Foreign Body Ingestion During Dental Implant Procedures

Two cases of swallowing of foreign material related to dental implants during dental practice are described. A conservative approach by clinical-radiographic follow-up was performed in both cases; however, one of the patients required colonoscopy under general anesthesia for the removal of the impacted foreign body from the intestinal region. These complications not only have associated economic cost but also carry the risk of malpractice litigation against the professional; thus, the surgeon was responsible for all the costs of hospital and surgery management of this case. Details of the clinical signs, radiographic examinations, type of treatment, and follow-up are presented.

Nuts and seed: A natural yet dangerous foreign body

Rationale and aim: This paper has the object to present the impact of nuts' and seeds' injuries withdrawing data from the Susy Safe registry, highlighting that as for other foreign bodies the main item efficiently and substantially susceptible to changes to decrease the accidents' rates is the education of adults and children, that can be shared with parents both from pediatricians and general practitioners. Indeed labeling and age related warnings have also a fundamental relevance in prevention. Methods: The present study draws its data from the Susy Safe registry. Details on injuries are entered in the Susy Safe Web-registry through a standardized case report form, that includes information regarding: children age and gender, features of the object, circumstances of injury (presence of parents and activity) and hospitalization's details (lasting, complications and removal details). Cases are prospectively collected using the Susy Safe system from 06/2005; moreover, also information regarding past consecutive cases available in each centre adhering to the project have been entered in the Susy Safe registry. Results: Nuts and seeds are one of the most common food item retrieved in foreign bodies injuries in children. In Susy Safe registry they represent the 38% in food group, and almost the 10% in general cases. Trachea, bronchi and lungs were the main location of FB's retrieval, showing an incidence of 68%. Hospitalization occurred in 83% of cases, showing the major frequency for foreign bodies located in trachea. This location was also the principal site of complications, with a frequency of 68%. There were no significant associations between these outcomes and the age class of the children. The most common complications seen (22.4%) was bronchitis, followed by pneumonia (19.7%). Adult presence was recorded as positive in 71.2% of cases, showing an association (p value 0.009) between the adult supervision and the hospitalization outcome. On the contrary there was a non significant association between adult presence and the occurrence of complications. In 80.7% of cases, the incident happened while the child was eating. Among those cases, 88.6% interested trachea, lungs and bronchi. Conclusions: Food-related aspiration injuries are common events for young children, particularly under 4 years of age, and may lead to severe complication. There is a need to study in more depth specific characteristics of foreign bodies associated with increased hazard, such as size, shape, hardness or firmness, lubricity, pliability and elasticity, in order to better identify risky foods, and more precisely described the pathogenetic pathway. Parents are not adequately conscious and aware toward this risk; therefore, the number and severity of the injuries could be reduced by educating parents and children. Information about food safety should be included in all visits to pediatricians in order to make parents able to understand, select, and identify key characteristics of hazardous foods and better control the hazard level of various foods. Finally, preventive measures including warning labels on high-risk foods could be implemented. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

Broncoscopia flexível como primeira opção para a remoção de corpo estranho das vias aéreas em adultos

OBJETIVO: Determinar a taxa de sucesso da broncoscopia flexível como primeira opção na remoção de corpos estranhos das vias aéreas em adultos. MÉTODOS: Estudo retrospectivo de todos os pacientes adultos (acima de 18 anos) com aspiração de corpo estranho submetidos a broncoscopia no Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, em São Paulo (SP). RESULTADOS: A amostra foi constituída por 40 pacientes adultos, com média de idade de 52 anos (variação: 18-88 anos). A mediana do tempo de permanência do corpo estranho na via aérea foi de 15 dias (variação: 12 h a 10 anos). Todos os pacientes foram submetidos primeiramente a broncoscopia flexível diagnóstica. A retirada do corpo estranho por meio de broncoscopia flexível foi bem-sucedida em 33 dos pacientes (82,5%). Em 1 paciente, um objeto metálico alojado na árvore brônquica distal requereu o uso de fluoroscopia. Seis pacientes (15%) foram submetidos a broncoscopia rígida devido a dispneia induzida por corpo estranho traqueal, em 2, e porque o corpo estranho era muito grande para as pinças flexíveis, em 4. A broncoscopia falhou em apenas 1 paciente, que portanto necessitou de broncotomia. CONCLUSÕES: Embora a broncoscopia rígida seja considerada o padrão ouro na remoção de corpos estranhos na via aérea, nossa experiência mostrou que a broncoscopia flexível pode ser utilizada segura e eficientemente no diagnóstico e tratamento de pacientes adultos estáveis.

Influence of Helmet Use in Facial Trauma and Moderate Traumatic Brain Injury Victims of Motorcycle Accidents

Objective: The objective of this research was to study the influence of the use of helmet in facial trauma victims of motorcycle accidents with moderate traumatic brain injury. Methods: We retrospectively reviewed the incidence of facial injuries in helmeted and nonhelmeted victims with moderate traumatic brain injury at a referral trauma hospital. Results: The sample consisted of 272 patients predominantly men (94.5%) and between 21 and 40 years old (62.9%). The majority of patients were using helmet (80.1%). The occurrence of facial fractures was most frequent for zygomatic bone (51.8%), followed by mandible (18.8%) and nasal bones (9.2%). Conclusions: Individuals in the most productive age group are most affected, which causes a great loss to financial and labor systems. It is important to take measures to alert the public regarding the severity of injuries likely to occur in motorcycle-related accidents and ways to prevent them.

Dangerous waters: outbreak of eye lesions caused by fresh water sponge spicules

Purpose To describe an extremely uncommon outbreak of eye lesions in a specific area of the Brazilian Amazonia. Methods Prospective noncomparative case series. Fifty-nine patients who developed eye lesions after swimming in the Araguaia river of Tocantins state in Brazil were examined. A team of ophthalmologists equipped with a slit-lamp, gonioscopic lenses, and indirect ophthalmoscopy performed full eye examination. Analysis of the flora and fauna of the river water was undertaken by a group of experts. Results and Conclusions Eighty-three eyes were affected. The most common lesions were corneal opacities seen in 34 eyes and conjunctival nodules diagnosed in 12 eyes. Severe visual acuity loss was detected in seven children with unilateral anterior chamber lesions. Spicules of the sponge species Drulia uruguayensis and Drulia ctenosclera were found inside three blind eyes that have been enucleated for diagnostic purposes. All eye lesions could be attributed to an outbreak of foreign bodies from fresh water sponges. Organic enrichment of the water resulting from the absence of sanitation probably was the key factor, which initiated a cycle of ecological imbalance that provoked human disease.

The place of (explicit) grammar within the methods and approaches of foreign language teaching: in the north, in the centre or on the margins?

This article analyzes the role that has been attributed to grammar throughout the history of foreign language teaching, with special emphasis on methods and approaches of the twentieth century. In order to support our argument, we discuss the notion of grammar by proposing a conceptual continuum that includes the main meanings of the term which are relevant to our research. We address as well the issue of "pedagogical grammar" and consider the position of grammar in the different approaches of the "era of the methods" and the current "post-method condition" in the field of language teaching and learning. The findings presented at the end of the text consist of recognizing the central role that grammar has played throughout the history of the methods and approaches, where grammar has always been present by the definition of the contents' progression. The rationale that we propose for this is the recognition of the fact that the dissociation between what is said and how it is said can not be more than theoretical and, thus, artificial.

Identification of a Tooth-Like Foreign Body in Swine Sausage

A tooth-like foreign body (FB) was found inside a sausage bread. Analysis aimed to investigate whether the FB was a tooth and its origin. The FB was measured, weighed, photographed, and radiographed. Macroscopic findings were suggestive of an anterior tooth. Histological slides of undecalcified cross-sections of the FB and samples of human and swine teeth were prepared. Histological features of the FB (in light microscopy, 125X magnification) were discrepant from human tissues. Compared histological analysis displayed majority of features consistent with a hypsodont swine tooth, probably a canine. Cellularized cementum in crown region, adjacent to the enamel, and shape of the cementocytes were the main criteria excluding the possibility of human origin of the FB. Scanning electronic microscopy and energy-dispersive spectroscopy were not performed because of fewer features to be analyzed and FB size. It was concluded that the FB may have been incorporated during meat grinding of the sausage.

Foreign Surrogate Motherhood: mater semper certa erat

This Article compares the conflicting approaches to resolve the questions surrounding surrogate motherhood in a domestic context and then addresses some of its transnational implications, especially the recognition of foreign surrogacy judgments. It argues that not every case of foreign surrogacy involves the circumvention of the forum's prohibition of surrogacy and that courts need to take this into account when applying the public policy exception. It further argues that the adoption of the child by the commissioning parents should be seen as an alternative and adequate solution to the limping legal parenthood that would otherwise arise from the non-recognition of a surrogacy judgment.

In vitro behaviour of endothelial cells on a titanium surface

Abstract Background Endothelial cells play an important role in the delivery of cells to the inflammation site, chemotaxis, cell adhesion and extravasation. Implantation of a foreign material into the human body determines inflammatory and repair reactions, involving different cell types with a plethora of released chemical mediators. The evaluation of the interaction of endothelial cells and implanted materials must take into account other parameters in addition to the analysis of maintenance of cell viability. Methods In the present investigation, we examined the behavior of human umbilical vein endothelial cells (HUVECs) harvested on titanium (Ti), using histological and immunohistochemical methods. The cells, after two passages, were seeded in a standard density on commercially plate-shaped titanium pieces, and maintained for 1, 7 or 14 days. Results After 14 days, we could observe a confluent monolayer of endothelial cells (ECs) on the titanium surface. Upon one-day Ti/cell contact the expression of fibronectin was predominantly cytoplasmatic and stronger than on the control surface. It was observed strong and uniform cell expression along the time of α5β1 integrin on the cells in contact with titanium. Conclusion The attachment of ECs on titanium was found to be related to cellular-derived fibronectin and the binding to its specific receptor, the α5β1 integrin. It was observed that titanium effectively serves as a suitable substrate for endothelial cell attachment, growth and proliferation. However, upon a 7-day contact with Ti, the Weibel-Palade bodies appeared to be not fully processed and exhibited an anomalous morphology, with corresponding alterations of PECAM-1 localization.

Figures of equilibrium for tidally deformed non-homogeneous celestial bodies

Abstract (2,250 Maximum Characters): Several theories of tidal evolution, since the theory developed by Darwin in the XIX century, are based on the figure of equilibrium of the tidally deformed body. Frequently the adopted figure is a Jeans prolate spheroid. In some case, however, the rotation is important and Roche ellipsoids are used. The main limitations of these models are (a) they refer to homogeneous bodies; (b) the rotation axis is perpendicular to the plane of the orbit. This communication aims at presenting several results in which these hypotheses are not done. In what concerns the non-homogeneity, the presented results concerns initially bodies formed by N homogeneous layers and we study the non sphericity of each layer and relate them to the density distribution. The result is similar to the Clairaut figure of equilibrium, often used in planetary sciences, but taking into full account the tidal deformation. The case of the rotation axis non perpendicular to the orbital plane is much more complex and the study has been restricted for the moment to the case of homogeneous bodies.

Talking bodies: nonverbal behavior in the assessment of depression severity

BACKGROUND: Evaluations of clinical depression are traditionally based on verbal information. Nonverbal expressive behavior, however, being associated with a person's reflexive responses, may reveal negative emotional or social processes that are not under complete control of the patients. However, investigations of nonverbal behavior in the evaluation of depressed patients are still scarce. This study examines the nonverbal behaviors of a group of Brazilian patients, associating their nonverbal behavior with severity of depression. METHODS: Forty depressed patients were evaluated at baseline (T0) and after a two-week transcranial direct current stimulation treatment (T1), according to rating scales and through a 21-category Ethogram for assessment of the frequency of nonverbal behaviors displayed during an interview. RESULTS: Behaviors that were related to negative feelings and social disinterest decreased with corresponding clinical improvement and were associated with increased severity of symptoms at T0 and greater negative affect and dissatisfaction at T1. Pro-social behaviors were associated with milder symptoms at T0 and increased after treatment. Facial, head and hand expressive movements stood out as important indicators because of their associations with severity of depression. LIMITATIONS: Duration of behaviors was not assessed and there was not a healthy control group with which to compare the findings. CONCLUSIONS: These results support the usefulness of nonverbal behavior as an evaluation technique in the assessment of clinical depression.

Effects of trophic levels (chlorophyll and phosphorous content) in three different water bodies (urban lake, reservoir and aquaculture facility) on gill morphology of Nile tilapia (Oreochromis niloticus)

Histological and ultrastructural analyses of gills were observed in Nile tilapia collected from three different waterbodies in southeast Brazil: an urban lake in a park in the city of São Paulo, a reservoir in a rural city, and a commercial aquaculture facility. These aterbodies were analyzed and classified as hypereutrophic, eutrophic, and supereutrophic, respectively, with 310.00, 94.00, 28.00 of phosphate (PO2_ 4 lg L _1) and 65.49, 24.95, 12.83 of chlorophyll (lg L _1). A significant difference in the histological alterations index (HAI) was observed only in fish from the urban lake, with the presence of cell hypertrophy, hyperplasia, aneurism, and other alterations. When compared to the other groups, a large quantity of rodlet cells was also observed in the urban group. These results demonstrate the correlation of eutrophic states of water with gill morphology. Also discussed is the premise that large amounts of organic material dissolved in water can alter the morphology of the fish gills