Implications of Salinity and Acidic Environments on Fitness and Oxidative Stress Parameters in Early Developing Seahorses Hippocampus reidi.

Water acidification affects aquatic species, both in natural environmental conditions and in ex situ rearing production systems. The chronic effects of acidic conditions (pH 6.5 vs. pH 8.0) in seahorses (Hippocampus spp.) are not well known, especially when coupled with salinity interaction. This study investigated the implications of pH on the growth and oxidative stress in the seahorse Hippocampus reidi (Ginsburg, 1933), one of the most important seahorse species in the ornamental trade. Two trials were carried out in juveniles (0-21 and 21-50 DAR-days after the male's pouch release) reared under acid (6.5) and control (8.0) pH, both in brackish water (BW-salinity 11) and seawater (SW-salinity 33). In the first trial (0-21 DAR), there was no effect of pH on the growth of seahorses reared in SW, but the survival rate was higher for juveniles raised in SW at pH 6.5. However, the growth and survival of juveniles reared in BW were impaired at pH 6.5. Compared to SW conditions, the levels of superoxide dismutase and DT-diaphorase, as well as the oxidative stress index, increased for juveniles reared in BW. In the second trial, seahorse juveniles were reared in SW at pH 8.0, and subsequently kept for four weeks (from 21 to 50 DAR) at pH 6.5 and 8.0. The final survival rates and condition index were similar in both treatments. However, the growth under acidic conditions was higher than at pH 8.0. In conclusion, this study highlights that survival, growth, and oxidative status condition was enhanced in seahorse juveniles reared in SW under acidic conditions (pH = 6.5). The concurrent conditions of acidic pH (6.5) and BW should be avoided due to harmful effects on the fitness and development of seahorse juveniles.

Turnover Rates and Diet-Tissue Discrimination Factors of Nitrogen and Carbon Stable Isotopes in Seahorse Hippocampus reidi Juveniles Following a Laboratory Diet Shift.

The initial development of seahorse juveniles is characterized by low digestion capabilities. Stable isotope analysis is an effective tool in studies of trophic food webs and animal feeding patterns. The present study provides new insights for the understanding of growth and food assimilation in early developing seahorses following a laboratory diet switch. The study was performed in the early life stages of the seahorse Hippocampus reidi by assessing the influence of diet shift on changes and turnovers in carbon (δ13C) and nitrogen (δ15N) stable isotope in juveniles. Newborn seahorses were fed for 60 days following two feeding schedules (A6 and A11) based initially on copepods Acartia tonsa and subsequently on Artemia nauplii (since days 6 and 11, respectively). After the prey shift, we determined δ13C and δ15N turnover rates as functions of change in either body mass (fitting model G) and days of development (fitting model D), contributions of metabolism and growth to those turnover rates, and diet-tissue discrimination factors. Survival, final dry weight, and final standard length for diet A11 were higher compared to diet A6. The shift from copepods to Artemia led to fast initial enrichments in δ13C and δ15N. Afterwards, the enrichment was gradually reduced until the isotopic equilibrium with the diet was reached. In most cases, both fitting models performed similarly. The isotopic analysis revealed that 100% of tissue turnover was attributed to growth in diet A11, whereas 19-25% was linked to metabolism in diet A6. Diet-tissue discrimination factors were estimated for the first time in seahorse juveniles, resulting in higher estimates for diet A11 (2.9 ± 0.7‱ for δ13C; 2.5 ± 0.2‱ for δ15N) than in diet A6 (1.8 ± 0.1‱ for δ13C; 1.9 ± 0.1‱ for δ15N). This study highlights the relevance of feeding on copepods and their effect on isotopic patterns and discrimination factors in seahorse juveniles after a dietary shift. Regarding the application of the results achieved in relation to the feeding schedules in the rearing of H. reidi, a long period of feeding on copepods during the first days of development is highly recommended.

The Protective Role of Self-Compassion in the Relationship between Perfectionism and Burnout in Portuguese Medicine and Dentistry Students.

Recent studies have documented the high prevalence of burnout among medicine and dentistry students, with potentially catastrophic consequences for both students and patients. Both environmental and personality factors play a part in burnout; perfectionism, a common trait in medicine students' personalities, has been linked to psychological distress and increasing students' vulnerability to burnout. Self-compassion, i.e., treating oneself kindly through hardship, has recently emerged as a buffer between perfectionism and psychological distress. While using a novel three-factor conceptualization of perfectionism (BIG3), this study aims to analyze if self-compassion has a protective role in the relationship between perfectionism and burnout, in a sample of medicine and dentistry students, through mediation analysis. We found that self-compassion significantly mediated the relationship between all three forms of perfectionism and burnout: as a partial mediator in self-critical and rigid perfectionism, as well as a full mediator in narcissistic perfectionism. Our findings underline self-compassion's relevance in burnout prevention and management, supporting its use as an intervention target in burnout reduction programs and strategies.

Does acidification lead to impairments on oxidative status and survival of orange clownfish Amphiprion percula juveniles?

The nitrification process in recirculating aquaculture systems can reduce water pH. Fish can also be exposed to water acidification during transport, an important feature in the aquarium industry, as live fish can be kept in a closed environment for more than 24 h during overseas aerial transportation. Therefore, it is important to study the responses of fish to acidic environments. We investigated the impacts of acute exposure to decreasing pH levels in orange clownfish Amphiprion percula juveniles on their survival and oxidative stress status. Fish were exposed to pH 5, 6, 7, and 8 for 96 h. We observed a significant reduction in survival (85%) and protein damage as measured by P-SH (protein thiol) for fish maintained at pH 5. Despite no effects on survival or oxidative damage, fish exposed to pH 6 showed an increase in their antioxidant defense systems, demonstrating this pH level could not be suitable for them as well. Furthermore, there were no negative effects for fish kept at pH 7, compared to those maintained at pH 8 during this short-term evaluation.

Effects of Tissue Preservation on Carbon and Nitrogen Stable Isotope Signatures in Syngnathid Fishes and Prey.

Isotopic stable analysis (SIA) is a powerful tool in the assessment of different types of ecological and physiological studies. For that, different preservation methods for sampled materials are commonly used prior to isotopic analysis. The effects of various preservation methods (freezing, ethanol and formaldehyde) were analyzed for C:N, and δ13C and δ15N signals on a variety of tissues including dorsal fins (three seahorse and two pipefish species), seahorse newborns (three seahorses species), and prey (copepods and different stages of Artemia) commonly used to feed the fishes under rearing conditions. The aims of the study were: (i) to evaluate isotopic effects of chemical preservation methods across different types of organisms and tissues, using frozen samples as controls, and (ii) to construct the first conversion models available in syngnathid fishes. The chemical preservation in ethanol and, to a lesser extent, in formaldehyde significantly affected δ13C values, whereas the effects on δ15N signatures were negligible. Due to their low lipid content, the isotopic signals in fish fins was almost unaffected, supporting the suitability of dorsal fins as the most convenient material in isotopic studies on vulnerable species such as syngnathids. The regression equations provided resulted convenient for the successful conversion of δ13C between preservation treatments. Our results indicate that the normalization of δ15N signatures in preserved samples is unnecessary. The conversion models should be applicable in isotopic field studies, laboratory experiments, and specimens of historical collections.

Anteromedial Tibial Tubercle Osteotomy Improves Results of Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability in Patients With Tibial Tuberosity-Trochlear Groove Distance of 17 to 20 mm.

PURPOSE: To compare the midterm clinical outcomes of anteromedialization tibial tubercle osteotomy combined with medial patellofemoral ligament reconstruction (TTO+MPFLR) with MPFLR alone (MPFLRa) for the treatment of recurrent patellar instability (RPI) in patients with a tibial tuberosity-trochlear groove (TT-TG) of 17 to 20 mm. METHODS: From January 2008 to August 2013, patients with RPI and a TT-TG of 17 to 20 mm were divided into 2 groups: TTO+MPFLR or MPFLRa. Subjects were evaluated for J sign classification (1-4+); patellar glide (1-4+); the apprehension test; increased femoral anteversion; the Caton index; trochlear dysplasia; TT-TG; and Kujala, Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores. Kujala improvement was the primary outcome. RESULTS: Forty-two subjects were evaluated, 18 in the TTO+MPFLR group and 24 in the MPFLRa group. Mean follow-up time was 40.86 months (range, 24-60 months). Demographics between the groups were not different. Preoperatively, there was no statistically significant difference between groups regarding J sign classification; patellar glide; the apprehension test; increased femoral anteversion; the Caton index; trochlear dysplasia; TT-TG; and Kujala, Lysholm, IKDC, and Tegner scores. Postoperative J sign classification mean results comparing TTO+MPFLR and MPFLRa, respectively, were 1 and 1.33 (P = .006). Improvement was significantly higher in the TTO+MPFLR group in all scores except for Tegner. Kujala improvement, 30.27 and 23.95, respectively (P = .003), was also clinically significant, favoring TTO+MPFLR. Lysholm improvement was 40.5 and 36.2, respectively (P = .02), and IKDC improvement was 38.59 and 31.6, respectively (P = .002). There were no reported recurrent subluxations or dislocations in either group. CONCLUSIONS: TTO+MPFLR resulted in better functional outcome scores and patellar kinematics compared with MPFLRa in the surgical treatment of RPI in patients with a TT-TG distance of 17 to 20 mm. LEVEL OF EVIDENCE: Level II, prospective comparative study.

The King-Devick test in mixed martial arts: the immediate consequences of knock-outs, technical knock-outs, and chokes on brain functions.

The aim of this prospective cohort study was to determine the effect of an 'event,' defined as a knock-out (KO), technical knock-out (TKO), choke, or submission, on King-Devick (K-D) test times in mixed martial arts (MMA) athletes. MMA athletes (28.3 ± 6.6 years, n = 92) underwent K-D testing prior to and following a workout or match. Comparison of baseline and post-workout/match K-D times to assess any significant change. K-D tests worsened (longer) in a majority of athletes following an 'event' (N = 21) (49.6 ± 7.8 s vs 46.6 ± 7.8 s, p = 0.0156, Wilcoxon signed-rank test). K-D tests improved (shorter) following a standard workout or match in which no 'event' occurred in a majority of cases (n = 69) (44.2 ± 7.2 s vs 49.2 ± 10.9 s, p = <0.0001, Wilcoxon signed-rank test). Longer duration (worsening) of post-match K-D tests occurred in most athletes sustaining an 'event'; K-D tests shortened (improved) in a majority of athletes not sustaining an 'event'. Our study suggests MMA athletes suffering an 'event' may have sustained a brain injury similar to a concussion.

Secção anatômica manual e automatizada de modelos 3D de côndilos mandibulares: proposição de método e avaliação de confiabilidade / Manual and automated anatomical section of 3D models of mandibular condyles: a method proposition and reliability assessmen

O objetivo deste estudo foi determinar os planos de secção dos côndilos mandibulares e a confiabilidade de 2 métodos de secção de imagens tridimensionais (3D) destas estruturas anatômicas, denominados como: manual e automatizado. As imagens 3D foram adquiridas com a utilização de tomografias computadorizadas de feixe-cônico (CBCT). Foram utilizadas 81 CBTCs correspondentes ao acompanhamento de 27 pacientes do banco de dados de indivíduos submetidos a cirurgia de avanço mandibular isolado no Hospital Memorial da Universidade da Carolina do Norte (University of North Carolina - UNC Memorial Hospital). As CBCTs foram obtidas para cada indivíduo em 3 tempos distintos: antes da cirurgia (T1); após a remoção da goteira cirúrgica, de 4 a 6 semanas pós-cirurgia (T2) e um ano após a cirurgia (T3). Foram construídos modelos virtuais 3D dos côndilos de todos os indivíduos nos três tempos avaliados. Após ser realizada a superposição dos modelos de T1, T2 e T3, foram selecionadas aleatoriamente 9 imagens seccionadas de côndilos, de 8 pacientes (um paciente teve selecionado ambos os côndilos) com a finalidade de permitir a secção dos mesmos por dois avaliadores através dos dois métodos selecionados. O côndilo foi dividido em 4 secções anatômicas: anterolateral (AL), anteromedial (AM), posterolateral (PL) e posteromedial (PM). Ambos os métodos foram repetidos com 2 semanas de intervalo para avaliar a reprodutibilidade pelos 2 avaliadores. O teste de Wilcoxon foi utilizado para testar se as medianas encontradas para cada comparação eram estatisticamente diferentes de 0, bem como para testar se houve diferenças significativas intra-avaliador entre os métodos avaliados. Já para a comparação interavaliador entre os métodos avaliados foi utilizado o teste de Mann-Whitney U. Os resultados mostraram que todas as secções anatômicas do côndilo sofreram alterações significativamente diferentes de zero nas medidas intra e inter-avaliadores, tanto pelo método manual, quanto automatizado (p < 0,05). A comparação interavaliadores revelou diferenças estatisticamente significativas para ambos os métodos em todas as regiões avaliadas. A comparação intra-avaliadores revelou diferenças significativas para as secções anatômicas AM, PL e PM do avaliador 1 e somente para a secção AL do avaliador 2 (p < 0,05). Ao considerar-se uma tolerância de 1,5 mm, verificou-se uma concordância intra-avaliador para o método manual (avaliador 1=74% e avaliador 2=94,5%) e automatizado (avaliador 1=89% e avaliador 2=96,5%). Para esta mesma tolerância, foi verificada uma concordância inter-avaliadores de 49% para o método manual e de 78% para o método automatizado. Concluiu-se que o método automatizado mostrou-se mais reprodutível na determinação de planos de secção dos côndilos mandibulares.

This study aimed to determine the sectional planes of the mandibular condyles and evaluate the reliability of two tridimensional images (3D) sections methods: manual and automated. The 3D images were acquired using computed tomography cone-beam (CBCT). Eighty one CBCTs were selected from 27 patients from database of patients undergoing isolated mandibular advancement surgery in the University of North Carolina - UNC Memorial Hospital). CBCTs were obtained for each individual in three different times: before surgery (T1); after surgical removal of the eaves - 4 to 6 weeks post-surgery (T2) and one year after surgery (T3). Virtual models (3D) of the condyles of all individuals in these three times were built. After superposition of the models was performed in T1, T2 and T3, 9 images were randomly selected, from 8 patients (a patient had both condyles selected) and the section of them was performed by two evaluators using both methods: manual and automated. The condyle was divided into 4 anatomic sections: anterolateral (AL), anteromedial (AM), posterolateral (PL) and posteromedial (PM). Both methods were repeated with 2 week intervals to assess the reproducibility by 2 reviewers.The Wilcoxon test was used to verify if the recorded medians for each comparison were statistically different from 0, as well as, to test if it were significant intra-raters differences among the evaluated methods. For the inter-raters comparison between the different methods the Mann-Whitney U test was used. The results showed that all the evaluated regions showed significant differences when compared to 0 for intra and inter-raters comparisons for both methods (manual and authomated) (p < 0,05). The inter-raters comparison revealed statistically significant differences for both methods in all the evaluated regions. The intra-raters comparison showed statistically significant differences for the following regions: AM, PL e PM (rater 1) and only AL (rater 2) (p < 0,05). When considering a tolerance of 1,5 mm, the intra-rater agreement for the manual method was (rater 1=74% and rater 2=94,5%) and for the authomated method (rater 1=89% and rater 2=96,5%). Considering the upcited tolerance the recorded inter-raters agreement was 49% for the manual method and 78% for the authomated method. It was concluded that there the automated method were more reliable in the determination sectional planes of the mandibular condyles.

Is it safe the empirical distal femoral resection angle of 5 to 6 of valgus in the Brazilian geriatric population? / É seguro o corte femoral distal em artroplastia total do joelho com 5° a 6° de valgo empiricamente na população geriátrica brasileira?

OBJECTIVE: The purpose of this study is to determine if there is a safe distal femoral resection angle to restore the normal axial alignment of the limb in total knee arthroplasty (TKA) in the Brazilian geriatric population with knee arthrosis. METHOD: This study analyzed 99 pre-operative hip-knee-ankle radiographs of osteoarthritic knees of 66 patients (54 women, 12 men) with knee osteoarthritis. The distal femoral cut angle was determined based on the femoral mechanical-anatomical angle (FMA). Mean, median and standard deviation measurements of the distal femoral cut angle were calculated, differentiated by gender and side. The mean result of the distal femoral resection angle was compared to 5.7°, the mean average angle of previous and similar study based on European population of patients with knee arthrosis. RESULTS: The mean average of the distal femoral resection angle of the study was 6.05 (range 3-9°). The distribution of this angle between genders showed a slight superior average of the male population (6.17°) compared to the female (6.02°), but with no statistically significant difference (p = 0.726). There was no statistically significant difference (p = 0.052) between the mean average of this study (6.05°) compared to the mean average of the literature (5.7°). However, considering 3° as the limit of acceptable error in the coronal plane, this empirical femoral resection angle would not be appropriated for 19.7% of the population. CONCLUSION: The distal femoral resection angle of 5-6° is not completely safe for the Brazilian geriatric population. .

OBJETIVO: Determinar se existe um ângulo seguro para o corte femoral distal, para que o membro resulte alinhado após uma artroplastia total de joelho (ATJ), na população geriátrica brasileira com gonartrose. MÉTODO: Foram feitas radiografias panorâmicas de 99 membros inferiores em 66 pacientes consecutivos (54 mulheres e 12 homens) portadores de gonartrose do joelho. O ângulo do corte femoral distal foi determinado pelo encontro entre o eixo mecânico femoral (EMF) e o eixo anatômico femoral (EAF). Foram calculados os valores da média, o desvio padrão e a mediana do ângulo do corte femoral distal desses pacientes diferenciados por sexo e lado. O valor médio do ângulo de corte do fêmur distal ideal aqui obtido foi comparado com o valor médio de 5,7 obtido em estudo prévio semelhante a esse feito com populações europeias de pacientes osteoartríticos submetidos a ATJ. RESULTADOS: A média do ângulo formado pelos EAF × EMF, considerado o ângulo do corte femoral distal em uma ATJ, do grupo estudado foi de 6,05 (variação de 3° a 9°). A distribuição desse ângulo entre os sexos evidenciou uma média discretamente superior entre os homens (6,17°) em comparação com as mulheres (6,02°), porém sem significância estatística (p = 0,726). Não houve diferença estatística (p = 0,052) entre o valor médio obtido na amostra atual (6,05 - DP 1,27) com o valor médio obtido na literatura (5,7°). Entretanto, se considerarmos aceitável um erro de 3° no plano coronal, 19,7% da população operada se encontrariam fora dessa faixa aceitável se optarmos pelo corte femoral empírico de acordo com o instrumental. CONCLUSÃO: O corte femoral distal na ATJ em 5° ou 6° de valgo não é ...

Is it safe the empirical distal femoral resection angle of 5° to 6° of valgus in the Brazilian geriatric population?

OBJECTIVE: The purpose of this study is to determine if there is a safe distal femoral resection angle to restore the normal axial alignment of the limb in total knee arthroplasty (TKA) in the Brazilian geriatric population with knee arthrosis. METHOD: This study analyzed 99 pre-operative hip-knee-ankle radiographs of osteoarthritic knees of 66 patients (54 women, 12 men) with knee osteoarthritis. The distal femoral cut angle was determined based on the femoral mechanical-anatomical angle (FMA). Mean, median and standard deviation measurements of the distal femoral cut angle were calculated, differentiated by gender and side. The mean result of the distal femoral resection angle was compared to 5.7°, the mean average angle of previous and similar study based on European population of patients with knee arthrosis. RESULTS: The mean average of the distal femoral resection angle of the study was 6.05 (range 3-9°). The distribution of this angle between genders showed a slight superior average of the male population (6.17°) compared to the female (6.02°), but with no statistically significant difference (p = 0.726). There was no statistically significant difference (p = 0.052) between the mean average of this study (6.05°) compared to the mean average of the literature (5.7°). However, considering 3° as the limit of acceptable error in the coronal plane, this empirical femoral resection angle would not be appropriated for 19.7% of the population. CONCLUSION: The distal femoral resection angle of 5-6° is not completely safe for the Brazilian geriatric population.

OBJETIVO: Determinar se existe um ângulo seguro para o corte femoral distal, para que o membro resulte alinhado após uma artroplastia total de joelho (ATJ), na população geriátrica brasileira com gonartrose. MÉTODO: Foram feitas radiografias panorâmicas de 99 membros inferiores em 66 pacientes consecutivos (54 mulheres e 12 homens) portadores de gonartrose do joelho. O ângulo do corte femoral distal foi determinado pelo encontro entre o eixo mecânico femoral (EMF) e o eixo anatômico femoral (EAF). Foram calculados os valores da média, o desvio padrão e a mediana do ângulo do corte femoral distal desses pacientes diferenciados por sexo e lado. O valor médio do ângulo de corte do fêmur distal ideal aqui obtido foi comparado com o valor médio de 5,7 obtido em estudo prévio semelhante a esse feito com populações europeias de pacientes osteoartríticos submetidos a ATJ. RESULTADOS: A média do ângulo formado pelos EAF × EMF, considerado o ângulo do corte femoral distal em uma ATJ, do grupo estudado foi de 6,05 (variação de 3o a 9o). A distribuição desse ângulo entre os sexos evidenciou uma média discretamente superior entre os homens (6,17o) em comparação com as mulheres (6,02o), porém sem significância estatística (p = 0,726). Não houve diferença estatística (p = 0,052) entre o valor médio obtido na amostra atual (6,05 - DP 1,27) com o valor médio obtido na literatura (5,7°). Entretanto, se considerarmos aceitável um erro de 3° no plano coronal, 19,7% da população operada se encontrariam fora dessa faixa aceitável se optarmos pelo corte femoral empírico de acordo com o instrumental. CONCLUSÃO: O corte femoral distal na ATJ em 5° ou 6° de valgo não é completamente seguro para a população geriátrica brasileira.

Reconstrução do ligamento cruzado anterior com duplo feixe utilizando os tendões dos músculos semitendíneo e grácil: fixação com dois parafusos de interferência / Arthroscopic double- bundle reconstruction of anterior cruciate ligament using hamstring tendon grafts: fixation with two interference screws

Procedimentos cirúrgicos de reconstrução do ligamento cruzado anterior com duplo feixe dos tendões dos músculos semitendíneo e grácil têm sido descritos na última década. A maioria das técnicas descritas utiliza o dobro de material de síntese empregado na reconstrução com feixe único. Relatamos uma técnica original para a reconstrução do ligamento cruzado anterior com duplo feixe, na qual mantemos as inserções tibiais dos tendões dos músculos semitendíneo e grácil e realizamos dois túneis tibiais e dois túneis femorais. Os túneis femorais são realizados "de fora para dentro" e a fixação do enxerto é realizada somente com dois parafusos de interferência.

Surgical procedures for double-bundle reconstruction of anterior cruciate ligament, which currently use semitendinous and gracilis tendon grafts, have been described in the last decade. Most of the techniques utilize twice the hardware used in single-bundle reconstructions. We report an original anterior cruciate ligament double-bundle reconstruction technique using semitendinous and gracilis tendon grafts, maintaining their tibial bone insertions with two tibial and two femoral tunnels. A simplified and precise outside-in femoral drilling technique is utilized, and the graft fixation is made utilizing only two interference screws.

Avaliação tomográfica da posição condilar em pacientes portadores de mordida cruzada posterior unilateral funcional / Condylar position tomographic evaluation in patients with functional unilateral posterior cross-bite

OBJETIVO: avaliar a posição dos côndilos no sentido anteroposterior e no sentido lateral, em indivíduos com mordida cruzada posterior funcional, relacionando-a com o lado em que a mordida cruzada se apresentava, e determinar a existência de modificação da posição condilar desses pacientes após a correção da má oclusão. METODOLOGIA: foi utilizada uma amostra de 13 pacientes que apresentavam mordida cruzada posterior unilateral funcional. Esses pacientes realizaram uma tomografia de três cortes laterais de cada ATM e uma de dois cortes frontais de cada ATM, antes e após a correção da mordida cruzada. Para a correção da mordida cruzada, foi empregado um aparelho do tipo Porter. RESULTADOS: não foi encontrada nenhuma posição condilar específica, para os indivíduos com mordida cruzada posterior funcional, e sim uma grande dispersão dos posicionamentos, tanto no sentido anteroposterior como no lateral. Também não foi encontrada uma correlação significativa entre esse posicionamento e o lado da mordida cruzada, em ambos os sentidos analisados. Foi encontrada modificação da posição condilar após o tratamento da mordida cruzada posterior funcional, porém sem um padrão específico.

AIM: To evaluate the condylar position, in anteroposterior and transverse directions, in subjects with functional unilateral posterior cross-bite, relating it to the side in which the cross-bite was present and also to determine if there was any change in the condylar position of these patients after the malocclusion treatment. METHODS: It was used a sample of thirteen (13) patients who presented unilateral posterior cross-bite. These patients were submitted to a tomography with three lateral cross-sections of each ATM and another tomography with two frontal cross-sections of each ATM, before and after the cross-bite correction. To treat the cross-bite was used a Porter appliance. RESULTS: It was not found any specific condylar position for the subjects with unilateral posterior cross-bite but a wide variability of positions, not only in the anteroposterior direction but also in the transverse one, it was not found, as well, a significative correlation between the position and the side of the cross-bite in both directions. It was found a change in the condylar position after the treatment of the unilateral posterior cross-bite, however it didn't present a specific pattern.

Arthroscopic anterior cruciate ligament double-bundle reconstruction using hamstring tendon grafts-fixation with two interference screws: technical note.

In this article, an original double-bundle anterior cruciate ligament reconstruction technique is described. The procedure is developed using hamstring tendon grafts while maintaining tibial osseous insertion. Two tibial tunnels are drilled and a simplified and precise outside-in double tunnel femoral drilling technique is utilized. The graft fixation is made using only two interference screws.

DARTHROSCOPIC DOUBLE- BUNDLE RECONSTRUCTION OF ANTERIOR CRUCIATE LIGAMENT USING HAMSTRING TENDON GRAFTS - FIXATION WITH TWO INTERFERENCE SCREWS.

Surgical procedures for double-bundle reconstruction of anterior cruciate ligament, which currently use semitendinous and gracilis tendon grafts, have been described in the last decade. Most of the techniques utilize twice the hardware used in single-bundle reconstructions. We report an original anterior cruciate ligament double-bundle reconstruction technique using semitendinous and gracilis tendon grafts, maintaining their tibial bone insertions with two tibial and two femoral tunnels. A simplified and precise outside-in femoral drilling technique is utilized, and the graft fixation is made utilizing only two interference screws.

Halitosis: a review of basic principles

Halitosis, also known as bad breath or oral malodor, is the general term used to describe any disagreeable odor in expired air, regardless of whether the odorous substances originate from oral or non-oral sources. Bad breath can be detrimental to one’s self-image and confidence, causing social, emotional and psychological anxiety. This paper provides a comprehensive review of the historical background, prevalence, social aspects and pathological causes of halitosis as well as the dental professional’s responsibility.

Changes in facial profile of young adults with normal occlusion: a longitudinal study.

AIM: To evaluate longitudinally the cephalometric changes in the facial profile of young adults. METHODS: The sample was composed of 27 individuals of both genders who presented with Class I and normal occlusion; the initial mean age was 21.2 years. After a mean period of 7.2 years, patients were re-evaluated. All measurements were carried out via digitalized lateral cephalometric radiographs. One calibrated operator identified the cephalometric landmarks. Software was used to take linear and angular values; the mean dimensions were used for data. The evaluated measurements were nasal depth, soft pogonion thickness, upper and lower lip thickness, upper and lower lip position in relation to the esthetic plane of Ricketts, facial convexity including the nose, and facial convexity excluding the nose. The paired t test was used to evaluate the changes. RESULTS: Data indicate that the nose depth increased by a mean of 1.07 mm. The soft pogonion thickness and the lower lip thickness increased a mean of 0.51 mm and 0.55 mm, respectively, and the facial convexity excluding the nose decreased 0.72 degrees. Only the facial convexity including the nose was different between the genders, with greater values for the male subjects. CONCLUSIONS: Facial profile changes throughout the third decade of life; in the present study, these changes were statistically significant for nose depth, observed in both sexes.

Bilateral stress fracture of the patellae: a case report.

A case of bilateral simultaneous stress fracture of the patella is presented in a 64 year old Marathon runner sustained when he slipped off a curb whilst out walking. This was confirmed on Xray and treated by tension band wiring using the AO technique. He had an excellent result returning to normal function in both knees. This case is unusual since the fractures were not due to osteoporosis, as would be expected in this age group.

Inclination of the joint line in supracondylar osteotomy of the femur for valgus deformity.

The inclination of the joint line after supracondylar osteotomy of the femur for valgus deformity was studied in 22 patients and 26 knees. The patients (four males and 18 females) were 17-77 years old (mean, 49.5 years). The obliquity of the joint line was measured in positive degrees (medial inclination) and negative degrees (lateral inclination). Mean obliquity was +3.1 degrees in the pre-operative study and -2.0 degrees in the post-operative study. A more horizontal joint line was obtained following surgical treatment (mean correction: 5.0 degrees ).