Epidemiologic and clinical survey of victims of centipede stings admitted to Hospital Vital Brazil (Sao Paulo, Brazil)

We retrospectively analyzed 98 proven cases of centipede stings admitted to Hospital Vital Brazil, Butantan Institute, Sao Paulo, Brazil, between 1990 and 2007. Most stings occurred at the metropolitan area of Sao Paulo city (n = 94, 95.9%), in the domiciles of patients (n = 67, 68.4%), and during the warm-rainy season (n = 60, 61.2%). The mean age of the victims was 32.0 +/- 18.8-years-old. Cryptops and Otostigmus genera were responsible for most cases. Around 86% of the patients sought medical care within 6 h after the sting. Both lower (56.1%) and upper limbs (41.8%) were most frequently bitten, especially the feet and hands (89.8%). The most frequent local clinical manifestations were pain (94.9%), erythema (44.9%) and edema (21.4%), and the latter was mainly observed in patients bitten by Otostigmus spp. Supportive treatment was used in only 28.6% of the patients, namely administration of local anesthesia (9.2%) and systemic analgesia (13.3%). No sequels or complications were observed in patients, and the prognostic was benign. (c) 2008 Elsevier Ltd. All rights reserved.

PRECLINICAL INVESTIGATION OF THE RETINAL BIOCOMPATIBILITY OF SIX NOVEL VITAL DYES FOR CHROMOVITRECTOMY

Purpose: To investigate the retinal biocompatibility of six novel vital dyes for chromovitrectomy. Methods: An amount of 0.05 mL of 0.5% and 0.05% light green (LG), fast green (FG), Evans blue (EB), brilliant blue (BriB), bromophenol blue (BroB), or indigo carmine (IC) was injected intravitreally in the right eye, whereas in the left eye balanced salt solution was applied for control in rabbits` eyes. Clinical examination, fluorescein angiography, histology with light microscopy, and transmission electron microscopy were performed after 1 and 7 days. Retinal cell layers were evaluated for morphologic alterations and number of cells. The electroretinographic changes were assessed at baseline, 24 hours and 7 days. Results: Fluorescein angiography disclosed hypofluorescent spots only in the 0.5% EB group. Light microscopy and transmission electron microscopy disclosed slight focal morphologic changes in eyes exposed to 0.05% IC, FG, BriB, similar to the control at 1 and 7 days. In the lower dose groups, EB, LG, and BroB caused substantial retinal alterations by light microscopy. At the higher dose, BroB and EB produced diffuse cellular edema and vacuolization within the ganglion cells, bipolar cells, and photoreceptors. FG and IC at 0.5% caused slight retinal alterations similar to balanced salt solution injection. LG at 0.5% caused diffuse vacuolization of bipolar cells after 1 and 7 days. Injection of 0.5% EB caused a significant decrease in neuroretinal cell counts in comparison to control eyes in the 7-day examination (P < 0.05). Electroretinography revealed intermittent prolonged latency and decreased amplitude in eyes injected with 0.5% EB, LG, BriB, and BroB, while at the lower dose, only LG and EB induced few functional changes. Conclusion: The progressive order of retinal biocompatibility, from safest to most toxic, was IC, FG, BriB, BroB, LG, EB.

SEM Study of Apical Morphological Alterations in Primary Teeth with Vital and Necrotic Pulps

This study evaluated, by SEM, the morphology of human primary teeth roots. Twenty-four teeth were divided into 3 groups: pulp vitality (group I) and pulp necrosis without (group II) and with apical periodontitis (group III). Roots were analyzed by the presence of periodontal ligament (PDL) fibers and resorption areas. In groups I and II, presence of PDL fibers and absence of resorption were observed in all cases (100%), while all specimens (100%) of group III showed no PDL fibers and resorption areas. In conclusion, there are morphological differences in the apical region of primary teeth with different pulpal and periapical pathologies.

Biofilm on the apical region of roots in primary teeth with vital and necrotic pulps with or without radiographically evident apical pathosis

Aim To evaluate, by scanning electron microscopy (SEM), the presence of biofilms on the external surfaces of the apical third of roots of human primary teeth with vital or necrotic pulps with and without radiographically evident periradicular pathosis. Methodology Eighteen teeth were selected: group I - normal pulp (n = 5), group II - pulp necrosis without radiographic evidence of periapical pathosis (n = 7) and group III - pulp necrosis with well-defined radiographic periapical pathosis (n = 6). After extraction, the teeth were washed with saline and immersed in 0.03 g mL(-1) trypsin solution for 20 min. The teeth were then washed in sodium cacodilate buffer and stored in receptacles containing modified Karnovsky solution. The teeth were sectioned, dehydrated in an ethanol series, critical-point dried with CO(2), sputter coated with gold and the external root surface in the apical third examined by SEM. Results In the teeth of groups I and II, the apical root surfaces were covered by collagen fibres, with no evidence of bacteria (100%). In the teeth of group III, the root apices had no collagen fibres but revealed resorptive areas containing microorganisms (cocci, bacilli, filaments and spirochetes) in all cases (100%). Conclusion Microorganisms organized as biofilms on the external root surface (extraradicular infection) were detected in primary teeth with pulp necrosis and radiographically visible periapical pathosis.

Metallopeptidase inhibitors arrest vital biological processes in the fungal pathogen Scedosporium apiospermum

P>Scedosporium apiospermum is an emerging agent of opportunistic mycoses in humans. Previously, we showed that mycelia of S. apiospermum secreted metallopeptidases which were directly linked to the destruction of key host proteins. In this study, we analysed the effect of metallopeptidase inhibitors on S. apiospermum development. As germination of inhaled conidia is a crucial event in the infectious process of S. apiospermum, we studied the morphological transformation induced by the incubation of conidia in Sabouraud-dextrose medium at 37 degrees C. After 6 h, some conidia presented a small projection resembling a germ-tube. A significant increase, around sixfold, in the germ-tube length was found after 12 h, and hyphae were exclusively observed after 24 h. Three distinct metallopeptidase inhibitors were able to arrest the transformation of conidia into hyphae in different ways; for instance, 1,10-phenanthroline (PHEN) completely blocked this process at 10 mu mol l-1, while ethylenediamine tetraacetic acid (EDTA) and ethylene glycol-bis (beta-aminoethyl ether; EGTA) only partially inhibited the differentiation at up to 10 mmol l-1. EGTA did not promote any significant reduction in the conidial growth, while PHEN and EDTA, both at 10 mmol l-1, inhibited the proliferation around 100% and 65%, respectively. The secretion of polypeptides into the extracellular environment and the metallopeptidase activity secreted by mycelia were completely inhibited by PHEN. These findings suggest that metallo-type enzymes could be potential targets for future therapeutic interventions against S. apiospermum.

Características oclusais de pacientes com Classe II, divisão 1, tratados sem e com extrações de dois pré-molares superiores

OBJETIVOS: o objetivo deste estudo foi identificar características oclusais iniciais de pacientes Classe II, divisão 1, tratados sem e com extrações de dois pré-molares superiores. MÉTODOS: foram selecionados 62 pacientes que apresentavam má oclusão de Classe II, divisão 1, os quais foram divididos em dois grupos, de acordo com a forma de tratamento proposta, sendo o grupo 1 constituído de 42 pacientes (23 do sexo feminino e 19 do sexo masculino), com idade média de 12,7 anos, tratados sem extrações e com aparelho fixo combinado com extrabucal; e o grupo 2, composto de 20 pacientes (6 do sexo feminino e 14 do sexo masculino), com idade média de 13,5 anos, tratados também com aparelho fixo combinado com uso de extrabucal, mas que tiveram indicação de extrações de dois pré-molares superiores em seus planos de tratamento. Para observar as características oclusais iniciais e finais, assim como suas alterações com o tratamento, foi utilizado o Índice de Prioridade de Tratamento (IPT). Os valores dos índices foram submetidos à análise estatística pelo teste t independente, para comparar as variáveis entre os grupos. RESULTADOS E CONCLUSÕES: os resultados demonstraram que o grau de má oclusão inicial foi diferente nos dois grupos quando avaliados pelo IPT, sendo maior no grupo tratado com extrações de dois pré-molares superiores

Evolução temporal da dengue no município de Ribeirão Preto, São Paulo, 1994 a 2003

Este estudo caracteriza-se epidemiológico-descritivo com objetivo de descrever a evolução temporal dos casos de dengue em Ribeirão Preto, São Paulo, no período de 1994 a 2003, segundo mês de ocorrência e sexo. Os dados foram obtidos junto às fichas de notificação compulsória fornecidas pela Vigilância Epidemiológica da Secretaria Municipal de Saúde do município. Foram obtidos os coeficientes de incidência por 100.000 habitantes, segundo estimativas populacionais do Instituto Brasileiro de Geografia e Estatística. O município viveu uma epidemia de dengue no ano de 2001, quando o coeficiente de incidência chegou a 619,65 casos/100.000 habitantes, sendo que dentre os 5.553 casos encontrados no período estudado, 0,07% ocorreram no ano de 1994, 3,68% em 1995, 4,52% em 1996, 2,40% em 1997, 1,82% em 1998, 5,73% em 1999, 3,75% em 2000, 57,37% em 2001, 6,25% em 2002 e, 14,39% em 2003 . Os meses do ano de maior ocorrência da doença foram de janeiro a maio. Em relação à variável sexo, a proporção entre o número de casos foi de aproximadamente 1:1, mostrando pequenas flutuações de casos de dengue entre homens e mulheres, para todo período estudado. Os resultados apontam a necessidade do desenvolvimento de estudos sobre a temática e reforçam o papel das instituições de ensino na questão da dengue no nosso país.

Novo protocolo para as ações de saúde bucal coletiva: padronização no armazenamento, distribuição e uso do material de higiene bucal

Este trabalho avaliou o material de higiene bucal usado em escolas para estabelecer um protocolo às ações de higiene bucal coletiva. O estudo foi dividido em duas etapas: 1ª- 20 responsáveis pelos procedimentos coletivos com escolares de Bauru e São José dos Campos - SP responderam a dois questionários sobre o uso de cinco kits de higiene bucal coletiva. A análise estatística foi realizada através do teste Wilcoxon (p < 0,05); 2ª - 178 escolares de 4 a 8 anos de Bauru e Bariri-SP dispensaram na escova uma quantidade de creme dental e dentifrício líquido para a prática da escovação, a qual foi pesada através de uma balança portátil. A análise estatística foi obtida através do coeficiente de correlação de Pearson e a análise de covariância (p< 0,05). O kit 5 obteve graus de satisfação e muita satisfação quando comparado aos kits 1 a 4. A quantidade de creme dental dispensada pelos escolares foi em média 0,41g (Bauru) e 0,48g (Bariri). Não houve diferença estatística entre os escolares de Bauru e Bariri em relação ao dentifrício líquido (média de 0,15g). O dentifrício líquido, através da "técnica da gota", foi considerado prático, dispensando uma pequena quantidade padronizada. O kit 5 demonstrou ser uma boa alternativa ao estabelecimento de um protocolo de ações em saúde bucal coletiva no SUS.

Crianças com fissura labiopalatina e baixo peso ao nascimento em testes auditivos centrais

INTRODUÇÃO: Alterações neurológicas ou sensoriais, entre elas as alterações auditivas periféricas e/ou centrais, são enfatizadas na população com baixo peso ao nascimento (BP), assim como, na presença de malformação craniofacial, tal como a fissura labiopalatina (FLP). OBJETIVO: Verificar e comparar o resultado de testes de processamento auditivo, Teste Dicótico de Dígitos (TDD) e Teste de Fusão Auditiva-Revisado (AFT-R), de crianças com FLP com e BP ao nascimento, com o de crianças sem FLP e nascida com peso normal. MÉTODO: Estudo retrospectivo e comparativo de 73 prontuários, dos quais foram verificados o sexo, peso ao nascimento, presença/ausência de FLP e o resultado de TDD e AFT-R. Foram constituídos três grupos de acordo com a análise do peso ao nascimento e presença ou ausência de FLP. RESULTADOS: Para o TDD a Análise de Covariância não mostrou diferença entre os grupos e sexos, porém a co-variável idade mostrou relação estatisticamente significante. Para o AFT-R não mostrou diferença entre os grupos, sexos e idades. CONCLUSÃO: Crianças com FLP e BP, embora sem significância estatística, apresentam maiores alterações nos testes de processamento auditivo utilizados ao comparar com crianças com FLP isolada e com crianças sem esta malformação craniofacial e sem BP. Ressalta-se ainda que o aumento da idade melhorou o desempenho no TDD.

Fracture resistance of weakened roots restored with composite resin and glass fiber post

This study evaluated the fracture resistance of weakened roots restored with glass fiber posts, composite resin cores and complete metal crowns. Thirty maxillary canines were randomly divided into 3 groups of 10 teeth each: teeth without weakened roots (control); teeth with partially weakened roots (PWR) and teeth with and largely weakened roots (LWR). The control group was restored with glass fiber posts and a composite resin core. Teeth in the PWR and LWR groups were flared internally to standardized dimensions in order to simulate root weakness. Thereafter, the roots were partially filled with composite resin and restored in the same way as in the control group. The specimens were exposed to 250,000 cycles in a controlled chewing simulator. All intact specimens were subjected to a static load (N) in a universal testing machine at 45 degrees to the long axis of the tooth until failure. Data were analyzed by one-way ANOVA and Dunnett's test for multiple comparisons (p=0.05). There were statistically significant difference differences (p<0.01) among the groups (control group = 566.73 N; PWR = 409.64 N; and LWR = 410.91 N), with significantly higher fracture strength for the control group. There was no statistically significant difference (p>0.05) between the weakened groups. The results of this study showed that thicker root dentin walls significantly increase the fracture resistance of endodontically treated teeth.

FiltekTM Silorane and FiltekTM Supreme XT resins: tissue reaction after subcutaneous implantation in isogenic mice

The aim of this study was to evaluate the tissue compatibility of a silorane-based resin system (FiltekTM Silorane) and a methacrylate-based nanoparticle resin (FiltekTM Supreme XT) after implantation in the subcutaneous connective tissue of isogenic mice. One hundred and thirty five male isogenic BALB/c mice were randomly assigned to 12 experimental and 3 control groups, according to the implanted material and the experimental period of 7, 21 and 63 days. At the end of each period, the animals were killed and the tubes with the surrounding tissues were removed and processed for microscopic analysis. Samples were subjected to a descriptive and a semi-quantitative analyses using a 4-point scoring system (0-3) to evaluate the collagen fiber formation and inflammatory infiltrate. Data were statistically analyzed using the Kruskal Wallis test (?=0.05). The results showed that there was no significant difference between the experimental and control groups considering the three evaluation periods (p>0.05). The silorane-based and the methacrylate-based nanoparticle resins presented similar tissue response to that of the empty tube (control group) after subcutaneous implantation in isogenic mice.

Masticatory afficiency in denture wearers with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

Subcutaneous tissue response of isogenic mice to calcium hydroxide-based pastes with chlorhexidine

This study was evaluated the response of subcutaneous connective tissue of isogenic mice to calcium hydroxide-based pastes with chlorhexidine digluconate (CHX). Seventy isogenic male BALB/c mice aged 6-8 weeks and weighing 15-20 g were randomly assigned to 8 groups. The animals received polyethylene tube implants as follows: Groups I, II, and III (n=10) - Calen® paste mixed with 0.4% CHX (experimental paste; Calen/CHX) for 7, 21, and 63 days, respectively; Groups IV, V, and VI (n=10) - UltraCal™ paste mixed with 2% CHX (experimental paste supplied by Ultradent Products Inc.; Ultracal/CHX) for 7, 21, and 63 days, respectively; and Groups VII and VIII (n=5): empty tube for 7 and 21 days, respectively. At the end of the experimental periods, the implants were removed together with the surrounding tissues (skin and subcutaneous connective tissue). The biopsied tissues were subjected to routine processing for histological analysis. Using a descriptive analysis and a four-point (0-3) scoring system, the following criteria were considered for qualitative and quantitative analysis of the tissue around the implanted materials: collagen fiber formation, tissue thickness and inflammatory infiltrate. A quantitative analysis was performed by measuring the thickness (µm), area (µm²) and perimeter (µm) of the reactionary granulomatous tissue formed at the tube ends. Data were analyzed statistically by the Kruskal-Wallis test and Dunn's post-test (α=0.05). Calen/CHX showed biocompatibility with the subcutaneous and reactionary tissues, with areas of discrete fibrosis and normal conjunctive fibrous tissue, though without statistically significant difference (p>0.05) from the control groups. In Groups I to III, there was a predominance of score 1, while in Groups IV to VI scores 2 and 3 predominated for all analyzed parameters. UltraCal/CHX, on the other hand, induced the formation of an inflammatory infiltrate and abundant exudate, suggesting a persistent residual aggression from the material, even 63 days after implant placement. In conclusion, the Calen paste mixed with 0.4% CHX allowed an adequate tissue response, whereas the UltraCal paste mixed with 2% CHX showed unsatisfactory results.

A novel bioactive glass-ceramic for treating dentin hypersensitivity

Dentin hypersensitivity (DH) is a painful response to stimulus applied to the open dentinal tubules of a vital tooth. It's a common oral condition, however, without an ideal treatment available yet. This work evaluated in vitro the effect of micron-sized particles from a novel bioactive glass-ceramic (Biosilicate) in occluding open dentinal tubules. A dentin disc model was employed to observe comparatively, using scanning electron microscopy (SEM), dentinal tubule occlusion by different products and deposition of hydroxyl carbonate apatite (HCA) on dentin surface by Biosilicate, after a single application: G1 - Dentifrice with potassium nitrate and fluoride; G2 - Two-step calcium phosphate precipitation treatment; G3 - Water-free gel containing Biosilicate particles (1%); G4 - Biosilicate particles mixed with distilled water in a 1:10 ratio; all of them after 1, 12 and 24 hours of immersion in artificial saliva. Fourier transform infrared spectroscopy (FTIR) was performed to detect HCA formation on dentin discs filled with Biosilicate after 2 minutes, 30 minutes and 12 hours of immersion in artificial saliva. SEM showed a layer of HCA formed on dentin surface after 24 hours by G4. G1, G2 and G3 promoted not total occlusion of open dentinal tubules after 24 hours. FTIR showed HCA precipitation on the dentin surface induced by Biosilicate after 30 minutes. The micron-sized particles from the bioactive glass-ceramic thus were able to induce HCA deposition in open dentinal tubules in vitro. This finding suggests that Biosilicate may provide a new option for treating DH.

Effect of laser welding on the titanium composite tensile bond strength

The aim of this study was to analyze the shear bond strength between commercially pure titanium, with and without laser welding, after airbone-particle abrasion (Al2O3) and 2 indirect composites. Sixty-four specimens were cast and divided into 2 groups with and without laser welding. Each group was divided in 4 subgroups, related to Al2O3 grain size: A - 250 µm; B - 180 µm; C- 110 µm; and D - 50 µm. Composite rings were formed around the rods and light polymerized using UniXS unit. Specimens were invested and their shear bond strength at failure was measured with a universal testing machine at a crosshead speed of 2.0 mm/min. Statistical analysis was carried out with ANOVA and Tukey's test (α=0.05). The highest bond strength means were recorded in 250 µm group without laser welding. The lowest shear bond strength means were recorded in 50 µm group with laser welding. Statistically significant differences (p<0.05) were found between all groups. In conclusion, airborne particle abrasion yielded significantly lower bond strength as the Al2O3 particle size decreased. Shear bond strength decreased in the laser welded specimens.