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1.
Am J Orthod Dentofacial Orthop ; 157(5): 690-703, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32354442

RESUMO

Dental health and patient satisfaction at the end of orthodontic treatment are needed if the treatment is to be considered successful. This case report highlights the importance of proper diagnosis for a patient initially treated with camouflage, despite the indications for surgery. A 16-year-old male patient sought treatment complaining about his appearance. He had been using an appliance for 6 years without improvement. He had a convex profile, an enlarged lower third of the face, reduced cervical-mandibular line, and Class II molar relationship. The maxillary incisors had excessive buccal root torque, throbbing pain, and dental mobility, with no visible bone coverage in the tomographic sections. The cephalometric analysis confirmed the skeletal Class II relationship (ANB, 11.6°; Wits appraisal, 14.2 mm) because of severe mandibular deficiency (SNB, 71.2°), aggravated by the vertical growth tendency (FMA, 27.3°). Changes in IMPA (108.1°) and U1-NA (0.9°; -2.9 mm) reflected the previous orthodontic attempt to compensate for the malocclusion. After periodontal and endodontic evaluation, a new treatment plan was developed. The incisors would be positioned in their bone bases, the mandibular first premolars would be extracted to create space for the second molars and increase the overjet, and the patient would be referred for orthognathic surgery. The patient was satisfied with the esthetic and functional results of this treatment.


Assuntos
Má Oclusão de Angle Classe II , Má Oclusão , Adolescente , Cefalometria , Estética Dentária , Humanos , Incisivo , Masculino , Mandíbula , Maxila
2.
J Orthop Surg Res ; 15(1): 72, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32093768

RESUMO

BACKGROUND: Motivation and necessity to adopt minimally invasive therapies in the field of spinal regenerative medicine is increasing. Autologous platelet-rich plasma (PRP) therapy has recently been used as an effective technological and biological approach to tissue repair and has shown to improve multiple conditions including back pain and degenerative disc pathology. In addition, it is well established that the anatomic elements of the spinal system affected by degenerative pathology include the intervertebral disc (IVD) and vertebral subchondral bone (VSB), which play a crucial role in maintaining a healthy spinal column. Both elements are the target of a novel biological approach to the treatment of low back pain. METHODS: A novel minimally invasive regenerative therapeutic approach is presented herein with a protocol based on combining vertebral intraosseous (VIO) and intradiscal (ID) infiltrations of plasma rich in growth factors (PRGF-Endoret), a type of leukocyte-free PRP, for the treatment of disc degeneration pathology. RESULTS: We describe a novel technique applied in a patient treated for IVD degeneration and VSB damage, showing significant improvement on magnetic resonance imaging, including partial regression of protruded disc and significant resorption of intravertebral herniations (Schmörl's nodes), after PRGF therapy. CONCLUSIONS: To the best of our knowledge, we present the first reported case description of the utilization of VIO and ID PRP infiltrations to treat protruded discs and intravertebral herniations with a successful clinical outcome.

3.
Braz. dent. sci ; 23(2,supl): 1-8, 2020.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1100310

RESUMO

Background: Temporomandibular disorder (TMD) belongs to a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, musculature and adjacent components. These conditions can generate signs and symptoms and be influenced by an altered biopsychosocial condition. Objective: This study aims to seek information to assist the patient in the presence of TMD signs and symptoms and Orofacial Pain, associated with the period of social isolation during the COVID-19 pandemic. Material and methods: For the preparation of this manual, a bibliographic search was performed in the databases PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), BBO (BVS), Scopus, Web of Science and The Cochrane Library, using the keywords: orofacial pain, temporomandibular disorders, bruxism, stress, anxiety, biopsychosocial, diagnosis, self-care with important information on how to reduce and control the signs and symptoms of TMD and Orofacial Pain in this moment of pandemic that we are experiencing a social detachment. Results: The results show that the pandemic of COVID-19 and the need for social isolation, generates psychological impact that raises the pattern of anxiety and can directly affect patients with bruxism and TMD. Conclusion: Psychological factors associated with the pandemic can lead to an increased risk of developing, worsening and perpetuating bruxism, especially waking bruxism and TMD, so dentists should be aware of the occurrence of signs and symptoms to manage the multifactorial aspects of this condition. At that time, individual self-management strategies are advised for the patient, which consist of self-massage techniques, body education, exercise practices, sleep hygiene, meditation also the use of mobile apps and online tools that facilitate this activity. (AU)


Introdução: A Desordem Temporomandibular (DTM) pertence a um grupo heterogêneo de condições musculoesqueléticas e neuromusculares envolvendo o complexo articular temporomandibular, a musculatura e os componentes adjacentes. Essas condições podem gerar sinais e sintomas e serem influenciadas por uma condição biopsicossocial alterada. Objetivo: Esse estudo teve como objetivo buscar informações que possam auxiliar ao paciente na presença de sinais e sintomas de DTM e Dor Orofacial associado ao período de isolamento social durante a pandemia do COVID -19. Material e Métodos: Para a elaboração deste manual, foi realizada uma pesquisa bibliográfica nas bases de dados PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), BBO (BVS), Scopus, Web of Science e The Cochrane Library, utilizando as palavras-chaves: dor orofacial, desordem temporomandibular, bruxismo, estresse, ansiedade, biopsicossocial, diagnóstico e autocuidados, com informações importantes sobre como reduzir e controlar os sinais e sintomas de DTM e Dor Orofacial nesse momento de pandemia que estamos vivenciando um distanciamento social. Resultados: Os resultados mostram que a pandemia de COVID-19 e a necessidade de isolamento social, gera impacto psicológico que eleva o padrão de ansiedade e pode afetar diretamente pacientes com bruxismo e DTM. Conclusão: Fatores psicológicos associados à pandemia podem levar a um maior risco de desenvolver, piorar e perpetuar o bruxismo, principalmente bruxismo de vigília e DTM, por isso os cirurgiões-dentistas devem estar atentos a ocorrência de sinais e sintomas para gerenciar os aspectos multifatoriais dessa condição. Aconselha-se, nesse momento, estratégias individualizadas de autogerenciamento para o paciente que consistem em técnicas de automassagem, educação corporal, práticas de exercícios, higiene do sono e meditação. Além do uso de aplicativos digitais e ferramentas online facilitadores dessa atividade (AU)


Assuntos
Ansiedade , Autocuidado , Dor Facial , Bruxismo , Transtornos da Articulação Temporomandibular , Infecções por Coronavirus , Análise do Estresse Dentário , Diagnóstico
4.
Arq. neuropsiquiatr ; 77(12): 888-895, Dec. 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1055200

RESUMO

ABSTRACT The establishment of modern medicine in Brazil was marked by the arrival of the Portuguese Court in 1808, when the Bahia and Rio de Janeiro Faculties of Medicine were founded. The French School of Medicine exerted a strong influence on Brazilian medicine and on the main pioneers of Brazilian neurology. The elite of "Parisian neurology" trained students and doctors from around the world, and were mentors to the pioneers of Brazilian neurology in the early 20th century. In this article, the authors review the origins of neurology faculties in Brazilian medicine and the main pioneers of Brazilian neurology. Neurology is certainly a continuously changing field and has always adapted to new advances and discoveries, and it is an honor for the authors to pay homage to their pioneers.


RESUMO O estabelecimento da medicina moderna no Brasil foi marcado pela chegada da corte portuguesa em 1808, quando foram fundadas as faculdades de medicina da Bahia e do Rio de Janeiro. A Escola Francesa de Medicina exerceu forte influência na Medicina Brasileira e nos principais pioneiros da Neurologia Brasileira. A elite da "Neurologia parisiense", treinou estudantes e médicos de todo o mundo e foram os mentores dos pioneiros da neurologia brasileira no início do século XX. Neste texto, os autores revisam as origens das faculdades de Neurologia na Medicina Brasileira e os principais pioneiros da Neurologia Brasileira. A neurologia é certamente um campo em constante mudança e sempre se adaptou a novos avanços e descobertas, e é uma honra para os autores homenagear seus pioneiros.

6.
Biomaterials ; 192: 440-460, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30500725

RESUMO

The healing of vascularized mammalian tissue injuries initiate with hemostasis and clotting as part of biological defense system leading to the formation of a fibrin clot in which activated platelets are trapped to quickly stop bleeding and destroy microbials. In order to harness the therapeutic potential of biomolecules secreted by platelets and stemmed from plasma, blood deconstruction has allowed to yield autologous platelet-and plasma-derived protein fibrin scaffold. The autologous growth factors and microparticles stemmed from platelets and plasma, interact with fibrin, extracellular matrix, and tissue cells in a combinatorial, synergistic, and multidirectional way on mechanisms governing tissue repair. This interplay will induce a wide range of cell specifications during inflammation and repair process including but not limited to fibrogenesis, angiogenesis, and immunomodulation. As biology-as-a-drug approach, autologous platelet-and plasma-derived protein fibrin scaffold is emerging as a safe and efficacious natural human-engineered growth factor delivery system to repair musculoskeletal tissues, and skin and corneal ulcers and burns. In doing so, it acts as therapeutic agent not perfect but close to biological precision. However, this autologous, biocompatible, biodegradable, and long in vivo lasting strategy faces several challenges, including its non-conventional single dose-response effect, the lack of standardization in its preparation and application, and the patient's biological features. In this review, we give an account of the main events of tissue repair. Then, we describe the procedure to prepare autologous platelet-and plasma-derived protein fibrin scaffolds, and the rationale behind these biomaterials, and finally, we highlight the significance of strategic accuracy in their application.


Assuntos
Fibrina/química , Plasma Rico em Plaquetas/química , Tecidos Suporte/química , Cicatrização , Animais , Coagulação Sanguínea , Sistemas de Liberação de Medicamentos/métodos , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/administração & dosagem , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico
7.
Head Neck Pathol ; 13(2): 125-130, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29556916

RESUMO

Primordial odontogenic tumor (POT) was recently recognized in the 2017 World Health Organization (WHO) Classification as a distinct mixed odontogenic tumor most commonly observed in the posterior mandible of young patients. POT appears as an expansile radiolucency associated to an unerupted tooth. The aim of the present study was to perform a retrospective microscopic evaluation of pediatric odontogenic tumors diagnosed in an Oral Pathology Laboratory from Rio de Janeiro-Brazil, in order to reclassify potential cases as POT. From 150 cases of odontogenic tumors in children diagnosed in the last 50 years, one case filled the criteria for POT, being therefore better diagnosed as such. The patient was in the first decade of life and presented a well-defined expansile tumor in the posterior mandible, which had been initially diagnosed as immature complex odontoma. To the best of our knowledge, only 12 cases of POT have been reported in the English-language literature. We herein present an additional case of POT and review of its clinicopathological findings is offered.


Assuntos
Neoplasias Mandibulares/patologia , Tumores Odontogênicos/patologia , Pré-Escolar , Humanos , Masculino
8.
Trends Biotechnol ; 37(4): 340-344, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30579716

RESUMO

Stem cell and platelet-rich plasma (PRP) therapies are promising breakthroughs in the treatment of multiple conditions. However, the lack of reproducibility due to inaccurate reporting of the protocols used to obtain these biologics can hinder their therapeutic progress. A reporting guideline for biological therapies is required to address this issue.


Assuntos
Terapia Biológica/métodos , Terapia Biológica/normas , Plasma Rico em Plaquetas , Transplante de Células-Tronco/métodos , Transplante de Células-Tronco/normas , Animais , Guias como Assunto , Humanos , Reprodutibilidade dos Testes
9.
Arq Neuropsiquiatr ; 77(12): 888-895, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31939586

RESUMO

OBJECTIVE: The establishment of modern medicine in Brazil was marked by the arrival of the Portuguese Court in 1808, when the Bahia and Rio de Janeiro Faculties of Medicine were founded. METHODS: The French School of Medicine exerted a strong influence on Brazilian medicine and on the main pioneers of Brazilian neurology. The elite of "Parisian neurology" trained students and doctors from around the world, and were mentors to the pioneers of Brazilian neurology in the early 20th century. CONCLUSION: In this article, the authors review the origins of neurology faculties in Brazilian medicine and the main pioneers of Brazilian neurology. RESULTS: Neurology is certainly a continuously changing field and has always adapted to new advances and discoveries, and it is an honor for the authors to pay homage to their pioneers.


Assuntos
Neurologia/história , Faculdades de Medicina/história , Brasil , História do Século XIX , História do Século XX , Humanos , Literatura Medieval/história , Psiquiatria/história , Universidades/história
10.
World J Clin Cases ; 6(6): 132-138, 2018 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-29988868

RESUMO

Herpes zoster (HZ) infection occurs in approximately 10% to 30% of individuals. Visceral neuropathies secondary to HZ can cause cystitis and urinary retention. But colonic pseudo-obstruction can also occur. Peripheral neuropathy may reveal segmental motor paresis of either upper or lower limbs, the abdominal muscles or the diaphragm. We report the case of a 62-year-old male patient who presented with abdominal distention and cutaneous vesicular eruption on the left side of the abdominal wall. Plain X-rays and computed tomography scan showed distended small bowel. A diagnosis of intestinal pseudo-obstruction was made secondary to segmental paresis of the small intestine and visceral neuropathy. Conservative management was successful and the patient was discharged uneventfully. Intestinal pseudo-obstruction ought to be considered when dealing with non-obstructive (adynamic) conditions of the digestive tract associated with HZ infection; since early recognition may help to avoid unnecessary surgery.

11.
Dent Traumatol ; 34(5): 378-381, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29999586

RESUMO

Maxillofacial injuries are a regular consequence of sport activities that can force athletes to take a long time off from training and competitions. One way to decrease the time that the athlete needs to get back to his or her training exercises after surgery is to use a custom facemask as a coadjuvant in the postoperative recovery phase. This case report describes the case of a 16-year-old male athlete who suffered facial trauma (orbitozygomatic fractures) during a soccer game. After surgery, a facemask was used during the postoperative phase. He returned to his regular physical activities only 3 weeks after surgery. This simple and very efficient procedure is a good option for athletes who suffer facial injuries.


Assuntos
Traumatismos Maxilofaciais/prevenção & controle , Fraturas Orbitárias/cirurgia , Equipamentos de Proteção , Futebol/lesões , Adolescente , Desenho de Equipamento , Humanos , Masculino , Fraturas Orbitárias/diagnóstico por imagem , Radiografia Panorâmica , Tomografia Computadorizada por Raios X
14.
J Int Med Res ; 45(2): 631-638, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28367708

RESUMO

Objective Triggering receptor expressed on myeloid cells (TREM)-1 is a receptor that is thought to improve recognition of patients with true infection. In this study, we investigated whether Triggering receptor expressed on myeloid cells (TREM-1) is present in urine samples from children with urinary tract infection (UTI) and in samples from healthy children. Methods A total of 128 samples met the inclusion criteria for the study. Urine samples were processed for culture and urinalysis as a regular protocol for patients with UTI. Samples were classified according to culture and urinalysis results. TREM-1 protein expression was detected with flow cytometry and sTREM-1 was assessed by ELISA. Results Flow cytometry showed detectable expression of TREM-1 in 100% of samples, UTI and non-UTI groups ( p < 0.001). Mean fluorescence intensity of TREM-1 was different between the groups ( p < 0.001). Levels of sTREM-1 were detected in patients with UTI, but not in non-UTI patients. Conclusions All of our patients (healthy and diseased) showed TREM-1 expression. However, TREM-1 levels in patients with UTI tend to be higher and are associated with increased neutrophils and cytokine activity induced by bacteria.


Assuntos
Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/urina , Glicoproteínas de Membrana/urina , Células Mieloides/metabolismo , Infecções Urinárias/diagnóstico , Infecções Urinárias/urina , Adolescente , Biomarcadores/urina , Estudos de Casos e Controles , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Feminino , Citometria de Fluxo , Expressão Gênica , Humanos , Lactente , Masculino , Glicoproteínas de Membrana/genética , Células Mieloides/patologia , Receptores Imunológicos/genética , Receptor Gatilho 1 Expresso em Células Mieloides , Infecções Urinárias/microbiologia , Infecções Urinárias/patologia , Escherichia coli Uropatogênica/patogenicidade , Escherichia coli Uropatogênica/fisiologia
15.
Rev Med Inst Mex Seguro Soc ; 55(3): 317-323, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28440985

RESUMO

BACKGROUND: Early-onset neonatal sepsis (EONS) is an infectious disease of low incidence but high morbidity and mortality with severe consequences to the newborn prognosis. Identifying the associated factors related to EONS allows to start a timely treatment and to take preventive measures. METHODS: In this case and controls study we identified all the newborns (NB) with and without EONS (cases and controls), diagnosed through blood culture in a period of three years. We studied risk factors such as: low gestational age, gender, weight, maternal infections, and premature rupture of membranes. RESULTS: Our study consisted of 27 cases and 36 controls, with a mean age of 32.43 and 33.19 weeks of gestation (WOG), respectively (p > 0.05). Of these, 22 and 29 of the cases and controls had a gestational age < 37 WOG, (p > 0.05). However, maternal infection (odds ratio [OR] 1.76), respiratory distress syndrome (OR 4.72), the need of resuscitation (OR 2.9), intubation (OR 5.1) and ventilation support (OR 2.6) were statistically different between both groups (p < 0.05). The most isolated microorganism was Staphylococcus coagulase negative (42.3%). CONCLUSIONS: Risk factors associated with EONS were maternal infection, the need of resuscitation, and intubation to ventilation support.


Assuntos
Sepse Neonatal/etiologia , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Masculino , México , Sepse Neonatal/diagnóstico , Fatores de Risco
17.
J Obstet Gynaecol ; 37(2): 162-169, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27750476

RESUMO

Studies have shown that triggering receptor expressed on myeloid cells-1 (TREM-1) is the mediator and activator of neutrophils and monocytes after stimulation with lipopolysaccharide (LPS), heat-inactivated Gram (-) bacteria, Gram (+) bacteria or fungi. Different studies have measured the expression of TREM-1 in patients with bacterial infections and critical states. The purpose of this study was to evaluate the expression of TREM-1 in circulating maternal leukocytes in premature rupture of the membranes (PRM). Two groups of patients were included in this case control study: pregnant women with PRM and healthy controls. All patients were free of any infection, including cervix and urinary tract. Although all patients expressed TREM-1 to some extent, there was no statistically significant difference in the expression of different cellularities in both groups; except for the mononuclear leukocytes (p < 0.05). In this study, TREM-1 was not altered in PRM.


Assuntos
Líquido Amniótico/metabolismo , Leucócitos Mononucleares/metabolismo , Glicoproteínas de Membrana/metabolismo , Neutrófilos/metabolismo , Receptores Imunológicos/metabolismo , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Feminino , Ruptura Prematura de Membranas Fetais/etiologia , Ruptura Prematura de Membranas Fetais/metabolismo , Citometria de Fluxo , Humanos , Leucócitos Mononucleares/imunologia , Glicoproteínas de Membrana/sangue , Glicoproteínas de Membrana/imunologia , Neutrófilos/imunologia , Gravidez , Receptores Imunológicos/sangue , Receptores Imunológicos/imunologia , Estatísticas não Paramétricas , Receptor Gatilho 1 Expresso em Células Mieloides , Adulto Jovem
18.
J Orthop ; 14(1): 68-69, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27829726
19.
Expert Opin Biol Ther ; 17(2): 197-212, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27845852

RESUMO

INTRODUCTION: In mammals, axons of injured peripheral nerves (PNI) can and do regenerate, but often the functional recovery is incomplete or suboptimal. In recent years, in vivo tissue engineering approaches through molecular intervention and scaffolding are offering promising outcomes. Evidence is accumulating in both preclinical and clinical settings indicating that Platelet-rich plasma (PRP) and fibrin scaffolds obtained from this technology hold an important adjuvant therapeutic potential. Areas covered: This review addresses current molecular and cellular data in intrinsic nerve repair processes and describes different strategies to harness and enhance these processes by using biochemical and biomechanical cues. It focuses on autologous fibrin, plasma and platelet-derived growth factors as filler or scaffolds that can synergize with the gold standard therapy and other nerve guidance conduits. Expert opinion: PRP is applied as a filler of nerve conduits or vein-muscle grafts across nerve gaps post trauma by infiltrating the nerve stumps perineurally and intraneurally in neuropathies, or as scaffolds to bridge or wrap nerve stumps, with significant neurological recovery and pain reduction. The application of PRP at the injured nerve site might be considered as an 'off the shelf' alternative.


Assuntos
Materiais Biomiméticos/administração & dosagem , Regeneração Nervosa/fisiologia , Nervos Periféricos/fisiologia , Plasma Rico em Plaquetas/fisiologia , Tecidos Suporte , Animais , Biomimética/métodos , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/administração & dosagem , Peptídeos e Proteínas de Sinalização Intercelular/fisiologia , Regeneração Nervosa/efeitos dos fármacos , Nervos Periféricos/efeitos dos fármacos , Recuperação de Função Fisiológica/efeitos dos fármacos , Recuperação de Função Fisiológica/fisiologia , Engenharia Tecidual/métodos
20.
Trends Biotechnol ; 35(2): 91-93, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27908451

RESUMO

A new therapeutic tool is emerging based on a biomimetic strategy: platelet-rich plasma (PRP) technology. Allogeneic off-the-shelf PRP represents a safe and cost-effective treatment for osteoarthritis and related diseases. This breakthrough opens the door not only to improved treatments and opportunities but also to new challenges with multiple uncertainties.


Assuntos
Substitutos Sanguíneos/química , Substitutos Sanguíneos/uso terapêutico , Osteoartrite/terapia , Plasma Rico em Plaquetas/química , Plasma Rico em Plaquetas/metabolismo , Transplante Homólogo/métodos , Humanos , Osteoartrite/sangue
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