Perspectives on the Therapeutic Effects of Pelvic Floor Electrical Stimulation: A Systematic Review.

Pelvic, perineal, and nervous lesions, which derive principally from pregnancy and childbirth, may lead to pelvic floor dysfunctions, such as organ prolapses and lesions in the nerves and muscles due to muscle expansion and physiology. It is estimated that 70% of women affected by this clinical picture have symptoms that do not respond to the classical treatments with antimuscarinic and anticholinergic drugs. Therefore, resorting to efficient alternatives and less invasive methods is necessary to assist this public health problem that predominantly affects the female population, which is more susceptible to the risk factors. This study aimed to perform an updated and comprehensive literature review focused on the effects of pelvic floor electrical stimulation, considering new perspectives such as a correlation between electric current and site of intervention and other molecular aspects, different from the present reviews that predominantly evaluate urodynamic aspects. For that purpose, PubMed and ScienceDirect databases were used to perform the search, and the Methodi ordinatio method was applied. With well-researched therapeutic effects, electrical stimulation induced promising results in histological, nervous, and molecular evaluations and spinal processes, which showed beneficial results and revealed new perspectives on ways to evoke responses in the lower urinary tract in a non-invasive way. Thus, it is possible to conclude that this type of intervention may be a non-invasive alternative to treat pelvic and perineal dysfunctions.

Corneal endothelial cell density and pterygium: a cross-sectional study.

PURPOSE: To investigate the effects of pterygium on corneal endothelial cell density in patients with unilateral pterygium. METHODS: We performed a cross-sectional analysis of data from patients with unilateral pterygium who were selected from September 1, 2015 to July 31, 2016 at Hospital de Base do Distrito Federal to assess the corneal endothelial cell density, coefficient of variation in the cell area, hexagonality, and corneal pa-chymetric results. In all patients, noncontact specular microscopy was performed in both eyes and a minimum endothelial cell count of 75 cells/mm2 was required for inclusion in the study. The contralateral eye served as the control. RESULTS: Sixty-one patients were included in the study. Twenty-nine (47.5%) patients were men and 32 (52.5%) were women (mean age, 50.84 ± 13.8). The percentage of pterygium that invaded the cornea ranged from 4.87% to 24.59% (median, 9.70% ± 4.99%). The mean corneal endothelial cell density (cells/mm) was lower in the pterygium eyes than in the controls (2451.83 ± 284.96 vs. 2549.95 ± 268.94, respectively; p=0.04). No differences in the mean coefficients of variation of cell size, hexagonality, and corneal pachymetric results were observed between the patients and controls. The Pearson correlation test showed a significant negative linear relationship between pterygium invasion and endothelial cell density [p<0.001, n=61, r=-0.553 (95% CI, -0.34 to -0.73)]. CONCLUSION: Compared with the contralateral eyes, those of patients with unilateral pterygium were associated with a decrease in corneal endothelial cell density.

Corneal endothelial cell density and pterygium: a cross-sectional study / Contagem de células endoteliais e pterígio: um estudo transversal

ABSTRACT Purpose: To investigate the effects of pterygium on corneal endothelial cell density in patients with unilateral pterygium. Methods: We performed a cross-sectional analysis of data from patients with unilateral pterygium who were selected from September 1, 2015 to July 31, 2016 at Hospital de Base do Distrito Federal to assess the corneal endothelial cell density, coefficient of variation in the cell area, hexagonality, and corneal pa­chymetric results. In all patients, noncontact specular microscopy was performed in both eyes and a minimum endothelial cell count of 75 cells/mm2 was required for inclusion in the study. The contralateral eye served as the control. Results: Sixty-one patients were included in the study. Twenty-nine (47.5%) patients were men and 32 (52.5%) were women (mean age, 50.84 ± 13.8). The percentage of pterygium that invaded the cornea ranged from 4.87% to 24.59% (median, 9.70% ± 4.99%). The mean corneal endothelial cell density (cells/mm) was lower in the pterygium eyes than in the controls (2451.83 ± 284.96 vs. 2549.95 ± 268.94, respectively; p=0.04). No differences in the mean coefficients of variation of cell size, hexagonality, and corneal pachymetric results were observed between the patients and controls. The Pearson correlation test showed a significant negative linear relationship between pterygium invasion and endothelial cell density [p<0.001, n=61, r=-0.553 (95% CI, -0.34 to -0.73)]. Conclusion: Compared with the contralateral eyes, those of patients with unilateral pterygium were associated with a decrease in corneal endothelial cell density.

RESUMO Objetivo: Investigar os efeitos do pterígio na densidade de células endoteliais cor­neanas em pacientes com pterígio unilateral. Métodos: Foi realizado um estudo do tipo transversal envolvendo pacientes com pterígio unilateral selecionados entre 1 de setembro de 2015 a 31 de julho de 2016 no Hospital de Base do Distrito Federal para avaliar a densidade de células endoteliais corneanas, coeficiente de variação da área celular, hexagonalidade, e paquimetria corneana. Em todos os pacientes foram realizadas microscopias especulares de não-contato em ambos os olhos, sendo necessário obter uma contagem endotelial mínima de 75 células/mm2 para que o paciente fosse incluído no estudo. O olho contralateral funcionou como grupo controle. Resultados: Um total de 61 pacientes foram incluídos no estudo. Vinte e nove (47,5%) eram homens e 32 (52,5%) mulheres. A média de idade era de 50,84 ±13,8. O percentual de invasão do pterígio na córnea variou entre 4,87% a 24,59%, com uma mediana de 9,70% ± 4,99%. A media de densidade de células endoteliais corneanas foi menor nos olhos com pterígio quando comparados ao grupo controle (2451,83 ± 284,96 vs 2549,95 ± 268,94; p=0,04). Não foram encontradas diferenças entre os casos e controles em relação à média do coeficiente de variação da área celular, hexagonalidade, e paquimetria. Teste de correlação de Pearson mostrou uma relação linear negativa entre a invasão do pterígio e a densidade de células endoteliais corneanas [p<0,001, n=61, r=-0,553 (95% CI -0,34 a -0,73)]. Conclusão: Em pacientes com pterígio unilateral, o olho com pterígio está asso­ciado a uma menor densidade de células endoteliais corneanas quando comparado ao olho contralateral.

Electrical stimulation structurally affects the tissues of the rectum and anus of nulliparous rats.

Considering that the muscles of the anus perform a critical role in maintaining continence, losses in their structure can negatively affect the physiological control of the intestinal contents. Anorectal electro-stimulation (ARES) has been reported to have a positive effect on the functionality of treated patients, but how ARES affects the structural tissues of the anorectal segment remains unknown. Because the study of how ARES structurally affects human tissues is not possible, this study aimed to clarify these effects in a murine model, which has a similar anorectal segment (structure and physiology) to humans. For the descriptive and comparative study, randomly selected nulliparous adult Wistar rats (n = 5) were submitted to 30 anorectal sessions of ARES with a biphasic current (700 µs, 50 Hz from 2 to 4 mA). After treatment, the animals were euthanized, and the anorectal segments were dissected and processed for histopathological analysis. Our results showed that ARES increased the widths of the mucosal, submucosal and muscle layers of the rectum, as well as the number of leukocytes in the mucosa. ARES also caused hyperplasia of the smooth muscle of the internal anal sphincter and hypertrophy of the external anal sphincter muscle. In conclusion, our results showed that ARES had not only a positive effect on the structure (morphology) of all tissues associated with the rectum and anus but, more importantly, on the structural gain of the muscles (hyperplasia and hypertrophy), which could point to a functional gain of the anal sphincter, reinforcing the applicability of ARES as a non-invasive treatment for anal incontinence.

Detecção de simulação com o uso do wisconsin card sorting test e do trail making test / Detection of malingering using the wisconsin card sorting test and the trail making test

Neste trabalho, tentamos identificar índices de simulação na avaliação neuropsicológica forense, através da avaliação dos padrões de resposta em provas neuropsicológicas. A amostra foi constituída por 56 sujeitos com traumatismo crânioencefálico. Todos se encontravam numa situação de possível recompensa monetária por incapacidade. Utilizamos os instrumentos Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT), Inventário de Sintomas Psicopatológicos (BSI), e a grelha de análise dos autos do processo. Cerca de 30% da amostra enquadrou-se no grupo de prováveis simuladores. Essa porcentagem é congruente com a literatura. Verificou-se uma grande homogeneidade entre os indivíduos com e sem indicadores de simulação, a nível sintomatológico e características sócio-demográficas, o que reforça a necessidade de desenvolvimento de métodos eficazes na detecção da simulação.(AU)

The objective of this study was to identify indicators of malingering in forensic neuropsychological assessment by identifying response patterns in neuropsychological tests. The sample was composed by 56 subjects diagnosed with a cranioencephalic trauma. All subjects were in a situation of monetary reward if incapacity was proven. The instruments used were the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT), the Brief Symptom Inventory (BSI), and a legal process data file. Approximately 30% of the studied sample was identified as probable malingerers. This percentage is consistent with the literature. We identified a high level of homogeneity of psychological symptoms and socio-demographic features in the group of subjects with indicators of malingering and in the group without such indicators. These results reinforce the necessity to develop efficient methods to detect malingering.(AU)

Detecção de simulação com o uso do wisconsin card sorting test e do trail making test / Detection of malingering using the wisconsin card sorting test and the trail making test

Neste trabalho, tentamos identificar índices de simulação na avaliação neuropsicológica forense, através da avaliação dos padrões de resposta em provas neuropsicológicas. A amostra foi constituída por 56 sujeitos com traumatismo crânioencefálico. Todos se encontravam numa situação de possível recompensa monetária por incapacidade. Utilizamos os instrumentos Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT), Inventário de Sintomas Psicopatológicos (BSI), e a grelha de análise dos autos do processo. Cerca de 30% da amostra enquadrou-se no grupo de prováveis simuladores. Essa porcentagem é congruente com a literatura. Verificou-se uma grande homogeneidade entre os indivíduos com e sem indicadores de simulação, a nível sintomatológico e características sócio-demográficas, o que reforça a necessidade de desenvolvimento de métodos eficazes na detecção da simulação.

The objective of this study was to identify indicators of malingering in forensic neuropsychological assessment by identifying response patterns in neuropsychological tests. The sample was composed by 56 subjects diagnosed with a cranioencephalic trauma. All subjects were in a situation of monetary reward if incapacity was proven. The instruments used were the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT), the Brief Symptom Inventory (BSI), and a legal process data file. Approximately 30% of the studied sample was identified as probable malingerers. This percentage is consistent with the literature. We identified a high level of homogeneity of psychological symptoms and socio-demographic features in the group of subjects with indicators of malingering and in the group without such indicators. These results reinforce the necessity to develop efficient methods to detect malingering.

Metabolic and cardiac autonomic effects of high-intensity resistance training protocol in Wistar rats.

The aim of this study was to assess the effects of metabolic and autonomic nervous control on high-intensity resistance training (HRT) as determined by pancreatic glucose sensitivity (GS), insulin sensitivity (IS), blood lactate ([La]), and heart rate variability (HRV) in rats. Thirty male, albino Wistar rats (292 ± 20 g) were divided into 3 groups: sedentary control (SC), low-resistance training (LRT), and HRT. The animals in the HRT group were submitted to a high-resistance protocol with a progressively increasing load relative to body weight until exhaustion, whereas the LRT group performed the same exercise regimen with no load progression. The program was conducted 3 times per week for 8 weeks. The [La], parameters related to the functionality of pancreatic tissue, and HRV were measured. There was a significant increase in peak [La] only in the HRT group, but there was a reduction in [La] when corrected to the maximal load in both trained groups (LRT and HRT, p < 0.05). Both trained groups exhibited an increase in IS; however, compared with SC and LRT, HRT demonstrated a significantly higher GS posttraining (p < 0.05). With respect to HRV, the low-frequency (LF) band, in milliseconds squared, reduced in both trained groups, but the high-frequency band, in milliseconds squared and nu, increased, and the LF in nu, decreased only in the HRT group (p < 0.05). The HRT protocol produced significant and beneficial metabolic and cardiac autonomic adaptations. These results provide evidence for the positive benefits of HRT in counteracting metabolic and cardiovascular dysfunction.

Microscopic evaluation of the effect of different storage media on the periodontal ligament of surgically extracted human teeth.

The objective of this study was to microscopically evaluate the human periodontal ligament adhered to extracted teeth, after extra-alveolar period of 1 h using, as storage media, pasteurized milk (group I), chicken egg white (group II) and artificial saliva (group III). Forty intact premolars were selected, with indication of tooth extraction for orthodontic reasons. After the extraction of 30 teeth, they were maintained dried on a gauze at room temperature for 10 min, and then immersed in the selected storage media. After the established time, the teeth were washed with saline solution and placed in 10.0% buffered formalin. Ten teeth were extracted and immediately immersed in 10.0% neutral formalin (group IV). Thereafter, they were submitted to histological processing. After fixation and decalcification, the specimens were cut at the cervical, medium and apical thirds, inserted in paraffin and serially sectioned, with 6-mum thickness. They were stained by hematoxylin-eosin and analyzed under light microscopy. According to the results of quantitative analysis, there was no statistically significant difference in the number of cells per mm(2) between groups I, II and III. The qualitative analysis showed similar results in relation to the organization of collagen fibers and the number of cells in groups I and II, but group III displayed a higher disorganization of the collagen fibers and also a higher reduction in the number of cells. Based on these results, it was concluded that the quality of periodontal ligament was affected by the storage media, when compared with the control group. There was a statistically significant difference in the number of cells per mm(2) between the control group and groups I, II and III. There was no significant statistical difference in the number of cells per mm(2) between groups I, II and III.

Intrusive luxation: a case report.

Intrusive luxation is one of the most severe types of dental trauma. The occurrence of pulp necrosis in intruded teeth with open apices is 100%. The risk of development of inflammatory or replacement root resorptions is high. Thus, endodontic intervention is required soon after the occurrence of trauma, in an attempt to prevent or delay the appearance of such lesions. On the other hand, the access to the root canal is difficult, as the crown is intruded. A multidisciplinary approach comprising Surgery, Orthodontics and Endodontics is required to allow exposure of the crown, orthodontic extrusion and onset of endodontic therapy. The patient GCSA, aged 15 years, attended the community project 'Lugar de dente é na boca' ('teeth should be in the mouth') of the Federal University of Goiás, Brazil, 1 week after complete intrusion of the right maxillary central incisor. Radiographic examination revealed that the incisal edge of this tooth was at the level of the crown-root interface of the adjacent teeth. After surgical exposure of the crown, pulp sensitivity was evaluated and was found to be negative. After onset of endodontic therapy, the patient was referred for orthodontic extrusion of the intruded tooth. Successive changes of root canal dressing were performed and the root canal was definitely obturated at 3 years and 6 months after onset of treatment. The present paper reports on a case of severe intrusive luxation, discusses the different treatments recommended for repositioning of traumatically intruded teeth, and questions the ideal period of maintenance of calcium hydroxide dressing in the root canal, in an attempt to prevent the occurrence of root resorption and repair any existing resorption.

Avaliação microscópica do efeito de diferentes meios de conservação sobre o ligamento periodontal de dentes humanos extraídos cirurgicamente / Microscopic evaluation of the effect of differents storage media on periodontal ligament of human's teeth surgical extracted

O objetivo do presente trabalho consistiu em avaliar microscopicamente o ligamento periodontal humano aderido ao dente extraído, após o período extra-alveolar de uma hora, tendo sido utilizados, como meios de conservação, o leite bovino pasteurizado (Grupo I), a clara do ovo de galinha (Grupo II) e a saliva artificial (Grupo III). Foram selecionados quarenta pré molares hígidos, com indicação de exodontia, por finalidade ortodôntica. Após a extração de trinta dentes, foram mantidos a seco sobre uma gaze, em temperatura ambiente, por dez minutos e, a seguir, imersos nos meios de conservação selecionados. Dez dentes foram extraídos e imersos imediatamente no formol neutro a 10,0% (Grupo IV). Após o período de tempo estabelecido, os dentes foram lavados com soro fisiológico e colocados no formol tamponado a 10,0%. No grupo controle, os dez dentes foram extraídos e, imediatamente, imersos no formol neutro a 10,0%. A seguir, foram encaminhados para processamento histológico. Após a fixação e descalcificação, as peças foram cortadas nos terços cervical, médio e apical, incluídas em parafina e cortadas seridamente com seis micrometros de espessura, coradas pela hematoxilina-eosina e analisadas sob microscopia óptica. De acordo com os resultados da análise quantitativa, não houve diferença estatisticamente significante entre o número de células, por mm², entre os grupos I, II, e III. A análise qualitativa mostrou resultados semelhantes com relação à organização dos feixes de fibras colágenas e à celularidade dos grupos I e II, mas no grupo III pôde ser observada uma maior desorganização dos feixes de fibras colágenas e também uma redução maior na celularidade. Concluímos que a qualidade do ligamento periodontal foi afetada pelos meios de conservação quando comparada com o grupo controle; houve diferença, estatisticamente significante no número de células por mm², entre o grupo controle e aqueles que foram mantidos a seco por dez minutos e, a seguir, imersos em leite bovino, clara de ovo de galinha e saliva artificial, pelo período de uma hora; não houve diferença estatisticamente significante entre o número de células por mm², entre os grupos de dentes conservados no leite bovino pasteurizado, na clara do ovo de galinha e na saliva artificial

Tumor odontogênico adenomatóide associado a pré-molar retido / Adenomatois odontogenic tumour associated to impacted premolar

Os autores apresentam um caso clínico de tumor odontogênico adenomatóide associado ao 1§ pré-molar superior retido e discutem alguns pontos referentes a origem desse tumor no complexo maxilo-mandibular