Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis.

Temporomandibular joint (TMJ) disc displacement is a clinical sign often found in patients with temporomandibular disorders (TMDs) and associated with TMJ osteoarthrosis. Osteoarthrosis is a degenerative joint disease that may be associated with pain and functional disability. The aim of this study was to evaluate the odds ratio (OR) of joints with disc displacement presenting osteoarthrosis via magnetic resonance imaging (MRI) analysis. In total, 224 TMJ images from patients with signs and symptoms of a TMD were evaluated. The OR, a measure of association, was used to calculate the likelihood of TMJ disc displacement (with or without reduction) with osteoarthrosis. Joints with anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) were 2.73- and 8.25-times, respectively, more likely to have osteoarthrosis. A nine-times greater likelihood of osteophyte occurrence was observed in cases of ADDwoR, whereas a lower OR for their occurrence (OR 2.96) was observed in cases of ADDwR. The significant OR of joints with disc displacement presenting osteoarthrosis, particularly in cases of ADDwoR, emphasizes the importance of accurate assessment of changes in disc position, which may be associated with other painful and functional disorders of the TMJ.

A new fetal rat model of gastroschisis: development and early characterization.

BACKGROUND/PURPOSE: The perinatal management and pathophysiology of gastroschisis remain controversial. Large animal experimental models of gastroschisis are inherently limited by expense and length of gestation, making multiple studies and statistical analysis difficult. To address these limitations the authors have developed a model of gastroschisis in the fetal rat. METHODS: Twenty-one time-dated pregnant rats underwent laparotomy at 18 (1/2) day's gestational age. The exposed uterus was bathed in ritodrine for tocolysis. The right posterior leg was exteriorized through a hysterotomy, and under a dissecting microscope (16x) the fetal small bowel was exteriorized through a small incision performed on the right lower abdominal quadrant. The amniotic fluid was restored with saline solution and the hysterotomy closed with a purse-string suture. Control fetuses underwent hysterotomy and leg manipulation only. The surgical time was uniformly less than 60 minutes. Fetuses were harvested by cesarean section at 21 (1/2) days' gestational age. Fetal intestine was assessed by microscopic examination, and fetal weight, intestinal length, and intestinal weight per unit length were evaluated. RESULTS: There was a significant surgical and anesthetic learning curve, which is not included in this report. After this, the authors achieved a maternal survival of 100% (n = 21). We created gastroschisis in 64 fetuses (58 survivors, 90.6%), and 33 fetuses were only manipulated (30 survivors, 90.9%). The number of induced gastroschisis per pregnant rat varied between 2 and 5 with median of 3. On gross examination, eviscerated intestine appeared dilated, edematous, and covered by peel when compared with control intestine. Fetuses with gastroschisis had significantly reduced body weight (4.1+/-0.5 v 5.6 g +/- 0.5 g) and intestinal length (102+/-19 v 210+/-17 mm) relative to controls, whereas the intestinal weight per unit length (1.75+/-0.29 v 0.71 +/- 0.1 mg/mm) was markedly increased (P<.001). CONCLUSIONS: The pathophysiology observed in this experimental model appears to resemble human gastroschisis. In comparison with large animal models, the rat model offers the advantages of low expense, short gestation, littermate controls, and high maternal and fetal survival rates. In addition, there are specific probes and reagents available for application of molecular methodology to clarify the mechanisms responsible for the intestinal damage. This model appears appropriate for future experimental studies on gastroschisis.

Prenatal diagnosis of abdominal enteric duplications.

Alimentary tract duplications are rare congenital malformations with few reports of the antenatal sonographic appearance. Early diagnosis is of paramount importance to prevent complications. We present a case of a cystic gastric duplication diagnosed antenatally at 31 weeks' gestation, which was treated successfully. Simultaneously, we review all published cases of prenatally diagnosed enteric duplications.

Listeria monocytogenes hepatitis in a liver transplant recipient: a case report and review of the literature.

Listeria is an uncommon cause of hepatitis in adults. We report the case of a liver transplant recipient who presented with a clinical picture of acute hepatitis, 8 months after grafting. Blood cultures yielded Listeria monocytogenes. The patient made a full clinical recovery after adequate antimicrobial therapy (ampicillin and gentamicin intravenously for 4 weeks). Hepatitis was attributed to the Listeria infection. We believe this is the first reported case of Listeria hepatitis in an organ transplant recipient.

[Hemophiliacs with inhibitor. Experience at the Center of Medical Action for Hemophilia of the S. José Hospital]. / Hemofílicos com inibidor. Experiência do Centro de Acção Médica de Hemofilia do Hospital de S. José.

Factor VIII inhibitors arise in 5% to 15% of patients with hemophilia A in response to infusion to factor VIII concentrates and make the treatment of bleeding episodes extremely difficult. Various therapeutic approaches have been tried the decision depending on the type of haemorrhage, the antibody's titre and whether the patient has a low or high response. We report the clinical experience in 13 hemophiliacs with inhibitors to factor VIII. Prothrombin complex concentrates were administered with favorable effects in the most common haemorrhagic episodes, in the majority of patients. In two patients activated prothrombin complex concentrates were administered and in one case plasma exchange was made before high doses of factor VIII. These therapeutic approaches proved to be very effective in the control of hemostasis.

Anthropometric and cycloergometric assessment of the nutritional status of the children of agricultural migrant workers in Southern Brazil.

In our survey of the food habits and nutritional status of "Boia-Fria" agricultural migrant workers in Southern Brazil, a special project was undertaken to assess the influence of socioeconomic and dietary deprivation on the physical growth and development and physical performance of their children. Four hundred fifty-five children in Boia-Fria families from Vila Recreio, a periurban slum of Ribeirao Preto located in the interior of the state of Sao Paulo, were examined for body weight, standing height, mid-upper arm muscle circumference, and head circumference. For comparison, 475 children from "Vita et Pax", a private school attended primarily by children of well-to-do families from the city of Ribeirao Preto, were also examined using similar anthropometric procedures. A small group of selected Boia-Fria children and their well-to-do counterparts were subjected to ergometric-cum-electrocardiographic testing for submaximal physical work performance. The overall results of this comparative study indicate that the physical growth and development and the physical performance of the Boia-Fria children are significantly lower than their well-to-do counterparts. It is suggested that the poor anthropometric and ergometric status of the Boia-Fria children is a reflection of poor dietary habits and socioeconomic deprivation prevalent among the agricultural migrant workers and poor periurban populations of Brazil.

Vitamin E status of agricultural migrant workers in Southern Brazil.

Vitamin E status of agricultural migrant workers representing low socioeconomic population of Southern Brazil was evaluated by determining dietary intake and plasma levels of vitamin E. The mean plasma vitamin E level of 85 female and 39 male subjects was 1.14 +/- 0.33 mg/100 ml or 2.27 +/- 0.53 mg/g of total lipids in plasma. The difference between the plasma vitamin E values of male and female subjects was insignificant. Using various criteria for the assessment of plasma vitamin E levels, it was established that plasma vitamin E expressed in terms of plasma total lipids is a better indicator of vitamin E status. The actual mean alpha-tocopherol intake of this population was 5.51 +/- 3.30 mg/person from a typical diet supplying about 1500 kcal/day. On a 2500 kcl basis, the estimated mean alpha-tocopherol intake would be about 9 mg/day which compares favorably with the intake values reported for well-nourished populations. The main dietary source of vitamin E in this population is the traditional rice and beans diet with increased use of soybean oil and vegetable oil products in recent years. On the whole the vitamin E status of this Brazilian population is quite satisfactory despite inadequacies in their intake of dietary calories and other essential nutrients. The plasma vitamin E status of these subjects supports the dietary data for the intake of vitamin E in this population.

Food habits and nutritional status of agricultural migrant workers in Southern Brazil.

A new class of migrant workers, commonly known as "Boia-Frias", is rapidly growing in the periurban slumbs (favelas) of Brazil. In 1978 a collaborative study was undertaken to assess the food habits and nutritional status of 100 migrant worker families of Vila Recreio, a typical Boia-Fria settlement near Ribeirao Preto in the state of Sao Paulo. The findings of this survey revealed that the traditional diet of Boia-Frias is nutritionally inadequate both in quality and quantity. Their rice and bean-based diet lacks sufficient variety because of the infrequent use of fresh fruits and vegetables, which are available locally, and of supplemental amounts of protein-rich foods of animal origin. Empty-calorie foods such as carbonated drinks and alcoholic beverages are consumed freely; and starchy foods, traditionally used in the North and Northeast of Brazil, are used commonly as weaning foods. Although dietary practices of pregnant and lactating women are poor, breast-feeding is still practiced by most mothers. The biochemical analysis of blood samples did not indicate major subclinical deficiencies except low hematological values and low plasma vitamin A concentrations in about 25% of the population examined. Plasma cholesterol and plasma vitamin E values were found to be normal. However, anthropometric examinations revealed clear signs of malnutrition and/or undernourishment, which likely impairs their capacity for physical work and adversely affects their overall health.