Mortalidade infantil por causas evitáveis na Bahia, 2000-2012 / Child mortality by avoidable causes in Bahia, 2000-2012 / Mortalidad infantil por causas evitables en Bahia, 2000-2012

Este artigo tem como objetivo analisar as causas e taxas de mortes evitáveis em crianças com menos de um ano de idade na Bahia no período de 2000 a 2012. Para isso, realizou-se um estudo ecológico de série temporal. Foram considerados os óbitos de crianças da faixa em questão, cujas mães residiam na Bahia naquele período. A classificação de evitabilidade dos óbitos seguiu a Lista brasileira de causas de mortes evitáveis por intervenções do Sistema Único de Saúde. Os dados foram extraídos dos sistemas de informação em saúde (Sistema de Informação sobre Mortalidade, Sistema de Informação sobre Nascidos Vivos). Apesar das reduções não só da taxa de mortalidade infantil geral como daquela por causas evitáveis no período estudado, ainda persistem altas proporções dessa última em menores de um ano de idade na Bahia. Destacaram-se a diminuição das taxas de mortalidade reduzíveis por adequada assistência ao recém nascido e o aumento das taxas de mortalidade reduzíveis por adequada atenção à mulher na gestação.Concluiu-se que a abordagem da evitabilidade é um potente avaliador da resolutividade dos serviços de saúde prestados à saúde materno-infantil.

This article aims to analyze the causes of avoidable death in children under one and their rates from 2000 to2012 in Bahia. It is based on an ecological time series study which takes account the deaths of children underone whose mothers resided in Bahia during that period. The avoidable deaths classification followed the Lista brasileira de causas de mortes evitáveis por intervenções do Sistema Único de Saúde (Brazilian list o favoidable deaths causes due to Unified Health System interventions). The data were extracted from health information systems (Mortality Information System, Live Births Information System). Despite reductions in both overall infant mortality rate and death rate by avoidable causes during the study period, there are still high rates of avoidable deaths in children under one in Bahia. The decrease in avoidable mortality ratesby appropriated assistance to the newborn and the increase in avoidable mortality rates by appropriated women care during pregnancy draw attention. We can conclude that the approach of the avoidable death causes is a potent evaluator of how to improve the health services supplied to maternal and child health.

Este artículo tiene el objetivo de analizar las causas y tasas de muertes evitables de niños menores de unaño de edad en Bahia en el periodo de 2000 a 2012. Para eso fue realizado un estudio ecológico de serie temporal. Fueran consideradas las muertes de niños con edad inferior a un año, de los cuales las madres residían en Bahia en aquel periodo. La clasificación de la posibilidad de evitar las muertes siguió la Lista brasileira de causas de mortes evitáveis por intervenções do Sistema Único de Saúde (Lista brasileña de causas de muertes evitables por intervenciones del Sistema Único de Salud). Los datos fueron extraídos de los sistemas de información en salud (Sistema de Información al respecto de Mortalidad, Sistema de Información al respecto de Nacidos Vivos). A pesar de las reducciones en las tasas de mortalidad infantil general y por causas evitables en el periodo estudiado, aun persisten elevadas proporciones de muertes evitables en menores de un año de edad en Bahia. Sobre sale la reducción de las tasas de mortalidad reducibles por apropriada asistencia al recién nacido y también el crecimiento de las tasas de mortalidad reducibles por apropriada atención a la mujer en la gestación. Concluimos que el enfoque de la evitabilidad es potente para evaluación de como mejorar la eficiencia de los servicios prestados a la salud materno infantil.

Effect of low-level laser therapy (λ660 nm) on angiogenesis in wound healing: a immunohistochemical study in a rodent model.

The aim of the present investigation was to evaluate the angiogenesis on dorsal cutaneous wounds in a rodent model treated with λ660 nm laser light. New vessel formation is a multistep process involving vessel sprouting, endothelial cell migration, proliferation and tube formation. Although several in vivo studies have shown that laser phototherapy influences tissue repair, a fully understanding of angiogenesis mechanisms are not yet known. Twenty-four young adult male Wistar rats weighing between 200 and 250 g were used. Under general anesthesia, one excisional wound was created on the dorsum of each animal and they were randomly distributed into two groups: one control and one treated with laser (λ660 nm, 16 mW, 10 J/cm2). Each group was subdivided into three subgroups according to the animal death timing (2, 4 and 6 days). Laser irradiation started immediately after surgery and was repeated every other day during the experiment and marked with Sirius Red, specific for collagen, and immunomarked with anti-TGF-ß and anti-von Willebrand factor. Marked sections underwent histological analysis by light microscopy and the mean area of the wound of each animal was calculated and analyzed by ANOVA and Tukey's test (α=0.05). Although at some death periods, collagen expression and number of blood vessels on irradiated animals were higher than in the control ones, no significant differences were found at any time in relation to TGF-ß expression (p>0.05). It was concluded that laser treatment (λ660 nm) contributed to increase angiogenesis.

Effect of Low-Level Laser Therapy (660 nm) on Angiogenesis in Wound Healing: A Immunohistochemical Study in a Rodent Model

The aim of the present investigation was to evaluate the angiogenesis on dorsal cutaneous wounds in a rodent model treated with λ660 nm laser light. New vessel formation is a multistep process involving vessel sprouting, endothelial cell migration, proliferation and tube formation. Although several in vivo studies have shown that laser phototherapy influences tissue repair, a fully understanding of angiogenesis mechanisms are not yet known. Twenty-four young adult male Wistar rats weighing between 200 and 250 g were used. Under general anesthesia, one excisional wound was created on the dorsum of each animal and they were randomly distributed into two groups: one control and one treated with laser (λ660 nm, 16 mW, 10 J/cm2). Each group was subdivided into three subgroups according to the animal death timing (2, 4 and 6 days). Laser irradiation started immediately after surgery and was repeated every other day during the experiment and marked with Sirius Red, specific for collagen, and immunomarked with anti-TGF-β and anti-von Willebrand factor. Marked sections underwent histological analysis by light microscopy and the mean area of the wound of each animal was calculated and analyzed by ANOVA and Tukey's test (α=0.05). Although at some death periods, collagen expression and number of blood vessels on irradiated animals were higher than in the control ones, no significant differences were found at any time in relation to TGF-β expression (p>0.05). It was concluded that laser treatment (λ660 nm) contributed to increase angiogenesis.

O objetivo do trabalho foi avaliar a angiogênese em feridas cutâneas no dorso de ratos tratados com o laser de λ660 nm. A neovascularização é um processo que envolve o aparecimento vascular, a migração das células endoteliais, a proliferação e a formação tubular. Embora diversos estudos in vivo demonstrem que a fototerapia laser influencia no reparo tecidual, uma compreensão completa dos mecanismos da angiogênese ainda não é conhecida. Foram utilizados 24 ratos Wistar novos, machos e adultos pesando entre 200 e 250 g. Uma ferida excisional foi criada no dorso de cada animal sob anestesia geral e os animais foram distribuídos aleatoriamente em dois grupos: G0 (controle) e G1 (laser λ660 nm, 16 mW, 10 J/cm2). Cada grupo foi subdividido em três subgrupos de acordo com o sincronismo da morte dos animais (2, 4 e 6 dias). A irradiação laser foi iniciada imediatamente após a cirurgia, sendo repetida diariamente durante a experiência, avaliada por meio de vermelho de Sirius, específico para o colágeno e avaliação imunológica com anti-TGF-β e o Fator anti-von Willebrand. As seções marcadas foram submetidas à análise histológica no foto-microscópio, onde a área média de cada subgrupo foi calculada e analisada usando o teste ANOVA e de Tukey (α=0,05). Os valores dos animais irradiados foram maiores em certos períodos da morte, na expressão do colágeno e no número de vasos em comparação com os grupos controles. Nenhuma diferença significativa foi encontrada na expressão do TGF-β entre os grupos nos períodos. Conclui-se que o tratamento com laser λ660 nm contribuiu para o aumento da angiogênese.

Orthokeratinized odontogenic cyst: a report of two cases in the mandible / Cisto odontogênico ortoqueratinizado: relato de dois casos em mandíbula

PURPOSE: To describe the behavior clinical and pathological features of two cases of odontogenic cyst orthokeratinized. CASE DESCRIPTION: In case 1, a 17-year-old woman presented hard and painless swelling in the left posterior mandible. Radiographically, a radiolucent area with a radiopaque was observed. A clinical diagnosis of ameloblastoma or odontogenic keratocystic tumor was established. The histopathological examination revealed an orthokeratinized odontogenic cyst. In case 2, a 23-year-old woman presented a radiolucent lesion surrounded by radiopaque halo symmetrically distributed on both partially erupted lower third molars. A clinical diagnosis of bilateral dentigerous cyst (DC) was rended. The histopathological examination showed bilateral orthokeratinized odontogenic cyst. CONCLUSION: Orthokeratinized odontogenic cyst should be considered in the differential diagnosis of lesions occurring in the jawbones associated with an impacted tooth, particularly those cases simulating dentigerous cyst. In addition, we observed the importance of radiographs taken prior to orthodontic treatment as an important tool in the diagnosis of oral pathologies. Performing routine radiograph is of high clinical value, especially before orthodontic treatment.

OBJETIVO: Descrever os aspectos clinicopatológicos de dois casos de cisto odontogênico ortoqueratinizado e a compará-los a relatos anteriores. RELATO DO CASO: No caso 1, uma mulher de 17 anos de idade, apresentou edema endurecido e indolor na mandíbula posterior esquerda. Radiograficamente, uma área radiolúcida com uma radiopacidade foi observada. O diagnóstico clínico de ameloblastoma ou tumor odontogênico ceratocístico foi estabelecido. O exame histopatológico revelou um cisto odontogênico ortoqueratinizado. No caso 2, uma mulher de 23 anos apresentou duas lesões radiolúcidas circundadas por halos radiopacos simetricamente distribuídas, associada aos terceiros molares inferiores irrompidos. Um diagnóstico clínico de cisto dentígero bilateral (DC) foi estabelecido. O exame histopatológico mostrou ser um cisto odontogênico ortoqueratinizado. CONCLUSÃO: Cisto odontogênico ortoqueratinizado deve ser considerado no diagnóstico diferencial das lesões que ocorrem na mandíbula associado com dentes impactados, especialmente aqueles casos que simulem o cisto dentígero. Além disso, observamos a importância de tomadas radiográficas antes do tratamento ortodôntico no diagnóstico de patologias bucais.

Effect of LED phototherapy (λ700 ± 20 nm) on TGF-ß expression during wound healing: an immunohistochemical study in a rodent model.

OBJECTIVE: The aim of the present investigation was to evaluate transforming growth factor ß (TGF-ß) expression on cutaneous wounds in rodents treated or not treated with LED light. BACKGROUND: TGF-ß is a multifunctional cytokine that presents a central action during tissue repair. Although several studies both in vitro and in vivo have shown that LED phototherapy influences tissue repair, a full understanding of the mechanisms involved in its usage, such as in the modulation of some growth factors, remains unclear. MATERIALS AND METHODS: Under general anesthesia, 24 young adult male Wistar rats weighing 200-250 g had one excisional wound created on the dorsum of each, and were randomly distributed into two groups: G0 (Control) and G1 (LED, λ700 ± 20 nm, 16 mW, SAEF = 5 J/cm(2), Illuminated Area = 2 cm(2), 8 mWcm(2), 626 s) Each group was subdivided into three subgroups according to the animal death timing (2, 4, and 6 days). LED phototherapy started immediately after surgery and was repeated every other day during the experimental time. Following animal death, specimens were removed, routinely processed to wax, cut and immunomarked with polyclonal anti-TGF-ß, and underwent histological analysis by light microscopy. The mean area of expression of each group was calculated. The data were statistically analyzed using ANOVA and Tukey's test. RESULTS: The area of the expression of TGF-ß on LED-irradiated animals was significantly smaller than on controls at day 2 (p = 0.013). No significant difference was found at later times. It is concluded that the use of LED light, at these specific parameters, caused an inhibition of the expression of TGF-ß at an early stage of the healing process.

Altered expression of cytokeratins in primary, recurrent and syndrome keratocystic odontogenic tumors.

Keratocystic odontogenic tumor (KOT) is a benign cystic tumor that affects the jaw bones and may be associated with the nevoid basal cell carcinoma syndrome (NBCCS). Twenty-five cases diagnosed as KOT, including primary and recurrent tumors and those associated with NBCCS, were submitted to immunohistochemical study for analysis of cytokeratins (CKs) 7, 8, 10, 13, 14, 18 and 19. The results showed CK13 immunostained on the intermediate layers and upper cells. CK14 was expressed in all epithelial layers and in those areas where inflammation and subepithelial splits were present; this protein was preserved within the basal cells. CK 18 was expressed mainly in the basal layer, whereas CK19 was expressed mainly on the intermediate and superficial layers. The remaining CKs tested were not immuoreactive. The status of maturation of cytokeratin seems to be altered on KOTs, and this is not distinct when different tumors are compared.

Association of TP53 mutation, p53 overexpression, and p53 codon 72 polymorphism with susceptibility to apoptosis in adult patients with diffuse astrocytomas.

Clarification of TP53 alterations is important to understand the mechanisms underlying the development of diffuse astrocytomas. It has been suggested that the alleles of TP53 at codon 72 differ in their ability to induce apoptosis in human cancers. The aim of this study was to analyze the possible association of TP53 mutation, p53 overexpression, and p53 codon 72 polymorphism with susceptibility to apoptosis in adult Brazilian patients with diffuse astrocytomas. We analyzed 56 surgical specimens of diffuse astrocytomas for alterations of TP53, using polymerase chain reaction single-strand conformation polymorphism (PCR-SSCP) direct sequencing. p53 and cleaved caspase 3 protein expression were assessed by immunohistochemistry. We found TP53 mutations in 19.6% (11 out of 56) of tumors tested, with the lowest mutation rate found in the cases of glioblastomas (8.8%) (p = 0.03). Only 16.1% of tumors tested showed cleaved caspase 3-positive staining, demonstrating that apoptosis is very inhibited in these tumors. All tumors having TP53 mutation and p53 accumulation had no expression of cleaved caspase 3. Additionally, no association was observed in tumors having proline and arginine alleles and expression of cleaved caspase 3. We concluded that clarification of the TP53 alterations allows a better understanding of the mechanisms involved in the progression of diffuse astrocytomas, and the allele status at codon 72 was not associated with apoptosis in these tumors.