Ectrópio palpebral em portador da síndrome de Down e conjuntivite alérgica: Relato de caso

This is a case report of a patient with Down's syndrome with an important mechanical ectropion and elongation of the lower lid related to chronic allergic conjunctivitis, besides cataract and keratoconus. The tarsal strip technique and ressection of redundant and thick conjunctiva was the surgical approach chosen for this case. Functional and cosmetic outcomes were considered satisfactory.

Dental age in patients with Down syndrome

The aim of this research was to evaluate dental age in 102 patients with Down Syndrome, using panoramic radiographs. A software program developed by the Discipline of Radiology, School of Dentistry of São José dos Campos, São Paulo State University (UNESP), was used. A table of mineralization chronology of permanent teeth among Brazilians conceived by Nicodemo, Moraes and Medici Filho was used within the software. Statistical analysis of the results showed that 70.91% of the males land 61.21% of the females presented advanced dental age. Only 32.09% of the males and 39.79% of the females presented delayed dental age. Regarding the differences between the dental and chronological ages, two thirds of the males and females presented dental age with differences of up to 12 months, which means that they can be considered to be within normal standards, whereas only 18.87% of the males and 10.21% of the females presented dental age outside normal standards, with differences of over 24 months. In conclusion, the majority of the patients with Down Syndrome were considered to be within the normal standards of mineralization chronology.

Skeletal age of individuals with Down syndrome

The aim of this study was to assess the skeletal age of Brazilian individuals with Down syndrome (DS) using the method of Greulich and Pyle. Forty subjects with DS between the ages of 6 and 16 years were studied and compared to a control sample of children without DS. The statistical analysis showed that at the age of 7 years the skeletal age (SA) of the individuals with DS was delayed in relation to their chronological age (CA) (SA < CA). On the other hand, at the age of 15 years, their SA was advanced in relation to their CA (SA > CA). An evaluation of the results suggests that the period of adolescent development for individuals with DS was shorter. These individuals reach the completion of bone maturation earlier compared to individuals without DS. © 2008 Special Care Dentistry Association and Wiley Periodicals, Inc.

Infliximabe no tratamento inicial da retocolite ulcerativa moderada e grave. Terapia top down: Relato preliminar

The first option for the treatment of UC is both: salicylates or corticoids. Recently, in late November of 2006, the Brazilian Ministry of Health has approved infliximab (Remicade c, Mantecorp, Brazil) to treat ulcerative colitis. We report the use of infliximab as a first option for the treatment of two patients with severe ulcerative colitis. Case report: Patient 1: AZF, 52 years-old, female, was first diagnosed with UC after history and clinical examination; colonoscopy showed pancolitis with positive biopsy (crypt microabscess). Her Mayo score was 10 (range: 0 to 12/asymptomatic to severe colitis). She received intra venous infusion of infliximab at a dose of 5mg/Kg of body weigh at week 0, 2, 6 and 14. Then, patient was given mesalazine 4.5 g/day for maintenance therapy. Clinical response was defined as a decreased from baseline in the total Mayo score of at least 3 points. At present, patient is asymptomatic with Mayo score of 3 one moth after the last dose of infliximab. Patient 2: MLA, 45 years-old, female was first diagnosed with bloody diarrhea; colonoscopy showed left colitis and the biopsy was positive for ulcerative colitis. Her Mayo score was 9. She was offered and accepted the step down treatment. She was given infliximab 5mg/Kg of body weight at week 0, 2, 6 and 14. After initial treatment with infliximab, she received mesalazine 4.2 g/day. At present, she is asymptomatic with Mayo score of 2 eighteen days after the last dose of infliximab. At our knowledge, this is the first Brazilian report of the use of infliximab as fist-line therapy in ulcerative colitis. Few days after the begging of the infusion, an impressive clinical and colonoscopy improvement was seen in these two patients. Recently, it has been reported the use of infliximab as first-line therapy in pediatric Crohn disease. Infliximab could be a good option in cases of moderate and severe UC to avoid the side effects of the use of high doses of corticoids in patients with moderate and severe UC. However, the question if step-down therapy in ulcerative colitis is better then conventional therapy with salicylates and corticoids needs to be answered by randomized trials.

Use of high energy ball milling on the sintering optimization of alumina ceramics

In this work, the effect of the milling time on the densification of the alumina ceramics with or without 5wt.%Y 2O 3, is evaluated, using high-energy ball milling. The milling was performed with different times of 0, 2, 5 or 10 hours. All powders, milled at different times, were characterized by X-Ray Diffraction presenting a reduction of the crystalline degree and crystallite size as function of the milling time increasing. The powders were compacted by cold uniaxial pressing and sintered at 1550°C-60min. Green density of the compacts presented an increasing as function of the milling time and sintered samples presented evolution on the densification as function of the reduction of the crystallite size of the milled powders. © (2010) Trans Tech Publications.

Efficiency evaluation of ZrB2 incorporation in the MgB 2 matrix phase using high-energy milling

The present study suggests the use of high energy ball milling to mix (to dope) the phase MgB2 with the AlB2 crystalline structure compound, ZrB2, with the same C32 hexagonal structure than MgB 2, in different concentrations, enabling the maintenance of the crystalline phase structures practically unaffected and the efficient mixture with the dopant. The high energy ball milling was performed with different ball-to-powder ratios. The analysis of the transformation and formation of phases was accomplished by X-ray diffractometry (XRD), using the Rietveld method, and scanning electron microscopy. As the high energy ball milling reduced the crystallinity of the milled compounds, also reducing the size of the particles, the XRD analysis were influenced, and they could be used as comparative and control method of the milling. Aiming the recovery of crystallinity, homogenization and final phase formation, heat treatments were performed, enabling that crystalline phases, changed during milling, could be obtained again in the final product. © (2010) Trans Tech Publications.

High-yield direct synthesis of Mg 2FeH 6 from the elements by reactive milling

Magnesium complex hydrides as Mg 2FeH 6 are interesting phases for hydrogen storage in the solid state, mainly due to its high gravimetric and volumetric densities of H2. However, the synthesis of this hydride is not trivial because the intermetallic phase Mg2Fe does not exist and Mg and Fe are virtually immiscible under equilibrium conditions. In this study, we have systematically studied the influence of the most important processing parameters in reactive milling under hydrogen (RM) for Mg 2FeH 6 synthesis: milling time, ball-to-powder weight ratio (BPR), hydrogen pressure and type of mill. Low cost 2Mg-Fe mixtures were used as raw materials. An important control of the Mg 2FeH 6 direct synthesis by RM was attained. In optimized combinations of the processing parameters, very high proportions of the complex hydride could be obtained. © (2011) Trans Tech Publications.

Developing a system for down-hole seismic testing together with the CPTU

This paper presents a system for performing down-hole seismic test together with the piezocone test in order to determine the shear wave velocity (Vs) and for calculating the maximum shear modulus (Go); a basic parameter for analyzing the dynamic soil behavior and a reference value of the soil stiffness. The system components are described and tests results for checking the geophone response are also presented, both before and after installation into the probe. The system was used in down-hole tests carried out at three experimental research sites located in the interior of Sao Paulo State, Brazil, where in situ seismic test results are available. The Vs values measured in down-hole tests carried out with this system were consistent with those determined in cross-hole tests and with a commercial seismic piezocone, which enabled to validate the developed system.

Cephalometric evaluation of hyoid bone position in a patient with Down syndrome: Case report

The hyoid bone contributes to the maintenance of the airway, chewing and swallowing, given to its anatomical and functional relations to the craniocervical complex. Cephalometric analysis has great importance for orthopedics, orthodontics and oral maxillary surgery. For the treatment of patients with special care needs, the cephalometric evaluation of the position of the hyoid bone should also contribute as a complementary element for dental diagnosis and the selection of the adequate treatment. The aim of this paper is to demonstrate the alteration of the hyoid position after carrying out the functional orthopedic maxillary treatment in a 9 year-old patient with Down Syndrome. Initial cephalometric analysis revealed inadequate position of hyoid bone. The association of speech therapy to dynamic functional rehabilitation of jaws showed a positive effect in occlusal relation and facial expression. After treatment, all dimensions obtained from the hyoid triangle were higher than initial ones, except the anterior-posterior value of C3-H, which suggested function improvement of stomatognathic system. Once considered its anatomical and physiological relationship with the others structures of the stomatognathic system, cephalometric analysis of hyoid bone position was helpful to the comprehension of the craniofacial abnormalities related to chromosomal anomaly, and thus is essential to the interdisciplinary dialogue.

Functional activity of neutrophils and systemic inflammatory response of Down's syndrome patients with periodontal disease

Periodontal disease (PD) is characterized as an inflammatory process that compromises the support and protection of the periodontium. Patients with Down's syndrome (DS) are prone to develop PD. Neutrophils (NE) are the first line of defense against infection and their absence sets the stage for disease. Aim: To compare the activity and function of NE in the peripheral blood from DS patients with and without PD, assisted at the Center for Dental Assistance to Patients with Special Needs affiliated with the School of Dentistry of Araçatuba, Brazil. Methods: Purified NE were collected from peripheral blood of 22 DS patients. NE were used to detect the 5-lypoxigenase (5-LO) expression by RT-PCR. Plasma from peripheral blood was collected to measure tumor necrosis factor-a (TNF-α) and interleukin-8 (IL-8) by ELISA and nitrite (NO 3) using a Griess assay. Results: Data analysis demonstrated that DS patients with PD present high levels of TNF-a and IL-8 when compared with DS patients without PD. However, there was no statistically significant difference in the levels of NO 3 production between the groups. The levels of the inflammatory mediator 5-LO expression increased in DS patients with PD. Conclusions: According with these results, it was concluded that TNF-α and IL-8 are produced by DS patients with PD. Furthermore, DS patients with PD presented high levels of 5-LO expression, suggesting the presence of leukotriene B 4 (LTB 4) in PD, thus demonstrating that the changes in NE function due to the elevation of inflammatory mediators contribute to PD.

A DC-DC converter based on the three-state switching cell for high current and voltage step-down applications

This paper presents a pulsewidth modulation dc-dc nonisolated buck converter using the three-state switching cell, constituted by two active switches, two diodes, and two coupled inductors. Only part of the load power is processed by the active switches, reducing the peak current through the switches to half of the load current, as higher power levels can then be achieved by the proposed topology. The volume of reactive elements, i.e., inductors and capacitors, is also decreased since the ripple frequency of the output voltage is twice the switching frequency. Due to the intrinsic characteristics of the topology, total losses are distributed among all semiconductors. Another advantage of this converter is the reduced region for discontinuous conduction mode when compared to the conventional buck converter or, in other words, the operation range in continuous conduction mode is increased, as demonstrated by the static gain plot. The theoretical approach is detailed through qualitative and quantitative analyses by the application of the three-state switching cell to the buck converter operating in nonoverlapping mode $(D < 0.5)$. Besides, the mathematical analysis and development of an experimental prototype rated at 1 kW are carried out. The main experimental results are presented and adequately discussed to clearly identify its claimed advantages. © 1986-2012 IEEE.

Comparative analysis between three methods of bone estimating age in individuals with down syndrome by mode of the hand and wrist ray

The wrist and hand region has been the most commonly used for estimating age and osseous development due to the great number of ossification centers. The aim was to determine which method, Tanner & Whitehouse's (TW3), Greulich & Pyle's (GP) or Eklof & Ringertz's, more closely relates to the chronological age in subjects with Down syndrome with chronological ages between 61 and 180 months, using wrist and hand radiographs. The sample consisted of 85 radiographs, 52 of males and 33 of females. Eklof & Ringertz's method was computerized (Radiomemory). Greulich & Pyle's atlas was used and compared with the wrist and hand radiographs. For the TW3 method, 13 ossification centers were evaluated; for each one of them, there are seven or eight development stages to which scores are assigned; these scores are then added and the results are transformed into osseous age values. No statistically significant differences were observed between the male and female genders for methods TW3 and GP, contrasting with the observed differences for the Eklof & Ringertz method. Correlation (r2) between osseous and chronological ages was 0.8262 for TW3 and 0.7965 for GP, while for the method of Eklof & Ringertz, it was 0.7656 for females and 0.8353 for males. The author concluded that the osseous age assessment method that better related to the chronological age was the TW3, followed by Greulich & Pyle's and Eklof & Ringertz's.

Effect of ball milling on structural and physicochemical characteristics of cassava and Peruvian carrot starches

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

Annexin-A1 peptide down-regulates the leukocyte recruitment and up-regulates interleukin-10 release into lung after intestinal ischemia-reperfusion in mice

Background: Intestinal ischemia/reperfusion (IR) injury is a serious and triggering event in the development of remote organ dysfunction, from which the lung is the main target. This condition is characterized by intense neutrophil recruitment, increased microvascular permeability. Intestinal IR is also responsible for induction of adult respiratory distress syndrome, the most serious and life-threatening form of acute lung injury. The purpose of this study was to investigate the effect of annexin-A1 protein as an endogenous regulator of the organ remote injury induced by intestinal ischemia/reperfusion. Male C57bl/6 mice were subjected to intestinal ischemia, induced by 45 min occlusion of the superior mesenteric artery, followed by reperfusion. Results: The intestinal ischemia/reperfusion evoked a high intensity lung inflammation as indicated by the number of neutrophils as compared to control group. Treatment with annexin-A1 peptidomimetic Ac2-26, reduced the number of neutrophils in the lung tissue and increased its number in the blood vessels, which suggests a regulatory effect of the peptide Ac2-26 in the neutrophil migration. Moreover, the peptide Ac2-26 treatment was associated with higher levels of plasma IL-10. Conclusion: Our data suggest that the annexin-A1 peptidomimetic Ac2-26 treatment has a regulatory and protective effect in the intestinal ischemia/reperfusion by attenuation of the leukocyte migration to the lung and induction of the anti-inflammatory cytokine IL-10 release into the plasma. The anti-inflammatory action of annexin-A1 and its peptidomimetic described here may serve as a basis for future therapeutic approach in mitigating inflammatory processes due to intestinal ischemia/reperfusion. © 2013 Guido et al.; licensee BioMed Central Ltd.