Exuberant case of verrucous cutaneous leishmaniasis

Abstract Cutaneous leishmaniasis represents a public health problem that affects 85 countries. It is an endemic disease in Brazil, having an important socioeconomic impact. An exuberant case of cutaneous leishmaniasis is reported herein. A 28-year-old male patient with Down syndrome had had verrucous plaques on the back for over a year, with progressive growth. PCR of a lesion sample was positive for Leishmania braziliensis. The patient's condition was classified as atypical cutaneous leishmaniasis. He was successfully treated with amphotericin B and miltefosine. The treatment remains a challenge, given the toxicity and low cure rate of the currently recommended drugs.

Ultrasound-guided peripheral abdominal wall blocks

The practice of regional anesthesia is in a state of progressive evolution, mainly due to the advent of ultrasound as an anesthesiologist's instrument. Alternative techniques for postoperative analgesia of abdominal surgeries, such as transversus abdominis plane block, oblique subcostal transversus abdominis plane block, rectus abdominis muscle sheath block, ilioinguinal and iliohypogastric nerve block, and quadratus lumborum plane block, have proven useful, with good analgesic efficacy, especially when neuroaxial techniques (spinal anesthesia or epidural anesthesia) are not possible. This review discusses such blockades in detail, including the anatomical principles, indications, techniques, and potential complications.

Biomecânica da língua durante a deglutição após laringectomia total: revisão integrativa / Biomechanics of the tongue during swallowing after total laryngectomy: an integrative review

RESUMO Objetivo Sintetizar o estado do conhecimento científico sobre biomecânica da língua durante a deglutição após laringectomia total. Estratégia de pesquisa Formulou-se a questão PICO e combinações de descritores e termos livres para busca nas bases de dados PubMed/Medline, EMBASE, LILACS e SciELO. Critérios de seleção incluíram-se artigos nos idiomas português, inglês ou espanhol; sem limite de tempo; com resultados sobre a biomecânica da língua durante a deglutição em laringectomizados totais; e estudos do tipo ensaio clínico randomizado ou não randomizado, coorte, caso controle, transversal, série de casos e estudos de caso. Análise dos dados analisou-se ano, país, população, objetivo, delineamento do estudo, instrumentos de avaliação, principais desfechos e qualidade metodológica. Resultados Foram incluídos quatro estudos realizados nos Estados Unidos, um na Austrália e um no Brasil, publicados entre 1986 e 2014. Em todos os estudos incluídos a biomecânica da língua foi um desfecho secundário. A maioria dos artigos teve baixa qualidade metodológica, com amostras pequenas, predomínio do sexo masculino e desenho transversal prevalente. Os instrumentos de avaliação foram videofluoroscopia, manometria, acelerômetro ou dispositivo para captar pressão de língua. Resultados principais indicaram mais força de propulsão da base de língua para superar a alta resistência da neofaringe ao fluxo do bolo alimentar; redução do contato e pressão entre base de língua e parede posterior da faringe; resíduo em base de língua após deglutição; pressão aumentada e resistência reduzida da língua oral. Conclusão Existem indícios de movimentos compensatórios de língua durante a deglutição após laringectomia total, porém, as evidências científicas são insuficientes.

ABSTRACT Purpose To synthesize the state of scientific knowledge about biomechanics of the tongue during swallowing after total laryngectomy. Research strategy The PICO question and combinations of descriptors and single terms were formulated in the PubMed/Medline, EMBASE, LILACS, and SciELO databases. Selection criteria Articles in Portuguese, English, or Spanish were included, without time limit, with results on the biomechanics of the tongue during swallowing and total laryngectomy, and studies on randomized or non-randomized clinical trials, cohort, case control, cross-sectional, case series, and case studies. Data analysis year, country, population, objective, study design, assessment methods, main outcomes, and methodological quality were analyzed. Results There were four studies in the United States, one in Australia, and one in Brazil, all published between 1986 and 2014. In all studies, the biomechanics of the tongue was the secondary outcome. Most articles had low methodological quality, small samples, predominance of the male gender, and a prevalent cross-sectional design. The assessment instruments were fluoroscopy, manometry, accelerometer or a device to capture tongue pressure. Main results indicated a higher propulsion force of the tongue base to overcome the high resistance of the neopharynx to the bolus flow, reduced contact and pressure between the base of the tongue and the posterior pharyngeal wall, residues in the tongue base after swallowing, increased pressure, and reduced resistance of the oral tongue. Conclusion There are indications of compensatory tongue movements during swallowing after total laryngectomy; however, the scientific evidence is insufficient.

COVID-19 e disfagia: guia prático para atendimento hospitalar seguro - número 1 / COVID-19 and dysphagia: practical guide to safe hospital care - number 1

RESUMO A pandemia da COVID-19 é associada com o novo tipo do coronavírus, o SARS-Cov-2, que causa síndrome respiratória aguda grave. Esse vírus afeta o trato respiratório superior e é transmitido, principalmente, por gotículas, espirros e aerossóis e, por isso, há um alto risco de transmissão durante os procedimentos do fonoaudiólogo que atua no ambiente hospitalar. O objetivo deste artigo foi descrever as iniciativas que podem ser adotadas pelo fonoaudiólogo que atende pacientes à beira do leito, com disfagia, visando diminuir o risco de contaminação cruzada na prática clínica durante a pandemia do SARS-CoV-2.

ABSTRACT The COVID-19 pandemic is associated with a new strain of coronavirus, SARS-Cov-2, which causes severe acute respiratory syndrome. This virus affects the upper respiratory tract and is transmitted mainly by droplets, sneezes and aerosols, so there is a high risk of transmission during the procedures of the speech therapist who works in the hospital environment. This article aims to describe the steps that can be taken by the speech therapist who attends bedside patients with dysphagia, to reduce the risk of cross-contamination in clinical practice during the COVID-19 pandemic.

3' untranslated region A>C (rs3212227) polymorphism of Interleukin 12B gene as a potential risk factor for Hodgkin's lymphoma in Brazilian children and adolescents.

Interleukin 12 plays an important role in immunoregulation between the T helper 1/T helper 2 lymphocytes and in the antiviral and antitumor immune response. The aim of this study was to investigate the possible association between the interleukin 12B polymorphism rs3212227 and the risk to develop Hodgkin's lymphoma in childhood and adolescents. A total of 100 patients with Hodgkin's lymphoma and a group of 181 healthy controls were selected at random from a forensic laboratory of the University of Pernambuco. The AA genotype was detected in the controls (53.04%) and the AC genotype was found in the patients (54%). The AC genotype showed an association with the development of Hodgkin's lymphoma (odds ratio = 2.091, 95% confidence interval = 1.240-3.523, p = 0.007). When AC + CC genotypes were analyzed together, an increase in risk of 1.9 times more chances for HL development could be observed (odds ratio = 1.923, 95% confidence interval = 1.166-3.170, p = 0.014). However, there was no association between the AC and CC genotypes of the interleukin 12B polymorphism with the clinical risk group (p = 0.992, p = 0.648, respectively). Our results suggest that the presence of the C allele may be contributing to the development of Hodgkin's lymphoma in children and adolescents.

Laparoscopic nephrectomy for urolithiasis: when is better to avoid it. / Nefrectomia laparoscópica por nefrolitíase: quando é melhor evitar.

OBJECTIVE: to investigate the risk factors for conversion to open surgery in laparoscopic nephrectomy (LN) for urolithiasis. METHODS: we reviewed data on all patients over 18 years of age submitted to LN between January 2006 and May 2013 at our institution. We analyzed the Charlson's index, the ASA score, renal function by the equation and stage of MDRD (Modification of Diet in Renal Disease), preoperative computed tomography (CT) findings, complications by the Clavien-Dindo classification and conversion rate. We used logistic regression analysis to determine the risk factors for conversion. RESULTS: eighty-four patients underwent LN, 16 (19%) sustaining convertion to open surgery due to the strong adhesion of the renal hilum to the adjacent organs. Other causes associated with conversion were excessive bleeding (n=6) and lesion of the large intestine (n=3). In the univariate analysis, previous renal surgery, perirenal fat blurring, renal abscess, perirenal abscess, pararenal abscess, fistula, adherence to the liver or spleen, and adherence to the intestine were associated with conversion. In the multivariate analysis, pararenal abscess and adherence to the intestine were significant risk factors for conversion. CONCLUSION: pararenal abscess and bowel adhesions demonstrated in the preoperative CT are risk factors for conversion to open surgery in LN due to urolithiasis.

OBJETIVO: investigar os fatores de risco de conversão para cirurgia aberta na nefrectomia laparoscópica (NL) para urolitíase. MÉTODOS: foram revisados os dados de todos os pacientes maiores de 18 anos de idade submetidos à NL entre janeiro de 2006 e maio de 2013 em nossa Instituição. Índice de Charlson, escore ASA, função renal pela equação e estágio de MDRD (Modification of Diet in Renal Disease), achados de tomografia computadorizada (TC) pré-operatória, complicações pela classificação de Clavien-Dindo e taxa de conversão foram analisados. Determinaram-se os fatores de risco para conversão por meio de regressão logística. RESULTADOS: oitenta e quatro pacientes foram submetidos à LN, sendo que 16 (19%) tiveram seu procedimento convertido para cirurgia aberta devido à forte aderência do hilo renal aos órgãos adjacentes. Outras causas associadas à conversão foram sangramento excessivo (n=6) e lesão do intestino grosso (n=3). Na análise univariada, cirurgia renal prévia, borramento da gordura perirrenal, abscesso renal, abscesso perirrenal, abscesso pararrenal, fístula, aderência ao fígado ou baço e aderência ao intestino foram associados à conversão. Na análise multivariada, abscesso pararrenal e aderência ao intestino foram fatores de risco significativos para a conversão. CONCLUSÃO: abscesso pararrenal e aderência ao intestino demonstrados na TC pré-operatória são fatores de risco de conversão para cirurgia aberta em LN por urolitíase.

Low Dose Fluoroscopy During Ureteroscopy Does Not Compromise Surgical Outcomes.

Objective: To evaluate whether reducing the dose of fluoroscopy to » of standard dose during unilateral ureteroscopy for ureteral stone treatment would impact in a reduction of total radiation emitted and whether this strategy would impact operation time, stone-free rate, and complication rate. Methods: From August 2016 to August 2017, patients over 18 years submitted to ureteroscopy for ureteral stone between 5 and 20 mm were prospectively randomized for » dose reduction or standard dose fluoroscopy. Patients with abnormal urinary anatomy such as horseshoe kidney, pelvic kidney, or duplex system were excluded from the study. Results: Ninety-four patients were enrolled. The fluoroscopic dose reduction strategy to » of the standard dose was able to significantly reduce the cumulative radiation emitted by C-arm fluoroscopy and the dose area product (3.6 ± 4.5 mGy vs 16.2 ± 19.3 mGy, p = 0.0001 and 0.23 ± 0.52 mcGycm2vs 1.15 ± 2.74 mcGycm2, p = 0.02, respectively). Fluoroscopy time was similar between groups (74.5 ± 84.8 seconds vs 88.3 ± 90 seconds, p = 0.44). There was no need to increase the fluoroscopy dose during any of the procedures. Surgical outcomes were not affected by fluoroscopic dose reduction strategy. Conclusion: Low dose fluoroscopy reduces the emitted radiation during ureteroscopy without compromising surgical outcomes.

Predictors of surgical complications of nephrectomy for urolithiasis

ABSTRACT Objectives: Nephrectomy due to stone disease may be a challenging procedure owing to the presence of significant inflammation and infection, involving high complication rate. The objective of our study was to identify predictors for complications of nephrectomy for urolithiasis. Patients and Methods: A retrospective review of 149 consecutive patients > 18y submitted to simple nephrectomy for urolithiasis from January 2006 to July 2012 was performed. Clinical data, computed tomography findings and pathology report were analyzed. Postoperative complications were categorized based on Clavien - Dindo classification. Logistic multivariate regression models assessed the predictors for surgical complications of nephrectomy for urolithiasis. Results: Eighty-three (55.7%) patients were submitted to laparoscopic nephrectomy and 66 (44.2%) to open procedure. Conversion to open surgery was necessary in 19.2% (16 / 83). On univariable analysis, higher preoperative chronic kidney stage (p = 0.02), Charlson comorbidity index ≥ 2 (p = 0.04), higher ASA score (p = 0.001), urgency due to sepsis (p = 0.01), kidney size ≥ 12 cm (p = 0.006), renal and perirenal abscess (p = 0.004 and 0.002 respectively) and visceral adhesion (p = 0.04) were associated with Clavien - Dindo score > 1. On multivariate analysis, higher ASA score (p = 0.01), urgency due to sepsis (p = 0.03), kidney size ≥ 12 cm (p = 0.04) and preoperative abscess (p = 0.04) remained significantly associated with complications. End - stage renal disease with dialysis was needed post - operatively in 3.4% (5 / 144) of patients. Conclusions: We identified that higher ASA score, urgency due to sepsis, kidney size ≥ 12 cm and preoperative abscess were associated with Clavien - Dindo score > 1.

Predictors of surgical complications of nephrectomy for urolithiasis.

OBJECTIVES: Nephrectomy due to stone disease may be a challenging procedure owing to the presence of significant inflammation and infection, involving high complication rate. The objective of our study was to identify predictors for complications of nephrectomy for urolithiasis. PATIENTS AND METHODS: A retrospective review of 149 consecutive patients > 18y submitted to simple nephrectomy for urolithiasis from January 2006 to July 2012 was performed. Clinical data, computed tomography findings and pathology report were analyzed. Postoperative complications were categorized based on Clavien - Dindo classification. Logistic multivariate regression models assessed the predictors for surgical complications of nephrectomy for urolithiasis. RESULTS: Eighty-three (55.7%) patients were submitted to laparoscopic nephrectomy and 66 (44.2%) to open procedure. Conversion to open surgery was necessary in 19.2% (16 / 83). On univariable analysis, higher preoperative chronic kidney stage (p = 0.02), Charlson comorbidity index ≥ 2 (p = 0.04), higher ASA score (p = 0.001), urgency due to sepsis (p = 0.01), kidney size ≥ 12 cm (p = 0.006), renal and perirenal abscess (p = 0.004 and 0.002 respectively) and visceral adhesion (p = 0.04) were associated with Clavien - Dindo score > 1. On multivariate analysis, higher ASA score (p = 0.01), urgency due to sepsis (p = 0.03), kidney size ≥ 12 cm (p = 0.04) and preoperative abscess (p = 0.04) remained significantly associated with complications. End - stage renal disease with dialysis was needed post - operatively in 3.4% (5 / 144) of patients. CONCLUSIONS: We identified that higher ASA score, urgency due to sepsis, kidney size ≥ 12 cm and preoperative abscess were associated with Clavien - Dindo score > 1.

Nefrectomia laparoscópica por nefrolitíase: quando é melhor evitar / Laparoscopic nephrectomy for urolithiasis: when is better to avoid it

RESUMO Objetivo: investigar os fatores de risco de conversão para cirurgia aberta na nefrectomia laparoscópica (NL) para urolitíase. Métodos: foram revisados os dados de todos os pacientes maiores de 18 anos de idade submetidos à NL entre janeiro de 2006 e maio de 2013 em nossa Instituição. Índice de Charlson, escore ASA, função renal pela equação e estágio de MDRD (Modification of Diet in Renal Disease), achados de tomografia computadorizada (TC) pré-operatória, complicações pela classificação de Clavien-Dindo e taxa de conversão foram analisados. Determinaram-se os fatores de risco para conversão por meio de regressão logística. Resultados: oitenta e quatro pacientes foram submetidos à LN, sendo que 16 (19%) tiveram seu procedimento convertido para cirurgia aberta devido à forte aderência do hilo renal aos órgãos adjacentes. Outras causas associadas à conversão foram sangramento excessivo (n=6) e lesão do intestino grosso (n=3). Na análise univariada, cirurgia renal prévia, borramento da gordura perirrenal, abscesso renal, abscesso perirrenal, abscesso pararrenal, fístula, aderência ao fígado ou baço e aderência ao intestino foram associados à conversão. Na análise multivariada, abscesso pararrenal e aderência ao intestino foram fatores de risco significativos para a conversão. Conclusão: abscesso pararrenal e aderência ao intestino demonstrados na TC pré-operatória são fatores de risco de conversão para cirurgia aberta em LN por urolitíase.

ABSTRACT Objective: to investigate the risk factors for conversion to open surgery in laparoscopic nephrectomy (LN) for urolithiasis. Methods: we reviewed data on all patients over 18 years of age submitted to LN between January 2006 and May 2013 at our institution. We analyzed the Charlson's index, the ASA score, renal function by the equation and stage of MDRD (Modification of Diet in Renal Disease), preoperative computed tomography (CT) findings, complications by the Clavien-Dindo classification and conversion rate. We used logistic regression analysis to determine the risk factors for conversion. Results: eighty-four patients underwent LN, 16 (19%) sustaining convertion to open surgery due to the strong adhesion of the renal hilum to the adjacent organs. Other causes associated with conversion were excessive bleeding (n=6) and lesion of the large intestine (n=3). In the univariate analysis, previous renal surgery, perirenal fat blurring, renal abscess, perirenal abscess, pararenal abscess, fistula, adherence to the liver or spleen, and adherence to the intestine were associated with conversion. In the multivariate analysis, pararenal abscess and adherence to the intestine were significant risk factors for conversion. Conclusion: pararenal abscess and bowel adhesions demonstrated in the preoperative CT are risk factors for conversion to open surgery in LN due to urolithiasis.

Microbial investigation of biofilms recovered from endotracheal tubes using sonication in intensive care unit pediatric patients

Abstract Objectives To compare cultured microorganisms identified on endotracheal tubes biofilms through sonication technique with traditional tracheal aspirate collected at extubation of pediatric intensive care unit patients. Methods Demographic and epidemiological data were analyzed to identify factors possibly related with the microbiological profile of the two collection methods. Associations between categorical and continuous variables were analyzed using the chi-square or Fisher's exact test, or Student's t test. p-Value <0.05 were considered significant. Results Thirty endotracheal tubes and tracheal aspirates samples from 27 subjects were analyzed. Only one patient presented the clinical diagnosis of ventilator-associated pneumonia. Overall, 50% of bacteria were Gram-negative bacilli, followed by Gram-positive bacteria in 37%, and fungi in 10%. No statistically significant difference on the distribution of Gram-positive or Gram-negative bacteria (p = 0.996), and fungi (p = 0.985) were observed between the collection methods. Pseudomonas spp. was the most frequent microorganism identified (23.8%), followed by Streptococcus spp. (18.5%), Acinetobacter spp. (15.9%), coagulase-negative staphylococci (11.2%), and Klebsiella spp. (8.6%). Concordant results between methods amounted to 83.3%. Pseudomonas aeruginosa and Acinetobacter baumannii showed carbapenem resistance in 50% and 43.7% of the isolates, respectively. In general, cultures after endotracheal tubes sonication (non-centrifuged sonication fluid and centrifuged sonication fluid) yielded bacteria with higher rates of antimicrobial resistance compared to tracheal aspirates cultures. Additionally, in 12 subjects (40%), we observed discrepancies regarding microbiologic profiles of cultures performed using the collection methods. Conclusions Our study demonstrated that sonication technique can be applied to ET biofilms to identify microorganisms attached to their surface with a great variety of species identified. However, we did not find significant differences in comparison with the traditional tracheal aspirate culture approach.

Serial structural MRI evaluation of arthroscopy rotator cuff repair: does Sugaya's classification correlate with the postoperative clinical outcomes?

INTRODUCTION: Sugaya's classification is the most commonly used for postoperative evaluation of rotator cuff repairs. However, the correlation between this classification and clinical outcomes after supraspinatus tendon repair were not performed with serial MRI examinations in standardized time intervals. MATERIALS AND METHODS: This prospective case series involved 54 patients undergoing repair of the supraspinatus tendon tear. Magnetic resonance imaging (MRI, 1.5 T) was used to determine the Sugaya's classifications at 3, 6, and 12 months, and these data were correlated with the visual analog scale for pain (VAS), Constant and University of California at Los Angeles (UCLA) assessments. RESULTS: Patients with types I, II, and ≥III of Sugaya's classification experienced pain of 1.27 ± 1.95, 1.00 ± 1.40, and 3.43 ± 3.36, respectively (p = 0.010), according to the VAS. The Constant and UCLA scales did not differ significantly. Type II predominated, though their percentage decreased over time (from 77.8 to 66.7 %), whereas type I became more frequent (from 1.9 to 20.4 %). CONCLUSIONS: The pain was more intense in patients classified as types III, IV, or V of Sugaya's classification. The postoperative appearance of the supraspinatus tendon was not correlated with the Constant and UCLA scales. The occurrence of type II, the most prevalent, decreased over time, whereas the occurrence of type I increased; these differences were not significant. Level de evidence: prospective cohort evaluation-level III.

Tunnel collision during simultaneous anterior cruciate ligament and posterolateral corner reconstruction.

PURPOSE: To verify the safest angle to drill femoral tunnels in simultaneous anterior cruciate ligament (ACL) and posterolateral corner (PLC) reconstructions to minimize the risk of tunnel collision and to examine the relationship between lateral femoral condyle (LFC) width and tunnel collision occurrence. METHODS: Ten fresh-frozen cadaveric knees were used. In each knee, anatomical single-bundle ACL femoral tunnels were arthroscopically drilled at 120 and 140 degrees of flexion, and tunnels for popliteus tendon (PLT) and fibular collateral ligament (FCL) were drilled at 20° axial/20° coronal angulations and 10° axial/30° coronal angulations. Three-dimensional computed tomography exams of the knees were performed. The presence of tunnel collision was evaluated, and the minimal distance between tunnels and the LFC width was measured. RESULTS: Risk of tunnel collision was significantly increased if FCL and PLT tunnels were drilled at 10° axial/30° coronal angulation (P < 0.05). Tunnel collision was noted in only one knee when FCL and PLT tunnels were drilled at 20° axial/20° coronal angulations. Knees with smaller LFC width had significantly higher risk for tunnel collision (P < 0.05). CONCLUSION: Drilling PLT and FCL femoral tunnels at 20° axial/20° coronal angulation is a safe positioning for simultaneous ACL and PLC reconstructions. However, in smaller knees, the risk for tunnel collision could be greater. Surgeons should consider the possibility of tunnel collision when performing simultaneous ACL and PLC anatomical reconstruction, especially in knees with a small LFC width where the risk for tunnel collision could be greater.

Avaliação do perfil periodontal dos pacientes atendidos na Faculdade de Odontologia da Unievangélica / Periodontal assessment profile of patients treated in the College of Dentistry UniEVANGÉLICA / Periodontal assessment profile of patients treated in the College of Dentistry UniEVANGÉLICA

INTRODUÇÃO: A Doença Periodontal é caracterizada por uma doença infecciosa resultante da inflamação dos tecidos de suporte e do tecido de revestimento dos dentes. Esta pode ser classificada em: gengivite quando compromete o periodonto de proteção e periodontite que acomete os tecidos de inserção. OBJETIVO: Este estudo teve como objetivo verificar o perfil periodontal dos pacientes atendidos na Faculdade de Odontologia da UniEVANGÉLICA, Anápolis- GO. MATERIAL E MÉTODO: Esta pesquisa documental descritiva retrospectiva avaliou prontuários de pacientes atendidos na clínica da Faculdade de Odontologia da UniEVANGÉLICA no período de 2009 a 2014. Nos prontuários foram analisados principalmente o Registro Periodontal Simplificado (PSR), a classificação da doença periodontal e o periograma dos pacientes que apresentaram periodontite. RESULTADOS: Dentre os 233 prontuários, 68% (n = 158) eram mulheres, 33,05% (n = 77) tinham entre 40 e 50 anos e 21% (n = 51) eram fumantes. Destes, 55 % (n = 129) possuíam gengivite e 45% (n=104) periodontite. Dos pacientes com periodontite, a Crônica Localizada foi constatada em 48% (n = 50), a Crônica Generalizada em 40% (n = 42), enquanto as Agressivas Localizada e Generalizada foram encontradas em 7% (n = 7) e 5% (n = 5) respectivamente. Pelos dados do PSR, pode-se observar que 49% (n = 114) apresentaram o código asterisco. CONCLUSÃO: De acordo com os resultados obtidos nesta pesquisa, pode-se notar uma prevalência de pacientes do gênero feminino e a gengivite foi a doença periodontal mais prevalente seguida pela periodontite crônica localizada.

INTRODUCTION: The Periodontal Disease is characterized by an infectious disease resulted from the inflammation of covering tissues (gingivitis) and/or of the support tissue (periodontitis) of teeth. OBJECTIVE: The objective of this study was to verify the periodontal profile of the patients attended at UniEVANGÉLICA’S Dental School. MATERIAL AND METHOD: This is a descriptive documental and retrospective research that evaluated the records of the patients that were attended at UniEvangélica’s Dental School clinic from 2009 to 2014. The Periodontal Screening and Record (PSR), the periodontal disease’s classification and the periodontal chart of the patients that presented periodontitis were the main analysis performed from the records. RESULTS: Among the 233 records, 68% (n=158) were women, 33,05% (n=77) among 40 to 50 years old and 21% (n=51) were smokers. Among these, 55% (n=129) presented gingivitis, from the patients with periodontitis, 48% (n=50) were diagnosed with the Localized Chronic periodontitis, 40% (n=42) with the Generalized Chronic, while 7% (n=7) and 5% (n=5) had the Aggressive Localized and the Generalized Periodontitis, respectively. Through the PSR data, it was noticed that 49% (n=114) presented the asterisk code. CONCLUSION: According to the results of this research, a female prevalence could be noticed and the gingivitis was the most prevalent periodontal disease, followed by the Localized Chronic Periodontitis

Inflammatory activity modulation by hypertonic saline and pentoxifylline in a rat model of strangulated closed loop small bowel obstruction.

BACKGROUND: Intestinal obstruction is an abdominal disease associated to mortality, especially if complicated with sepsis. Resuscitation increases survival, although controversies remain concerning to therapeutic strategy. METHODS: To assess the effects of hypertonic saline and pentoxifylline on the inflammatory response and oxidative stress, Wistar rats underwent a laparotomy loop intestinal obstruction and ischemia. After 24 h, the intestinal segment was resected (IO) without any other treatment and resuscitation/pentoxifylline were administered according to the group: Ringer's lactate (RL); hypertonic saline (HS); pentoxifylline (PTX); Ringer's lactate with pentoxifylline (RL + PTX); hypertonic saline with pentoxifylline (HS + PTX) and the control group (CG) that was not submitted to ischemia and obstruction. Mean arterial pressure (MAP) was recorded 4 times, and euthanasia was done 3 h after the resuscitation to obtain lung tissue, for malondialdehyde (MDA) by thiobarbituric acid reactive substances (TBARS) method, inflammatory cytokines were assessed using ELISA and NF-κΒ by Western blotting. RESULTS: The initial MAP levels were higher in the RL and HS groups than in the others; however, the last measurement was similar among all the groups. IL-1ß, IL-6 and CINC-1 (Cytokine-Induced Neutrophil Chemoattractant-1) were lower in the HS, PTX and HS + PTX groups compared with the IO and RL groups. IL-10 was lower in the HS + PTX group than in the IO group. NF-κB in the HS, PTX and HS + PTX groups were lower than in the IO group; NF-κB in the HS + PTX group was lower than in the RL group. MDA in the lung was lower in the HS + PTX group compared with other groups. CONCLUSION: Hypertonic saline and pentoxifylline, both alone and in combination, attenuated oxidative stress and the activation of NF-κB, leading to a decrease in the inflammatory response.

Oxidative stress and inflammation are differentially affected by atorvastatin, pravastatin, rosuvastatin, and simvastatin on lungs from mice exposed to cigarette smoke.

Our aim was to investigate the effects of four different statins on acute lung inflammation induced by cigarette smoke (CS). C57BL/6 male mice were divided into a control group (sham-smoked) and mice exposed to CS from 12 cigarettes/day for 5 days. Mice exposed to CS were grouped and treated with vehicle (i.p.), atorvastatin (10 mg/kg), pravastatin (10 mg/kg), rosuvastatin (5 mg/kg), or simvastatin (20 mg/kg). Treatment with statins differentially improved the pulmonary response when compared to the CS group. Atorvastatin and pravastatin demonstrated slightly effects on inflammation and oxidative stress. Rosuvastatin demonstrated the best anti-inflammatory effect, whereas simvastatin demonstrated the best antioxidant response.

Antioxidant action of propolis on mouse lungs exposed to short-term cigarette smoke.

Propolis is a natural product with antioxidant properties. In this study, we tested the efficacy of propolis against acute lung inflammation (ALI) caused by cigarette smoke (CS). C57BL6 male mice were exposed to CS and treated with propolis (200mg/kg orally, CS+P) or only with propolis (P). A Control group treated with propolis was sham-smoked (Control+P). We collected the lungs for histological and biochemical analyses. We observed an increase in alveolar macrophages and neutrophils in the CS group compared with the Control+P. These counts reduced in the CS+P group compared to the CS group. The treatment with propolis normalized all biochemical parameters in the CS+P group compared with the CS group, including nitrite, myeloperoxidase level, antioxidant enzyme activities (superoxide dismutase, catalase and glutathione peroxidase), reduced glutathione/oxidized glutathione ratio and malondialdehyde. Additionally, TNF-α expression reduced in the CS+P group when compared with the CS group. These data imply a potential antioxidant and anti-inflammatory role for propolis with regard to ALI caused by CS in mice.

Em busca da quantidade "ótima" de prática constante na estrutura constante-variada: um olhar para a validade ecológica e a especificidade da tarefa / In searching of the "optimal" amount of constant practice in the constant-varied schedule: a looking to the ecological validity and task specificity

Este trabalho investigou os efeitos da prática constante, anteriormente à prática variada, no processo adaptativo de aprendizagem motora em razão da validade ecológica e da especificidade da tarefa. Os participantes foram 108 crianças de ambos os sexos, com idade média de 11,3 (±0,4 anos), que foram divididas entre dois experimentos envolvendo cada um a aprendizagem de uma habilidade específica: (1) rebatida do tênis de mesa e (2) tacada do golfe. Ambos os estudos contaram com três grupos de diferentes quantidades de prática constante anteriormente à prática variada (aleatória ou por blocos) e, também, duas fases (estabilização e adaptação). As variáveis dependentes foram pontos (rebatida do tênis de mesa) e acertos no buraco (tacada do golfe). Os resultados evidenciaram efeitos da especificidade da tarefa, pois permitiram inferir a existência de uma quantidade ótima de prática constante (anteriormente à variada) apenas para a aprendizagem da rebatida do tênis de mesa.

This study investigated the effects on the amount of constant practice previously to the varied practice in the adaptive process for motor learning according to the ecological validity and specificity of the task. Participants were 108 children of both sexes (11.3 ± 0.4 years). They were split into two experiments involving the learning of a specific skill: (1) hit the table tennis and (2) putt golf. Both studies involved three groups of different amounts of constant practice prior to varied practice (blocked or random), and also two phases (stabilization and adaptation). Dependent variables were scores (hit the table tennis), and the number of hits the hole (golf putt). The results showed effects of task specificity because they showed the existence of an optimal amount of constant practice (prior to the varied) only for the learning of the hit the table tennis.

Effects of Euterpe oleracea Mart. (AÇAÍ) extract in acute lung inflammation induced by cigarette smoke in the mouse.

Short term inhalation of cigarette smoke (CS) induces significant lung inflammation due to an imbalance of oxidant/antioxidant mechanisms. Açai fruit (Euterpe oleracea) has significant antioxidant and anti-inflammatory actions. The present study aimed to determine whether oral administration of an açai stone extract (ASE) could reduce lung inflammation induced by CS. Thirty C57BL/6 mice were assigned to three groups (n=10 each): the Control+A group was exposed to ambient air and treated orally with ASE 300 mg/kg/day; the CS group was exposed to smoke from 6 cigarettes per day for 5 days; and the CS+A group was exposed to smoke from 6 cigarettes per day for 5 days and treated orally with ASE (300 mg/kg/day). On day 6, all mice were sacrificed. After bronchoalveolar lavage, the lungs were removed for histological and biochemical analyses. The CS group exhibited increases in alveolar macrophage (AMs) and neutrophil numbers (PMNs), myeloperoxidase (MPO), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase activities (GPx), TNF-α expression, and nitrites levels in lung tissue when compared with the control ones (p<0.001 for all parameters). The AMs, PMNs, MPO, SOD, CAT, GPx and nitrite were significantly reduced by oral administration of ASE when compared with CS group (p<0.001 for all parameters, with exception of AMs p<0.01). The present results suggested that systemic administration of an ASE extract could reduce the inflammatory and oxidant actions of CS. Thus, the results of this study in mice should stimulate future studies on ASE as a potential agent to protect against CS-induced inflammation in humans.

Mate tea ameliorates emphysema in cigarette smoke-exposed mice.

Exposure to cigarette smoke (CS) is associated with lung inflammation, oxidative stress, and emphysema. The aim of this work was to study Mate tea as a possible natural antioxidant resource against emphysema development. C57BL/6 mice were distributed into 4 groups: exposed to ambient air (control), exposed to the smoke of 12 cigarettes (CS), exposed to ambient air and treated with Mate (500 mg/kg/day diluted in 100 µL) (Mate), and exposed to CS and treated with Mate (CS+Mate). All mice were treated for 60 days. On day 61 the mice were killed. Right and left lungs were removed for histology and biochemical analysis, respectively. Emphysematous lesions and inflammatory cell influxes in the CS group were evident by histological analysis. Cells showed higher 4-hydroxynonenal labeling in the CS group than in the CS+Mate group. Myeloperoxidase activity was reduced in the CS+Mate group compared to the CS group. Superoxide dismutase and catalase activities were significantly higher in the CS+Mate group compared to the CS group. The ratio of reduced to oxidized glutathione was greater in the CS+Mate group than in the CS group. CS-induced emphysema in C57BL/6 mice was prevented by Mate in association with a reduction in inflammatory and oxidative stress parameters.