Digital Planning for Immediate Implants in Anterior Esthetic Area: Immediate Result and Follow-Up after 3 Years of Clinical Outcome-Case Report.

In this case report, we demonstrate how the correct positioning of implants, associated with optimal gingival conditioning, and the correct choice of biomaterial can yield very predictable and fantastic aesthetic results. OBJECTIVE: We aimed to use dental implants to rehabilitate the area of elements #11 and #21 in a satisfactory surgical and prosthetic manner, using guided surgery, connective tissue, nano-biomaterials, and a porcelain prosthesis. CASE REPORT: A 32-year-old male patient presented with bone loss of elements #11 and #21, which was proven radiographically and clinically. Thus, oral rehabilitation with the use of dental implants was required. It was decided to proceed via digital planning with the DSD program (Digital smile design) and with the software Exoplan, (Smart Dent-Germany) whenever it was possible to plan immediate provisional and accurate dental implant positioning through reverse diagnostics (Software Exoplan, Smart Dent-German). The dental elements were extracted atraumatically; then, a guide was established, the implants were positioned, the prosthetic components were placed, the conjunctive tissue was removed from the palate and redirected to the vestibular wall of the implants, the nano-graft (Blue Bone®) was conditioned in the gaps between the vestibular wall and the implants, and, finally, the cemented provision was installed. RESULTS: After a 5-month accompaniment, an excellent remodeling of the tissues had been achieved by the implants; consequently, the final prosthetic stage could begin, which also achieved a remarkable aesthetic result. CONCLUSIONS: This report demonstrates that the correct planning of dental implants, which is associated with appropriate soft tissue and bone manipulation, allows for the achievement of admirable clinical results.

Integrated analysis of label-free quantitative proteomics and bioinformatics reveal insights into signaling pathways in male breast cancer.

Male breast cancer (MBC) is a rare malignancy that accounts for about 1.8% of all breast cancer cases. In contrast to the high number of the "omics" studies in breast cancer in women, only recently molecular approaches have been performed in MBC research. High-throughput proteomics based methodologies are promisor strategies to characterize the MBC proteomic signatures and their association with clinico-pathological parameters. In this study, the label-free quantification-mass spectrometry and bioinformatics approaches were applied to analyze the proteomic profiling of a MBC case using the primary breast tumor and the corresponding axillary metastatic lymph nodes and adjacent non-tumor breast tissues. The differentially expressed proteins were identified in the signaling pathways of granzyme B, sirtuins, eIF2, actin cytoskeleton, eNOS, acute phase response and calcium and were connected to the upstream regulators MYC, PI3K SMARCA4 and cancer-related chemical drugs. An additional proteomic comparative analysis was performed with a primary breast tumor of a female patient and revealed an interesting set of proteins, which were mainly involved in cancer biology. Together, our data provide a relevant data source for the MBC research that can help the therapeutic strategies for its management.

High-throughput mass spectrometry and bioinformatics analysis of breast cancer proteomic data.

Data present here describe a comparative proteomic analysis among the malignant [primary breast tumor (PT) and axillary metastatic lymph nodes (LN)], and the non-tumor [contralateral (NCT) and adjacent (ANT)] breast tissues. Protein identification and quantification were performed through label-free mass spectrometry using a nano-liquid chromatography coupled to an electrospray ionization-mass spectrometry (nLC-ESI-MS/MS). The mass spectrometry proteomic data have been deposited to the ProteomeXchange Consortium via PRIDE partner repository with the dataset identifier PXD012431. A total of 462 differentially expressed proteins was identified among these tissues and was analyzed in six groups' comparisons (named NCTxANT, PTxNCT, PTxANT, LNxNCT, LNxANT and PTxLN). Proteins at 1.5 log2 fold change were submitted to the Ingenuity® Pathway Analysis (IPA) software version 2.3 (QIAGEN Inc.) to identify biological pathways, disease and function annotation, and interaction networks related to cancer biology. The detailed data present here provides information about the proteome alterations and their role on breast tumorigenesis. This information can lead to novel biological insights on cancer research. For further interpretation of these data, please see our research article 'Quantitative label-free mass spectrometry using contralateral and adjacent breast tissues reveal differentially expressed proteins and their predicted impacts on pathways and cellular functions in breast cancer' [2].

Quantitative label-free mass spectrometry using contralateral and adjacent breast tissues reveal differentially expressed proteins and their predicted impacts on pathways and cellular functions in breast cancer.

Proteins play an essential role in the biological processes associated with cancer. Their altered expression levels can deregulate critical cellular pathways and interactive networks. In this study, the mass spectrometry-based label-free quantification followed by functional annotation was performed to investigate the most significant deregulated proteins among tissues of primary breast tumor (PT) and axillary metastatic lymph node (LN) and corresponding non-tumor tissues contralateral (NCT) and adjacent (ANT) from patients diagnosed with invasive ductal carcinoma. A total of 462 proteins was observed as differentially expressed (DEPs) among the groups analyzed. A high level of similarity was observed in the proteome profile of both non-tumor breast tissues and DEPs (n = 12) were mainly predicted in the RNA metabolism. The DEPs among the malignant and non-tumor breast tissues [n = 396 (PTxNCT) and n = 410 (LNxNCT)] were related to pathways of the LXR/RXR, NO, eNOS, eIF2 and sirtuins, tumor-related functions, fatty acid metabolism and oxidative stress. Remarkable similarity was observed between both malignant tissues, which the DEPs were related to metastatic capabilities. Altogether, our findings revealed differential proteomic profiles that affected cancer associated and interconnected signaling processes. Validation studies are recommended to demonstrate the potential of individual proteins and/or pathways as biological markers in breast cancer. SIGNIFICANCE: The proteomic analysis of this study revealed high similarity in the proteomic profile of the contralateral and adjacent non-tumor breast tissues. Significant differences were identified among the proteome of the malignant and non-tumor tissue groups of the same patients, providing relevant insights into the hallmarks, signaling pathways, biological functions, and interactive protein networks that act during tumorigenesis and breast cancer progression. These proteins are suggested as targets of relevant interest to be explored as potential biological markers related to tumor development and metastatic progression in the breast cancer disease.

Estressores em familiares de pacientes internados na unidade de terapia intensiva / Stressors in the relatives of patients admitted to an intensive care unit

RESUMO Objetivo: Identificar e estratificar os principais fatores estressores para os familiares de pacientes internados na unidade de terapia intensiva adulto de um hospital escola. Métodos: Estudo transversal descritivo com familiares de pacientes internados na unidade de terapia intensiva no período de abril a outubro de 2014. Foi utilizado questionário contendo identificação e dados demográficos dos familiares, dados clínicos dos pacientes, bem como 25 fatores estressores adaptados da Escala de Estressores em Unidade de Terapia Intensiva. O grau de estresse de cada fator foi determinado por uma escala de valores pontuando de 1 a 4. Os fatores estressores foram ranqueados conforme média dos pontos obtida. Resultados: A principal causa de admissão na unidade de terapia intensiva foi clínica em 36 (52,2%) casos. Os principais fatores estressores foram a presença do estado de coma (3,15 ± 1,23), o paciente não conseguir falar (3,15 ± 1,20) e o motivo da internação (3,00 ± 1,27). Quando retirados da análise os 27 (39,1%) pacientes em coma, os fatores de maior estresse para os familiares foram o motivo da internação (2,75 ± 1,354), ver o paciente na unidade de terapia intensiva (2,51 ± 1,227) e o paciente não conseguir falar (2,50 ± 1,269). Conclusão: A dificuldade na comunicação e na relação com o paciente internado na unidade de terapia intensiva foi apontada como os maiores estressores por seus familiares, com destaque para o estado de coma. Por outro lado, o ambiente, as rotinas de trabalho e a relação entre familiar e equipe da unidade de terapia intensiva tiveram menor impacto como fatores estressores.

ABSTRACT Objective: To identify and stratify the main stressors for the relatives of patients admitted to the adult intensive care unit of a teaching hospital. Methods: Cross-sectional descriptive study conducted with relatives of patients admitted to an intensive care unit from April to October 2014. The following materials were used: a questionnaire containing identification information and demographic data of the relatives, clinical data of the patients, and 25 stressors adapted from the Intensive Care Unit Environmental Stressor Scale. The degree of stress caused by each factor was determined on a scale of values from 1 to 4. The stressors were ranked based on the average score obtained. Results: The main cause of admission to the intensive care unit was clinical in 36 (52.2%) cases. The main stressors were the patient being in a state of coma (3.15 ± 1.23), the patient being unable to speak (3.15 ± 1.20), and the reason for admission (3.00 ± 1.27). After removing the 27 (39.1%) coma patients from the analysis, the main stressors for the relatives were the reason for admission (2.75 ± 1.354), seeing the patient in the intensive care unit (2.51 ± 1.227), and the patient being unable to speak (2.50 ± 1.269). Conclusion: Difficulties in communication and in the relationship with the patient admitted to the intensive care unit were identified as the main stressors by their relatives, with the state of coma being predominant. By contrast, the environment, work routines, and relationship between the relatives and intensive care unit team had the least impact as stressors.

Remoção cirúrgica de adenoma pleomórfico em região do frênulo labial superior / Surgical removal of pleomorphic adenoma in the region of the upper labial frenulum

Adenoma pleomórfico é o tumor benigno de glândula salivar mais comum na cavidade oral. O tratamento preconizado para esse tipo de lesão é a exérese cirúrgica, além do controle pós-operatório do paciente. O presente artigo relata um caso de remoção cirúrgica de adenoma pleomórfico de glândula salivar menor na região do frênulo labial superior, em uma criança de 12 anos

Pleomorphic adenoma is the most common benign tumor of the salivary gland in the oral cavity. The treatment for this type of tumor is the surgical resection, besides the postoperative control of the patient. The present article reports a case of surgical removal of pleomorphic adenoma in the region of the upper labial frenulum, in a 12-year-old child

A reologia microvascular das microesferas de perfluoropropano na presença da isquemia-reperfusão, diabetes e sepsis / The microvascular reology of ultrasound contrast in ischemia-reperfusion injury, diabetes and sepsis

Fundamentos: A adesão das microesferas aos leucócitos no tecido inflamado tem sido discutida, porém, pouco se sabe sobre seu comportamento nos capilares. A avaliação dos efeitos circulatórios desse agente pode trazer informações sobre sua ação no miocárdio. Objetivo: Avaliar o comportamento microvascular e hemodinâmico das microesferas nos seguintes grupos: controle, isquemia-reperfusão, diabetes tipo 2, diabetes com isquemia e sepsis. Métodos: Experimentalmente estudou-se a microcirculação da bolsa da bochecha de 65 hamsters machos, sendo separados por grupos conforme a indução da doença de base G-1 igual isquemia/reperfusão. GD igual diabetes, GDI igual diabetes com isquemia GS igual sepsis em relação ao GC (grupo controle). Dentro de cada grupo avaliou-se a pressão arterial...

Utilização da técnica de retalho semi lunar para recobrimento radicular em recessões gengivais vestibulares / Usage of semilunar flap technique for root coverage in buccal and proximal gingival recession

A gengiva é a parte da mucosa mastigatória que cobre o pro -cesso alveolar e circunda a porção cervical dos dentes, sendo com -posta por gengiva livre ou marginal e gengiva inserida, ambas constituídas por mucosa ceratinizada. Dentre os defeitos mucogengivais a recessão gengival é o mais comum, caracterizado por um posicionamento apical da mar gem em relação à junção cemento-esmalte e exposição radicular.Os sintomas relacionados à sua presença podem se manifestar tanto por hipersensibilidade radicular (provocada particularmente por estímulos térmicos ou pelo contato), como por sensibilidadegengival à escovação e à mastigação principalmente quando o tecido marginal é de mucosa alveolar (BORGUETTI e MONNETCORTI et al., 2002). Sua etiologia é considerada multifatorial, sendo o fator anatômico preponderante. Seu diagnóstico precoce é importante tanto para sua prevenção quanto para o seu tratamento (GORMAN & O`LEARY, 1967). A cirurgia plástica periodontal deve ser considerada se a recessão for progressiva. Desse modo, várias técnicas cirúrgicas foram desenvolvidas com o objetivo de corrigir estes defeitos (CASATI et al., 2001). O objetivo do presente trabalho é apresentar a técnica do retalho semilunar posicionado coronariamente e suas vantagens no tratamento desses defeitos gengivais vestibulares e interproximais. Concluiu-se que o sucesso do tratamento se baseia no conhecimento da sua etiologia e num planejamento cirúrgico adequado, sendo que os resultados obtidos foram satisfatórios dentro dos critérios de avaliação para cirurgias mucogengivais.

The gingiva is a part of the masticatory mucosa that coversthe alveolar process and surrounds the cervical portion of teeth,being composed of free or marginal gingiva and attached gingiva,both constituted by keratinized mucosa.Gingival recession is one ofthe most common mucogingival defects and is characterized by api -cal positioning of the margin in relation to the cementoenamel junc -tion and root exposure. The symptoms related to their presence maybe manifested by root hypersensitivity (especially triggered by ther -mal or contact stimuli) and also by gingival sensitivity to tooth -brushing and mastication, especially when the marginal tissue iscomposed of alveolar mucosa (BORGUETTI et al., 2002). Its etio -logy is considered multifactorial, and the anatomic aspect is funda -mental. The early diagnosis is important for both prevention andtreatment (GORMAN & O`LEARY, 1967).Periodontal plastic surge -ries should be considered in cases of progressive recession. Thus,several surgical techniques have been developed to correct thesedefects (CASATI et al., 2001). This paper presents the semilunarflap technique with coronal positioning and its advantages for treat -ment of these buccal and proximal gingival defects.It was concludedthat the success of treatment is based on its etiology and proper sur -gical planning, and the results achieved were satisfactory accordingto the criteria for evaluation of mucogingival surgeries.

Sulco palatogengival, pérola do esmalte e extensão cervical do esmalte: alterações do desenvolvimento dos dentes e sua relação com o periodonto / Palata-gingival groove, enamel pearl and cervical extension of the enamel extension: alterations in the development of teeth and its relation with the periodontium

Sulco palatogengival, pérola de esmalte e extensão cervical do esmalte, representam alterações no desenvolvimento da forma dos dentes, as quais apresentam características morfológicas peculiares de importância para o cirurgião-dentista, em especial, para o periodontista. Na tentativa de contribuir para o aumento dos índices de conhecimento sobre o assunto, o objetivo deste artigo de revisão é indicar as diversas formas de apresentação, meios de diagnóstico clínico-radiográfico e modalidades terapêuticas das referidas anomalias. Consequentemente, aumentar as chances de diagnóstico precoce e o sucesso do procedimento, evitando deste modo, o desconhecimento do profissional quando da indicação do tratamento