Composite pontics for orthodontic patients with extraction spaces.

Esthetic orthodontic appliances continue to appeal to more patients, which results in objections to extraction spaces that remain for several months during orthodontic therapy. This has led orthodontists to design temporary pontics that fill extraction sites and that can be reduced as the spaces close. This report describes a simple, efficient, and expeditious technique for making such pontics. © 2010 Quintessence Publishing Co, Inc.

European Ancestry Predominates in Neuromyelitis Optica and Multiple Sclerosis Patients from Brazil

Background: Neuromyelitis optica (NMO) is considered relatively more common in non-Whites, whereas multiple sclerosis (MS) presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs) to estimate the genetic ancestry contribution to NMO patients. Methods: Twelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP), Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP). Principal Findings: European ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7%) patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5%) patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population. Conclusions: Our findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil. © 2013 Brum et al.

Mesh cancer: long-term mesh infection leading to squamous-cell carcinoma of the abdominal wall

Purpose: It is recognized that chronic inflammation can cause cancer. Even though most of the available synthetic meshes are considered non-carcinogenic, the inflammatory response to an infected mesh plays a constant aggression to the skin. Chronic mesh infection is frequently the result of misuse of mesh, and due to the challenging nature of this condition, patients usually suffer for years until the infected mesh is removed by surgical excision. Methods: We report two cases of squamous-cell carcinoma (SCC) of the abdominal wall, arising in patients with long-term mesh infection. Results: In both patients, the degeneration of mesh infection into SCC was presumably caused by the long-term inflammation secondary to infection. Patients presented with advanced SCC behaving just like the Marjolin's ulcers of burns. Radical surgical excision was the treatment of choice. The involvement of the bowel played an additional challenge in case 1, but it was possible to resect the tumor and the involved bowel and reconstruct the abdominal wall using polypropylene mesh as onlay reinforcement, in a single stage operation. He is now under adjuvant chemotherapy. The big gap in the midline after tumor resection in case 2 required mesh bridging to close the defect. The poor prognosis of case 2 who died months after the operation, and the involvement of the armpit, groin and mesenteric nodes in case 1 shows how aggressive this disease can be. Conclusion: Infected mesh must be treated early, by complete excision of the mesh. Long-standing mesh infection can degenerate into aggressive squamous-cell carcinoma of the skin. © 2013 Springer-Verlag France.

Perfil sérico de estresse oxidativo, antioxidantes e micronutrientes em pacientes com hanseníase

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Papel de polimorfismos genéticos nos genes IL10, TNF e LTA na hanseníase

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo terapêntico comparando a associação de rifampicina, ofloxacina e minociclina com a associação rifampicina, clofazimina e dapsona em pacientes multibacilar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aspectos emocionais do paciente hanseniano no quadro reacional tipo 2: um estudo exploratório

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da qualidade de vida de pacients tratados e em tratamento para hanseníase: uso do Dermatology Life Quality Index e do Whoqol-bref

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Quality of life in patients with Charcot-Marie-Tooth disease type 1A

Avaliou-se o comprometimento funcional de pacientes com Charcot-Marie-Tooth provenientes da duplicação 17p11.2-p12 (CMT1A), utilizando o SF-36, que é um questionário para medir a qualidade de vida. Vinte e cinco pacientes de ambos os sexos com idades ≥10 anos e diagnóstico molecular de CMT1A foram selecionados. Idade, sexo, condições sociodemográficas e profissionais foram pareados com o Grupo Controle (sem histórico familiar de neuropatia). Os resultados mostraram que o maior impacto da CMT1A na qualidade de vida ocorreu nos domínios social e emocional dos pacientes avaliados. A capacidade funcional também tende a ser significativamente afetada, enquanto outros indicadores de deficiência física foram preservados. Por fim, os aspectos sociais e emocionais dos pacientes acometidos por CMT1A costumam ser negligenciados na assistência médica prestada aos pacientes brasileiros, e devem ser melhor compreendidos a fim de oferecer uma assistência global à saúde, resultando em adequada qualidade de vida.

A new clinical sign probably associated to left hemiplegia with left hemineglect syndrome: the crossed legs

Objetivo : Descrever um novo sinal clínico associado à síndrome de negligência unilateral (SNU) em pacientes com acidente vascular cerebral isquêmico (AVCi). Método : Em 150 pacientes com acidente vascular cerebral isquêmico, foram realizadas tomografias de crânio e aplicada a National Institute of Health Stroke Scale. Aqueles pacientes com lesões vasculares à direita, hemiplegia esquerda e perna direita persistentemente cruzada sobre a esquerda, foram submetidos a testes específicos para SNU. Trinta pacientes também com lesões vasculares à direita, hemiplegia esquerda, porém sem evidências de permanecerem com as pernas cruzadas, foram submetidos aos mesmos testes clínicos. Resultados : Entre 150 pacientes com AVCi, 9 apresentaram lesão vascular cerebral à direita, hemiplegia esquerda e tendência em permanecer com a perna direita cruzada sobre a esquerda. Em 8 deles, testes específicos realizados nos primeiros dias de internação, confirmaram SNU à esquerda. Um paciente morreu antes que os testes pudessem ser aplicados. Dos 30 pacientes que não cruzaram as pernas, os testes foram normais em 20. Dez pacientes apresentaram alterações mínimas, insuficientes para o diagnóstico de SNU. Conclusão : A perna direita cruzada sobre a esquerda pode representar um novo sinal semiológico associado à hemiplegia esquerda e SNU à esquerda.

Translation, cultural adaptation to Brazil and validation of the venous leg ulcer quality of life questionnaire (VLU-QoL-Br)

Objetivo:traduzir o instrumento Venous legulcer quality of life questionnaire (VLU-QoL), adaptá-lo culturalmente para o português do Brasil e validá-lo com pacientes do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMB) da Universidade Estadual Paulista (Unesp). Métodos:o questionário foi traduzido por um tradutor profissional e por dois dermatologistas especialistas na área de úlceras venosas (UV), sendo reformulado em reunião com os três tradutores. O constructo (VLU-QoL-Br) foi submetido a pré-entrevista com 10 portadores de UV para a adaptação da linguagem. Posteriormente, foi aplicado em pacientes do HC-Unesp, e como teste-reteste para verificação de sua reprodutibilidade. Resultados:foram avaliados 82 pacientes, sendo 56 (68%) do sexo feminino. A idade média foi de 67,3 anos. O questionário foi traduzido, adaptado e aplicado aos pacientes. O constructo apresentou alta consistência interna (alfa= 0,94) e adequada correlação item-total. Quando avaliados os 32 retestes, observou-se correlação intraclasse para concordância de 0,78 (p < 0,01), indicando boa reprodutibilidade do constructo. A análise fatorial confirmatória corroborou as dimensões do questionário original: atividades, psicológico e sintomas. Escores do VLU-QoL-Br se associaram, independentemente, à área total das úlceras e a menor escolaridade dos sujeitos (p < 0,01). Conclusão:a tradução, a adaptação e a validação do questionário VLU-Qol-Br demonstrou boa performance psicométrica, permitindo seu uso clínico no Brasil. É importante avaliar seu desempenho em outras regiões e em diferentes amostras de indivíduos.

Estudo da maturação de células dendríticas em indivíduos portadores de hanseníase

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação da função macrofágica na hanseníase virchowiana: marcadores de superfície, receptores TLR e NLR e mediadores inflamatórios

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Metabolic Syndrome Criteria As Predictors of Insulin Resistance, Inflammation and Mortality in Chronic Hemodialysis Patients

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Percepção dos portadores de hanseníase acerca do auto cuidado

This study aimed at evaluating the perception of leprosy patients, the disease, with regard to its concept and self-care practice, as well as their knowledge concerning drug therapy. Fifteen patients participated in the study, of whom 11 were classified as multibacillary and 04 as paucibacillary. Semi-structure interviews containing six guiding questions were used for data collection, and the Collective Subject Discourse (CSD) was utilized as a theoretical framework. Analysis was performed based on the Theory of Complexity. It showed that patients suffer pain, a fact that is reflected on the need to change habits and prevent disability. It also showed that patients have doubts and feel insecure about treatment and prognosis, and that they are also the target of social prejudice even thought the term leprosy has been replaced by Hansen‟s disease. As regards self-care, the subjects showed lack of autonomy, limitations and subjection to instructions from health care professionals, who, according to the discourse that emerged, are mostly responsible for transmitting the knowledge concerning self-care practice. This fact can be explained by evidence of self-knowledge deficit by the the subjects. Concerning polychemotherapy treatment, which is recommended by the Ministry of Health, it was observed that the knowledge concerning its action and adverse effects is precarious. This information is provided during consultation; however, CSD showed that the subjects do not apprehend it. Therefore, health care professionals must instruct their clients not only as regards conventional treatment practices, but they must also help them to know themselves and to improve their critical judgment so that they can choose the best form of living after being diagnosed with the disease, thus guiding self-care by taking such choice into account