A study of the interleukin-1 gene cluster polymorphisms and inflammatory external root resorption in replanted permanent teeth.

AIM: To investigate whether single nucleotide polymorphisms (SNPs) within the interleukin-1 gene cluster (IL1) are associated with the occurrence and severity of inflammatory external root resorption (IERR) after replantation of avulsed permanent teeth. METHODOLOGY: Indexes of IERR were radiographically assessed in 182 mature replanted permanent teeth from 146 patients at the onset of endodontic therapy. DNA was extracted from buccal mucosa cells and genotyped using TaqMan probes-based assays for the SNPs IL1A -889C/T (rs 180058), IL1B +3954C/T (rs1143634) and IL1RN +2018C/T (rs419598). Teeth were grouped into two categories: IERR absent to mild (indexes ≤ 4) and moderate to severe IERR (indexes > 4). Genetic variations in the IL1 gene cluster were tested for their effect on the occurrence and extension of IERR using the GEE model (generalized estimation equation). Patient's age at the moment of injury, timing of pulpectomy, extra-alveolar period and storage condition of the avulsed teeth was included as possible confounders. RESULTS: No association was found between SNPs IL1A -889C/T, IL1B +3954C/T (rs1143634) and IL1RN +2018C/T (rs419598) and IERR indexes. Timing of pulpectomy (OR 3.5 IC 95% 2.0-6.2 P < 0.001) and patient's age at the moment of trauma (OR 0.29 IC 95% 0.12-0.67 P = 0.004) significantly affected the risk of developing severe IERR. CONCLUSIONS: While timing of pulpectomy and patient's age at the moment of trauma were confirmed as important risk factors, SNPs within the IL1 gene cluster did not affect the susceptibility for IERR after replantation of permanent teeth.

Screening for congenital hypothyroidism in extreme premature and/or very low birth weight newborns: the importance of a specific protocol.

BACKGROUND: Neonatal screening for congenital hypothyroidism (CH) in premature infants is not as well established as in term newborns regarding age and number of samples. AIMS: 1. To evaluate the effectiveness of the protocol recommended by the Neonatal Screening Program of the State of Minas Gerais (PETN-MG) for CH neonatal screening in very low birth weight premature infants. 2. To estimate the prevalence of delayed TSH elevation and thyroid function alterations in the target population. METHODS: TSH was assessed by ELISA on the 5th, 10th and 30th days of life in all newborns with gestational age <32 weeks and/or very low birth weight (VLB) (<1,500 g) in the period from October 2004 to September 2006. RESULTS: Out of the 14,462 newborns screened, 2,647 were premature with gestational age <32 weeks and/or VLB. Forty-four cases of altered TSH were found and 11 infants underwent treatment. Delayed TSH elevation was detected in 66% of altered cases. Five out of the 11 cases were detected in the second sample and five cases were only detected in the third sample. CONCLUSION: The high prevalence of thyroid function alterations that demanded treatment (1:242) and delayed TSH elevation in VLB premature infants reinforce the need for a specific protocol, based on retesting procedures, for CH neonatal screening.

Efficacy of glutamine-supplemented parenteral nutrition on short-term survival following allo-SCT: a randomized study.

Fifty-three patients with hematological malignancies who underwent Allo-SCT from HLA-identical siblings were randomly assigned to receive glutamine-enriched parenteral nutrition-PN (GlPN, n=27) or standard PN (PN, n=26), in isonitrogenous solutions. Deaths (D+100 and D+180), infections, acute GVHD, length of stay, time of neutropenia and intestinal permeability (IP) were studied. Ages, gender, diagnosis, disease status and treatment variables were equally distributed between groups. Survival on D+180 was increased in GlPN (74%) vs PN (46%), P=0.03 (log-rank), as on D+100 (P=0.05). Most deaths occurred before D+100, especially in PN (10/26, 39%) vs GlPN (4/27, 15%). GVHD was the most frequent cause of death (8/21, 38%), especially in PN (n=6, five before D+100). Other outcomes were not affected. IP was affected on admission, was not affected by glutamine enrichment, but consistently worsened throughout the study. Results showed that GlPN was efficacious in increasing short-term survival after Allo-SCT. Benefits of glutamine seem to be independent of mucosal protection, as IP was not affected by its use. A trend to a lower incidence of GVHD deaths may suggest an immunomodulatory role of glutamine.

Arterial blood pressure of term newborns during the first week of life.

The progressive behavior of the blood pressure of term newborns during the first week of life was assessed by the simultaneous use of oscillometric and Doppler methods. A total of 174 term neonates born at the Municipal Hospital Odilon Behrens in Belo Horizonte, from March 1996 to February 1997, were prospectively assessed. The oscillometric and Doppler ultrasonic methods were simultaneously used for four consecutive recordings obtained at 12 +/- 6, 24 +/- 6 and 72 +/- 24 h and on the 7th +/- 1 day of life. The combined use of the two methods simplified the procedure, with automatic cuff inflation and deflation, and speed was properly controlled with an automatic pressure monitor. The procedure was performed using a Y-connection to the mercury sphygmomanometer, with blood pressure being recorded with an automatic device and systolic blood pressure being measured simultaneously by Doppler ultrasound. The newborns were awake, not crying and in the supine position. A statistically significant increase in systolic and diastolic blood pressure was observed between the first and second, and the third and fourth measurements by Doppler and oscillometric methods. No significant correlation between birth weight, length, ponderal index and blood pressure was observed. The technique used represents a simpler and more accurate procedure for blood pressure measurement.

Plantas medicinais da Bacia do Rio das Velhas: avaliação das condições para produção e uso em saúde pública / Medicinal plants of the Rio das Velhas watershed region: potential for production and use in public health

RESUMO O desenvolvimento de projetos que contemplem o cultivo e beneficiamento de plantas medicinais, com qualidade, é urgente e necessário, especialmente quando se considera a expansão da oferta desses produtos para o Sistema Único de Saúde (SUS). Nesta pesquisa, foi avaliada a existência de iniciativas que produzem e disponibilizam plantas medicinais de interesse do SUS, em municípios que compõem a Bacia Hidrográfica do Rio das Velhas (BHRV), em Minas Gerais. Foram visitados 45 municípios da Bacia buscando informações sobre atividades já existentes de produção e uso coletivo de plantas medicinais. Os dados sobre plantas medicinais já existentes foram posteriormente confrontados com informações epidemiológicas, como as principais causas de internações hospitalares e cobertura de equipes da Estratégia da Saúde da Família (ESF). A pesquisa evidenciou a existência de atividades filantrópicas e comerciais, relativas à utilização coletiva de plantas medicinais, apenas em Belo Horizonte, Capim Branco, Curvelo, Lassance, Nova Lima e Sete Lagoas. Vinte e sete espécies, nativas e exóticas, presentes na RDC 10/2010 da Anvisa são produzidas nessas iniciativas, e elas ocorrem tanto de forma espontânea como por meio de cultivo. A correlação das principais causas de internação hospitalar com as espécies vegetais disponíveis revelou potenciais locais de aproveitamento das plantas, inclusive pela ESF. O desenvolvimento da cadeia produtiva, trabalhando desde o cultivo até a dispensação aos usuários do SUS, pode representar uma oportunidade de integração de diferentes atores e instituições da região, além de incrementar o desenvolvimento econômico-social e a preservação da biodiversidade local.

ABSTRACT The development of projects that include the cultivation and processing of medicinal plants with quality is urgent and necessary, especially when considering the offer increase of these products to the Unified Health System (SUS). In this study, we evaluated the potential of the Rio das Velhas" watershed region (BHRV) in producing and using medicinal plants. We visited 45 cities of the watershed, seeking information about existing production and collective use of medicinal plants. Afterwards, the data obtained in the fieldwork were confronted with epidemiological information, such as hospitalization rates and coverage of the Family Health Strategy. The research showed the existence of commercial and philanthropic activities in Belo Horizonte, Capim Branco, Curvelo, Lassance, Nova Lima and Sete Lagoas. Twenty-seven species, native and exotic ones, included in the 10/2010 Resolution edited by the Brazilian Health Surveillance Agency (Anvisa), are produced in these initiatives, and they occur both spontaneously and through cultivation. The correlation of the leading causes for hospitalization and the available plant species showed potential use of local plants, including by the Family Health Strategy. The development of the production chain, from the plants" cultivation to the medicines" dispensation for the SUS users, may represent an opportunity of integration of different actors and institutions in the region, besides increasing the economic and social development and contributing to the preservation of local biodiversity.

Long term follow up of rheumatic fever and predictors of severe rheumatic valvar disease in Brazilian children and adolescents.

OBJECTIVES: To investigate the progress of rheumatic fever (RF) and the predictors of severe chronic valvar disease. DESIGN: Patients prospectively followed up since their first attack of acute RF (ARF). SETTING: Universidade Federal de Minas Gerais, Brazil. PATIENTS: 258 children and adolescents who met the revised Jones criteria for RF. The follow up period ranged from 2-15 years. MAIN OUTCOME MEASURES: The presence and severity of mitral or aortic valvar disease were determined by both clinical and Doppler echocardiographic examinations. The variables associated with severe chronic valvar disease were initially identified by the Kaplan-Meier method and, later, by multivariate analysis. RESULTS: Doppler echocardiography of 258 patients studied showed that 186 (72.1%) developed chronic valvar disease and 41 (15.9%) progressed to severe chronic mitral or aortic lesions. Of 146 patients who developed carditis, 49 (33.6%) had a normal clinical examination in the chronic phase but only nine (6.2%) had normal Doppler echocardiographic findings--that is, 40 (27.4%) patients progressed to chronic subclinical valvar disease. Moderate or severe carditis, recurrences of ARF, and mother's low educational level were risk factors in predicting severe chronic valvar diseases. CONCLUSION: The increased risk of progressing to severe chronic valvar disease was associated with moderate or severe carditis, recurrences of ARF, and mother's low educational level. Hence, in a country such as Brazil, the options available for disease control are mainly primary and secondary prophylaxis.

Arterial blood pressure of term newborns during the first week of life

The progressive behavior of the blood pressure of term newborns during the first week of life was assessed by the simultaneous use of oscillometric and Doppler methods. A total of 174 term neonates born at the Municipal Hospital Odilon Behrens in Belo Horizonte, from March 1996 to February 1997, were prospectively assessed. The oscillometric and Doppler ultrasonic methods were simultaneously used for four consecutive recordings obtained at 12 ± 6, 24 ± 6 and 72 ± 24 h and on the 7th ± 1 day of life. The combined use of the two methods simplified the procedure, with automatic cuff inflation and deflation, and speed was properly controlled with an automatic pressure monitor. The procedure was performed using a Y-connection to the mercury sphygmomanometer, with blood pressure being recorded with an automatic device and systolic blood pressure being measured simultaneously by Doppler ultrasound. The newborns were awake, not crying and in the supine position. A statistically significant increase in systolic and diastolic blood pressure was observed between the first and second, and the third and fourth measurements by Doppler and oscillometric methods. No significant correlation between birth weight, length, ponderal index and blood pressure was observed. The technique used represents a simpler and more accurate procedure for blood pressure measurement

Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children

The objective of the present study was to evaluate associations between fiber intake, colonic transit time and stool frequency. Thirty-eight patients aged 4 to 14 years were submitted to alimentary evaluation and to measurement of colonic transit time. The median fiber intake of the total sample was age + 10.3 g/day. Only 18.4 percent of the subjects presented a daily dietary fiber intake below the levels recommended by the American Health Foundation. In this group, the median left colonic transit time was shorter than in the group with higher dietary fiber intake (11 vs 17 h, P = 0.067). The correlation between stool frequency and colonic transit time was negative and weak for left colon (r = -0.3, P = 0.04), and negative and moderate for rectosigmoid and total colon (r = -0.5, P<0.001 and r = -0.5, P<0.001, respectively). The stool frequency was lower in the group with slow transit time (0.8 vs 2.3 per week, P = 0.014). In conclusion, most patients with chronic functional constipation had adequate dietary fiber intake. The negative correlation between stool frequency and colonic transit time increased progressively from proximal segments to distal segments of the colon. Patients with normal and prolonged colonic transit time differ in terms of stool frequency

O estudante de medicina da Universidade Federal de Minas Gerais: perfil e tendências / Undergraduate students of \"Universidade Federal de Minas Gerais\": profile and trends

OBJETIVOS: A proposta deste trabalho é investigar o perfil socioeconômico, o motivo de estudar medicina, a opçao por especialidade e residência médica e a preferência em trabalhar como profissional liberal ou assalariado entre os estudantes de medicina da Universidade Federal de Minas Gerais (UFMG). MÉTODO: Durante o ano de 1997, realizou-se estudo comparativo entre os estudantes de medicina da UFMG do 5o. período, iniciando o ciclo clínico, e aqueles do internato, terminando o ciclo clínico. Como instrumento foi utilizado um questionário distribuído a todos alunos das duas turmas. RESULTADOS: Houve grande semelhança entre os estudantes de 5o. período e os do internato. Em torno de 50 por cento dos estudantes eram do sexo feminino, mais da metade procedeu da capital do Estado, em Belo Horizonte, nasceu em família pequena com menos de três filhos, foi aprovada no primeiro vestibular e o pai cursou escola superior. A renda familiar situou-se entre 10 e 50 salários em 2/3 dos casos. Estes dados sao compatíveis com a origem de classe média alta, embora em aproximadamente 12 por cento a renda familiar foi inferior a 10 salários. A grande maioria estudou medicina por vocaçao ou altruísmo (80 por cento), raramente por questoes de mercado (<5 por cento). Houve grande preferência pela medicina como profissao liberal (98 por cento), mas em torno de 80 por cento aceitaria o emprego público como alternativa. Quase todos (98 por cento) pretendiam fazer residência médica e se tornar especialistas, poucos (<20 por cento) indicaram entre estas as especialidades de área geral, como clínica médica, gineco-obstetrícia, pediatria e cirurgia. CONCLUSAO: O estudo mostrou perfil socioeconômico relativamente elevado do estudante de medicina da UFMG e preferência pela prática especializada da medicina

Prevalence of anemia among school-children from Rio-Acima (State of Minas Gerais, Brazil): use of the standardized prevalence method and evaluation of iron deficiency

The prevalence of anemia and iron deficiency was investigated in 332 children aged 7 to 15 years, 156 (47 per cent) boys and 176 (53 per cent) girls enrolled in the schools of the municipality of Rio Acima, MG. Seventy-four children were white (22.3 per cent), 218 were mulatto (65.7 per cent), and 40 were black (12 per cent). Mean hemoglobin level was 12.75 ñ 0.75 g/ dl. Lower values were determined for black children (12.32 + 0.87 g/dl) compared to white (l2.76 ñ 0.99 g/dl) and mulatto (12.81 ñ 0.94 g/dl) children. The prevalence of anemia was 16.6 per cent when determined on the basis of the percentage of children with hemoglobin values lower than the 3rd percentile for age and sex (standard method), and 36.2 per cent when determined by the standardized prevalence method for the evaluation of the prevalence of malnutrition in populations. Depletion of iron reserves was 8.13 per cent for the population in general and 20 per cent for the anemic children. This low prevalence of iron deficiency may have been the result of the value adopted as the lower normal limit (10 ng/ml) for serum ferritin values. The small percentage of anemic children with iron depletion may also be justified by the standard of normality adopted for hemoglobin values which was originally elaborated for the white population of North America and Finland and therefore may be inadequate for the population studied here, of diverse racial composition.