A Rare Case of an Infant With 1p36 Deletion Syndrome Presenting With Systolic Heart Failure Secondary to Severe Dilated Cardiomyopathy.

1p36 deletion syndrome is a common terminal chromosomal deletion syndrome in humans. It is caused by the deletion of genetic material from a specific region in the short arm of chromosome 1. Symptoms range from seizure disorders, abnormalities of tone, visual and auditory disturbances. Cardiac abnormalities like left ventricular non-compaction (LVNC) and dilated cardiomyopathies (DCM) are commonly associated with this syndrome. This case report presents a 15-month-old female with dilated cardiomyopathy associated with 1p36 deletion syndrome, who has been followed from birth. Cardiac function was normal at birth with an ejection fraction of 65%. At three weeks of age, the patient presented with severe tachypnea, cyanosis, poor weight gain, and diaphoresis with feeding. Echocardiogram showed an ejection fraction of 22%. The patient was diagnosed with Modified Ross Heart Failure Class III. The patient was admitted to the cardiovascular intensive care unit where diuretics, phosphodiesterase inhibitors, and ionotropic agents were used to manage the heart failure. The patient relapsed two months later following a severe adenovirus infection. She was readmitted and heart failure medications were optimized. This patient has maintained a steady growth, meeting most milestones with no further relapse. The heterogeneity of 1p36 deletion syndrome presentation poses a diagnostic challenge for most clinicians. Cardiac involvements are very common and infants presenting with signs and symptoms of heart failure need to be screened for chromosomal abnormalities when other causes have been ruled out.

Epidemiology, control, and prevention of Newcastle disease in endemic regions: Latin America.

Newcastle disease (ND) infects wild birds and poultry species worldwide, severely impacting the economics of the poultry industry. ND is especially problematic in Latin America (Mexico, Colombia, Venezuela, and Peru) where it is either endemic or re-emerging. The disease is caused by infections with one of the different strains of virulent avian Newcastle disease virus (NDV), recently renamed Avian avulavirus 1. Here, we describe the molecular epidemiology of Latin American NDVs, current control and prevention methods, including vaccines and vaccination protocols, as well as future strategies for control of ND. Because the productive, cultural, economic, social, and ecological conditions that facilitate poultry endemicity in South America are similar to those in the developing world, most of the problems and control strategies described here are applicable to other continents.

Jornada Participativa do SUS / Participative Journey of the Unified Health System (SUS)

A Jornada Participativa do SUS de Santo André é um projeto intersetorial, criado em 2015, que reuniu diversas iniciativas para aprimorar o planejamento e desempenho das eleições dos 56 Conselhos Locais de Saúde (CLS). Esse projeto realizou uma avaliação minuciosa das eleições de 2013, identificando as dificuldades e falhas do seu percurso. Esse processo de análise envolveu uma avaliação da conjuntura política do país, que tem gerado um progressivo desinteresse e descrédito da população nas instituições e nos partidos políticos, o que contribuiu para o esvaziamento dos Conselhos Locais. A Gestão Participativa em Santo André é um método de governo que requer constante avaliação e ousadia para escutar e dialogar com os diversos setores no acompanhamento e transparência da gestão.

Validation of a continuous flow method for the determination of soluble iron in atmospheric dust and volcanic ash.

Iron is an essential micronutrient for phytoplankton growth and is supplied to the remote areas of the ocean mainly through atmospheric dust/ash. The amount of soluble Fe in dust/ash is a major source of uncertainty in modeling-Fe dissolution and deposition to the surface ocean. Currently in the literature, there exist almost as many different methods to estimate fractional solubility as researchers in the field, making it difficult to compare results between research groups. Also, an important constraint to evaluate Fe solubility in atmospheric dust is the limited mass of sample which is usually only available in micrograms to milligrams amounts. A continuous flow (CF) method that can be run with low mass of sediments (<10mg) was tested against a standard method which require about 1g of sediments (BCR of the European Union). For validation of the CF experiment, we run both methods using South American surface sediment and deposited volcanic ash. Both materials tested are easy eroded by wind and are representative of atmospheric dust/ash exported from this region. The uncertainty of the CF method was obtained from seven replicates of one surface sediment sample, and shows very good reproducibility. The replication was conducted on different days in a span of two years and ranged between 8 and 22% (i.e., the uncertainty for the standard method was 6-19%). Compared to other standardized methods, the CF method allows studies of dissolution kinetic of metals and consumes less reagents and time (<3h). The method validated here is suggested to be used as a standardized method for Fe solubility studies on dust/ash.

Ocorrência e caracterização da tuberculose em caprinos leiteiros criados no estado de Pernambuco / Occurrence and characterization of tuberculosis in dairy goats bred in the state of Pernambuco, Brazil

Acreditou-se durante muito tempo que a espécie caprina era resistente à infecção por Mycobacterium bovis, porém tal hipótese foi desconsiderada quando relatos da enfermidade surgiram em vários países. No entanto, ainda permanecem desconhecidas certas características da tuberculose em caprinos e suas implicações na saúde pública e caprinocultura nacional. Objetivou-se com este trabalho descrever os aspectos nosológicos, radiológicos, anátomo-histopatológicos, baciloscópicos e biomoleculares da tuberculose em caprinos leiteiros com doença respiratória, naturalmente infectados e procedentes do estado de Pernambuco. Para isso foram tuberculinizadas 442 cabras com sintomas respiratórios e, destas, 3,4% (15/442) foram consideradas positivas ao teste. Dos animais positivos, sete foram monitorados clinicamente durante 12 meses, descrevendo-se os achados obtidos. O agente etiológico foi identificado através da reação em cadeia da polimerase, por amplificação de sequências genômicas do Complexo Mycobacterium tuberculosis e posteriormente de Mycobacterium bovis. Este é o primeiro diagnóstico molecular com caracterização do envolvimento do Mycobacterium bovis na tuberculose caprina no Brasil.

For a long time, it was believed that the goat species is resistant to infection by Mycobacterium bovis; however, this hypothesis changed when reports of the disease became apparent in various countries. Nevertheless, certain characteristics of tuberculosis in goats and its impact on public health are still unknown. The objective of this study was to describe nosologic, radiologic, anatomo-histopathological, bacilloscopic and biomolecular aspects of tuberculosis in dairy goats with respiratory disease naturally infected, from the state of Pernambuco, Brazil. When we tuberculinized 442 goats with respiratory symptoms, 3.4% (15/442) of these were considered positive in the test. From the positive goats, seven were monitored clinically for 12 months. The etiological agent was identified through the polymerase chain reaction, by amplification of genomic sequences of the Mycobacterium tuberculosis complex and later Mycobacterium bovis. This is the first molecular diagnosis which characterizes the involvement of Mycobacterium bovis in goat tuberculosis in Brazil.

Influence of optical properties of esthetic brackets (color, translucence, and fluorescence) on visual perception.

INTRODUCTION: The aims of this study were to evaluate the optical properties of esthetic brackets and determine their influence on visual perception. METHODS: Eighty esthetic brackets of 16 commercial brands were tested. The color and translucency of the brackets, as well as the color of the maxillary central incisors of 40 subjects, were measured with a spectrophotometer. The fluorescence of the brackets was determined by duly calibrated appraisers. The color differences between the brands of brackets and the teeth were calculated. Data were analyzed by using 1-way analysis of variance; the Scheffé multiple comparison test was used to establish the difference between brands of brackets, (α = 0.05). RESULTS: The color parameters L ∗ a ∗ b ∗ of nontranslucent brackets ranged from 49.4 to 86.0, -1.6 to 3.0, and 1.9 to 14.6, respectively. The direct transmission of light ranged from 0.0% to 38.8% transmittance. No bracket showed fluorescence. The color and translucency, as well as the color difference, of the brackets were influenced by brand (P <0.01). CONCLUSIONS: The optical properties of esthetic brackets have a direct influence on visual perception; translucent brackets and the nontranslucent InVu (TP Orthodontics, LaPorte, Ind) brackets were less visually perceptible.

Aspectos clínicos da intoxicação experimental pelas favas de Stryphnodendron fissuratum (Leg. Mimosoideae) em caprinos / Clinical aspects of the experimental poisoning by the pods of Stryphnodendron fissuratum (Leg. Mimosoideae) in goats

Com o objetivo de caracterizar o quadro clínico da intoxicação por Stryphnodendron fissuratum Mart. (Leg. Mimosoideae) em caprinos, administraram-se as favas dessa planta a oito caprinos, por via oral forçada em doses únicas e a outros dois caprinos, em doses fracionadas. A menor dose que causou sinais clínicos e morte foi a de 10g/kg. Doses de 20g/kg e 40g/kg causaram sinais acentuados e doses únicas de 5g/kg não provocaram sinais. Doses fracionadas de 5g/kg durante quatro dias, totalizando 20g/kg provocaram sinais acentuados e morte. Em ambos os grupos, os primeiros sinais de intoxicação foram observados a partir do primeiro dia de experimento e a evolução variou de 4-25 dias. A doença caracterizou-se principalmente por alterações digestórias e nervosas que consistiram em anorexia, desidratação, hipomotilidade e atonia ruminal, timpanismo, gemidos constantes, dor à percussão abdominal, fezes com muco, ranger de dentes, apatia, ataxia, dismetria, tremores de cabeça, tremores musculares, fraqueza com o andar cambaleante e trôpego, acentuada depressão e decúbito esternal ou lateral prolongado e morte. Alguns animais apresentaram acentuada queda de pêlos na região dorsal; apenas um caprino apresentou fezes líquidas, marrom-escuras e fétidas. Outros sinais incluíram perda de fluido ruminal durante a ruminação, sialorréia, exsudato nasal seroso e lacrimejamento. As provas de função hepática e renal revelaram alterações discretas. As concentrações séricas de aspartato aminotransferase encontraram-se levemente aumentadas e as de creatinofosfocinase muito aumentadas.

In order to confirm the susceptibility of goats to the poisoning by Stryphnodendron fissuratum Mart. (Leg. Mimosoideae) and to characterize the clinical disease, the pods of the plant were given orally to each of eight young goats and in fractioned doses to other two. The lowest lethal dose was 10g/kg. The same dose was the lowest that induced disease. Doses of 20g/kg and 40g/kg caused pronounced clinical signs and doses of 5g/kg did not caused signs. Fractioned doses of 5g/kg during four days also caused pronounced signs. In each groups the first signs of poisoning were observed from the first day of experiments and the changes ranged from 4-25 days. The disease was characterized mainly by digestive and nervous disorders. Clinical signs were partial to complete anorexia, dehydration, decrease in ruminal activity up to atonia, tympanism, constant vocalizations, grinding of the teeth pain up on abdominal palpation, apathy, ataxia, depression, dysmetria, head and muscle tremors, weakness, difficulty in rising, sternal or lateral recumbency and death. Some goats presented extense hair loss in the skin of the dorsum; one goat presented liquid and black fetid feces. Other signs included loss of ruminal fluid during rumination, drooling, serous nasal and ocular discharges. Liver and kidney function tests had resulted in slight changes. AST serum levels were slightly increased and creatine phosphokinase levels were highly increased. These changes can associated to the effects of triterpenic saponins contained in the S. fissuratum pods.

Aspectos clínicos da intoxicação experimental pelas favas de Stryphnodendron fissuratum (Leg. Mimosoideae) em caprinos / Clinical aspects of the experimental poisoning by the pods of Stryphnodendron fissuratum (Leg. Mimosoideae) in goats

Com o objetivo de caracterizar o quadro clínico da intoxicação por Stryphnodendron fissuratum Mart. (Leg. Mimosoideae) em caprinos, administraram-se as favas dessa planta a oito caprinos, por via oral forçada em doses únicas e a outros dois caprinos, em doses fracionadas. A menor dose que causou sinais clínicos e morte foi a de 10g/kg. Doses de 20g/kg e 40g/kg causaram sinais acentuados e doses únicas de 5g/kg não provocaram sinais. Doses fracionadas de 5g/kg durante quatro dias, totalizando 20g/kg provocaram sinais acentuados e morte. Em ambos os grupos, os primeiros sinais de intoxicação foram observados a partir do primeiro dia de experimento e a evolução variou de 4-25 dias. A doença caracterizou-se principalmente por alterações digestórias e nervosas que consistiram em anorexia, desidratação, hipomotilidade e atonia ruminal, timpanismo, gemidos constantes, dor à percussão abdominal, fezes com muco, ranger de dentes, apatia, ataxia, dismetria, tremores de cabeça, tremores musculares, fraqueza com o andar cambaleante e trôpego, acentuada depressão e decúbito esternal ou lateral prolongado e morte. Alguns animais apresentaram acentuada queda de pêlos na região dorsal; apenas um caprino apresentou fezes líquidas, marrom-escuras e fétidas. Outros sinais incluíram perda de fluido ruminal durante a ruminação, sialorréia, exsudato nasal seroso e lacrimejamento. As provas de função hepática e renal revelaram alterações discretas. As concentrações séricas de aspartato aminotransferase encontraram-se levemente aumentadas e as de creatinofosfocinase muito aumentadas.

In order to confirm the susceptibility of goats to the poisoning by Stryphnodendron fissuratum Mart. (Leg. Mimosoideae) and to characterize the clinical disease, the pods of the plant were given orally to each of eight young goats and in fractioned doses to other two. The lowest lethal dose was 10g/kg. The same dose was the lowest that induced disease. Doses of 20g/kg and 40g/kg caused pronounced clinical signs and doses of 5g/kg did not caused signs. Fractioned doses of 5g/kg during four days also caused pronounced signs. In each groups the first signs of poisoning were observed from the first day of experiments and the changes ranged from 4-25 days. The disease was characterized mainly by digestive and nervous disorders. Clinical signs were partial to complete anorexia, dehydration, decrease in ruminal activity up to atonia, tympanism, constant vocalizations, grinding of the teeth pain up on abdominal palpation, apathy, ataxia, depression, dysmetria, head and muscle tremors, weakness, difficulty in rising, sternal or lateral recumbency and death. Some goats presented extense hair loss in the skin of the dorsum; one goat presented liquid and black fetid feces. Other signs included loss of ruminal fluid during rumination, drooling, serous nasal and ocular discharges. Liver and kidney function tests had resulted in slight changes. AST serum levels were slightly increased and creatine phosphokinase levels were highly increased. These changes can associated to the effects of triterpenic saponins contained in the S. fissuratum pods.

Protective effect of hyperimmune egg yolk IgY antibodies against Eimeria tenella and Eimeria maxima infections.

Avian coccidiosis is caused by several distinct species of Eimeria protozoa and is the major parasitic disease of poultry of economic importance. As an alternative strategy to control avian coccidiosis without using prophylactic medications, we have investigated the efficacy of inducing passive immunity against coccidiosis by orally feeding hyperimmune IgY antibodies. In this study, a commercially available egg yolk powder, Supracox (SC), a purified IgY fraction of egg yolk prepared from hens hyperimmunized with three major species of Eimeria oocysts, were continuously fed to young chicks from hatch. Upon orally infecting these broiler chicks with Eimeria tenella and Eimeria maxima oocysts at 1 week of age, they showed significantly higher body weight gains (P<0.05) compared to the untreated controls. Furthermore, SC-fed chicks showed significantly less intestinal lesions and reduced fecal oocyst output compared to the untreated controls following oral infections with E. tenella and E. maxima. These results provide clear evidence that passive immunization of chicks with hyperimmune egg yolk IgY antibodies provide significant protection against E. tenella or E. maxima infections.

Induction of passive immunity in broiler chickens against Eimeria acervulina by hyperimmune egg yolk immunoglobulin Y.

The protective effect of hyperimmune IgY fraction of egg yolk prepared from hens hyperimmunized with multiple species of Eimeria oocysts on experimental coccidiosis was evaluated in young broilers. Chickens were continuously fed from hatch with a standard diet containing hyperimmune IgY egg yolk powder or a nonsupplemented control diet and orally challenged at d 7 posthatch with 5.0 x 10(3) sporulated Eimeria acervulina oocysts. Body weight gain between d 0 and 10 and fecal oocyst shedding between d 5 and 10 postinfection were determined as parameters of protective immunity. Chickens given 10 or 20% hyperimmune IgY egg yolk powder showed significantly increased BW gain and reduced fecal oocyst shedding compared with control birds fed the nonsupplemented diet. In another trial, lower IgY concentrations (0.01, 0.02, and 0.05%) were used to treat birds with 1.0 x 10(4) oocysts of E. acervulina. Total oocyst shedding was significantly (P < 0.05) reduced in chickens fed the 0.02 and 0.05% hyperimmune IgY supplemented-diets compared with animals fed the nonsupplemented diet. Similarly, chickens fed 0.5% of hyperimmune IgY egg yolk powder diet and challenged with 1.0 x 10(4) oocysts exhibited reduced oocyst shedding compared with the control birds given 0.5% of IgY from nonimmunized hen eggs, although BW gain was not affected. We conclude that passive immunization of chickens with anti-coccidia IgY antibodies provide protective immunity against coccidiosis challenge infection.

La esencia de la locura. Reflexiones en torno al uso del vocablo / The essence of the madness. Reflections around the use of the word

El autor intenta en breves párrafos resumir el concepto de la esencia de la perturbación mental en su máximo exponente, la psicosis, popularmente llamada locura. Motiva la presente publicación las dificultades que atraviesa un concepto médico tan particular y preciso como es la psicosis, el cual se halla adulterado en la realidad mediática y vulgar de la perturbación, al punto que se la endilga sobre sujetos que no portando la enfermedad mental, son presentados como tales. El referente es alarmante por la difusión que ha tomado atacar de este modo a un ser humano para presentarlo como despreciable buscando desvalorizar, y más terrible aún, humillarlo de la manera más mordaz. Como el tema es de muy larga historia, nos sentimos ante la necesidad de publicar qué es la locura en su esencia y los efectos que provoca cuando se la difunde equivocadamente.

The author is trying to summarize the idea of the essence of mental disorder at its highest, psychosis, usually referred to as madness. The reason for this publication lies in the fact that such a particular and precise medical notion is adulterated by the media and the popular awareness of this disorder which is, more often than not, attributed to individuals who are not clinically psychotic. Thus, it is common to use this word to refer to somebody in a derogative way, trying to minimize, show scorn, or humiliate the subject. For this reason, we feel the need to explain what the essence of insanity is, and its effects when the term is misused.

Experimental swainsonine poisoning in goats ingesting Ipomoea sericophylla and Ipomoea riedelii (Convolvulaceae)

Ipomoea sericophylla and Ipomoea riedelii cause a glycoprotein storage disease in goats. This paper reports the experimental poisoning in goats by dried I. sericophylla and I. riedelii containing 0.05 percent and 0.01 percent swainsonine, respectively. Three groups with four animals each were used. Group 1 received daily doses of 2g/kg body weight (bw) of dried I. sericophylla (150mg of swainsonine/kg). Goats from this group had clinical signs 36-38 days after the start of ingestion. Group 2 received dried I. riedelii daily doses of 2g/kg of I. riedelii (30mg of swainsonine/kg) for 70 days. No clinical signs were observed, therefore the swainsonine dose was increased to 60mg/kg for another 70 days. Goats from Group 2 had clinical signs 26-65 days after increase in swainsonine dose to 60mg/kg. Group 3 was used as control. In these experiments the minimum toxic dose was 60mg/kg which represents 0.0004 percent of the dry matter in goats ingesting 1.5 percent bw of the dry matter. For goats ingesting 2 percent-2.5 percent bw of dry matter this dose would be 0.00024 percent-0.0003 percent of the dry matter. After the end of the experiment two goats were euthanized and another six were observed for recovery of clinical signs. Four goats that continued to consume swainsonine containing plant for 39-89 days after the first clinical signs had non reversible signs, while two goats that ingested the plant for only 15 and 20 days after the first clinical signs recovered completely. These and previous results indicate that irreversible lesions due to neuronal loss occur in goats that continue to ingest the plants for about 30 days after the first clinical signs. Clinical signs and histological lesions were similar to those reported previously for goats poisoned by swainsonine containing plants. No significant alterations were found in packed cell volume, red and white blood cell counts, hemoglobin and mean corpuscular hemoglobin concentrations, mean...

Ipomoea sericophylla e Ipomoea riedelii causam uma doença de armazenamento de glicoproteínas em caprinos. Este trabalho relata a intoxicação experimental em caprinos por I. sericophylla e I. riedelii contendo 0,05 por cento e 0,01 por cento de swainsonina, respectivamente. Foram utilizados três grupos de quatro animais. O Grupo 1 recebeu doses diárias de 2g/kg peso vivo (pv) de I. sericophylla dessecada (150mg de swainsonina/kg). Os caprinos deste grupo apresentaram sinais clínicos 36-38 dias após o início da ingestão. O Grupo 2 ingeriu diariamente 2g/kg de I. riedelii dessecada (30mg de swainsonina/kg) por 70 dias. Como não foram observados sinais clínicos a dose de suainsonina foi aumentada para 60mg/kg por outros 70 dias. Os caprinos do Grupo 2 apresentaram sinais clínicos 26-65 dias após o aumento da dose de swainsonina para 60mg/kg. O Grupo 3 foi utilizado como controle. Neste experimento, a menor dose tóxica de swainsonina foi de 60mg/kg, que representa 0,0004 por cento da matéria seca, em caprinos ingerindo 1,5 por cento pv de matéria seca. Para caprinos ingerindo 2 por cento-2,5 por cento pv de matéria seca essa dose corresponderia a 0,00024 por cento-0,0003 por cento da matéria seca. Após o final do experimento dois caprinos foram eutanasiados e outros seis foram observados para conferir a recuperação dos sinais clínicos. Quatro caprinos que continuaram ingerindo as plantas contendo suainsonina por 39-89 dias após os primeiros sinais clínicos permaneceram com sinais clínicos irreversíveis, enquanto que dois caprinos que ingeriram as plantas por 15 e 20 dias após os primeiros sinais clínicos se recuperaram totalmente. Estes resultados e os de trabalhos anteriores sugerem que as lesões irreversíveis, devidas à perda neuronal, ocorrem quando os caprinos continuam ingerindo a planta por aproximadamente 30 dias após o início dos sinais clínicos. Os sinais clínicos e as lesões histológicas foram similares às descritas anteriormente...

Absence of alpha3 (Cx46) and alpha8 (Cx50) connexins leads to cataracts by affecting lens inner fiber cells.

Lens development and transparency have been hypothesized to depend on intercellular gap junction channels, consisting of alpha3 (Cx46) and alpha8 (Cx50) connexin subunits, to transport metabolites, secondary messages and ions between lens cells. To evaluate this hypothesis, we have generated alpha3(-/-) alpha8(-/-) double knockout mice and characterized their lens phenotypes. Without gap junctions between lens fiber cells, alpha3(-/-) alpha8(-/-) lenses displayed severe cataracts resulting from cell swelling and degeneration of inner fibers while normal peripheral fiber cells continued to form throughout life. Neither an increase of degraded crystallins nor an increase of water-insoluble crystallins was found in alpha3(-/-) alpha8(-/-) lenses. However, a substantial reduction of gamma-crystallin proteins, but not alpha- and beta-crystallins, was detected. These results suggest that gap junction communication is important for maintaining lens homeostasis of inner fiber cells and that a loss of gap junctions leads to cataract formation as well as reductions of gamma-crystallin proteins and transcripts.

Crítica a la medicina de la evidencia desde la psiquiatría / Critical reflection of medicine based on evidence from the psychiatric point of view

El autor intenta realizar una reflexión crítica acerca de la Medicina Basada en la Evidencia [MBE] desde la clínica general, y especialmente desde el punto de vista psiquiátrico. Toma como punto de partida el aspecto bibliográfico y de la literatura médica, así como su vínculo con el real y efectivo "progreso médico". Propone denominar a la MBE en "Medicina de Referencia" en tanto y cuanto, la primera es perfectible y no debería ser dogmática frente a los hallazgos clínicos que se demuestran por estudios randomizados. En tal sentido, propone ejemplos en la Historia de la Medicina que lograron un verdadero progreso, por la observación sagaz y profunda desde la clínica, sin el control citado. Asimismo y a modo de conclusión, enfatiza que la Medicina en el área psiquiátrica debe volver a Hipócrates y Ph. Pinel, tal como lo postula actualmente Perri Klass, sugiriendo no interponer entre el enfermo y el médico una aparatología innecesaria.

Crítica a la medicina de la evidencia desde la psiquiatría / Critical reflection of medicine based on evidence from the psychiatric point of view

El autor intenta realizar una reflexión crítica acerca de la Medicina Basada en la Evidencia [MBE] desde la clínica general, y especialmente desde el punto de vista psiquiátrico. Toma como punto de partida el aspecto bibliográfico y de la literatura médica, así como su vínculo con el real y efectivo "progreso médico". Propone denominar a la MBE en "Medicina de Referencia" en tanto y cuanto, la primera es perfectible y no debería ser dogmática frente a los hallazgos clínicos que se demuestran por estudios randomizados. En tal sentido, propone ejemplos en la Historia de la Medicina que lograron un verdadero progreso, por la observación sagaz y profunda desde la clínica, sin el control citado. Asimismo y a modo de conclusión, enfatiza que la Medicina en el área psiquiátrica debe volver a Hipócrates y Ph. Pinel, tal como lo postula actualmente Perri Klass, sugiriendo no interponer entre el enfermo y el médico una aparatología innecesaria. (AU)

Técnicas para confecção de provisórios com acesso ao tratamento endodôntico / Techniques for provisionalization with access to endodontic therapy

Os autores descrevem duas técnicas que permitem isolamento adequado para a realização do tratamento endodôntico em dentes extremamente destruídos, utilizando restaurações provisórias com agulhas hipodérmicas e coroas metálicas que possibilitam o acesso para a endodontia