no processo de cicatrização de feridas. Utilizaram-se os descritores: Plantas Medicinais e Cicatrização de Feridas e seus equivalentes em inglês e espanhol, com o operador booleano "AND" em três bases eletrônicas de dados (PubMed, LILACS e COCHRANE). Foram selecionados 57 artigos para compor a revisão. Os resultados apontam que um total de 52 plantas medicinais e um composto de ervas foram estudados experimentalmente ou clinicamente, quanto aos seus efeitos no auxílio do processo de cicatrização, sendo que a maioria (88,5%) apresentou eficácia. Com isso, verifica-se que a utilização de plantas medicinais trata de importante alternativa no tratamento de feridas, que começa a fazer parte da atenção à saúde brasileira, o que sugere novos estudos de comprovação clínica, custos, e benefícios e a constante atualização acerca das publicações realizadas.

It was done a literature search aiming to sumarize earlier conducted researches and in order to obtain information on the use of medicinal plants in wound healing process. The descriptors used were as follows: Medicinal Plants and Wound Healing and their equivalents in English and Spanish with the Boolean operator "AND" in three electronic databases (PubMed, LILACS and COCHRANE). Fifty seven articles were chosen to compose the review. The findings from a total of fifty two medicinal plants and one herbal compound that were experimentally or clinically studied in respect to their effects in wound healing process indicate that the majority of them (eighty eight point five per cent) showed efficacy. Thus, it can be seen that the use of medicinal plants is an important alternative in wounds treatment that becomes part of Brazilian health care, suggesting further studies of clinical evidence, costs and benefits and constantly updating on produced publications.

Prognosis of HIV infected sub-Saharan patients on renal replacement therapy (RRT) in Brussels, Belgium: a single centre retrospective pilot study and review of the literature.

BACKGROUND: Few data exist documenting the survival experience of immigrated sub-Saharan patients infected by the human immunodeficiency virus (HIV) on renal replacement therapy (RRT). METHODS: This retrospective single centre pilot study includes 105 consecutive patients of sub-Saharan origin who started RRT in our unit, between January 1986 and April 2010. The aim was to analyse the characteristics and the survival rate on RRT of these patients. RESULTS: Out of 105 patients 81/105 (77%) were HIV-negative and 24/105(23%) were HIV-positive. HIV-positive patients were younger than HIV-negative patients and they were more often treated with peritoneal dialysis (PD) (21/24) than with haemodialysis (HD). Dialysis peritonitis was equally distributed between HIV-positive and HIV-negative patients. Because of opportunistic infections, duration of hospitalisation was longer for HIV-positive than for HIV-negative patients. In PD-treated patients, the number of hospitalisations tended to be greater in patients who experienced at least one peritonitis episode and the duration of hospitalisation also tended to be longer. The survival rate was better in patients younger than 50 years and in patients on HD, but was similar for both positive and negative HIV patients. CONCLUSIONS: To the best of our knowledge, these are the first data concerning patients who have emigrated from sub-Saharan Africa to Belgium, and who are on RTT. Their survival rate is better if they are younger than 50 years and on HD. As the majority of HIV patients were treated by PD in our center, a conclusion regarding survival on different dialysis modalities is not possible for this group of patients. Survival rates were similar for HIV-positive and HIV-negative patients despite longer duration of hospisalization for HIV-positive patients.

Microwave irradiation as an alternative method for disinfection of denture base acrylic resins.

AIM: This study evaluated the effect of microwave irradiation as an alternative method for disinfection of different types of denture base acrylic resins. METHODS: Twenty-four samples for each conventional, microwaved and characterized heat-cured acrylic resin were made and subjected to sterilization with ethylene oxide for the groups: 1) irradiated samples; 2) non-irradiated samples; and 3) samples without yeast. Each group was subdivided according to inoculation with C. albicans, C. dubliniensis and C. tropicalis. The samples were inoculated with 100 µL of inoculum of each species of Candida and later placed in an incubator at 37 °C for 1 hr to perform the first adhesion. After this time, each well was supplemented with sterile media and the plate was once again taken to a stove for incubation at 37 °C for 6 hr. The samples were immersed in 100 mL of sterile water and irradiated with microwave at 650 W for 3 min. Control samples were considered as the non-irradiated group. After incubation for 48 hr, irradiated and non-irradiated samples were subjected to a digital colony counter. RESULTS: Control group (non-irradiated) showed microbial growth for resins and the means of ufc/mL were without statistically significant differences. Microwave irradiated samples (experimental group) promoted no viable colonies for all Candida species and types of acrylic resins. The means of ufc/mL were without statistically significant differences. CONCLUSION: Microwave irradiation was an effective method for disinfection of the acrylic resins inoculated with C. albicans, C. dubliniensis and C. tropicalis.

Effect of polymerization cycles on the linear dimensional change, hardness and impact strength of denture base acrylic resins.

AIM: This study verified the effect of polymerizing cycles on the linear dimensional change, hardness and impact strength of denture acrylic resins. METHODS: One hundred and twenty samples (N.=10) each for the Classico and Vipi acrylic resins were made according to the manufacturers' instructions. The polymerization cycles were: 1- water bath at 74 ºC for 9 hr; 2- water bath at 74ºC for 8 hr and temperature increased to 100 ºC for 1 hr; 3- water bath at 74 ºC for 2 hr and temperature increased to 100 ºC for 1 hr; and 4- water bath at 120ºC and 60 pounds pressure for 1 hr. Samples were deflasked after flask cooling and submitted to finishing. Linear distances between referential points in the samples were measured at deflasking and after water storage for 7 and 30 days with a comparator microscope with an accuracy of 0.0005 mm. Knoop hardness test was accomplished in a durometer with a load of 25 gf for 10 sec and an average of three indentations was considered for the sample hardness. Impact strength (kgf/cm²) was measured by the Charpy system with load of 40 kpcm. Data were submitted to ANOVA and Tukey's test (5%). RESULTS: Dimensional changes in the A-B and A-C distances, hardness values and impact strength for Classico and Vipi resins were differently influenced by the polymerization cycles, when deflasking and water storage for 7 and 30 days were considered. CONCLUSION: Linear dimensional change, hardness and impact strength of denture acrylic resins were differently affected by the polymerization cycles.

PP045. Maternal mortality due to hypertension: A look at the puerperium.

INTRODUCTION: Maternal death is the death of a woman during pregnancy within 42days after delivery. It is one of the most serious violations of human rights of women, because it is a preventable tragedy in 92% of cases and occurs mainly in developing countries. Brazil, a country of continental dimensions has the challenge of reducing maternal deaths; one of the priority regions is Santos, a city in the state of São Paulo. It is felt that efforts are made to the adoption of care that can minimize risks during complicated pregnancy with hypertensive disorders, but not always this service is offered proportionally to postpartum. Perhaps the erroneous concept that the delivery is capable of quickly balancing the harm of maternal hypertensive disorders is implicated in reducing postpartum surveillance, exposing this group of women to undesirable outcomes. OBJECTIVES: Analyze the percentage of postpartum maternal deaths until 42days after delivery for hypertensive disorders in Santos in the period of 1999-2009. METHODS: Data were provided by the Ministry of Health of Brazil in www.datasus.gov.br (accessed February 2012). The number of maternal deaths was divided into maternal death in pregnancy, delivery and abortion and maternal death in puerperium up to 42, considering all causes of maternal death and identifying the proportion of deaths due to hypertensive syndromes. RESULTS: According to the general causes of death, more women die during pregnancy, delivery and abortion (69.7%) than postpartum (30.3%) and hypertensive disorders account for 20% of these outcomes. Analyzing the proportion of deaths due to hypertensive disorders in each period, we observed that during pregnancy the disorder accounts for 16.5% of all causes, however, the percentage reaches 30.3% in the puerperium. CONCLUSION: The increase of death in postpartum due to hypertensive syndromes, regarding all general causes, shows the necessary action to be done by the professional team to offer continuity care in and out of hospital in this period, considering that the challenges persist even after delivery.

Renal biopsy findings in Belgium: a retrospective single center analysis.

Renal biopsy is the definitive diagnostic test in patients with renal parenchymal disease. Renal biopsy registry is an important tool which can provide valuable data concerning early and correct epidemiological description and clinical correlations of renal diseases. Records of 326 adult renal biopsies performed at our hospital from January 1991 till the end of December 2006 were retrospectively examined. Overall, secondary glomerular diseases (SGD) were predominant (39.9%), followed by primary glomerular diseases (PGD) (30.4%), vascular diseases (13.2%) and TIN (6.7%). Total sclerosis of the kidney did not allow histopathological diagnosis in 5.8% of all biopsied kidneys. Focal and Segmental Glomerular Sclerosis (FSGS), IgA Nephropathy (IgAGN) and Minimal Change Disease (MCD) and Membranous Glomerulopathy (MGN) were the most common PGD, altogether representing 75.7% of all PGD. FSGS was the most frequent (30.3%), followed by IgAGN (21.2%), MCD (19.1%) and MGN in 15.1%. Vasculitis, HIVAN, diabetic nephropathy and amyloidosis were the most common SGD, altogether representing 90% of all SGD. Immune Mediated Glomerulonephritis (IMGN) were the most frequent (32.3%), followed by HIVAN (16.9%), diabetic nephropathy (14.6%) and amyloidosis (10%). Nephroangiosclerosis (benign and malignant nephroangiosclerosis) was the most frequent vascular nephropathy responsible for 79% of all vascular diseases. Thrombotic microangiopathy was seen in 9.3% and atherothrombotic disease in 7% of all vascular diseases. Concerning tubular diseases, chronic TIN accounted for 63.6% of all tubular diseases, followed by light chain-cast nephropathy (22.7%) and acute TIN (13.6%). Because of lack of material, 3.4% of all biopsies could not be analyzed. These data demonstrate that the distribution of biopsy-proved renal diseases in a Belgian population of the Brussels area is strongly influenced by the indications of renal biopsy. Harmonization of these indications might reflect with more accuracy the actual incidence of different nephropathies in a given population. Nation and worldwide renal biopsy registers are important to follow patterns of renal diseases in different populations. This information is important not only for health organizations in order to plan health budget but also for helping clinicians to provide a better care to patients.

Three-dimensional finite element analysis of stress distribution in peri-implant bone with relined dentures and different heights of healing caps.

The purpose of this study was to evaluate the influence of height of healing caps and the use of soft liner materials on the stress distribution in peri-implant bone during masticatory function in conventional complete dentures during the healing period by using finite element analysis. Three-dimensional models of a severely resorbed mandible with two recently placed implants in the anterior region were created and divided into the following situations: (i) submerged implants, (ii) healing cap at gingival level and (iii) 1·5-mm supragingival. All these situations were also analysed for a conventional complete denture and a denture relined with a 3-mm-thick layer of soft liner material. The models were exported to mechanical simulation software that presented two simulations, one with load in the inferior right canine (35 N) and the other in the inferior right first molar (50 N). Data were evaluated using Maximum Principal Stress provided by the software. All models showed a stress concentration in the cortical bone corresponding to the cervical part of the implant. The simulations with non-submerged implants showed higher values of stress concentration than those that were submerged. Likewise, soft liner materials presented better results than when the denture base was not relined. The height of the healing caps seems to have a direct influence on the stress distribution in the peri-implant bone during the healing period. Considering the values obtained in this study, the use of soft liners with submerged implants seems to be the most suitable method to use during the period of osseointegration.

Effects of laser-weld joint opening size on fatigue strength of Ti-6Al-4V structures with several diameters.

This study was conducted to evaluate the fatigue strength of Ti-6Al-4V laser-welded joints with several diameters and joint openings. Sixty dumbbell rods were machined in Ti-6Al-4V alloy with central diameters of 1·5, 2·0 and 3·5 mm. The specimens were sectioned and then welded using two joint openings (0·0 and 0·6 mm). The combination of variables created six groups, which when added to the intact groups made a total of nine groups (n = 10). Laser welding was executed as follows: 360 V per 8 ms (1·5 and 2·0 mm) and 380 V per 9 ms (3·5 mm) with focus and frequency regulated to zero. The joints were finished, polished and submitted to radiographic examination to be analysed visually for the presence of porosity. The specimens were then subjected to a mechanical cyclic test, and the number of cycles until failure was recorded. The fracture surface was examined with a scanning electron microscope (SEM). The Kruskal-Wallis test and Dunn test (α = 0·05) indicated that the number of cycles required for fracture was lower for all specimens with joint openings of 0·6 mm, and for 3·5-mm-diameter specimens with joint openings of 0·0 mm. The Spearman correlation coefficient (α = 0·05) indicated that there was a negative correlation between the number of cycles and the presence of porosity. So, laser welding of Ti-6Al-4V structures with a thin diameter provides the best conditions for the juxtaposition of parts. Radiographic examination allows for the detection of internal voids in titanium joints.