Brain structural change associated with Cognitive Behavioral Therapy in maltreated children.

BACKGROUND: Severely maltreatment child is a harmful social factor that can disrupt normal neurodevelopment. Two commonly reported effects of maltreatment are post-traumatic stress disorder (PTSD) symptoms and brain structural and functional alteration. While Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is effectively used to reduce PTSD symptoms in maltreated children, yet, its impact on brain structural alterations has not been fully explored. This study investigated whether TF-CBT can attenuate alterations in brain structures associated with PTSD in middle childhood. METHODS: The study evaluated the longitudinal effects of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) on post-traumatic stress disorder (PTSD) symptoms and gray matter volume (GMV) in two groups of children under 12 years old: maltreated children (MC) and healthy non- maltreatmentd children (HC). Structural magnetic resonance images T1 were obtained before and after TF-CBT in the MC group, while the HC group was scanned twice within the same time interval. Voxel-based morphometry (VBM) was used to analyze GMV changes over time. RESULTS: After TF-CBT, maltreated children showed significantly reduced PTSD symptoms. Furthermore, a significant group-by-time interaction effect was observed in certain areas of the Left Temporal, Left Occipital, and bilateral Frontal Cortex, the Basal Ganglia and Cerebellum. These interaction effects were driven by a GMV decrease in the MC group compared to the HC group. GMV changes can be predicted with clinical improvement in the left Middle Temporal gyrus, left Precuneus, and Cerebellum. CONCLUSIONS: Our results suggest that TF-CBT intervention in very young maltreated children may have an effect on gray matter. This evidence demonstrates the importance of timely intervention when neuroplasticity mechanisms may be activated.

Can psychopathy be prevented? Clinical, neuroimaging, and genetic data: an exploratory study.

The aim of the study was to explore the relationship among brain functional activations elicited by an emotional paradigm, clinical scores (PTSD, anxiety, and depression), psychopathic traits, and genetic characteristics (5-HTTLPR) in a group of severely maltreated children compared to a healthy control group before and after the implementation of a Trauma Focused-Cognitive Behavioral Therapy. The final sample consisted of an experimental group of 14 maltreated children (mean age = 8.77 years old, S.D. = 1.83) recruited from a non-governmental shelter in Mexico City for children who had experienced child abuse and a control group of 10 children from the general population (mean age = 9.57 years old, S.D. = 1.91). Both groups were matched according to age and gender and were assessed before and after the implementation of the aforementioned therapy by means of clinical scales and an emotional paradigm that elicited brain activations which were recorded through functional magnetic resonance imaging. Genotyping of the 5-HTTLPR polymorphism was made at first assessment. A region of interest analysis showed amygdala hyperactivation during exposure to fear and anger stimuli in the maltreated children before treatment. Following therapy, a decrease in brain activity as well as a decrease in clinical symptoms were also observed. 5-HTTLPR polymorphism did not show any effect on the severity of clinical symptoms in maltreated children. Trauma-Focused Behavioral Therapy may help reorganize the brain's processing of emotional stimuli. These observations reveal the importance of an early intervention when the mechanisms of neuroplasticity may be still recruited.

To Mob or Not to Mob: Habitat and Time of Day Influence in Mobbing Behavior in the Azure-Winged Magpie (Cyanopica cookii).

While mobbing, individuals utter distinctive calls and perform visual threatening displays. Like any other antipredatory strategies, it involves some costs (time, energy, injuries, and even death). Therefore, mobbing would be expected to vary depending on the perceived magnitude of the predation risk. Moreover, harassment behavior can also serve as a demonstration of social status and to teach juveniles to recognize predators and related behaviors. Therefore, mobbing could also persist even when predation risk is particularly low. To test our hypotheses, we used tawny owl playbacks and a taxidermy mount to elicit the mobbing response in azure-winged magpies throughout the daylight period. To classify mobbing intensity, we created five categories depending on the proximity to the owl model at which the mobbing was performed. The results revealed that mobbing behavior in azure-winged magpies was more intense where predation risk was higher: in the most suitable habitat for the tawny owl, the forest, although considerable levels of mobbing were found in the dehesa and the ecotone, which indicate that mobbing has different purposes. However, we did not find statistically significant differences in mobbing intensity depending on the time of the day. We could not show a daily adjustment of antipredator response, but magpies modulated mobbing depending on the perceived risk linked to the habitat.

Noise-induced hearing loss correlates with inner ear hair cell decrease in larval zebrafish.

Anthropogenic noise can be hazardous for the auditory system and wellbeing of animals, including humans. However, very limited information is known on how this global environmental pollutant affects auditory function and inner ear sensory receptors in early ontogeny. The zebrafish (Danio rerio) is a valuable model in hearing research, including investigations of developmental processes of the vertebrate inner ear. We tested the effects of chronic exposure to white noise in larval zebrafish on inner ear saccular sensitivity and morphology at 3 and 5 days post-fertilization (dpf), as well as on auditory-evoked swimming responses using the prepulse inhibition (PPI) paradigm at 5 dpf. Noise-exposed larvae showed a significant increase in microphonic potential thresholds at low frequencies, 100 and 200 Hz, while the PPI revealed a hypersensitization effect and a similar threshold shift at 200 Hz. Auditory sensitivity changes were accompanied by a decrease in saccular hair cell number and epithelium area. In aggregate, the results reveal noise-induced effects on inner ear structure-function in a larval fish paralleled by a decrease in auditory-evoked sensorimotor responses. More broadly, this study highlights the importance of investigating the impact of environmental noise on early development of sensory and behavioural responsiveness to acoustic stimuli.

Impact of noise on development, physiological stress and behavioural patterns in larval zebrafish.

Noise pollution is increasingly present in aquatic ecosystems, causing detrimental effects on growth, physiology and behaviour of organisms. However, limited information exists on how this stressor affects animals in early ontogeny, a critical period for development and establishment of phenotypic traits. We tested the effects of chronic noise exposure to increasing levels (130 and 150 dB re 1 µPa, continuous white noise) and different temporal regimes on larval zebrafish (Danio rerio), an important vertebrate model in ecotoxicology. The acoustic treatments did not affect general development or hatching but higher noise levels led to increased mortality. The cardiac rate, yolk sac consumption and cortisol levels increased significantly with increasing noise level at both 3 and 5 dpf (days post fertilization). Variation in noise temporal patterns (different random noise periods to simulate shipping activity) suggested that the time regime is more important than the total duration of noise exposure to down-regulate physiological stress. Moreover, 5 dpf larvae exposed to 150 dB continuous noise displayed increased dark avoidance in anxiety-related dark/light preference test and impaired spontaneous alternation behaviour. We provide first evidence of noise-induced physiological stress and behavioural disturbance in larval zebrafish, showing that both noise amplitude and timing negatively impact key developmental endpoints in early ontogeny.

Characterization of the Natural Soundscape of Zebrafish and Comparison with the Captive Noise Conditions.

Zebrafish is a well-established model organism in hearing research. Although the acoustic environment is known to shape the structure and sensitivity of auditory systems, there is no information on the natural soundscape of this species. Moreover, zebrafish are typically reared in large-scale housing systems (HS), although their acoustic properties and potential effects on hearing remain unknown. We characterized the soundscape of both zebrafish natural habitats and laboratory captive conditions, and discussed possible impact on auditory sensitivity. Sound recordings were conducted in five distinct zebrafish habitats (Southwest India), from quieter stagnant environments with diverse biological/abiotic sounds to louder watercourses characterized by current and moving substrate sounds. Sound pressure level (SPL) varied between 98 and 126 dB re 1 µPa. Sound spectra presented most energy below 3000 Hz and quieter noise windows were found in the noisiest habitats matching the species best hearing range. Contrastingly, recordings from three zebrafish HS revealed higher SPL (122-143 dB) and most energy below 1000 Hz with more spectral peaks, which might cause significant auditory masking. This study establishes an important ground for future research on the adaptation of zebrafish auditory system to the natural soundscapes, and highlights the importance of controlling noise conditions in captivity.

Effects of Glutamine and Alanine Supplementation on Central Fatigue Markers in Rats Submitted to Resistance Training.

Recent evidence suggests that increased brain serotonin synthesis impairs performance in high-intensity intermittent exercise and specific amino acids may modulate this condition, delaying fatigue. This study investigated the effects of glutamine and alanine supplementation on central fatigue markers in rats submitted to resistance training (RT). Wistar rats were distributed in: sedentary (SED), trained (CON), trained and supplemented with alanine (ALA), glutamine and alanine in their free form (G + A), or as dipeptide (DIP). Trained groups underwent a ladder-climbing exercise for eight weeks, with progressive loads. In the last 21 days, supplementations were offered in water with a 4% concentration. Albeit without statistically significance difference, RT decreased liver glycogen, and enhanced the concentrations of plasma glucose, free fatty acids (FFA), hypothalamic serotonin, and ammonia in muscle and the liver. Amino acids affected fatigue parameters depending on the supplementation form. G + A prevented the muscle ammonia increase by RT, whereas ALA and DIP augmented ammonia and glycogen concentrations in muscle. DIP also increased liver ammonia. ALA and G + A reduced plasma FFA, whereas DIP increased this parameter, free tryptophan/total tryptophan ratio, hypothalamic serotonin, and the serotonin/dopamine ratio. The supplementations did not affect physical performance. In conclusion, glutamine and alanine may improve or impair central fatigue markers depending on their supplementation form.

Influência da superfície dentinária bovina na resistência de união de sistemas adesivos / Influence of bovine dentin surface on the bond strength of adhesive systems

O objetivo deste estudo foi avaliar o efeito da superfície dentinária bovinana resistência de união (RU) de dois sistemas adesivos. Em dois grupos (n = 5) o esmalte vestibular de incisivos bovinos foi removido até a exposição da camada intermediária de dentina. Nos outros dois grupos os dentes bovinos foram desgastados a partir da face lingual ultrapassando os limites da câmara pulpar expondo dessa forma a parede vestibular da câmara pulpar. Os dentes foram planificados e polidos em lixadeira rotatória com lixas nas granulações sequenciais e crescente de 120 até 600 a fim de padronizar a formação da smear layer. Os adesivos utilizados foram o Single Bond 2 (3M - ESPE) (SB2) e o ClearFill (Kuraray) (CF). Os dentes dos grupos tratados com SB 2 e os tratados com CF tiveram um bloco de resina composta (TPH 3, Dentsply) construído sobre cada superfície tratada. Após armazenagem por 24 h em estufa 37 ºC, cada conjunto dente/restauração foi seccionado nos eixos X e Y (ISOMET 1000, Buehler) para obter espécimes em forma de palito, contendo 1 mm² de área de secção transversal. A RU foi obtida em teste de microtração em máquina de ensaio universal (EMIC DL-1000)utilizando-se o dispositivo de Geraldeli, a uma velocidade de 0,5 mm/min.As fraturas foram analisadas em estereomicroscópio e classificadas em duas categorias: Tipo I – fratura adesiva, Tipo II – fratura mista.Os valores de resistência de união (MPa) foram submetidos a análise de variância de 2 fatores e ao teste de Tukey para comparação entre os grupos, ambos com α = 0,05. Foram obtidos os seguintes valores: G1 (normal/convencional) = 43,9 ± 4,8 MPa; G2 (invertido/convencional) =29,2 ± 5,4 MPa; G3 (normal/autocondicionante) = 13,9 ± 2,1 MPa e G4 (invertido/autocondicionante) = 12,7 ± 3,4 MPa, com significância para direção da dentina ,para os sistemas adesivos bem como para a interação dos fatores. Limitado pela metodologia do estudo pode se concluir que direção de colagem influencia na resistência de união...

The aim of this study was to evaluate the influence of bovine dentin surface on the bond strength (BS) of two adhesive systems. In two groups(n = 5) buccal enamel of bovine incisors was removed by exposing the middle dentin. In the other two groups bovine teeth were ground from the lingual surface exposing the buccal wall of the pulp chamber. The teeth were ground flat and polished on sequentially with # 120 to 600 sandpapers in order to standardize the smear layer. The adhesives were Single Bond 2 (3M - ESPE) (SB2) and Clear Fill (Kuraray) (CF). A block of composite resin (TPH 3, Dentsply) was constructed on the adhesive treated surface. After storage for 24 hours at 37 °C, each set was sectioned in X and Y (ISOMET 1000, Buehler) axes to obtain i-shaped specimens, with 1 mm² cross sectional area. The BS was obtained by mechanical microtensile testing in a universal testing (EMIC DL - 1000)using the Geraldeli’s device at cross head speed of 0.5 mm/min. The fractures were examined under a stereo microscope and classified into two categories: Type I - adhesive fracture, type II - mixed fracture. Data of bond strength (MPa) were submitted to 2-way ANOVA and Tukey's test for comparison between groups, both with α = 0.05. With the average values for the groups tested as follows: G1 (normal/Conventional) = 43,9 ± 4,8 MPa, G2 (invert/conventional) = 29,2 ± 5,4 MPa; G3 (normal/self-etching)= 13,9 ± 2,1 MPa and G4 (invert/self-etching) = 12,7 ± 3,4 MPa with significance for the direction of the dentin for adhesive systems as well asfor the interaction of factors. Limited by the methodology of the study it canbe concluded that the direction of bonding influences on the bond strength primarily in self-etching adhesives

Parafunção severa: reabilitação oral com prótese total mandibular X overlay maxilar: relato de caso / Parafunction severe: oral rehabilitation with mandibular prosthesis total X overlay jaw: case report

Na reabilitação oral muitos profissionais se aventuram buscando renovar o sorriso das pessoas. No entanto esses procedimentos tem muitas implicações funcionais e estéticas que devem ser seguidas de maneira criteriosa, para que o resultado final seja realmente o esperado. O restabelecimento das relações intermaxilares, da fonética, da função mastigatória, da estética e do conforto do paciente são os objetivos a serem alcançados com êxito. Uma grande ferramenta para atingir esses objetivos, quando é impossível a reconstrução imediata com próteses definitivas, é lançar mão de um tipo de prótese parcial removível chamada overlay. O bruxismo é uma manifestação do desequilíbrio biopsicologico que acomete o sistema estomatognático, caracterizando-se pelo apertamento e/ou atrição dos dentes entre si, de forma cêntrica ou excêntrica, podendo ser de manifestação noturna ou diurna. Já seus efeitos podem se manifestar em uma ou mais partes do sistema estomatognático, variando a severidade do dano conforme a resistência das estruturas atingidas, o tempo de existência, sua regularidade e o estado geral do portador. A descrição dos passos seguidos na solução desse caso, no qual o paciente apresentava ausência de todos os elementos dentais do arco mandibular enquanto no arco maxilar havia ausência apenas dos dentes 16 e 26, com exceção dos dentes 17 e 27, todos os demais dentes apresentavam um desgaste muito acentuado no sentido cérvico incisal denotando, perda de dimensão vertical, da qualidade da função mastigatória e um acentuado prejuízo fonético. Esse caso tem como propósito através da descrição de um passo-a-passo, nortear o início de uma reabilitação, assim como a fase transitória de tratamento para recuperação das relações intermaxilares funcionais e estéticas

In many oral rehabilitation professionals seeking venture renew people smile. However, these procedures have functional implications and aesthetic criteria which must be satisfied so that the final result is predictable. The restoration of relations intermaxillary, phonetics, masticatory function, esthetics and patient comfort are the goals to be achieved. An effective way to achieve these goals when immediate reconstruction with permanent dentures is not possible, make use of a type of partial denture called overlay. Bruxism is a manifestation of biopsychological imbalance that affects the stomatognathic system, characterized by clenching and / or attrition of teeth together so centric or eccentric, can be manifestation of nocturnal or diurnal. Its effects can manifest themselves in different parts of the stomatognathic system, varying the severity of the damage as the resistance of the structures affected, the time of existence, its regularity and the general state of the wearer. The description of the steps followed in solving this case, in which the patient edentulous mandibular arch while the maxillary arch showed absence of teeth 16 and 26 and, except for the teeth 17 and 27, all other teeth showed wear very sharp in the sense denoting incisal cervical, severe impairment of the vertical dimension, the quality of masticatory function and a marked impairment phonetic, this case report aims to guide the beginning of a rehabilitation, as well as the transitional phase of treatment for recovery of functional and aesthetic relationships intermaxillary

Efeitos do tratamento químico na descontaminação de superfícies de implantes metálicos: estudo microscópico em subcutâneos de ratos / Effects of chemical treatment of surfaces in decontamination of metallic implants: microscopic study in subcutaneous rats

O objetivo deste trabalho foi avaliar o efeito do tratamento químico com ácido cítrico, tetraciclina, EDTA e ácido fosfórico em discos de titânio de superfícies lisas e rugosas, após serem contaminados por biofilme bacteriano humano, e inseridos no tecido conjuntivo subcutâneo de ratos. Utilizou-se 180 discos de titânio, sendo 90 lisos e 90 rugosos, que foram colocados em 19 placas de acrílico utilizadas por voluntários durante 7 dias. Estes discos foram divididos em 12 grupos contendo 15 discos cada um: Grupo 1L: 15 discos lisos tratados com ácido cítrico; Grupo 1R: 15 discos rugosos tratados com ácido cítrico; Grupo 2L: 15 discos lisos tratados com tetraciclina ácida; Grupo 2R: 15 discos rugosos tratados com tetraciclina ácida; Grupo 3L: 15 discos lisos tratados com EDTA; Grupo 3R: 15 discos rugosos tratados com EDTA; Grupo 4L: 15 discos lisos tratados com ácido fosfórico; Grupo 4R: 15 discos rugosos tratados com ácido fosfórico; Grupo CL: 15 discos lisos que não receberam descontaminação (controle positivo liso); Grupo CR: 15 discos rugosos que não receberam descontaminação (controle positivo rugoso); Grupo EL: 15 discos lisos que não foram contaminados (controle negativo liso) e Grupo ER: 15 discos rugosos que não foram contaminados (controle negativo rugoso). Estes discos foram implantados no subcutâneo de ratos, os quais foram sacrificados após 7, 28 ou 84 dias. Foi realizada a avaliação microscópica descritiva e quantitativa do tecido conjuntivo formado nestes ratos. Foram avaliadas as médias das espessuras das cápsulas, a densidade de fibroblastos e de neutrófilos nos 3 períodos de tempo. Os resultados mostraram diferença na densidade de neutrófilos principalmente aos 7 dias e o ácido fosfórico mostrou os melhores resultados neste período, e ao final de 84 dias todos os tratamentos apresentaram resultados similares inclusive com relação ao grupo controle contaminado. Com relação à rugosidade os discos de superfícies lisas, apresentaram menor média...

The purpose of this investigation was to evaluate the effects of treatment with citric acid, tetracycline, EDTA and phosphoric acid in titanium disks in smooth and roughened surfaces contaminated by bacterial biofilms in the connective tissue of rats. One hundred eighty titanium disks were used; 90 smooth surfaces and 90 roughened titanium surfaces, which were placed in 19 acrylic plates that were used by volunteers for 7 days. These disks were divided into 12 groups containing 15 disks each; Group 1L: 15 smooth disks were treated with citric acid; Group 1R: 15 roughened disks were treated with citric acid; Group 2L: 15 smooth disks were treated with tetracycline acid; Group 2R: 15 roughened disks were treated with tetracycline rough acid; Group 3L: 15 smooth disks were treated with EDTA; Group 3R: 15 roughened disks were treated with EDTA; Group 4L: 15 smooth disks were treated with phosphoric acid; Group 4R: 15 roughened disks were treated with phosphoric acid; Group CL: 15 smooth disks received no econtamination (smooth positive control); CR: 15 roughened disks did not receive decontamination (roughened positive control); EL: 15 smooth disks were not infected (smooth negative control) and ER: 15 roughened disks were not infected (roughened negative control). These disks were implanted subcutaneously in rats that were sacrificed after 7, 28 or 84 days. A descriptive and quantitative microscopic evaluation was performed. The average thickness of the capsules and the density of fibroblasts and neutrophils in three time periods were evaluated. The results showed differences in the density of neutrophilis mainly at 7 days and phosphoric acid showed the best results in this period, and at the end of 84 days, all treatments showed similar results even with the control group infected. In relation to the roughness, the smooth disks had a lower average capsule thickness compared with roughened disks, perhaps demonstrating an aspect of greater ....

Molhabilidade de material reembasador: efeito dos agentes químicos de limpeza / Wettability of denture relining materials: effect of denture cleanser

Riscos de injúrias mecânicas contra indicam a escovação e elegem os agentes químicos como meios adequados para higienização diária de próteses removíveis reembasadas com materiais resilientes. Foi avaliado o efeito de agentes químicos de limpeza sobre a capacidade de umedecimento de uma marca comercial de reembasador resiliente acrílico (Dentusoft®) por uma marca comercial de gesso pedra tipo IV (Durone IV®). Utilizou-se 20 discos de resina acrílica termoativada (VipiCril®) com 30mm de diâmetro e 4mm de espessura, recobertos por 2mm de reembasador. Divididos em 4 grupos foram estocados em saliva artificial a 37+1ºC por 30dias, imersos diariamente por 15minutos em água destilada(GI), pastilhas efervescentes (Corega®Tabs) à base de peróxido (GII), solução de bicarbonato de sódio(GIII) ou solução de hipoclorito de sódio (GIV), após os quais, sobre o reembasador foram vertidos 2ml de gesso tipo IV (Durone IV®). Atingida a presa final do gesso os espécimes foram seccionados vertical e medianamente, regularizados com lixa de água nº400 e montados em dispositivo adequado para leitura (nos lados direito e esquerdo) do ângulo de contato em microscópio Carl Zeiss (precisão 0,001). Os resultados obtidos, submetidos à análise, mostraram distribuição não-normal, optando-se por teste não-paramétrico. Realizado teste de Kruskal Wallis a 5% de significância, verificou-se diferença estatística entre os grupos, com média menor do ângulo de contato para GII. Concluiu-se que o agente químico de limpeza Corega®Tabs permitiu a melhor adaptação do material reembasador pelo gesso estudado

Risk of mechanical injuries contraindicate brushing and elect chemical agents as appropriate for daily cleaning of dentures relined with resilient materials. It was evaluated the effect of denture cleansers on the wettability of denture relining material (Dentusoft, Dental Medrano). We used 20 discs of acrylic resin thermoactivated VipiCril® with 30mm diameter and 4mm thick, covered by 2mm Dentusoft®. Divided into 4grupos were stored in artificial saliva at 37 +1 ºC for 30 days, immersed daily for 15minutes in distilled water (GI), Corega®Tabs (GII), a solution of sodium bicarbonate (GIII) or solution of sodium hypochlorite (GIV) after which, on the soft liner were poured 2 ml of type IV gypsum (Durone IV, Dentsply). Reached the final setting of the gypsum specimens were sectioned vertically and medially, settled water with sandpaper No. 400 and mounted on suitable device for reading (in the right and left) of the contact angle Carl Zeiss microscope (precision, 001). The results were submitted to analysis, showed non-normal distribution, opting for non-parametric test. Kruskal Wallis test performed at 5% significance, there was statistical difference between the groups with lower average contact angle for GII. It was concluded that the chemical cleaning Corega Tabs® allowed a better adaptation of relining the gypsum studied

Compatibilidade entre alginato e gesso ortodônticos: capacidade de umedecimento sob influência da desinfecção do molde / Compatibility of alginate and orthodontic stone under disinfection

O mercado odontológico tem ofertado materiais de moldagem e modelo para uso ortodôntico garantindo modelos precisos. A compatibilidade entre estes materiais é definida pelo umedecimento das superfícies do molde pela mistura água/gesso sobre ela vazada e sofre influência de método de desinfecção do molde e solução desinfetante utilizada. Avaliou-se a influência da desinfecção por aspersão com hipoclorito de sódio 1% sobre a capacidade de umedecimento de duas marcas comerciais de alginato (Jeltrate® e Orthoprint®) por duas marcas comerciais de gesso pedra tipo III (Gesso Rio® e Orthogesso®). Foram confeccionados 20 moldes de cada tipo de alginato, os quais foram divididos em dois grupos (Água e Hipoclorito de sódio), recebendo respectivamente aspersão com água e hipoclorito de sódio 1%. Cada grupo de moldes foi então novamente dividido em dois subgrupos, sendo que sobre a superfície dos moldes foram vertidos 2 ml de gesso (Gesso Rio® ou Orthogesso®). Atingida a presa final, os modelos foram seccionados vertical e medianamente e montados para leitura do ângulo de contato em microscópio Carl Zeiss (0.001). Os resultados obtidos foram submetidos ao teste ANOVA e mostraram significância estatística para as soluções utilizadas. Conclui-se que a desinfecção dos moldes com aspersão de hipoclorito de sódio 1% melhorou a capacidade de umedecimento dos alginatos pelos gessos estudados

The dental trade has offered dental impression and dental stone for orthodontic use ensuring accurate models. The compatibility between these materials is defined by the wetting of the model surfaces by the mixture water/stone poured over it and the influenced by the method of disinfection of model and disinfectant solution used. It was evaluated the influence of spray disinfection with sodium hypochlorite 1% on the wettability of two commercial alginate (Jeltrate® - Dentsply and Orthoprint® - Zhermack) at two commercial type III gypsum (Rio® - ME and AOBussoli Orthogesso Orthogesso®-SA). Twenty models were fabricated for each type of alginate, which were divided into two groups (water and sodium hypochlorite), receiving respectively water and sodium hypochlorite 1% spray. Each group of models was then further divided into two subgroups, and on their surface were poured 2 ml of type III gypsum (Gesso Rio® or Orthogesso®). Reached the final setting of the gypsum specimens were sectioned vertically and medially, settled water with sandpaper No. 400 and mounted on suitable device for reading (in the right and left) of the contact angle Carl Zeiss microscope (precision, 001). The results were submitted to ANOVA and founded statistical significance for solutions used. It was concluded that sodium hypochlorite spray improved wettability of alginates studied

Clinical comparative study of dose-volume and equivalent uniform dose based predictions in post radiotherapy acute complications.

BACKGROUND: Single points placed on Dose-Volume Histograms (DVHs) for treatment plan acceptance are still widely used compared to the Equivalent Uniform Dose (EUD). The aim of this work is to retrospectively measure and compare the ability of both criteria in correctly predicting two clinical outcomes, RTOG grade 2 acute gastrointestinal (GI) and genitourinary (GU) complications in 137 patients treated for prostate cancer. MATERIAL AND METHODS: For both complications,the best predictions have been achieved by fitting the EUD parameter and a tolerance dose (for a varying DVH point) by maximization of the Area Under the Receiver Operating Curve (AUROC). A complementary likelihood fitting of the Lyman's Normal Tissue Complication Probability (NTCP) allowed a graphical comparison between expected and observed frequencies, and to derive the associated parameters. RESULTS AND DISCUSSION: No significant differences were found in the AUROC values obtained by using dose-volume or EUD criteria, but all the results highlighted the role of high doses. Limiting V65 (for grade 2 GI) or V73 (for grade 2 GU) was as predictive as limiting EUD value, with n equal to 0.09 or 0.06 respectively, but in all cases AUROC values were low (< 0.7). Likelihood fitting gave m = 0.195 and TD50=72.5 Gy (fixing n=0.06 for acute GU) and m=0.19 and TD50=66 Gy (fixing n=0.09 for acute GI). Both AUROC and likelihood values revealed a better fit for acute GI than for acute GU. The use of a fractionation correction, new clinical contours or previous risk factors could improve these values.

Amputación domiciliaria de ortejos en pacientes diabéticos / At home digital amputation for diabetic foot

Introducción: tradicionalmente las amputaciones de ortejos por pie diabético se realizan en el quirófano con incremento en los costos de atención. No encontramos antecedentes que validen la realización del procedimiento en el domicilio.Métodos: en el periodo del 1 de agosto de 1997 al 30 de enero de 1998, se comparó retrospectivamente la morbilidad y mortalidad de pacientes con infección y necrosis de ortejos amputados en el domicilio (grupo 1; n = 14), en el consultorio (grupo 2; n = 11) y en el hospital (grupo 3; n = 20). Análisis estadístico: para variables nominales se usó Ji cuadrada o prueba exacta de Fisher y para las continuas ANOVA o Kruskal-Wallis.Resultados: las características demográficas y clínicas (edad, sexo, años de evolución de la diabetes, semanas de evolución de la lesión, número de ortejos amputados, pie afectado, enfermedad asociada y complicaciones crónicas) fueron similares en los grupos de estudio (p > 0.05). Las complicaciones y el nivel de reamputación en los pacientes complicados fueron independientes del lugar del procedimiento (p > 0.05). Sin nueva lesión o reamputación en el grupo domiciliario, un paciente del segundo requirió reamputación mayor por insuficiencia arterial. Ocho pacientes hospitalizados (grupo 3) con lesión fueron reamputados por problema vascular (p > 0.05). No se presentaron defunciones. Discusión: las amputaciones digitales realizadas en el domicilio, el consultorio o la cama del paciente mostraron evolución clínica similar, dentro de un programa de atención integral, por lo que son una opción en pacientes seleccionados.

Tratamiento domiciliario de pacientes diabéticos con úlcera del pié / Home treatment of diabetic patients with foot ulcers

Se realizó un estudio retrospectivo y comparativo con dos grupos. El grupo A estuvo formado por 60 diabéticos con úlceras del pie que fueron egresados tempranamente del Centro Médico Nacional "Adolfo Ruiz Cortines" para su atención ambulation y/o domiciliaria. El grupo B, o control, incluyó 77 pacientes hospitalizados durante los ocho meses previos a dicha atención, con características clínicas y demográficas similares a los del grupo A(p>0.05), con excexcepción de la duración en semanas de la lesión, más corta (p<0.001) en el grupo a (6.2ñ5.7) que en el B (15.3ñ14.3). El promedio de días de estancia, los reingresos hospitalarios y, consecuentemente, los costos de atención fueron menores en el grupo A (8.9ñ6.3 y 11-6 por ciento) que en el B (19.8ñ10.16 y 46.7 por ciento). Los principales motivos de reingreso fueron la necesidad de amputación, el incremento o complicación de la lesión y la descompensación metabólica.