Using conservative condylectomy for management of a large osteochondroma of the mandibular condyle with 6-year follow-up.

Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

Biomechanical evaluation of undersized drilling on implant biomechanical stability at early implantation times.

PURPOSE: The present study evaluated the effect of different drilling dimensions (undersized, regular, and oversized) in the insertion and removal torques of dental implants in a beagle dog model. METHODS: Six beagle dogs were acquired and subjected to bilateral surgeries in the radii 1 and 3 weeks before euthanasia. During surgery, 3 implants, 4 mm in diameter by 10 mm in length, were placed in bone sites drilled to 3.2 mm, 3.5 mm, and 3.8 mm in final diameter. The insertion and removal torque was recorded for all samples. Statistical analysis was performed by paired t tests for repeated measures and by t tests assuming unequal variances (all at the 95% level of significance). RESULTS: Overall, the insertion torque and removal torque levels obtained were inversely proportional to the drilling dimension, with a significant difference detected between the 3.2 mm and 3.5 mm relative to the 3.8 mm groups (P < 0.03). Although insertion torque-removal torque paired observations was statistically maintained for the 3.5 mm and 3.8 mm groups, a significant decrease in removal torque values relative to insertion torque levels was observed for the 3.2 mm group. A different pattern of healing and interfacial remodeling was observed for the different groups. CONCLUSIONS: Different drilling dimensions resulted in variations in insertion torque values (primary stability) and stability maintenance over the first weeks of bone healing.

Arthrocentesis procedure: using this therapeutic maneuver for TMJ closed lock management.

Temporomandibular joint (TMJ) disorder is a term that encompasses a number of overlapping conditions, such as closed lock. Closed lock of the TMJ is considered a consequence of a nonreducing deformed disc acting as an obstacle to the sliding condylar head that usually causes a decrease in the maximum mouth opening and acute pain. The management of the TMJ is still controversial. Thus, arthrocentesis of the TMJ is a valuable modification of the traditional method of arthroscopic lavage, which consists of washing the joint in order to remove chemical inflammatory mediators and intra-articular adhesions, changing intra-articular pressure. TMJ disorder has always presented as a therapeutic challenge to maxillofacial surgeons. Therefore, this paper aimed to describe a clinical report of a closed lock of the left TMJ in a 19-year-old female subject who was successfully treated by arthrocentesis procedure.

A novel simulador for agile and graphical modeling of surface plasmon resonance based sensors.

Surface plasmon resonance (SPR) sensor is a consolidated technology for analysis of biomolecular interaction, largely applied in biology and pharmaceutical research. The simulation of the surface plasmon optical excitation response is an important step in the development process of SPR based sensors. The structure, design and configuration of the desired sensor benefits from a previous simulated analyses of the generated responses, defining operational conditions and feasibility of the selected materials to composed the optical coupling layers. Here an online web-based SPR sensor's simulator is presented. With a visual-oriented interface, enable drag & drop actions to easily and quickly model a variety of sensor arrangements. Presenting an embedded materials database for metals, glasses, 2D materials, nanoparticles, polymers, and custom substances, the simulator enables flexible configuration for sensors operating in angular and spectral modes, as well as localized SPR. The light propagation through the multilayer of materials is presented in terms of Fresnel coefficients, which are graphically displayed. The so-called SPR morphology parameters can be visualized. Moreover, sensor dynamic behavior could be knowledge by a Sensorgram simulation. Localized surface plasmon resonance (LSPR) in homogeneous and spherical nanoparticles is also present in the simulator. Simulated scenario's in various configurations, designs and excitation were performed and compare with other simulator. The proposed simulator guarantees comparable results with low-code, agile, and intuitive flow of execution.

Effect of drilling dimension on implant placement torque and early osseointegration stages: an experimental study in dogs.

PURPOSE: Primary stability has been regarded as a key factor to ensure uneventful osseointegration of dental implants. Such stability is often achieved by placing implants in undersized drilled bone. The present study evaluated the effect of drilling dimensions in insertion torque and early implant osseointegration stages in a beagle dog model. MATERIALS AND METHODS: Six beagle dogs were acquired and subjected to bilateral surgeries in the radii 1 and 3 weeks before death. During surgery, 3 implants, 4 mm in diameter by 10 mm in length, were placed in bone sites drilled to 3.2 mm, 3.5 mm, and 3.8 mm in diameter. The insertion torque was recorded for all samples. After death, the implants in bone were nondecalcified processed and morphologically and morphometrically (bone-to-implant contact and bone area fraction occupancy) evaluated. Statistical analyses were performed using the Kruskal-Wallis test followed by Dunn's post hoc test for multiple comparisons at the 95% level of significance. RESULTS: The insertion torque levels obtained were inversely proportional to the drilling dimension, with a significant difference detected between the 3.2-mm and 3.8-mm groups (P = .003). Despite a significant increase in the bone-to-implant contact over time in vivo for all groups (P = .007), no effect for the drilling dimension was observed. Additionally, no effect of the drilling dimension and time was observed for the bone area fraction occupancy parameter (P = .31). The initial healing pathways differed between implants placed in bone drilled to different dimensions. CONCLUSIONS: Although different degrees of torque were observed with different drilling dimensions and these resulted in different healing patterns, no differences in the histometrically evaluated parameters were observed.

Hazard assessment of abraded thermoplastic composites reinforced with reduced graphene oxide.

Graphene-related materials (GRMs) are subject to intensive investigations and considerable progress has been made in recent years in terms of safety assessment. However, limited information is available concerning the hazard potential of GRM-containing products such as graphene-reinforced composites. In the present study, we conducted a comprehensive investigation of the potential biological effects of particles released through an abrasion process from reduced graphene oxide (rGO)-reinforced composites of polyamide 6 (PA6), a widely used engineered thermoplastic polymer, in comparison to as-produced rGO. First, a panel of well-established in vitro models, representative of the immune system and possible target organs such as the lungs, the gut, and the skin, was applied. Limited responses to PA6-rGO exposure were found in the different in vitro models. Only as-produced rGO induced substantial adverse effects, in particular in macrophages. Since inhalation of airborne materials is a key occupational concern, we then sought to test whether the in vitro responses noted for these materials would translate into adverse effects in vivo. To this end, the response at 1, 7 and 28 days after a single pulmonary exposure was evaluated in mice. In agreement with the in vitro data, PA6-rGO induced a modest and transient pulmonary inflammation, resolved by day 28. In contrast, rGO induced a longer-lasting, albeit moderate inflammation that did not lead to tissue remodeling within 28 days. Taken together, the present study suggests a negligible impact on human health under acute exposure conditions of GRM fillers such as rGO when released from composites at doses expected at the workplace.

SmartSPR sensor: Machine learning approaches to create intelligent surface plasmon based sensors.

Surface plasmon resonance (SPR) based sensors allow the evaluation of aqueous and gaseous solutions from real-time measurements of molecular interactions. The reliability of the response generated by a SPR sensor must be guaranteed, especially in substance detection, diagnoses, and other routine applications since poorly handled samples, instrumentation noise features, or even molecular tampering manipulations can lead to wrong interpretations. This work investigates the use of different machine learning (ML) techniques to deal with these issues, and aim to improve and attest to the quality of the real-time SPR responses so-called sensorgrams. A new strategy to describe a SPR-sensorgram is shown. The results of the proposed ML-approach allow the creation of intelligent SPR sensors to give a safe, reliable, and auditable analysis of sensorgram responses. Our arrangement can be embedded in an Intelligence Module that can classify sensorgrams and identify the substances presents in it. Also made it possible to order and analyze interest areas of sensorgrams, standardizing data, and supporting eventual audit procedures. With those intelligence features, the new generation of SPR-intelligent biosensors is qualifying to perform automated testing. A properly protocol for Leishmaniasis diagnosis with SPR was used to verify this new feature.

Incidência de sífilis no estado do Rio de Janeiro e nomunicípio de Seropédica nos anos de 2010 a 2022 / Incidence of syphilis in the state of Rio de Janeiro andmunicipality of Seropédica in the years 2010 to 2022

Sífilis é uma infecção sexualmente transmissível (IST) que sinaliza a necessidade de efetivas políticas públicas devido ao aumento de casos na última década. Dessa forma, o objetivo do trabalho é descrever a incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica. Métodos: foi realizado um estudo descritivo, com abordagem quantitativa. A coleta dos dados foi realizada por meio do Sistema de Informação de Agravos de Notificação (Sinan), referentes ao município de Seropédica e ao estado do Rio de Janeiro, no período de 2010 a 2022. Resultados: foram identificados 105.138, 79.609 e 42.819 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no estado do Rio de Janeiro e 187, 140 e 79 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no município de Seropédica. Foi observado uma incidência maior para sífilis adquirida entre homens em comparação com mulheres tanto no estado do Rio de Janeiro (62.719 versus 42.346) quanto no município de Seropédica (110 versus 77). Houve um aumento nas taxas de incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica ao longo dos anos. Conclusão: a sífilis segue sendo uma doença com alta incidência no território do Rio de Janeiro. Nesse sentido, é importante elaborar estratégias em saúde pública mais efetivas às pessoas acometidas por tal infecção.

Syphilis is a sexually transmitted infection (STI) that signals the need for effective public policies due to the increase in cases in the last decade. Thus, the aim of this study is to describe the incidence of syphilis in the state of Rio de Janeiro and in the municipality of Seropédica. Methods: a descriptive study with a quantitative approach was carried out. Data collection was performed through the Sistema de Informação de Agravos de Notificação (Sinan), referring to the municipality of Seropédica and the state of Rio de Janeiro, from 2010 to 2022. Results: overall, 105.138, 79.609 and 42.819 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the state of Rio de Janeiro, and 187, 140, and 79 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the municipality of Seropédica. A higher incidence of acquired syphilis was observed among men compared to women both in the state of Rio de Janeiro (62.719 versus 42.346) and in the municipality of Seropédica (110 versus 77). There has been an increase in the incidence rates of syphilis in the state of Rio de Janeiro and the municipality of Seropédica over the years. Conclusion: syphilis continues to be a disease with a high incidence in the territory of Rio de Janeiro. In this sense, it is important to develop more effective public health strategies for people affected by this infection.

Surface characterization, biomechanical, and histologic evaluation of alumina and bioactive resorbable blasting textured surfaces in titanium implant healing chambers: an experimental study in dogs.

PURPOSE: The present study was conducted to determine whether biomechanical and histologic parameters would differ between implant surfaces blasted with bioactive ceramic resorbable media (biologic blasting) and blasted with alumina and acid-etched. MATERIALS AND METHODS: Fourteen beagle dogs were used. Eight animals received two implants of each surface per limb, and each limb provided samples that remained in vivo for 3 and 6 weeks. The other six animals received two implants of each surface in one limb, which remained in vivo for 1 week. After euthanization, half of the implants were subjected to torque-to-interface fracture; the other half of the implants were processed for nondecalcified histology to calculate bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Statistical analysis was performed with the Kruskal-Wallis test (95% level of significance). RESULTS: While no significant differences were observed for BIC and BAFO between surfaces at all three times in vivo and for torque levels at 1 and 3 weeks, a significantly higher torque was observed for the biologic blasting group after 6 weeks in vivo. Bone morphology was similar between groups at all times. CONCLUSION: A significant increase in early biomechanical fixation was observed for implants with the biologic blasting surface. However, no significant differences were observed for BIC and BAFO at any observation point.

Implant biomechanical stability variation at early implantation times in vivo: an experimental study in dogs.

PURPOSE: To demonstrate the degree of stability decrease and subsequent increase of dental implants at early implantation times in a beagle model. MATERIALS AND METHODS: The mandibular premolars and first molars of eight beagle dogs were extracted and the ridges allowed to heal for 8 weeks. Thirty-two (n = 16 each group) implants were placed bilaterally, and remained in vivo for 1 and 3 weeks. The implants with comparable dimensions were divided as follows: group 1, Straumann Bone Level with SLActive surface; group 2, Nobel Speedy Replace RP with TiUnite surface. During insertion and following sacrifice, the implants were torqued to determine insertion and interface failure values. Histologic sections were prepared for microscopy. Statistical analysis was performed using Kruskal-Wallis and multiple paired and non-paired t tests considering unequal variances at a 95% level of significance. RESULTS: High insertion torque values were observed along with a significant decrease at 1 week in vivo (P = .003). At 3 weeks, the biomechanical fixation levels increased and were comparable to the insertion torque value. Histology showed that interfacial bone remodeling and initial woven bone formation was observed around both implant groups at 1 and 3 weeks. CONCLUSIONS: As time elapsed early after implantation, the biomechanical stability of dental implants initially decreased and subsequently increased.

Avaliação de risco à saúde humana do aterro controlado de Morretes / Human health risk assessment of the municipal solid waste landfill at Morretes

O presente trabalho teve por objetivo a avaliação do risco à saúde humana na área do aterro controlado de Morretes, Paraná, usando a metodologia RBCA. Realizou-se uma avaliação de risco determinística, considerando-se três cenários de exposição e três vias de exposição: ingestão de água subterrânea, exposição ao solo superficial e inalação de vapores e partículas em ambientes abertos. Os resultados mostraram maiores valores de índices de risco e de perigo para o cenário de exposição local (on site). Procedeu-se ainda a uma avaliação de risco probabilística para avaliar o efeito da correlação entre massa corporal e taxa de ingestão de água e entre massa corporal e taxa de inalação de ar sobre a distribuição de freqüência dos riscos. Os resultados mostraram que a adoção da hipótese de independência entre as variáveis conduz a decisões mais conservadoras.

This paper presents the human health risk assessment of a municipal solid waste landfill, located at Morretes, Paraná State, Brazil, using the RBCA methodology. It was performed a deterministic risk assessment, considering three receptors and three exposure pathways: groundwater ingestion, exposure to surface soil and outdoor inhalation of vapors and particulates. The results showed higher values of risk and hazard indexes for the on-site receptor. It was also performed a probabilistic risk assessment in order to evaluate the effect of both body mass and water ingestion rate correlation and body mass and air inhalation rate correlation on the risk frequency distributions. The results showed that using the hypothesis of independence between the variables leads to a more conservative decisions.

Avaliação da correlação entre as concentrações de poluentes atmosféricos e a mortalidade de idosos no município de Curitiba / Evaluation of the correlation between atmospheric pollutant concentrations and elderly mortality in Curitiba

Este estudo tem por objetivo verificar as associações de curto prazo entre as concentrações de poluentes atmosféricos e a mortalidade de idosos no município de Curitiba (PR). O período de análise compreendeu os anos de 2003 a 2008. Foram realizadas análises de correlação simples e de regressão múltipla, utilizando-se um modelo aditivo generalizado (MAG), para avaliar as relações entre os poluentes dióxido de enxofre (SO2), ozônio (O3) e partículas totais em suspensão (PTS) e o número de óbitos totais (ObT) e por doenças respiratórias (ObR) de pessoas com idade superior a 60 anos. Os resultados obtidos mostraram relações positivas e estatisticamente significativas entre os níveis de PTS e a mortalidade de idosos por todas as causas (ObT), mesmo considerando-se que os níveis de PTS atenderam aos padrões de qualidade do ar para o período em estudo.

This study aims to analyze the short-term association between concentration of atmospheric pollutants and the mortality of elderly in the city of Curitiba (Brazil). The data comprised the period from 2003 to 2008. The relationships between the pollutants sulfur dioxide (SO2), ozone (O3) and total suspended particles (TSP) and the number of total deaths (ObT) and deaths due to respiratory deceases (ObR) of people aged over 60 years were investigated with simple correlation and multiple regression analyses, using a generalized additive model (GAM). The results showed a positive and statistically significant relationship between TSP concentrations and elderly mortality from all causes (ObT), even considering that TSP concentrations met the air quality standards during the period of study.

Simulação das emissões atmosféricas sobre o município de Araucária com uso do modelo AERMOD / Simulation of atmospheric emissions over Araucaria municipality using the AERMOD model

O objetivo do presente trabalho foi avaliar o uso de um modelo computacional de dispersão de poluentes em meio atmosférico, modelo AERMOD, na modelagem da dispersão das emissões atmosféricas produzidas pelas principais indústrias do município de Araucária. Os dados estimados de emissões de poluentes na atmosfera referem-se às fontes estacionárias da refinaria Presidente Getúlio Vargas (REPAR) e das principais indústrias que compõem o distrito industrial de Araucária. Não foram utilizados dados das fontes móveis por representarem uma pequena parcela da carga total de poluentes. Inicialmente, o modelo AERMOD foi avaliado pela comparação entre concentrações simuladas e concentrações observadas de óxidos de nitrogênio (NOx), óxidos de enxofre (SOx) monóxido de carbono (CO) e materiais particulados (MP) na estação de amostragem de qualidade do ar existente na REPAR. Realizou-se uma análise de sensibilidade do modelo AERMOD em diferentes cenários de emissões, procurando avaliar a influência da variação dos parâmetros de entrada do modelo sobre as concentrações simuladas para a estação REPAR e para a região central do município de Araucária.

The present paper aims to evaluate the use of the air quality model AERMOD to simulate the dispersion of atmospheric emissions produced by the main industries located in the Araucária municipality area. Pollutant emissions were estimated for both stationary sources in the President Getúlio Vargas Refinery (REPAR) and stationary sources in the main industries located at the industrial district of Araucária municipality. As the pollutant emissions from mobile sources are small in comparison to stationary sources, the simulations were performed using only emissions from the stationary sources. Initially, the AERMOD model was evaluated by comparing simulated concentrations and observed concentrations from the air quality station located inside the REPAR. The observed data concerns the following pollutants: nitrogen oxides (NOx), sulfur oxides (SOx), carbon monoxide (CO) and particulate matter (MP). A sensitivity analysis was performed to evaluate the influence of input data variations on the simulated concentrations for two air quality stations located at REPAR and downtown Araucária.

Miíase na cavidade bucal em paciente geriátrico: relato de caso / Myiasis in the oral cavity in the geriatric patient: case report

Pacientes geriátricos que apresentam comprometimento sistêmico severo muitas vezes necessitam de cuidados especiais. A limitação da atividade motora pode estar relacionada com as diversas condições médicas que acometem esses pacientes. O acidente vascular cerebral pode causar sequelas graves como, por exemplo, o comprometimento da motricidade do indivíduo. Neste relato, apresentamos um caso clínico de um paciente geriátrico com importante comprometimento da atividade motora, decorrente de um acidente vascular cerebral, acometido por miíase oral, devido à falta de cuidados específicos.

Geriatric patients who have severe systemic involvement often require special care. The limitation of motor activity may be related to several medical conditions that affect thesepatients. Stroke can be cause serious sequelae, such as motor impairment of the individual. Here we report a case of a geriatric patient with a significant impairment of motor activity, resulting from a stroke, affected by oral myiasis due to lack of specific care.

Erro médico: reflexöes / Medical errors: reflections

Destaca os aspectos históricos do "Erro Médico", relata suas formas, seus conceitos mais antigos e atuais, chamando a atençäo principalmente para os fatores que concorrem para o mau resultado. Chama a atençäo ainda para a visäo amarga do doente sobre o "Erro Médico" no tocante à qualidade e à quantidade do dano produzido, além de apontar a juridicidade da questäo, tentando separar o que é erro médico e o que näo se pode entender como tal, principalmente levando em conta a exploraçäo dos meios de comunicaçäo

Euthanasia / Euthanasia

Reflexöes sobre a eutanasia e comentários sobre uma publicaçäo dos anos 30: um ensaio médico-social assinado por Januario Cicco provavelmente médico, que discute pela primeira vez no país um tema considerado maldito e até insolente para a época. O mesmo desfila com muita habilidade argumentos favoráveis e contrários, apresentados na engenhosa forma de um romance que se desenrola através da técnica do diálogo, a exemplo da obra reflexiva de Platäo. O livro pöe em evidência histórias sobre a saga dos moribundos, cenas ocorridas há mais de meio século no tenebroso cenário das Santas Casas de Misericórdia, naquele tempo verdadeiros depósitos de infelizes. Januario Cicco se inclina, ao fim da obra, pela aceitaçäo da eutanásia como forma piedosa de abreviar sofrimentos insuportáveis em pacientes terminais. Sua tese final é de que o médico baseado, em rígidos critérios deve atuar como a extensäo terrestre da misericórdia divina

Tecnologia: como avançar no conhecimento sem prejuízo da relação médico-paciente? / Technology: how to put knowledge forward without a damage to the relationship between doctor-patient

O autor faz um apanhado histórico sobre a introdução do conhecimento organizado no âmbito da saúde, discorre sobre os benefícios introduzidos no cuidado ao semelhante ao longo da história da medicina e os efeitos adversos decorrentes da intermediação tecnológica, do uso abusivo da ciência ou descuido humanitário em favor do instrumental técnico com repercussões na relação médico-paciente (M/P); aponta as principais desvantagens e perfila recomendações ético-normativas essenciais à preservação do escopo humanitário da medicina como profissão erudita, arte e ofício.

The author makes a brief historical overview about the introduction of knowledge in the field of health care; he describes those benefits which were introduced to the care of human being throughout the history of Medicine as well as the adverse effects from the technological intermediation, the abusive use of science or the lack of humanitarian care in favor of the technical instruments affecting negatively the relationship doctor-patient; he also points out the disadvantages of that process and gives ethical and normative recommendations that he considers essentials to the preservation of the humanitarian scope of medicine as an erudite profession, an art and a duty.

Perdas e danos no exercício das profissões de saúde e o dever de indenizar / Damaging in the exercise of the healt profession and the duty of reimbursing

O autor discorre sobre o conceito de responsabilidade do profissional de saúde inerente à perda de uma ou mais possibilidades de cura ou sobrevivência do paciente por ação hipossuficiente ou negligência; aponta as modalidades dessa conduta à luz dos efeitos adversos tardios e define a responsabilidade da indenização consoante nova jurisprudência sob inspiração dos tribunais de França.