Antimicrobial resistance of isolated Streptococcus pneumoniae in a hospital of the Brazilian public system

Streptococcus pneumoniae is the predominant bacterial agent that affects the human population with pneumonia. This disease is an important cause of death in the elderly and the children under five years old. In this study, 29 strains of invasive S. pneumoniae were isolated from 29 patients of pneumonia, bacteremia and meningitis in the laboratory of the Municipal Hospital in Paulinia, Brazil, from May 2006 to October 2007. Patients' age ranged from 8 months old to 60 years old. These strains of S. pneumoniae were isolated from blood, pleural fluid and cerebrospinal fluid (CSF) of patients. After typing of encapsulated strains of S. pneumoniae through quellung reaction, their resistance to antimicrobial agents was gauged through Disc Diffusion Technique followed by determination of minimum inhibitory concentration (MIC). Among the 29 strains analyzed, 23 were methicillin-sensitive and six were methicillin-resistant and penicillin intermediate resistant. No strain presented full resistance to penicillin. Serotyping was performed only in two samples, which belonged to serotype 18. Our data may alert ambulatory regarding the incidence of pneumococcal strains resistant to the most common drugs due to inappropriate use of antimicrobials and also collaborate to the elaboration of pneumococcal conjugate vaccines specific to each region.

Hiperoxalúria primária com insuficiência renal crônica terminal em lactente

Objetivo: descrever caso clínico de um lactente com insuficiência renal crônica terminal, causada por hiperoxalúria primária.Método: após revisão da literatura, verifica-se a raridade da doença; na França, a prevalência é de 1,05/milhão, com taxa de incidência de 0,12/milhão/ano. Pesquisa abordando centros especializados mundiais detectou, em 1999, 78 casos em lactentes; destes, em 14% o quadro inicial foi de uremia. A gravidade e a raridade da doença sugerem o relato deste caso.Resultados: criança de sexo feminino, com quadro de vômitos e baixo ganho de peso desde os primeiros meses de vida, desenvolveu insuficiência renal terminal aos 6 meses de idade, sendo mantida em tratamento dialítico desde então. Aos 8 meses, foi encaminhada para esclarecimento diagnóstico, apresentando déficit pôndero-estatural grave e os seguintes exames laboratoriais: uréia= 69 mg/dl, creatinina=2,2 mg/dl e clearance de creatinina= 12,5 ml/min/1.73m²SC. O exame de urina foi normal, a ultra-sonografia renal revelou tamanho normal e hiperecogenicidade de ambos os rins. A dosagem de oxalato urinário foi de 9,2mg/kg/dia ou 0,55 mmol/1.73m²SC, e a relação oxalato:creatinina, de 0,42. A biópsia renal diagnosticou presença de grande quantidade de depósitos de cristais de oxalato de cálcio no parênquima renal. A radiografia de ossos longos evidenciou sinais sugestivos de osteopatia oxalótica, e a fundoscopia indireta, sinais de retinopatia por oxalato. A criança foi mantida em diálise peritoneal ambulatorial contínua, tendo sido iniciado tratamento com piridoxina.Conclusões: a hiperoxalúria primária deve ser considerada como um dos diagnósticos diferenciais de insuficiência renal crônica em lactentes, especialmente na ausência de história sugestiva de outras patologias.

Serological profile of buffalo (Bubalus bubalis) female calves vaccinated with standard Brucella abortus strain 19 vaccine using rose bengal, 2-mercaptoethanol and complement fixation tests

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo longitudinal do sucesso clínico-radiográfico de dentes tratados com medicação intracanal de hidróxido de cálcio

INTRODUÇÃO: O tratamento endodôntico é de fundamental importância para abolir a infecção presente em dentes que apresentam necrose pulpar. OBJETIVO: O objetivo do presente estudo foi avaliar clínica e radiograficamente a eficácia dos tratamentos de canais radiculares de dentes com lesão periapical crônica, efetuados pelos graduandos em Odontologia, da Faculdade de Odontologia de Araçatuba - UNESP. MATERIAL E MÉTODO: Foram selecionados 100 pacientes que possuíam dentes com lesão periapical crônica para serem tratados. Após o preparo biomecânico, os canais radiculares receberam uma medicação intracanal de hidróxido de cálcio durante o período de 14 dias. Os canais radiculares foram obturados com cimento endodôntico à base de hidróxido de cálcio. Foi realizada a proservação por um período entre oito e 11 meses. RESULTADO: A análise dos resultados permitiu constatar a porcentagem de 78,46% dos casos com reparo total da lesão periapical e de 21,54% dos casos em que não houve evidências de reparo. CONCLUSÃO: Ocorreu reparo das lesões periapicais nos dentes tratados pelos graduandos da Faculdade de Odontologia de Araçatuba - UNESP.

Longitudinal clinical and radiographic evaluation of severely intruded permanent incisors in a pediatric population

Intrusion is defined as the axial dislodgment of the tooth into its socket and is considered one of the most severe types of dental trauma. This longitudinal outcome study was undertaken to evaluate clinically and radiographically severely intruded permanent incisors in a population of children and adolescents. All cases were treated between September 2003 and February 2008 in a dental trauma service. Clinical and radiographic data were collected from 12 patients (eight males and four females) that represented 15 permanent maxillary incisors. Mean age at the time of injury was 8 years and 9 months (range 7-14 years and 8 months). Mean time elapsed to follow-up was 26.6 months (range 10-51 months). The analysis of data showed that tooth intrusion was twice as frequent in males. The maxillary central incisors were the most commonly intruded teeth (93.3%), and falling at home was the main etiologic factor (60%). More than half of the cases (53.3%) were multiple intrusions, 73.3% of the intruded teeth had incomplete root formation and 66.6% of the teeth suffered other injuries concomitant to intrusion. Immediate surgical repositioning was the treatment of choice in 66.7% of the cases, while watchful waiting for the tooth to return to its pre-injury position was adopted in 33.3% of the cases. The teeth that suffered additional injuries to the intrusive luxation presented a fivefold increased relative risk of developing pulp necrosis. The immature teeth had six times more chances of presenting pulp canal obliteration that the mature teeth and a lower risk of developing root resorption. The most frequent post-injury complications were pulp necrosis (73.3%), marginal bone loss (60%), inflammatory root resorption (40%), pulp canal obliteration (26.7%) and replacement root resorption (20%). From the results of this study, it was not possible to determine whether the type immediate treatment had any influence on the appearance of sequelae like pulp necrosis and root resorption after intrusive luxation, but the existence of additional injuries and the stage of root development influenced the clinical case outcome in a negative and positive manner, respectively.

Mandibular Angle Fracture Treated With New Three-Dimensional Grid Miniplate

Fractures of the mandibular angle deserve particular attention because they represent the highest percentage of mandibular fractures and have the highest postsurgical complication rate, making them the most challenging and unpredictable mandibular fractures to treat. Despite the evolution in the treatment of maxillofacial trauma and fixation methods, no single treatment modality has been revealed to be ideal for mandibular angle fractures. Several methods of internal fixation have been studied with great variation in complications rates, especially postoperative infections. Recently, new studies have shown reduction of postsurgical complications rates using three-dimensional plates to treat mandibular angle fractures. Nevertheless, only few surgeons have used this type of plate for the treatment of mandibular angle fractures. The aim of this clinical report was to describe a case of a patient with a mandibular angle fracture treated by an intraoral approach and a three-dimensional rectangular grid miniplate with 4 holes, which was stabilized with monocortical screws. The authors show a follow-up of 8 months, without infection and with occlusal stability.

Incidence of Maxillary Sinusitis Following Le Fort I Osteotomy: Clinical, Radiographic, and Endoscopic Study

Purpose: The correction of maxillomandibular deformities may require maxillary osteotomy procedures that usually present low rates of postoperative complications, such as maxillary sinusitis. The present study evaluated the incidence of maxillary sinusitis after Le Fort I osteotomy in 21 adult patients who underwent maxillary surgery (Le Fort I osteotomy) or bimaxillary surgery (Le Fort I osteotomy plus sagittal mandibular osteotomies) for correction of dentofacial deformities.Patients and Methods: Verification of the presence of maxillary sinusitis was assessed through a brief questionnaire, x-rays (Waters views), and nasal endoscopy before surgery and 6 to 8 months after surgery.Results: Analysis of results showed an incidence of 4.76% of maxillary sinusitis as a postoperative complication in the studied population.Conclusion: Symptomatic patients with a positive radiographic finding or an increased risk for postoperative sinusitis will benefit from endoscopic evaluation to aid in treatment planning and follow-up. 0 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:346351, 2011

Structural and functional characterization of BnSP-7, a Lys49 myotoxic phospholipase A(2) homologue from Bothrops neuwiedi pauloensis Venom

BnSP-7, a Lys49 myotoxic phospholipase A, homologue from Bothrops neuwiedi pauloensis venom, was structurally and functionally characterized. Several biological activities were assayed and compared with those of the chemically modified toxin involving specific amino acid residues, the cDNA produced from the total RNA by RT-PCR contained approximately 400 bp which codified its 121 amino acid residues with a calculated pi and molecular weight of 8.9 and 13,727, respectively. Its amino acid sequence showed strong similarities with several Lys49 phospholipase A, homologues from other Bothrops sp, venoms. By affinity chromatography and gel diffusion, it was demonstrated that heparin formed a complex with BnSP-7, held at least in part by electrostatic interactions. BnSP-7 displayed bactericidal activity and promoted the blockage of the neuromuscular contraction of the chick, biventer cervicis muscle. In addition to its in vivo myotoxic and edema-inducing activity, it disrupted artificial membranes, Both BnSP-7 and the crude venom released creatine kinase from the mouse gastrocnemius muscle and induced the development of a dose-dependent edema. His, Tyr, and Lys residues of the toxin were chemically modified by 4-bromophhenacyl bromide (BPB), 2-nitrobenzenesulfonyl fluoride (NBSF), and acetic anhydride (AA), respectively. Cleavage of its N-terminal octapeptide was achieved with cyanogen bromide (CNBr), the bactericidal action of BnSP-7 on Escherichia coli was almost completely abolished by acetylation or cleavage of the N-terminal octapeptide, the neuromuscular effect induced by BnSP-7 was completely inhibited by heparin, BPB, acetylation, and CNBr treatment. The creatine kinase releasing and edema-inducing effects were partially inhibited by heparin or modification by BPB and almost completely abolished by acetylation or cleavage of the N-terminal octapeptide, the rupture of liposomes by BnSP-7 and crude venom was dose and temperature dependent. Incubation of BnSP-7 with EDTA did not change this effect, suggesting a Ca2+-independent membrane lytic activity. BnSP-7 cross-reacted with antibodies raised against B. moojeni (MjTX-II), B. jararacussu (BthTX-I), and B. asper (Basp-II) myotoxins as well as against the C-terminal peptide (residues 115-129) from Basp-II. (C) 2000 Academic Press.

cDNA sequence and molecular modeling of a nerve growth factor from Bothrops jararacussu venomous gland

The complete nucleotide sequence of a nerve growth factor precursor from Bothrops jararacussu snake (Bj-NGF) was determined by DNA sequencing of a clone from cDNA library prepared from the poly(A) + RNA of the venom gland of B.jararacussu. cDNA encoding Bj-NGF precursor contained 723 bp in length, which encoded a prepro-NGF molecule with 241 amino acid residues. The mature Bj-NGF molecule was composed of I 18 amino acid residues with theoretical pI and molecular weight of 8.31 and 13,537, respectively. Its amino acid sequence showed 97%, 96%, 93%, 86%, 78%, 74%, 76%, 76% and 55% sequential similarities with NGFs from Crotalus durissus terrificus, Agkistrodon halys pallas, Daboia (Vipera) russelli russelli, Bungarus multicinctus, Naja sp., mouse, human, bovine and cat, respectively. Phylogenetic analyses based on the amino acid sequences of 15 NGFs separate the Elapidae family (Naja and Bungarus) from those Crotalidae snakes (Bothrops, Crotalus and Agkistrodon). The three-dimensional structure of mature Bj-NGF was modeled based on the crystal structure of the human NGF. The model reveals that the core of NGF, formed by a pair of P-sheets, is highly conserved and the major mutations are both at the three beta-hairpin loops and at the reverse turn. (C) 2002 Societe francaise de biochimie et biologic moleculaire/Editions scientifiques et medicales Elsevier SAS. All rights reserved.

Depression in patients with Parkinson's disease: Impact on functioning

Depression is a frequently observed neuropsychiatric phenomenon in Parkinson's disease (PD) and it has been lately considered as a manifestation of such disease. The aim of the study was to investigate the relationship between depression and clinical aspects of PD and to assess the impact of the co-occurrence of such condition on the burden imposed by PD. Fifty Outpatients diagnosed with idiopathic PD according to the London Brain Bank criteria were examined. PD was evaluated using Hoehn & Yahr staging (H&Y), United Parkinson's Disease Rating Scale (UPDRS) and Schwab & England (S&E) functional capacity evaluation. A semi-structured clinical interview was used. The diagnosis of PD was made by neurologist experts on movement disorders, and the diagnosis of depression was trade by a psychiatrist, according to the ICD-10 diagnostic criteria. Depressive symptoms were additionally measured using the Montgomery-Asberg Depression Scale. The analysis of quantitative data was performed using descriptive statistics, Univariate linear regression, T-Student Test and ANOVA. Seventeen (34%) patients were diagnosed as clinically depressed and, when compared to the non-depressed ones, presented the following results: H&Y: 3.2 vs. 2.8; UPDRS total: 75.7 vs. 65.3; S&E: 53.5% vs. 65.8% and PD duration: 114.4 months vs. 125.8 months. Depressed patients showed more advanced staging (H&Y), a more severe global clinical condition (UPDRS) and also a greater decrease in their functional capacity (S&E). These data reinforce the hypothesis that depression is associated to poorer functioning in patients with PD. (C) 2008 Elsevier B.V All rights reserved.

The development of resistance to caffeine in Drosophila prosaltans: productivity and longevity after ten generations of treatment

The productivity of Drosophila prosaltans treated with six concentrations of caffeine (from 50 mu g/ml to 2,500 mu g/ml of culture medium) during ten generations (similar to 8 months) decreased in a dosage dependent manner in every generation, but at the end of the treatment the flies in all experiments recovered normal productivity, except for those treated with 2,500 mu g/ml. Longevity in the tenth generation was significantly reduced in males and females only in the 2,500 mu g/ml dosage, with males being much more affected than females. In a previous study in which the treatment was done in a single generation, productivity exhibited only a partial recovery when the treatment ceased and longevity was significantly reduced in 1,500 mu g/ml dosages. The hypothesis of selection occurring in ten generations leading to recovery in productivity and to a reduction in the processes which cause a decrease in longevity is being considered.

Sistema de reprodução de Rhynchanthera dichotoma (Lam.) DC

R. dichotoma (Lam.) DC. é um arbusto que ocorre na região central do Brasil em ambientes úmidos, brejosos, formando nestes locais grandes populações. O período de floração desta espécie é longo de 6-8 meses. Neste estudo realizado no município de Tanabi (São Paulo), o pico de floração ocorreu no mês de abril. Semelhante ao observado em outras Melastomataceae de anteras tubulares e deiscência poricida, R. dichotoma é polinizada por abelhas vibradoras. Este estudo constatou que esta espécie é autocompatível com 59% de sucesso obtido nas autopolinizações manuais (n=90) e não foi observada a presença de agamospernmia (n=85). A polinização cruzada (xenogamia) foi predominante, sendo que 66% das flores polinizadas desenvolveram frutos (n=92). Surpreendentemente, apesar desta espécie apresentar anteras poricidas constatou-se a ocorrência de autopolinização espontânea em 33% das flores (n=92).

Desenvolvimento do açaizeiro de terra firme, cultivar pará, sob atenuação da radiação solar em fase de viveiro

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

Influence of intentional ankylosis of deciduous canines to reinforce the anchorage for maxillary protraction

INTRODUÇÃO: nesse estudo cefalométrico retrospectivo, analisou-se a influência da anquilose intencional de caninos decíduos em pacientes com má oclusão de Classe III e mordida cruzada anterior, nos estágios de dentição decídua e mista precoce, tratados com expansão ortopédica da maxila, seguida de tração reversa. MÉTODOS: foram utilizadas telerradiografias em norma lateral de 40 pacientes, divididos em 2 grupos pareados por idade e sexo. O Grupo Anquilose foi constituído de 20 pacientes (10 meninos e 10 meninas) tratados com anquilose induzida e que apresentavam as idades médias inicial e final, respectivamente, de 7a 4m e 8a 3m, e o tempo médio de tração reversa de 11 meses. O Grupo Controle, composto de 20 pacientes (10 meninos e 10 meninas) tratados sem anquilose induzida e que apresentavam as idades médias inicial de 7a 8m e final de 8a 7m, e tempo médio de tração reversa de 11 meses. Foram empregadas as análises de Variância a dois critérios e de Covariância para comparar as variáveis cefalométricas inicial e final e as alterações de tratamento entre os grupos. RESULTADOS: segundo os resultados, as variáveis que evidenciaram as mudanças de tratamento significativas entre os grupos confirmaram que o procedimento de anquilose intencional potencializou a resposta sagital das bases apicais (Pg-NPerp) e aumentou os ângulos de convexidade facial (NAP e ANB). CONCLUSÃO: o protocolo envolvendo a anquilose intencional de caninos decíduos potencializou a resposta sagital das bases apicais.

Efeito da intervenção em esteira motorizada na aquisição da marcha independente e desenvolvimento motor em bebês de risco para atraso desenvolvimental

OBJETIVO: Examinar o efeito de intervenção em esteira motorizada na idade de aquisição da marcha independente em bebês de risco para atraso de desenvolvimento. MÉTODOS: Estudo experimental com 15 lactentes a partir do 5º mês de idade, sendo cinco deles com risco de atraso de desenvolvimento submetidos a sessões de fisioterapia e intervenção em esteira motorizada (Grupo Experimental); cinco com risco de atraso de desenvolvimento submetidos apenas a sessões de fisioterapia (Grupo Controle de Risco); e cinco bebês sem risco de atraso (Grupo Controle Típico). As sessões de fisioterapia ocorreram duas vezes por semana, seguidas de intervenção em esteira motorizada para o grupo experimental. Todos os bebês foram avaliados mensalmente pela Alberta Infant Motor Scale e os participantes do grupo experimental foram filmados durante a realização das passadas na esteira. Comparações entre os grupos ao longo do tempo foram realizadas por análise de variância (ANOVA) e de multivariância (MANOVA). RESULTADOS: Os bebês do Grupo Experimental adquiriram a marcha independente aos 12,8 meses e os do Grupo Controle de Risco aos 13,8 meses de idade corrigida, sendo que a aquisição do Grupo Controle de Risco ocorreu mais tarde em relação ao Grupo Controle Típico (1,1 meses; p<0,05). Os bebês do grupo experimental apresentaram padrão alternado das passadas na esteira, que aumentou ao longo da intervenção (p<0,05), e mostraram melhora do desenvolvimento motor global em relação aos bebês do Grupo Controle de Risco. CONCLUSÕES: A esteira pode ser considerada um agente facilitador para a aquisição do andar independente e do desenvolvimento motor global de bebês com risco de atraso de desenvolvimento.