Radiographic aspects in individuals infected by human T-lymphotropic virus type 1 (HTLV-1) with joint pain

Abstract Background: Joint pain in the absence or with little synovitis is observed in a large percentage of HTLV-1 infected subjects. As the virus infect CD4 +and CD8 +positive, macrophages and B cells an exaggerated production of pro-inflammatory cytokines is detected in these patients. However, the possible association of HTLV-1 infection with autoimmune diseases has not been documented definitively and the clinical characteristics of HTLV-1 associated arthropathy has not been defined. The objective this study is to describe clinic and radiographic features in HTLV-1-infected individuals with complaints of joint pain. Methods: Cross-sectional study enrolling HTLV-1-infected individuals with chronic joint pain, aged up to 75 years, both genders and seronegative controls with osteoarthritis. All participants underwent conventional radiography of the hips, knees and ankles. Results: Eighty-one HTLV-1 infected patients and 30 subjects with osteoarthritis participated in the study. Polyarticular and symmetrical arthritis prevailed in the HTLV-1 positive group (54%), while oligoarticular and asymmetrical (44%) were more common in controls ( p < 0.05). The frequency of enthesophytes (90%) in HTLV-1-infected patients was greater than in the control group (73%) ( p < 0.05). Radiographic features were similar in HTLV-1 carriers and in patients with probable or definite HTLV-1 associated myelopathy. The presence of enthesophytes in the absence of joint space reduction or osteophytes was only observed in HTLV-1-infected individuals ( p < 0.001). Magnetic resonance imaging of the ankles of five HTLV-1-infected patients and five controls demonstrated a higher frequency of enthesitis, bursitis and osteitis in the HTLV-1 infected group. Conclusion: HTLV-1-associated arthropathy is clinically characterized by symmetrical polyarthralgia and the main radiological finding is the presence of enthesophytes in the absence of osteophytes and joint space narrowing.

The relationship between atopy and neurological manifestations in HTLV-1 infection

Abstract INTRODUCTION: Human T-cell lymphotropic virus type 1 (HTLV-1)induces exaggerated Th1 responses, whereas atopy is associated with exacerbated Th2 responses. METHODS: Here, a cross-sectional study compared the prevalence of atopy in HTLV-1 carriers and HAM/TSP patients. It also compared the spontaneous cytokine production in HTLV-1-infected individuals. A retrospective cohort study evaluated the development of neurological manifestations in atopic and non-atopic carriers. RESULTS: Atopic HAM/TSP patients with high IFN-γ production exhibited higher IL-5 levels than non-atopic patients. Allergic rhinitis accelerated the development of Babinski signals and overactive bladders. CONCLUSIONS: Abnormal Th1 and Th2 responses coexist in HTLV-1-infected individuals and allergic diseases may worsen the clinical course of HTLV-1 infections.

Onabotulinumtoxin type A improves lower urinary tract symptoms and quality of life in patients with human T cell lymphotropic virus type 1 associated overactive bladder

ABSTRACT Aim: To evaluate the efficacy of the onabotulinum toxin type A in the treatment of HTLV-1 associated overactive bladder and its impact on quality of life (QoL). Methods: Case series with 10 patients with overactive bladder refractory to conservative treatment with anticholinergic or physical therapy. They received 200Ui of onabotulinumtoxin type A intravesically and were evaluated by overactive bladder symptoms score (OABSS) and King's Health Questionnaire. Results: The mean (SD) of the age was 52 + 14.5 years and 60% were female. All of them had confirmed detrusor overactivity on urodynamic study. Seven patients had HAM/TSP. The median and range of the OABSS was 13 (12-15) before therapy and decreased to 1.0 (0-12) on day 30 and to 03 (0-14) on day 90 (p < 0.0001). There was a significant improvement in 8 of the 9 domains of the King's Health Questionnaire after the intervention. Hematuria, urinary retention and urinary infection were the complications observed in 3 out of 10 patients. The mean time to request retreatment was 465 days. Conclusion: Onabotulinum toxin type A intravesically reduced the OABSS with last long effect and improved the quality of life of HTLV-1 infected patients with severe overactive bladder.

Cáncer relacionado con el trabajo en Brasil: descripción delas notificaciones, 2007-2012 / Work-related cancer in Brazil: description of the notifications, 2007-2012 / Câncer relacionado ao trabalho no Brasil: descrição das notificações, 2007-2012

Se estima que entre el 2 y el 4% del cáncer mundial está asociado a la exposición de agentes carcinogénicos en el ambientelaboral. Los objetivos de este estudio fueron describir las características de las notificaciones del cáncer relacionado con eltrabajo en Brasil en el periodo de 2007 a 2012 y evaluar la completitud de las variables de estas notificaciones. Estudio de cortetransversal de cuño descriptivo a partir de los datos recolectados en el Sistema de Información de Agravios de Notificación.En el período en estudio fueron notificados 269 casos de cáncer relacionado con el trabajo con mayor frecuencia en la regiónCentro-Oeste (59,1%) de casos de cáncer de piel (92,0%) entre trabajadores de la agropecuaria, forestales y de la caza y pesca(43,5%) que tenían 11 a 20 años de trabajo en la ocupación (24,2%) y eran autónomos (30,1%). Cuanto a la clasificaciónde campos incompletos se evidenció la minoría de las variables como muy malo en lo llenado. Es necesaria notificacionescon relleno completo y actuación de la vigilancia en salud del trabajador con acciones de prevención contra los cánceresrelacionados con el trabajo para reducir esta incidencia y promover la salud del trabajador en ambientes saludables

It is estimated that 2-4% of the world’s cancer is associated with exposure to carcinogens in the workplace. The objectives ofthe study were to describe the characteristics of occupational cancer notifications in Brazil from 2007 to 2012, and to evaluatethe completeness of the variables of these notifications. This was a descriptive cross-sectional study from the data collected inthe Injury Notification Information System. In the study period 269 cases of occupational cancer were more often reported inthe Midwest (59.1%), of cases of skin cancer (92.0%), among workers in agriculture, forestry and hunting and fishing (43.5%),who were 11-20 years of work in profession (24.2%), and were self-employed (30.1%). As for classification of incomplete fields,it was evident that the minority of the variables in the notification were poorly filled out. The complete filling out of notificationsand monitoring workers’ health with preventative actions against occupational cancers are necessary to reduce their incidenceand promote workers’ health in healthy environments

Estima-se que 2 a 4% do câncer mundial está associado à exposição de agentes carcinogênicos no ambiente de trabalho.Os objetivos deste estudo foram descrever as características das notificações do câncer relacionado ao trabalho no Brasilno período de 2007 a 2012 e avaliar a completitude das variáveis destas notificações. Estudo de corte transversal de cunhodescritivo a partir dos dados coletados no Sistema de Informação de Agravos de Notificação. No período em estudo foramnotificados 269 casos de câncer relacionado ao trabalho com maior frequência na região Centro-Oeste (59,1%) de casos decâncer de pele (92,0%) entre trabalhadores da agropecuária, florestais e da caça e pesca (43,5%) que tinham 11 a 20 anosde trabalho na ocupação (24,2%) e eram autônomos (30,1%). Quanto à classificação de campos incompletos evidenciou-sea minoria das variáveis como muito ruim no preenchimento. São necessárias notificações com preenchimento completo eatuação da vigilância em saúde do trabalhador com ações de prevenção contra os cânceres relacionados ao trabalho parareduzir esta incidência e promover a saúde do trabalhador em ambientes saudáveis

Emergências Odontológicas em Dor no Peito / Dental Emergencies Involving Chest Pain

Este trabalho consiste numa revisão atualizada daliteratura, objetivando o embasamento científico relevantepara emergências odontológicas em dor no peito parapacientes que apresentem um quadro de angina de peito ouinfarto agudo do miocárdio. Material e Métodos: foi realizadoum levantamento de artigos na língua portuguesa nas basesde dados do Google Scholar, utilizando-se a temática“emergência odontológica em dor no peito” no período de2006 a março de 2014, resultando-se em 16 artigoscientíficos. Resultados: nove dos estudos apontam que oscirurgiões-dentistas do serviço público ou privado sentemsedespreparados defronte as emergências odontológicas,dessa forma julgam não ser capazes de intervir mesmo emsituações não raras como da angina de peito e do infartoagudo do miocárdio relacionado à ansiedade de pacientesidosos, implicando em deveres legais. Conclusão: asemergências odontológicas em dor no peito como angina depeito e infarto agudo do miocárdio são competência eresponsabilidade obrigatória do cirurgião-dentista saberdefinir, diagnosticar, prevenir e tratar estas emergências naclínica odontológica evitando imputações civis e criminais...

This is an updated review of the literature aimingto provide relevant scientific basis for the management ofdental emergencies involving chest pain in patients withangina pectoris or acute myocardial infarction. Material andMethods: Bibliographical searches of articles in Portuguesewere carried out in the Google Scholar database using thedescriptor “dental emergency chest pain” from 2006 to March2014. The searches resulted in 16 scientific articles. Results:Nine studies have indicated that dentists working in public orprivate services feel unprepared faced to dentalemergencies. They judge not to be able to intervene even innot so rare conditions such as angina pectoris and acutemyocardial infarction related to anxiety in elderlies, whichimplies legal duties. Conclusion: Dental emergencies involvingchest pain, such as angina pectoris and acute myocardialinfarction, are a mandatory competence and responsibility ofdentists, whom should know how to define, diagnose, preventand treat them in the dental clinics and thus avoid civil andcriminal charges...

The use of botulinum toxin type A in the treatment of HTLV-1-associated overactive bladder refractory to conventional therapy

Urinary symptoms occur in 19% of human T-cell lymphotropic virus type 1 (HTLV-1)-infected patients who do not fulfill criteria for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and in almost 100% of HAM/TSP patients. Few studies have evaluated therapies for overactive bladder (OAB) caused by HTLV-1 infection. This case report describes the effect of onabotulinum toxin A on the urinary manifestations of three patients with HAM/TSP and OAB symptoms. The patients were intravesically administered 200 units of Botox®. Their incontinence episodes improved, and their OAB symptoms scores (OABSS) reduced significantly. These data indicate that Botox® should be a treatment option for OAB associated with HTLV-1 infection.

Humanização em saúde e a odontologia / Humanization in healthcare and dentistry

A humanização em saúde é fundamental para a assistência em odontologia. Objetivo: Investigar na literatura a abordagem do tema humanização em saúde na odontologia, com o intuito de compreender de que forma o mesmo tem sido utilizado nesse setor. Métodos: Trata-se de uma revisão sistemática da literatura nacional de caráter descritivo e exploratório sobre o processo de humanização em saúde na odontologia. A busca de dados deu-se na SciELO. Foi utilizada a análise de conteúdo temática de Bardin, que conduziu às categorias: sentidos da humanização, humanização em saúde, humanização do cuidado e humanização na odontologia. Resultados: O corpus documental deste estudo foi constituído por 28 produções científicas, sendo a maioria publicada no período de 2010 - 2013 (53,6%), na área de saúde coletiva (35,7%). Apenas 21,4% foram agrupados na categoria humanização na odontologia. Observou-se uma evolução quanto aos aspectos relacionados à humanização para o cirurgião-dentista no que concerne aos sistemas e serviços de saúde. Conclusão: A produção científica nacional da humanização em saú- de relacionada às práticas do cirurgião-dentista é escassa. Essa situação remete à necessidade da maior abordagem da Política Nacional de Humanização em cursos de odontologia, capacitação em saúde bucal, periódicos de circulação entre os cirurgiões-dentistas, na tentativa de permitir a superação do modelo centrado na doença para o modelo de produção da saúde...

Effect of different types of coronal flaring on the circularity and area of mandibular first molar mesial root canals / Efeito de diferentes tipos de preparo cervical na circularidade e na área de canais mesiais dos primeiros molares inferiores

Objective: This study assessed the effect of coronal flaring with the Gates-Glidden (GG) bur, La Axxess (LA) bur, and SX file on the area, circularity, and residual dentin thickness in the furcal direction of mandibular first molar root canals. Methods: The mesiolingual and mesiobuccal canals of twenty-one mandibular first molars were instrumented. The teeth were embedded in acrylic resin, and after coronal flaring, the roots were cut perpendicularly to their long axis 2 mm below the cementoenamel junction. The sections were photographed before and after flaring with GG bur no. 3, LA bur no. 1 and SX file. The area, circularity, and residual dentin thickness in the furcal direction were calculated by the software Image J. Results: Before instrumentation, the canals had a mean area of 0.56mm2±0.37 and mean circularity of 0.31±0.08. After flaring with the GG, SX and LA instruments, the mean areas were 0.68mm2±0.20, 0.64mm2±0.18, and 0.85 mm2±0.23, respectively; and the mean circularities were 0.39±0.08, 0.35±0.08, and 0.39±0.06, respectively. The areas achieved with the LA bur and SX file were statistically different (p<0.05). The final circularities (p>0.05) and residual dentin thicknesses in the furcal direction (p>0.05) did not differ between the groups. Conclusion: Coronal flaring with the study instruments was safe. The SX file achieved the smallest area. Circularity and residual dentin thickness in the furcal direction were not affected by the different instruments. No instrument was capable of achieving a circularity greater than 0.5.

Objetivo: Avaliar o efeito no preparo cervical da broca Gates-Glidden (GG), La Axxess (LA) e lima SX na área, circularidade e na espessura residual dentinária voltada para a região de furca de canais radiculares dos primeiros molares inferiores. Métodos: Foram utilizados canais mésio-vestibulares e os mésio-linguais de vinte e um primeiros molares inferiores. Os dentes foram incluídos em resina acrílica e após a abertura coronária foram seccionados 2mm abaixo da junção amelo-cementária. As secções foram fotografadas antes e após o preparo cervical usando GG n. 3, LA n. 1 e SX. A área, a circularidade e o remanescente de dentina voltada para a furca foram calculados com auxílio do programa computacional Image J. Resultados: Antes do preparo cervical os canais apresentaram 0,56mm2 (±0,37) para área e 0,31 (±0,08) para circularidade. Após o uso da GG, SX e LA os valores médios para área foram 0,68 mm2 (±0,20), 0,64 mm2 (±0,18) e 0,85 mm2 (±0,23) e para circularidade de 0,39 (±0,08), 0,35 (±0,08) e 0,39 (±0,06), respectivamente. Houve diferença estatística significante entre a área para LA e SX (p<0,05). Não houve diferença para à circularidade (p>0,05) e nem para à espessura residual de dentina da furca (p>0,05). Conclusão: O preparo cervical realizado com diferentes instrumentos apresentou adequada segurança sendo que a lima SX apresentou os menores valores de área. A circularidade e a quantidade de dentina residual na região de furca não foram influenciadas pelos diferentes instrumentos. Nenhum instrumento resultou em valores de circularidade maior que 0.5.

Single scrotal incision orchiopexy - a systematic review

Objective To conduct a systematic review on single scrotal incision orchiopexy. Materials and Methods: A search was performed using Pubmed, through which 16 articles were selected out of a total of 133. The following conditions were considered exclusion criteria: other surgical methods such as an inguinal procedure or a laparoscopic approach, retractile testes, or patients with previous testicular or inguinal surgery. Results A total of 1558 orchiopexy surgeries initiated with a transcrotal incision were analyzed. Patients' ages ranged between 5 months and 21 years. Thirteen studies used high scrotal incisions, and low scrotal incisions were performed in the remainder of the studies. In 55 cases (3.53%), there was a need for inguinal incision. Recurrence was observed in 9 cases, testicular atrophy in 3, testicular hypotrophy in 2, and surgical site infections in 13 cases. High efficacy rates were observed, varying between 88% and 100%. Conclusions Single scrotal incision orchiopexy proved to be an effective technique and is associated with low rates of complications. .

Índice de sustentabilidade agroambiental para o perímetro irrigado Ayres de Souza / Environmental sustainability index for Ayres de Souza irrigated district

Uma análise integrada do atual uso dos recursos naturais do Perímetro Irrigado de Ayres de Souza, localizado no Vale do Acaraú, Ceará, foi realizada através do desenvolvimento de um índice de sustentabilidade agroecológica. Os dados dessa pesquisa foram oriundos de questionários aplicados a 33 produtores agrícolas beneficiados pelo projeto de irrigação. Os indicadores de sustentabilidade foram estimados pelo emprego de análise fatorial, método da análise fatorial/análise de componentes principais. O índice de sustentabilidade estimado a partir dos indicadores selecionados registrou uma situação de sustentabilidade fragilizada ou de insustentabilidade reversível. As unidades produtivas apresentaram um porcentual de 60,6 por cento com alguma sustentabilidade; e os demais 39,4 por cento estão em condições de insustentabilidade. Os resultados também mostraram que os fatores dominantes do índice de sustentabilidade foram: nível da atividade agrícola praticada, agricultura familiar, condições atuais do sistema água-solo e infra-estrutura, fontes alternativas de renda e experiência em tratos culturais.

The aim of this work was to make an analysis of natural resources at Ayres de Souza Irrigated District sited in Acaraú basin, Ceará, Brazil. This study was performed through an agro ecological sustainability index (ASI). The approach was based on 33 cross-over form applied to small farms located in the irrigated district. Factors Analysis/Principal Components Analysis were applied to select the sustainability indicators of the irrigated district as well as to define the agro ecological sustainability index. The results showed that the Index is capable of demonstrating clear differences among productivity unit management system with respect to sustainability. 60 percent of the pooled productivity units presented weak sustainability and the other 39.4 percent were unsustainable. The dominants factors of the Index were: level of agricultural management practices, family agriculture, framework of irrigation and alternative income source.

Endometriose vesical / Vesical endometriosis

A endometriose vesical é uma enfermidade rara. Apresentamos dois casos e comentamos os aspectos clínicos, diagnósticos e terapêuticos, baseados na literatura