Effects of SARPE and MISMARPE on correction of transverse maxillary deficiency: A preliminary comparative evaluation.

AIM: The present study was designed to compare, on cone-beam computed tomography imaging, the skeletal and dental effects of the SARPE (Surgically assisted rapid palatal expansion) and MISMARPE (Minimally Invasive Surgical and Miniscrew-Assisted Rapid Palatal Expansion) techniques. MATERIALS AND METHODS: The sample of adult patients with transverse maxillary deficiency (TMD) was divided into two groups, and scans were obtained preoperatively (T0) and immediately after completion of expansion (T1). The posterior and anterior linear transverse distances of the maxilla and the angulation of the maxillary first molars were evaluated. The data were entered into a generalized estimating equations model to verify the postoperative effects of the different techniques. RESULTS: None of the techniques caused any appreciable change in the angulation of the molars. The skeletal changes were similar, with significantly greater gains in the nasal fossa and intermaxillary distance when using the MISMARPE. CONCLUSION: The technique can be an effective and lower morbidity alternative to SARPE.

First characterization of PIWI-interacting RNA clusters in a cichlid fish with a B chromosome.

BACKGROUND: B chromosomes are extra elements found in several eukaryote species. Usually, they do not express a phenotype in the host. However, advances in bioinformatics over the last decades have allowed us to describe several genes and molecular functions related to B chromosomes. These advances enable investigations of the relationship between the B chromosome and the host to understand how this element has been preserved in genomes. However, considering that transposable elements (TEs) are highly abundant in this supernumerary chromosome, there is a lack of knowledge concerning the dynamics of TE control in B-carrying cells. Thus, the present study characterized PIWI-interacting RNA (piRNA) clusters and pathways responsible for silencing the mobilization of TEs in gonads of the cichlid fish Astatotilapia latifasciata carrying the B chromosome. RESULTS: Through small RNA-seq and genome assembly, we predicted and annotated piRNA clusters in the A. latifasciata genome for the first time. We observed that these clusters had biased expression related to sex and the presence of the B chromosome. Furthermore, three piRNA clusters, named curupira, were identified in the B chromosome. Two of them were expressed exclusively in gonads of samples with the B chromosome. The composition of these curupira sequences was derived from LTR, LINE, and DNA elements, representing old and recent transposition events in the A. latifasciata genome and the B chromosome. The presence of the B chromosome also affected the expression of piRNA pathway genes. The mitochondrial cardiolipin hydrolase-like (pld6) gene is present in the B chromosome, as previously reported, and an increase in its expression was detected in gonads with the B chromosome. CONCLUSIONS: Due to the high abundance of TEs in the B chromosome, it was possible to investigate the origin of piRNA from these jumping genes. We hypothesize that the B chromosome has evolved its own genomic guardians to prevent uncontrolled TE mobilization. Furthermore, we also detected an expression bias in the presence of the B chromosome over A. latifasciata piRNA clusters and pathway genes.

Meiotic behavior, transmission and active genes of B chromosomes in the cichlid Astatotilapia latifasciata: new clues about nature, evolution and maintenance of accessory elements.

Supernumerary B chromosomes (Bs) are dispensable genetic elements widespread in eukaryotes and are poorly understood mainly in relation to mechanisms of maintenance and transmission. The cichlid Astatotilapia latifasciata can harbor Bs in a range of 0 (named B -) and 1-2 (named B +). The B in A. latifasciata is rich in several classes of repetitive DNA sequences, contains protein coding genes, and affects hosts in diverse ways, including sex-biased effects. To advance in the knowledge about the mechanisms of maintenance and transmission of B chromosomes in A. latifasciata, here, we studied the meiotic behavior in males and transmission rates of A. latifasciata B chromosome. We also analyzed structurally and functionally the predicted B chromosome copies of the cell cycle genes separin-like, tubb1-like and kif11-like. We identified in the meiotic structure relative to the B chromosome the presence of proteins associated with Synaptonemal Complex organization (SMC3, SYCP1 and SYCP3) and found that the B performs self-pairing. These data suggest that isochromosome formation was a step during B chromosome evolution and this element is in a stage of diversification of the two arms keeping the self-pairing behavior to protect the A chromosome complement of negative effects of recombination. Moreover, we observed no occurrence of B-drive and confirmed the presence of cell cycle genes copies in the B chromosome and their transcription in encephalon, muscle and gonads, which can indicates beneficial effects to hosts and contribute to B maintenance.

Total Customized Alloplastic Reconstruction for Treatment of Severe Temporomandibular Joint Pathologic Conditions: A Case Series of Combined Intraoral and Extraoral Approach.

ABSTRACT: Temporomandibular joint (TMJ) reconstruction with customized alloplastic implants has become a safe and effective treatment option of TMJ end-stage pathology with excellent outcomes reported in the literature. The purpose of this study is to report 5 cases of severe TMJ pathology and customized alloplastic reconstruction using a combined intraoral approach and extraoral approach. Four patients with TMJ involved for benign tumor and one patient with severe TMJ resorption were enrolled. Compromised joints were replaced with customized prosthesis under general anesthesia using an association of intraoral approach/extraoral approach. An implant handpiece with adapted drills for bone drilling and the insertion of screws was used to fixate the mandibular component intraorally; the fossa component was inserted via preauricular approach. The hemimandibulectomies/codilectomy with safety margin were successfully performed and for 2 patients Orthognathic Surgery was also required. Follow-up period was from 15 to 28 months (average 22 months), with no history of surgical site infection or damage to the prostheses. Occlusal relationship and function, as well as facial symmetry were kept stable in all patients. The combination of an intraoral and extraoral approach for total TMJ replacement with customized prosthesis may be an alternative and reliable strategy for pathologic reconstruction, keeping function and reducing aesthetic damage.

Differential expression of miRNAs in the presence of B chromosome in the cichlid fish Astatotilapia latifasciata.

BACKGROUND: B chromosomes (Bs) are extra elements observed in diverse eukaryotes, including animals, plants and fungi. Although Bs were first identified a century ago and have been studied in hundreds of species, their biology is still enigmatic. Recent advances in omics and big data technologies are revolutionizing the B biology field. These advances allow analyses of DNA, RNA, proteins and the construction of interactive networks for understanding the B composition and behavior in the cell. Several genes have been detected on the B chromosomes, although the interaction of B sequences and the normal genome remains poorly understood. RESULTS: We identified 727 miRNA precursors in the A. latifasciata genome, 66% which were novel predicted sequences that had not been identified before. We were able to report the A. latifasciata-specific miRNAs and common miRNAs identified in other fish species. For the samples carrying the B chromosome (B+), we identified 104 differentially expressed (DE) miRNAs that are down or upregulated compared to samples without B chromosome (B-) (p < 0.05). These miRNAs share common targets in the brain, muscle and gonads. These targets were used to construct a protein-protein-miRNA network showing the high interaction between the targets of differentially expressed miRNAs in the B+ chromosome samples. Among the DE-miRNA targets there are protein-coding genes reported for the B chromosome that are present in the protein-protein-miRNA network. Additionally, Gene Ontology (GO) terms related to nuclear matrix organization and response to stimulus are exclusive to DE miRNA targets of B+ samples. CONCLUSIONS: This study is the first to report the connection of B chromosomes and miRNAs in a vertebrate species. We observed that the B chromosome impacts the miRNAs expression in several tissues and these miRNAs target several mRNAs involved with important biological processes.

Typical Lung Carcinoids with Metastasis: Potential Role of MicroRNAs in the Regulation of Adaptive Immunity Associated with Disease: a Case Study.

BACKGROUND/AIMS: Lung carcinoids are uncommon neuroendocrine tumours. Molecular features of lung carcinoids have been poorly defined. microRNAs (miRNAs) are potent gene expression regulators with important roles in cancer development and progression. However, little is known on the role of miRNAs in the pathogenesis of lung carcinoids. Our goals were to identify commonly deregulated miRNAs in a rare case of lung carcinoid of typical histology with metastasis, as well as map miRNA target genes in pathways potentially associated with disease development and progression. METHODS: miRNA expression profiles were assessed using the TaqMan Low Density Arrays, which is a platform including 384 miRNAs. miRNA profiles were generated in the tumor and its corresponding lymph node metastasis, compared to reference normal lung tissues. Furthermore, miRNA expression was validated in a separate, publicly available external dataset (n=19 typical lung carcinoids; 2/19 were metastatic tumors, compared to six normal lung tissues, GSE77380). Following this analysis, computational tools were applied for data interpretation. miRTarBase was used to determine miRNA-target genes, followed by ToppGene Suite analysis to identify pathways and biological functions. In addition, the expression of genes targeted by miRNAs was validated in a second, separate external dataset (n=13 tumour samples, GSE35679). GEO2R data analysis tool was used in both validation analyses (miRNAs and genes). RESULTS: We identified 15 commonly significantly downregulated miRNAs (fold change, FC≥2 and p<0.05) in the tumour and its paired metastasis, with further decreasing levels in the metastatic lesion. Downregulation of miR-126-3p and miR-146b-5p was validated in the external dataset GSE77380. In addition, SOX2 and TCF4 genes, targeted by miR-126-3p, were consistently overexpressed in a subset of six typical lung carcinoids from the external dataset GSE35679. Pathways analysis showed that miRNAs miR-126-3p and miR-146b-5p target genes with a role in the regulation of adaptive immune response. CONCLUSION: Our results contribute to the identification of miRNA expression changes in a typical lung carcinoid and its corresponding lymph node metastasis. Down-regulated levels of miR-126-3p and miR-146b-5p and target gene over-expression could play a role in the progression of this case of primary typical lung carcinoid to regional metastasis. Identified miRNAs and target genes are potential candidates for validation in a larger number of cases.

Which Method Should Be Used to Assess Protein Intake in Peritoneal Dialysis Patients? Assessment of Agreement Between Protein Equivalent of Total Nitrogen Appearance and 24-Hour Dietary Recall.

OBJECTIVES: After dialysis initiation, a high protein diet is recommended due to significant nutrient losses through dialysate and increased risk of protein energy wasting. In peritoneal dialysis (PD) patients, protein intake can be assessed through different methods that have some advantages and limitations, which affect its use on routine care. The aim of this study is to evaluate the agreement between 2 different methods (24-hour dietary recall and PNA-protein equivalent of total nitrogen appearance) on estimating protein intake in PD patients. DESIGN AND METHODS: Patients on PD for at least 3 months, aged 18 years old or more, were enrolled. To estimate protein intake, 24-hour dietary recall and PNA was used. PNA was calculated from 24-hour urine on the same day of the 24-hour dietary recall. RESULTS: Fifty individuals on PD were included, mean age 55.7 ± 16.2 years, and body mass index 26.0 ± 4.5 kg/m2. The average energy consumption was 1788.79 ± 504.40 kcal/day, which corresponds to 26.81 ± 9.11 kcal/kg current body weight (BW)/day and 29.82 ± 8.39 kcal/kg ideal body weight (IBW)/day. The median of total daily and normalized protein intake estimated using dietary recall was 61.43 (45.28-87.40) g/day, 0.90 (0.58-1.22) g/kg current BW/day, and 1.04 (0.77-1.32) g/kg IBW/day, respectively. Daily protein intake estimated by PNA was 55.75 (48.27-67.74) g/day, protein intake normalized by current BW was 0.81 (0.72-0.99) g/kg and 0.92 (0.83-1.06) g/kg IBW/day. Bland-Altman analysis indicates no systematic bias for the assessment of total protein intake and normalized protein intake for current and ideal BW. Significant proportionality bias was observed for both evaluations, showing there is a dispersion of the values. CONCLUSIONS: Despite the absence of systematic bias in the Bland-Altman analysis, there is no agreement in the assessment of protein intake by dietary recall and PNA, due to the existence of proportionality bias. Thus, values can be influenced biased by the magnitude of the measures.

Telomere-associated genes and telomeric lncRNAs are biomarker candidates in lung squamous cell carcinoma (LUSC).

In the past decade, research efforts were made to identify molecular biomarkers useful as therapeutic targets in Non-Small Cell Lung Cancer (NSCLC), the most frequent type of lung carcinoma. NSCLC presents different histological subtypes being the most prevalent LUSC (Lung Squamous Cell Cancer) and LUAD (Lung Adenocarcinoma), and only a subset of LUAD patients' present tumors expressing known targetable genetic alterations. Telomeres and its components, including telomerase, the enzyme that replenishes telomeres, have been considered potential cancer biomarkers due to their crucial role in cell proliferation and genome stability. Our study aims to quantify expression changes affecting telomere-associated genes and ncRNAs associated with telomere regulation and maintenance in NSCLC. We first assessed the transcriptome (RNA-Seq) data of NSCLC patients from The Cancer Genome Atlas (TCGA) and then we tested the expression of telomere-associated genes and telomeric ncRNAs (TERC, telomerase RNA component, and TERRA, telomere repeat-containing RNA) in Brazilian NCSLC patient samples by quantitative RT-PCR, using matched normal adjacent tissue samples as the control. We also estimated the mean size of terminal restriction fragments (TRF) of some Brazilian NSCLC patients using telomeric Southern blot. The TCGA analysis identified alterations in the expression profile of TERT and telomere damage repair genes, mainly in the LUSC subtype. The study of Brazilian NSCLC samples by RT-qPCR showed that LUSC and LUAD express high amounts of TERT and that although the mean TRF size of tumor samples was shorter compared to normal cells, telomeres in NSCLC are probably maintained by telomerase. Also, the expression analysis of Brazilian NSCLC samples identified statistically significant alterations in the expression of genes involved with telomere damage repair, as well as in TERC and TERRA, mainly in the LUSC subtype. We, therefore, concluded that telomere maintenance genes are significantly deregulated in NSCLC, representing potential biomarkers in the LUSC subtype.

Association between vitamin D levels and mortality in hemodialysis patients: a cohort study.

Introduction: Low vitamin D levels are associated with mortality in hemodialysis (HD) patients; however, the serum vitamin D thresholds are unclear. This study aimed to identify the vitamin D level below which mortality increases in HD patients.Methods: A cohort of HD patients enrolled from January 2014 to January 2017 was evaluated. The variables were analyzed according to the season, namely, summer, winter, and annual average, mortality was the primary outcome. The patients were assigned to vitamin D quintiles, and multivariate Cox regression analysis adjusted for age, ethnicity, gender, body mass index (BMI), inhibitors of the renin-angiotensin system, statin, calcitriol, and antiplatelet drugs use, hemodialysis vintage, hypertension, diabetes mellitus, atherosclerotic disease, and C-reactive protein was performed.Results: There were studied 306 patients. Vitamin D levels of 18.0-23.6 ng/mL (hazard ratio [HR] = 4.30; 95% confidence interval [CI] 1.60-11.54, p = 0.004) and <18.0 ng/mL (HR = 3.83; 95% CI: 1.42-10.35, p = 0.008) in summer and vitamin D levels of 21.5-27.1 ng/mL (HR = 3.70; 95% CI: 1.50-9.11, p = 0.004) and ≤17.5 ng/mL (HR = 2.84; 95% CI: 1.13-7.13, p = 0.026) in winter were associated with mortality. The average annual values of vitamin D associated with all-cause mortality were <17.7 ng/dL (adjusted HR = 4.25, 95% CI: 1.57-11.48, p = 0.004), and between >17.7 ng/dL and ≤23.1 ng/dL (adjusted HR = 3.91, 95% CI: 1.47-10.42, p = 0.006).Conclusions: Annual average vitamin D levels <23.1 ng/mL were associated with higher all-cause mortality, regardless of the confounding variables evaluated.

Influence of the intra-peritoneal segment of the swan neck peritoneal catheter on infectious and mechanical complications and technique survival.

BACKGROUND: There is no consensus about the preferable type of catheter for successful peritoneal dialysis. Intra- and extra-peritoneal catheter configuration may be associated with mechanical and infectious complications affecting technique survival. The objective of this study was to compare the mechanical and infectious complications of coiled versus straight swan neck (SN) peritoneal dialysis catheters. METHODS: A prospective randomized trial was performed to compare mechanical (tip migration with dysfunction) and infectious (peritonitis and exit site infection) complications between catheters randomly divided into two groups: swan neck straight tip and swan neck coiled tip. The follow-up was 1 year. RESULTS: A total of 49 catheters, in 46 patients, were included from April 2015 to February 2016. The catheters groups were constituted as: 25 coiled tip SN and 24 straight tip SN. The baseline demographics were similar among the groups. Kaplan-Meier survival estimates were not different for time to first exit site infection, peritonitis and time to first catheter tip migration (log-rank test, p = 0.07, p = 0.54 and p = 0.83, respectively). Catheter survival and method survival were also similar (log-rank p = 0.88 and p = 0.91, respectively). CONCLUSIONS: The two types of intra-peritoneal segments of SN catheters studied presented similar infectious and mechanical rates with no differences in catheter and technique survival curve. These results were consistent with the recommendations of the International Society for Peritoneal Dialysis.

Semi-Automated Three-Dimensional Condylar Reconstruction.

The objective was to validate a semi-automated segmentation method for 3-dimensional (3D) reconstruction of the mandibular condyle from cone beam computed tomography (CBCT) data and illustrate its application in volumetric analysis of the condyle.Ten CBCT datasets were used to validate the proposed semi-automatic method for 3D rendering of mandibular condyles. First, a standardized orientation protocol of the skull was applied. After defining the volume of interest, a grey-scale cut-off value was selected to allow an automatic reconstruction of the condyle's surface. Subsequently, condylar contour was optimized manually. The whole process was repeated twice by 2 independent investigators. Volumetric measurements of the condyle were used as a measure of conformity between both investigators. The reproducibility of condylar volume reconstruction was excellent for intra-examiner measurements (CV = 3.65%, intraclass correlation coefficient = 0.97) and good for inter-examiner measurements (CV = 7.15%, ICC = 0.89). The overall mean time required for the segmentation process was 6.31 + 2.78 minutes. The proposed protocol provides an accurate and reproducible tool for 3D reconstruction of the mandibular condyle using CBCT data. Its implementation will enable adequate follow-up of morphological changes in bone tissue with a Hounsfield unit-based imaging segmentation method.

Cranial Base Superimposition of Cone-Beam Computed Tomography Images: A Voxel-Based Protocol Validation.

OBJECTIVES: The primary objective of the present study was to find the gold-standard accuracy of voxel-based superimposition of cone-beam computed tomography (CBCT) datasets with a protocol developed for the Dolphin Imaging 3D software. The secondary objectives were to analyze reproducibility and efficiency of this protocol. STUDY DESIGN: Twenty-five CBCT datasets of patients with dental implants present were selected. Each Base Volume dataset was duplicated to create a second volume. Subsequently, both volumes were superimposed with a voxel-based protocol consisting of 3 successive steps "Side-by-side Superimposition"; "Overlay Superimposition"; and "Export Orientation to 2nd Volume". The protocol's accuracy was evaluated by measuring the mean distance between the apex of each dental implant on the Base Volume and second volume datasets. Efficiency was given by the mean time needed to complete all superimposition steps. Reproducibility was analyzed by calculating the intraclass correlation coefficients. RESULTS: Mean time needed to complete the protocol was 198 seconds. The protocol had a rotational accuracy of 0.10° to 019° and a translational accuracy of 0.20 to 0.24 mm. Intra-observer and inter-observer reproducibility were 1 and 0.921 to 1, respectively. CONCLUSIONS: The protocol is accurate, precise, reproducible, and efficient. The validation of this method enables unbiased analysis of surgical outcomes based on a single, user-friendly software product that is widely available in academic and clinical settings.

The repetitive DNA element BncDNA, enriched in the B chromosome of the cichlid fish Astatotilapia latifasciata, transcribes a potentially noncoding RNA.

Supernumerary chromosomes have been studied in many species of eukaryotes, including the cichlid fish, Astatotilapia latifasciata. However, there are many unanswered questions about the maintenance, inheritance, and functional aspects of supernumerary chromosomes. The cichlid family has been highlighted as a model for evolutionary studies, including those that focus on mechanisms of chromosome evolution. Individuals of A. latifasciata are known to carry up to two B heterochromatic isochromosomes that are enriched in repetitive DNA and contain few intact gene sequences. We isolated and characterized a transcriptionally active repeated DNA, called B chromosome noncoding DNA (BncDNA), highly represented across all B chromosomes of A. latifasciata. BncDNA transcripts are differentially processed among six different tissues, including the production of smaller transcripts, indicating transcriptional variation may be linked to B chromosome presence and sexual phenotype. The transcript lengths and lack of similarity with known protein/gene sequences indicate BncRNA might represent a novel long noncoding RNA family (lncRNA). The potential for interaction between BncRNA and known miRNAs were computationally predicted, resulting in the identification of possible binding of this sequence in upregulated miRNAs related to the presence of B chromosomes. In conclusion, Bnc is a transcriptionally active repetitive DNA enriched in B chromosomes with potential action over B chromosome maintenance in somatic cells and meiotic drive in gametic cells.

The hnRNP Q-like gene is retroinserted into the B chromosomes of the cichlid fish Astatotilapia latifasciata.

B chromosomes are dispensable elements observed in many eukaryotic species, including the African cichlid Astatotilapia latifasciata, which might have one or two B chromosomes. Although there have been many studies focused on the biology of these chromosomes, questions about the evolution, maintenance, and potential effects of these chromosomes remain. Here, we identified a variant form of the hnRNP Q-like gene inserted into the B chromosome of A. latifasciata that is characterized by a high copy number and intron-less structure. The absence of introns and presence of transposable elements with a reverse transcriptase domain flanking hnRNP Q-like sequences suggest that this gene was retroinserted into the B chromosome. RNA-Seq analysis did not show that the B variant retroinserted copies are transcriptionally active. However, RT-qPCR results showed variations in the canonical hnRNP Q-like copy expression levels among exons, tissues, sex, and B presence/absence. Although the patterns of transcription are not well understood, the exons of the B retrocopies were overexpressed, and a bias for female B+ expression was also observed. These results suggest that retroinsertion is an additional and important mechanism contributing to B chromosome formation. Furthermore, these findings indicate a bias towards female differential expression of B chromosome sequences, suggesting that B chromosomes and sex determination are somehow associated in cichlids.

Dietary risk factors for colorectal cancer in Brazil: a case control study.

BACKGROUND: High meat intake and low consumption of vegetables, fruits and whole grains have been associated with increased risk of colorectal cancer in some relevant cohort studies conducted in distinct ethnic populations. The role of the dietary pattern on the risk of sporadic colorectal adenocarcinoma (SCA) in Brazil is unknown; therefore, it was the aim of the present study. METHODS: The dietary patterns of 169 patients with SCA and 101 controls were analysed by food frequency recall. Crude odds ratios were calculated and given within 95 % confidence intervals. RESULTS: Patients reported higher average intakes of beef (32.0 ± 1.8 versus 23.7 ± 1.6, P = 0.0069), chicken (18.1 ± 0.9 versus 12.2 ± 0.8, P = 0.0002), and pork (8.9 ± 0.9 versus 3.4 ± 0.5, P < 0.0001). These individuals had a 1.025, 1.069, and 1.121-fold increased risk of SCA. Similar consumption of fish, vegetables, fruits and whole grains was reported by patients and controls. CONCLUSIONS: Meat consumption is greater in patients with SCA in the Brazilian population. Considering the study population - characterized by ethnic heterogeneity -, the environmental factor related to food habits may be associated with higher incidence of this disease in Brazil.

Midfacial Protraction With Skeletal Anchorage After Pterygomaxillary Separation.

The present article reports the treatment of a 7-year-old girl with maxillary hypoplasia associated with multiple tooth agenesis through maxillary protraction with skeletal anchorage and pterygomaxillary separation. Two titanium mini-plates were placed in the lateral region of the nasal cavity and used as anchorage for maxillary protraction with a reverse-pull facemask. Pterygomaxillary separation was also performed to enhance the effects of maxillary protraction. One week after surgery, 300 g of force was applied on each side to protract the maxilla. Active treatment time was 4 months, with 12 additional months of follow-up. Analysis of the cone beam computed tomography images demonstrated that skeletal anchorage enabled the correction of the maxillomandibular discrepancy, with an improvement in facial appearance and occlusion and with no dental effects. Pterygomaxillary separation was not effective, showing no superior orthopedic response on maxillary advancement or restrictions to maxillary growth in the 12-month post-treatment follow-up.

Kinin B1 Receptor Deletion Affects Bone Healing in Type 1 Diabetic Mice.

The effects of kinin B1 receptor (B1 R) deletion were examined on femur bone regeneration in streptozotocin (STZ)-type 1 diabetes. Diabetes induction in wild-type C57/BL6 (WTC57BL6) mice led to decrease in body weight and hyperglycemia, compared to the non-diabetic group of the same strain. The lack of B1 R did not affect STZ-elicited body weight loss, but partially prevented hyperglycemia. Diabetic mice had a clear delay in bone regeneration, and displayed large areas of loose connective tissue within the defects, with a reduced expression of the mineralization-related protein osteonectin, when compared to the non-diabetic WTC57/BL6. The non-diabetic and diabetic B1 R knockout (B1 RKO) mice had bone regeneration levels and osteonectin expression comparable to that seen in control WTC57/BL6 mice. WTC57/BL6 STZ-diabetic mice also showed a marked reduction of collagen contents, with increased immunolabeling for the apoptosis marker caspase-3, whereas diabetic B1 RKO had collagen levels and caspase-3 activity comparable to those observed in non-diabetic WTC57/BL6 or B1 RKO mice. No significant difference was detected in the number of tartrate-resistant acid phosphatase (TRAP)-stained cells, or in RANK/RANKL/OPG system immunolabeling throughout the experimental groups. Data bring novel evidence on the relevance of kinin B1 R under type 1 diabetes with regards to its role in bone regeneration.

Occluded Tunneled Venous Catheter in Hemodialysis Patients: Risk Factors and Efficacy of Alteplase.

Thrombosis of tunneled central venous catheters (CVC) in hemodialysis (HD) patients is common and it can lead to the elimination of vascular sites. This study aimed to evaluate the incidence of thrombotic obstruction of tunneled CVC in HD patients and the efficacy of occlusion treatment with alteplase use, and identify factors associated with thrombotic occlusion. It was a prospective cohort study performed in two centers which evaluated the diagnosis and treatment of thrombotic occlusion of CVC in HD patients for 24 consecutive months. The catheter occlusion was defined as the difficulty infusing or withdrawing fluid from their paths. Alteplase dose was infused to fill the lumen of the occluded catheter and remained for 50 min. As there was no obstruction of the catheter, the procedure was repeated. Three hundred and thirty-nine CVC in 247 patients were evaluated and followed, totalling 67,244 CVC-days. One hundred fifty-seven patients had only one CVC, 88 patients had two CVC during the study, and two patients had three CVC. The median age was 58 (47-66) years, patients were predominantly men (54%), with diabetic nephropathy as the main cause of chronic kidney disease (44%), the internal jugular vein as the main site of implantation (82%), and duration of dialysis before CVC implantation of 119 (41.5 to 585.5) days. Eight hundred and fifteen occlusion episodes were diagnosed (12 episodes/1000 CVC-days), with primary success with alteplase in 596 episodes (77%) and secondary in 81 cases (10%). In 99 episodes (13%), success was not achieved after the second dose of alteplase. Two hundred and thirty CVC were removed during the study and the removal causes were arteriovenous fistula use in 88 patients (38.3%), infectious and mechanical complications in 89 (38.7%) and 21 (9.1%), respectively, and others (transplantation, transfer, or death) in 32 patients (13.9%). Adverse effects were also not observed. In the multivariate analysis, we identified the greatest number of days with CVC (OR = 1.02, CI = 1.01-1.04, P = 0.004), the presence of diabetes (OR = 1.560, CI = 1.351-1.894, P = 0.015), and exit site infection (ESI) (OR = 1.567 CI = 1347-1926, P = 0.023) as factors associated with obstruction. Thrombotic occlusion showed frequent mechanical complication in CVC of HD patients. We observed 12 episodes of obstruction per 1000 CVC-days, with a high success rate after alteplase use (87%). In the multivariate analysis, the time with CVC, the presence of diabetes, and ESI were identified as variables associated with thrombotic obstruction.

Selection index in the study of adaptability and stability in maize.

This paper proposes an alternative method for evaluating the stability and adaptability of maize hybrids using a genotype-ideotype distance index (GIDI) for selection. Data from seven variables were used, obtained through evaluation of 25 maize hybrids at six sites in southern Brazil. The GIDI was estimated by means of the generalized Mahalanobis distance for each plot of the test. We then proceeded to GGE biplot analysis in order to compare the predictive accuracy of the GGE models and the grouping of environments and to select the best five hybrids. The G × E interaction was significant for both variables assessed. The GGE model with two principal components obtained a predictive accuracy (PRECORR) of 0.8913 for the GIDI and 0.8709 for yield (t ha(-1)). Two groups of environments were obtained upon analyzing the GIDI, whereas all the environments remained in the same group upon analyzing yield. Coincidence occurred in only two hybrids considering evaluation of the two features. The GIDI assessment provided for selection of hybrids that combine adaptability and stability in most of the variables assessed, making its use more highly recommended than analyzing each variable separately. Not all the higher-yielding hybrids were the best in the other variables assessed.

Unusual complication after genioplasty.

Facial beauty depends on shape, proportion, and harmony between the facial thirds. The chin is one of the most important components of the inferior third and has an important role on the definition of facial aesthetic and harmony in both frontal and lateral views. There are 2 principal therapeutic approaches that one can choose to treat mental deformities, alloplastic implants, and mental basilar ostectomy, also known as genioplasty. The latest is more commonly used because of great versatility in the correction of three-dimensional deformities of the chin and smaller taxes of postoperative complications. Possible transoperative and postoperative complications of genioplasty include mental nerve lesion, bleeding, damage to tooth roots, bone resorption of the mobilized segment, mandibular fracture, ptosis of the lower lip, and failure to stabilize the ostectomized segment. The study presents 2 cases of displacement of the osteotomized segment after genioplasty associated with facial trauma during postoperative orthognathic surgery followed by rare complications with no reports in the literature.