Immunohistochemical evaluation of e-cadherin, Ki-67 and PCNA in canine mammary neoplasias: Correlation of prognostic factors and clinical outcome

E-cadherin is a cell-cell adhesion molecule and low e-cadherin expression is related to invasiveness and may indicate a bad prognosis in mammary neoplasms. The expression of cell proliferation markers PCNA and especially Ki-67, has also proved to have a strong prognostic value in this tumor class. The expression of these markers was related to the clinical-pathological characteristics of 73 surgically removed mammary tumors in female dogs by immunohistochemistry. There was no statistical correlation between these markers and death by neoplasm, survival time and disease-free interval. However, the loss of e-cadherin expression and marked Ki-67 expression (p=0.016) were considered statistically significant for the diagnosis (p=0.032). When evaluated as independent factors, there was evidence of the relationship between the loss of e-cadherin expression and high PCNA expression with changes in the body status (divided into obese, normal and cachectic) of female dogs (p=0.030); there was also evidence of the relationship between pseudopregnancy and e-cadherin alone (p=0.021) and for ulceration and PCNA alone (p=0.035). The significant correlation between the markers expression and these well known prognostic factors used individually or in combination suggests their prognostic value in canine mammary tumors.

A clinical decision support system for cancer diseases

The second main cause of death in Brazil is cancer, and according to statistics disclosed by National Cancer Institute from Brazil (INCA) 466,730 new cases of cancer are forecast for 2008. The analysis of tumour tissues of various types and patients' clinical data, genetic profiles, characteristics of diseases and epidemiological data may lead to more precise diagnoses, providing more effective treatments. In this work we present a clinical decision support system for cancer diseases, which manages a relational database containing information relating to the tumour tissue and their location in freezers, patients and medical forms. Furthermore, it is also discussed some problems encountered, as database integration and the adoption of a standard to describe topography and morphology. It is also discussed the dynamic report generation functionality, that shows data in table and graph format, according to the user's configuration. © ACM 2008.

Drug-induced gingival overgrowth: A clinical and histopathological report

Gingival overgrowth is a significant problem faced by periodontists and is particularly associated with the use of certain drugs such as nifedipine, a high-specificity calcium channel blocker used for the treatment and prophylaxis of certain cardiovascular diseases. Development of gingival overgrowth is characterized by increased collagen in gingival tissue. In general is asymptomatic, at times associated with spontaneous bleeding and ulceration and can promote aesthetic changes and compromise hygiene habits and mastication of the patient. The severity of the symptoms is associated with the presence of risk factors such association with other drugs. This paper aims to present a case report of a patient with generalized gingival overgrowth, with more severe characteristics in the anterior mandible induced by chronic use of nifedipine who underwent basic non-surgical periodontal treatment including supra and subgingival scaling and root planning in both jaws associated with rigorous oral hygiene instructions and surgical therapy in the anterior mandible, the most affected area, to remove the excess of gingival tissue. Nifedipine was replaced by the patient cardiologist to propanolol hydrochloride (40 mg/kg) in an attempt to minimize unwanted side effects. After 6 month follow-up, no recurrence was observed, oral hygiene had improved and the patient had clinical periodontal health and esthetic satisfaction.

Osseointegration of implants with dendrimers surface characteristics installed conventionally or with Piezosurgery®. A comparative study in the dog

Aim: The first aim of the present experiment was to compare bone healing at implants installed in recipient sites prepared with conventional drills or a piezoelectric device. The second aim was to compare implant osseointegration onto surfaces with and without dendrimers coatings. Material and Methods: Six Beagles dogs were used in this study. Five implants with two different surfaces, three with a ZirTi® surface (zirconia sand blasted, acid etched), and two with a ZirTi®-modified surface with dendrimers of phosphoserine and polylysine were installed in the right side of the mandible. In the most anterior region (P2, P3), two recipient sites were prepared with drills, and one implant ZirTi® surface and one coated with dendrimers implants were installed at random. In the posterior region (P4 and M1), three recipient sites were randomly prepared: two sites with a Piezosurgery® instrument and one site with drill and two ZirTi® surface and one coated with dendrimers implants installed. Three months after the surgery, the animals were sacrificed for histological analysis. Results: No complications occurred during the healing period. Three implants were found not integrated and were excluded from analysis. However, n = 6 was obtained. The distance IS-B at the buccal aspect was 2.2 ± 0.8 and 1.8 ± 0.5 mm, while IS-C was 1.5 ± 0.9 and 1.4 ± 0.6 mm at the Piezosurgery® and drill groups, respectively. Similar values were obtained between the dendrimers-coated and ZirTi® surface implants. The BIC% values were higher at the drill (72%) compared to the Piezosurgery® (67%) sites. The BIC% were also found to be higher at the ZirTi® (74%) compared to the dendrimers-coated (65%) implants, the difference being statistically significant. Conclusion: This study has revealed that oral implants may osseointegrate equally well irrespective of whether their bed was prepared utilizing conventional drills with abundant cooling or Piezosurgery®. Moreover, the surface coating of implants with dendrimers phosphoserine and polylysine did not improve osseointegration. © 2012 John Wiley & Sons A/S.

Orbifloxacin: A Review of Properties, Its Antibacterial Activities, Pharmacokinetic/Pharmacodynamic Characteristics, Therapeutic Use, and Analytical Methods

Orbifloxacin is a third generation of fluoroquinolone that exhibits increased antibacterial activity against the Enterobacteriaceae, gram-negative and gram-positive bacteria, anaerobes, and mycobacteria. This drug was synthesized in 1987 and developed as a veterinary chemotherapeutic to use for livestock and domestic pets. Orbifloxacin is labeled for the treatment of skin, soft tissue, and urinary tract infections in dogs, and skin and soft tissue infections in cats, but in some countries, orbifloxacin has been given for the treatment of gastrointestinal and respiratory infections in cattle and swine and other animals. The in vitro activity and clinical efficacy of orbifloxacin against naturally occurring bacterial infections of the skin, ear, soft tissue, udder, and gastrointestinal and respiratory systems in different animals have been evaluated and good responses have been found. The minimum inhibitory concentration of orbifloxacin has been determined in various different pathogens and the results found in the literature are shown in this work. The pharmacokinetics of orbifloxacin has been evaluated by different routes of administration in goats, horses, pigs, rabbits, dogs, cats, camels, cattle, sheep, and fish. Orbifloxacin exhibits excellent pharmacokinetic parameters that suggest that this drug may have good clinical effects on various bacterial infections in these species. All methods described in the scientific literature for determination of orbifloxacin in different matrices were collected and discussed. © 2013 Copyright Taylor and Francis Group, LLC.

Clinical, cytologic, and histologic features of a mammary micropapillary carcinoma in a dog

Mammary invasive micropapillary carcinoma is a rare variant of mammary carcinoma that was recently recognized in dogs. The cytologic features and biologic behavior of such neoplasms in dogs have not yet been widely discussed in the veterinary literature. We report the clinical, cytologic, and histologic features of a canine micropapillary carcinoma in a 13-year-old female mongrel dog. The mammary region presented with extreme local pain, severe edema and erythema, and multifocal epidermal ulceration, which is typical for an inflammatory mammary carcinoma. Fine-needle aspirates were highly cellular and consisted of individual cells and papillary cell clusters with characteristics of malignant epithelial cells. Histologic examination revealed neoplastic cells arranged in small papillae without fibrovascular cores, sometimes inside clear lymphatic spaces, indicating lymphovascular invasion. Regional lymph node evaluation revealed metastatic cells. Due to deteriorating clinical condition the dog was euthanatized 5 months after mastectomy. At necropsy, metastatic neoplastic mammary cells were found in popliteal and mediastinal lymph nodes, the right femoral biceps muscle, liver, heart, lungs, and urinary bladder. © 2013 American Society for Veterinary Clinical Pathology.

Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.

Panic Disorder and Agoraphobia in OCD patients: Clinical profile and possible treatment implications

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

Prevalence of burnout syndrome in clinical nurses at a hospital of excellence

Background: Burnout syndrome can be defined as long-term work stress resulting from the interaction between constant emotional pressure associated with intense interpersonal involvement for long periods of time and personal characteristics. We investigated the prevalence/propensity of Burnout syndrome in clinical nurses, and the factors related to Burnout syndrome-associated such as socio-demographic characteristics, work load, social and family life, leisure activities, extra work activities, physical activities, and work-related health problems. Method: We conducted a cross-sectional, quantitative, prospective epidemiological study with 188 surgical clinic nurses. We used the Maslach Burnout Inventory (MBI), which is a socio-demographic questionnaire and the most widely used instrument to assess Burnout syndrome (three basic dimensions: emotional exhaustion, despersonalization and professional underachievement). The socio-demographic profile questionnaire wascomposed of questions regarding identification, training, time at work, work characteristics and personal circumstances. Results: The prevalence of Burnout syndrome was higher (10.1%) and 55, 4% of subjects had a propensity to develop this syndrome. The analysis of the socio-demographic profile of the nurse sample studied showed that most nurses were childless married women, over 35 years of age, working the day shift for 36 hours weekly on average, with 2-6 years of post-graduation experience, and without extra employments. Factors such as marital status, work load, emotion and work related stress aggravated the onset of the syndrome. Conclusion: The prevalence and propensity of Burnout syndrome were high. Some factors identified can be useful for the adoption of preventive actions in order to decrease the prevalence of the clinical nurses Burnout syndrome.

Paracoccidioides lutzii sp nov.: biological and clinical implications

Paracoccidioides lutzii, formerly known as 'Pb01-like' strains in the P. brasiliensis complex, is proposed as a new species based on phylogenetic and comparative genomics data, recombination analysis, and morphological characteristics. Conidia of P. lutzii are elongated, different from those of P. brasiliensis. P. lutzii occurs in the central and northern regions of Brazil. Studies comparing P. brasiliensis and P. lutzii may have significant clinical consequences for the diagnosis and treatment of paracoccidioidomycosis.

Manifestation of molar-incisor hypomineralisation in twins: clinical case reports

Molar-incisor hypomineralisation is a qualitative defect of dental tissue of systemic origin affecting one or more permanent first molars and sometimes the permanent incisors as well. There are still no conclusive data on the aetiology of this hypomineralisation, however, systemic factors such as respiratory diseases and prenatal and perinatal complications are regarded as possible causes. The objective is to present three clinical cases of twins, one Monozygotic and two Dizygotic Twins with molar-incisor hypomineralisation, showing evidence of its manifestation as well as clinical the characteristics and aetiological factors involved. The clinical findings involving twins suggest that ameloblasts are specifically affected in their developmental phase, which includes a number of factors. Although prenatal and perinatal complications are not decisive in the development of molar-incisor hypomineralization, it is suggested a possible genetic susceptibility to the disease. Prospective observational studies using a population sample containing data on the last three months of gestation to the eruption of permanent teeth are needed to confirm the causeeffect relationships.

Clinical protocol for esthetic restoration using a self-etching adhesive

The advent of new adhesive systems is making techniques and clinical protocols to become faster and simpler, however it does not reduce the importance of knowledge of the properties, characteristics and interaction of dental materials with the tooth structure. Among the adhesives that have recently emerged, highlight the self-etching systems, especially the two-step selfetching, in which the acid primer is available in a separate bottle from the adhesive. These adhesives have shown good results for bond strength, microleakage and postoperative sensitivity, being an option for direct adhesive restorations in anterior teeth. This way, the present case report describes the step-by-step making of a class IV restoration in an upper right central incisor using atwo-step adhesive system, obtaining satisfactory results.

Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations.Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series.Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings.Results: 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n = 17), teacher (n = 4), salesclerk (n = 4), nurse (n = 1), retired (n = 1), and psychologist (n = 1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms.Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. (C) 2014 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Fluorescent antibody test, quantitative polymerase chain reaction pattern and clinical aspects of rabies virus strains isolated from main reservoirs in Brazil

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

Epigenetic and genetic approach to the transmissibility of dental characteristics in twins: report of two cases

Transmissibility of dental and jaw characteristics is strongly influenced by environmental factors during the years of extra uterine life when odontogenesis occurs. Through biochemical factors, such as enzymes, proteins, hormones and other mediators, genes are activated or silenced to suit the cell or organism to its environment. These changes are not transmitted to our descendants, because of that, these factors are called epigenetic. Among the most cited epigenetic factors are food, pollution, drugs and exercise. The objective of this study was to assess the transmissibility of dental characteristics in two pairs of twins. In one case, 13-year-old boys had the same basic dental and jaw characteristics with prolonged retention of the second upper deciduous molars and the presence of permanent successors. In the other case, 14-year-old boys had prolonged retention of lower deciduous second molars and absence of permanent successors, but only one of them had the germs of third lower molars. The phenotypic difference in the dentition of twins from clinical case 2 could be due to epigenetic factors, showing the absence of genetic determinism in the transmissibility of dental characteristics.