Hand and ultrasonic instrumentation for orthograde root canal treatment of permanent teeth

Root canal treatment is a frequently performed dental procedure and is carried out on teeth in which irreversible pulpitis has led to necrosis of the dental pulp. Removal of the necrotic tissue remnants and cleaning and shaping of the root canal are important phases of root canal treatment. Treatment options include the use of hand and rotary instruments and methods using ultrasonic or sonic equipment. OBJECTIVES: The objectives of this systematic review of randomized controlled trials were to determine the relative clinical effectiveness of hand instrumentation versus ultrasonic instrumentation alone or in conjunction with hand instrumentation for orthograde root canal treatment of permanent teeth. MATERIAL AND METHODS: The search strategy retrieved 226 references from the Cochrane Oral Health Group Trials Register (7), the Cochrane Central Register of Controlled Trials (CENTRAL) (12), MEDLINE (192), EMBASE (8) and LILACS (7). No language restriction was applied. The last electronic search was conducted on December 13th, 2007. Screening of eligible studies was conducted in duplicate and independently. RESULTS: Results were to be expressed as fixed-effect or random-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes with 95% confdence intervals. Heterogeneity was to be investigated including both clinical and methodological factors. No eligible randomized controlled trials were identifed. CONCLUSIONS: This review illustrates the current lack of published or ongoing randomized controlled trials and the unavailability of high-level evidence based on clinically relevant outcomes referring to the effectiveness of ultrasonic instrumentation used alone or as an adjunct to hand instrumentation for orthograde root canal treatment. In the absence of reliable research-based evidence, clinicians should base their decisions on clinical experience, individual circumstances and in conjunction with patients' preferences where appropriate. Future randomized controlled trials might focus more closely on evaluating the effectiveness of combinations of these interventions with an emphasis on not only clinically relevant, but also patient-centered outcomes.

An experimental model for the study of craniofacial deformities

PURPOSE: To develop an experimental surgical model in rats for the study of craniofacial abnormalities. METHODS: Full thickness calvarial defects with 10x10-mm and 5x8-mm dimensions were created in 40 male NIS Wistar rats, body weight ranging from 320 to 420 g. The animals were equally divided into two groups. The periosteum was removed and dura mater was left intact. Animals were killed at 8 and 16 weeks postoperatively and cranial tissue samples were taken from the defects for histological analysis. RESULTS: Cranial defects remained open even after 16 weeks postoperatively. CONCLUSION: The experimental model with 5x8-mm defects in the parietal region with the removal of the periosteum and maintenance of the integrity of the dura mater are critical and might be used for the study of cranial bone defects in craniofacial abnormalities.

Overview of the taxonomy and of the major secondary metabolites and their biological activities related to human health of the Laurencia complex (Ceramiales, Rhodophyta) from Brazil

In Brazil, the Laurencia complex is represented by twenty taxa: Laurencia s.s. with twelve species, Palisada with four species (including Chondrophycus furcatus now that the proposal of its transference to Palisada is in process), and Osmundea and Yuzurua with two species each. The majority of the Brazilian species of the Laurencia complex have been phylogenetically analyzed by 54 rbcL sequences, including five other Rhodomelacean species as outgroups. The analysis showed that the Laurencia complex is monophyletic with high posterior probability value. The complex was separated into five clades, corresponding to the genera: Chondrophycus, Laurencia, Osmundea, Palisada, and Yuzurua. A bibliographical survey of the terpenoids produced by Brazilian species showed that only six species of Laurencia and five of Palisada (including C. furcatcus) have been submitted to chemical analysis with 48 terpenoids (47 sesquiterpenes and one triterpene) isolated. No diterpenes were found. Of the total, 23 sesquiterpenes belong to the bisabolane class and eighteen to the chamigrene type, whose biochemical precursor is bisabolane, two are derived from lauranes and four are triquinols. Despite the considerable number of known terpenes and their ecological and pharmacological importance, few experimental biological studies have been performed. In this review, only bioactivities related to human health were considered.

Synteny of human chromosomes 14 and 15 in the platyrrhines (Primates, Platyrrhini)

In order to study the intra- and interspecific variability of the 14/15 association in Platyrrhini, we analyzed 15 species from 13 genera, including species that had not been described yet. The DNA libraries of human chromosomes 14 and 15 were hybridized to metaphases of Alouatta guariba clamitans, A. caraya, A. sara, Ateles paniscus chamek, Lagothrix lagothricha, Brachyteles arachnoides, Saguinus midas midas, Leontopithecus chrysomelas, Callimico goeldii, Callithrix sp., Cebus apella, Aotus nigriceps, Cacajao melanocephalus, Chiropotes satanas and Callicebus caligatus. The 14/15 hybridization pattern was present in 13 species, but not in Alouatta sara that showed a 14/15/14 pattern and Aotus nigriceps that showed a 15/14/15/14 pattern. In the majority of the species, the HSA 14 homologue retained synteny for the entire chromosome, whereas the HSA 15 homologue displayed fragmented segments. Within primates, the New World monkeys represent the taxon with the highest variability in chromosome number (2n = 16 to 62). The presence of the HSA 14/15 association in all species and subspecies studied herein confirms that this association is the ancestral condition for platyrrhines and that this association has been retained in most platyrrhines, despite the occurrence of extensive inter- and intrachromosomal rearrangements in this infraorder of Primates.

Migração e referenciais identificatórios: linguagem e preconceito

A ausência de diálogos no mundo massificado impõe um discurso padronizado. Tenta-se eliminar as diferenças e os limites que estruturam as identidades são ameaçados. A violência desse mundo joga para a periferia grandes segmentos da população, condenados a viver em condições desumanas. Migrantes e imigrantes, desenraizados dos fundamentos de suas identidades, constituem parte expressiva dessa população. Grandes metrópoles, como São Paulo, são verdadeiros lócus do embate intercultural que os ameaça. Nossa discussão se apóia em trabalho de pesquisa anterior com crianças nordestinas em escolas paulistas - pudemos constatar o preconceito, a humilhação que atingem essa população. O ponto de partida para a humilhação é, quase sempre, sua linguagem regional, vista como errada e inadequada. A lingüística e a sociolingüística nos mostram o contrário. Entretanto, tudo que enraíza e fortalece a identidade é negado. A “barbárie civilizada” destrói desejo, sonhos, esperança, alteridade.

Presença de culicídeos em município de porte médio do Estado de São Paulo e risco de ocorrência de febre do Nilo Ocidental e outras arboviroses

INTRODUÇÃO: O objetivo deste estudo foi mensurar a diversidade de espécies de culicídeos, descrever sua abundância e variação sazonal em áreas urbanas e matas de São José do Rio Preto, SP, e discutir o risco de ocorrência de arboviroses. MÉTODOS: Coletas de larvas e de mosquitos adultos foram realizadas mensalmente, em 2006 e 2007, em área urbana e em quatro fragmentos de mata. No perímetro urbano, coletaram-se larvas nos sítios mais prováveis de oviposição para mosquitos do gênero Culex e nas matas foi realizada a coleta de mosquitos adultos, sendo que em duas utilizaram-se armadilhas CDC à noite e, em duas, aspirador de Nasci de dia. RESULTADOS: Na área urbana identificaram-se 34 espécies de culicídeos em um total de 8.683 exemplares; destes, 80,7% corresponderam ao Culex quinquefasciatus, 9,6% ao Culex grupo Coronator, 3,2% ao Aedes albopictus (3,2%) e 1,1% ao Ochlerotatus fluviatilis. A abundância de larvas de Cx. quinquefasciatus correlacionou-se negativamente com a chuva. Nas quatro matas, foram coletados 2.268 mosquitos distribuídos entre 10 gêneros, 46 espécies ou grupos. As mais abundantes foram Aedeomyia squamipennis, Culex. coronator, Culex (Mel.) seção Melanoconion, Culex declarator, Ochlerotatus scapularis, Anopheles triannulatus, Culex bidens/interfor e Culex habilitator/pseudojhantinosoma. CONCLUSÕES: A abundância de Cx. quinquefasciatus na área urbana e a presença de outros culicídeos nas áreas urbanas e de matas apontam para a possibilidade de transmissão do vírus do Nilo Ocidental e de outras arboviroses em São José do Rio Preto e outras cidades do Brasil, sendo fundamental o estabelecimento de medidas visando à vigilância destas arboviroses.

Detection of Mycobacterium avium in pet birds

The present study is a report on the presence of Mycobacterium avium in four birds of the psittaciform order kept as pets. Anatomopathological diagnosis showed lesions suggestive of the agent and presence of alcohol-acid resistant bacilli (AARB) shown by the Ziehl-Neelsen staining. The identification of Mycobacterium avium was performed by means of PRA (PCR Restriction Analysis). DNA was directly extracted from tissue of the lesions and blocked in paraffin. The role of this agent in pet bird infection is discussed, as well as its zoonotic potential.

The expression of vulnerability through infant mortality in the municipality of Embu

CONTEXTO E OBJETIVO: A mortalidade infantil expressa uma conjunção de fatores relacionados às condições de vida, trabalho e acesso aos serviços de saúde, e a identificação desses fatores pode contribuir para definição de intervenções em saúde. O objetivo deste trabalho foi analisar a expressão da vulnerabilidade e conseqüentes diferenças de acesso aos serviços de saúde e na ocorrência de óbitos em menores de um ano no município do Embu. TIPO DE ESTUDO E LOCAL: Estudo descritivo, no município de Embu. MÉTODOS: Foram coletados dados secundários (declarações de óbitos) e primários (entrevistas a famílias de crianças residentes do município do Embu, falecidas nos anos de 1996 e 1997, antes de completarem um ano). Variáveis estudadas foram relacionadas às condições de vida, renda e trabalho, à assistência pré-natal, ao parto e à atenção à saúde da criança, as quais foram comparadas com resultados obtidos em estudo realizado no ano de 1996. RESULTADOS: Verificaram-se diferenças estatisticamente significantes quanto a renda, trabalho sem carteira assinada e acesso a plano privado de saúde entre famílias de crianças que foram ao óbito. Verificaram-se, também, diferenças quanto ao acesso e à qualidade da assistência pré-natal, à freqüência de baixo peso ao nascer e a intercorrências neonatais. CONCLUSÕES: A situação de emprego/desemprego foi decisiva na determinação da estabilidade familiar, conferindo maior vulnerabilidade para ocorrência de óbitos infantis, somada às condições de acesso e à qualidade dos serviços de saúde

Fatores determinantes de consumo alimentar: por que os indivíduos comem o que comem?

Objetivo: O presente trabalho teve como objetivo realizar uma revisão de literatura sobre os fatores determinantes do consumo alimentar. Método: Foi realizada uma revisão de literatura em bases de dados, como Medline e na biblioteca da Faculdade de Saúde Pública daUniversidade de São Paulo (FSP-USP). Resultados: Foram criadas quatro categorias de fatores determinantes do consumo alimentar: biológica, econômica, oferta/disponibilidade dos alimentos e social. Entre os fatores biológicos, podem-se destacar as características sensoriais dos alimentos, principalmente o sabor, apontado como um dos principais determinantes. Na categoria econômica são incluídos a renda familiar, o preço dos alimentos e a escolaridade. A oferta e a disponibilidade dos alimentos abrangem as influências do meio ambiente na aquisição dos alimentos e quanto aos determinantes sociais estão relacionados à estrutura, dinâmica e influência da família. Pouco se conhece sobre os fatores que determinam as escolhas e o consumo alimentar dos brasileiros. É necessária a realização de mais estudos para conhecê-los

Condutas terapêuticas de atenção às famílias da população infantojuvenil atendida nos centros de atenção psicossocial infantojuvenis (CAPSI) do estado de São Paulo

Os Centros de Atenção Psicossociais Infantojuvenis (CAPSi) são elementos estratégicos da atenção pública em saúde mental ofertado para população infantojuvenil com sofrimento psíquico intenso e persistente. São articulados numa rede de atenção que extrapola o campo da saúde e interage com os recursos do território de determinada comunidade para promover inclusão social de crianças e adolescentes e conta para tanto também com a co-responsabilização das famílias, escolas e outros setores sociais. No rol de suas condutas terapêuticas há espaço reservado para o atendimento de familiares quando essa medida for necessária para aquela dirigida à clientela em foco. OBJETIVO: identificar condutas terapêuticas oferecidas às famílias de crianças e adolescentes atendidos nos CAPSi. MÉTODO: estudo transversal em crianças e adolescentes provenientes dos prontuários ativos, selecionados aleatoriamente, de 19 CAPSi do Estado de São Paulo no período de setembro de 2008 a fevereiro de 2009. A análisedescritiva foi apresentada por meio de tabelas de número e porcentagem. RESULTADOS: a mãe se revelou a principal cuidadora dessa população fora dos serviços. Contudo, há de se destacar a importante ausência de registros de atendimento ou propostas realizadas às famílias. CONSIDERAÇÕES FINAIS: a principal conduta indicada para as famílias são os atendimentos grupais, as famílias têm sido pouco privilegiadas nas condutas terapêuticas dentro dos projetos terapêuticos da população atendida. As falhas de registro nos prontuários pesquisados podem ser uma limitação do estudo. As ações são preponderantemente institucionais e as ofertas extramuros são raríssimas

Development and mechanical testing of a short intramedullary nail for fixation of femoral rotational osteotomy in cerebral palsy patients

Background: Rotational osteotomy is frequently indicated to correct excessive femoral anteversion in cerebral palsy patients. Angled blade plate is the standard fixation device used when performed in the proximal femur, but extensile exposure is required for plate accommodation. The authors developed a short locked intramedullary nail to be applied percutaneously in the fixation of femoral rotational osteotomies in children with cerebral palsy and evaluated its mechanical properties. Methods: The study was divided into three stages. In the first part, a prototype was designed and made based on radiographic measurements of the femoral medullary canal of ten-year-old patients. In the second, synthetic femoral models based on rapid-prototyping of 3D reconstructed images of patients with cerebral palsy were obtained and were employed to adjust the nail prototype to the morphological changes observed in this disease. In the third, rotational osteotomies were simulated using synthetic femoral models stabilized by the nail and by the AO-ASIF fixed-angle blade plate. Mechanical testing was done comparing both devices in bending-compression and torsion. Results: The authors observed proper adaptation of the nail to normal and morphologically altered femoral models, and during the simulated osteotomies. Stiffness in bending-compression was significantly higher in the group fixed by the plate (388.97 +/- 57.25 N/mm) than in that fixed by the nail (268.26 +/- 38.51 N/mm) as torsional relative stiffness was significantly higher in the group fixed by the plate (1.07 +/- 0.36 Nm/degrees) than by the nail (0.35 +/- 0.13 Nm/degrees). Conclusions: Although the device presented adequate design and dimension to fit into the pediatric femur, mechanical tests indicated that the nail was less stable than the blade plate in bending-compression and torsion. This may be a beneficial property, and it can be attributed to the more flexible fixation found in intramedullary devices.

Massive infestation by Perulernaea gamitanae (Crustacea: Cyclopoida: Lernaidae) in juvenile gamitana, cultured in the Peruvian Amazon

The gamitana is a species of socio-economic importance in the Peruvian Amazon, often intensively produced locally for human consumption. Because of this, more studies concerning parasite populations affecting this species culture are necessary. In this study, a heavy copepod infestation of Perulernaea gamitanae is reported in a managed culture of gamitana. The prevalence of infection was 100% and mortality of the fish population was complete. The average intensity and abundance of the parasite was 268.8 parasites per individual.

Detailed study of the K(L)->pi(0)pi(0)pi(0) Dalitz plot

Using a sample of 68.3x10(6) K(L)->pi(0)pi(0)pi(0) decays collected in 1996-1999 by the KTeV (E832) experiment at Fermilab, we present a detailed study of the K(L)->pi(0)pi(0)pi(0) Dalitz plot density. We report the first observation of interference from K(L)->pi(+)pi(-)pi(0) decays in which pi(+)pi(-) rescatters to pi(0)pi(0) in a final-state interaction. This rescattering effect is described by the Cabibbo-Isidori model, and it depends on the difference in pion scattering lengths between the isospin I=0 and I=2 states, a(0)-a(2). Using the Cabibbo-Isidori model, and fixing (a(0)-a(2))m(pi)(+)=0.268 +/- 0.017 as measured by the CERN-NA48 collaboration, we present the first measurement of the K(L)->pi(0)pi(0)pi(0) quadratic slope parameter that accounts for the rescattering effect: h(000)=(+0.59 +/- 0.20(stat)+/- 0.48(syst)+/- 1.06(ext))x10(-3), where the uncertainties are from data statistics, KTeV systematic errors, and external systematic errors. Fitting for both h(000) and a(0)-a(2), we find h(000)=(-2.09 +/- 0.62(stat)+/- 0.72(syst)+/- 0.28(ext))x10(-3), and m(pi)(+)(a(0)-a(2))=0.215 +/- 0.014(stat)+/- 0.025(syst)+/- 0.006(ext); our value for a(0)-a(2) is consistent with that from NA48.

Facial sensibility of patients with trigeminal neuralgias

Objectives: Idiopathic trigeminal neuralgia (ITN) is an excruciating shock-like paroxysmal pain restricted to the trigeminal area of innervation, with discrete loss of sensibility (thermal, tactile and painful). Trigeminal postherpetic neuralgia (PHN) is a neuropathic pain at the trigeminal territory that persists after Herpes zoster infection, which also is associated to sensorial compromise. The objective of this study was to evaluate the somesthetic facial sensibility (pain, thermal and tactile) and to compare the findings between PHN and ITN. Methods: 18 patients with PHN and 26 patients with ITN were diagnosed by the IASP criteria. They were evaluated with a systematic approach, which included mechanical, thermal (cold and warm) and painful stimuli. Results: We found statistical significance at the ophthalmic branch of PHN in pain (p=0.001), tactile (p=0.002), cold (p=0.016) and warm (p=0.013); in ITN, the maxillary branch had higher threshold with pinpricks (p=0.016) and the mandibular branch had higher tactile threshold. Conclusions: The trigeminal area affected by the disease had the higher sensorial losses (ophthalmic branch in PHN and maxillary/mandibular branches in ITN). PHN patients had losses in large and small fibers; therefore, ITN patients had the losses mostly in large fibers, which support different peripheral neural mechanisms for these neuropathic diseases. (C) 2010 Elsevier B.V. All rights reserved.