Molecular typing of bacterial strains isolated from the Clinics of Surgery and Face Traumatology at Ribeirão Preto University

The number of infectious illnesses and cross infection is spreading drastically among the professionals of the dentistry area. Controlling infections in dental offices is one of the greatest challenges for dentists and researchers of this area. In practice, contacts between professionals and infected patients are relatively common. The transmission of infectious illnesses from the health professionals to their patients is also possible, either by direct contact or due to lack of cares in relation to biosafety, increasing the cycle of cross infection. Molecular typing is necessary since these methods are an important tool to investigate the epidemiology of bacterial infections. Moreover, they are important for supplying information and precedents through the analysis of the infectious agents eletrophoretic profile. The aim of the present work was to analyze by molecular typing the genomic profile of aerobic bacteria isolated from the Clinics of Surgery and Face Traumatology, Ribeirão Preto University, through the technique of Random Amplified Polymorphic DNA (RAPD) and grouped based on similarity coefficients. Of two carried out collections, 55 strains were isolates belonging to the following groups: 12 Staphylococcus aureus; 13 Klebsiella oxytoca; 7 Klebsiella pneumoniae; 8 Pseudomonas aeruginosa; 5 Hafnia alvei; 5 Proteus vulgaris; 4 Escherichia coli; and 1 Proteus mirabilis. The adopted molecular typing strategy allowed the determination of the persistence of definitive strains at the collection environment, besides the identification of strains proceeding from the hands and gloves of the surgeon dentists, which could have been found in distant places as sinks and reflectors.

Implante de tendão autógeno do músculo flexor superficial dos dedos no reparo de desvio do pênis de bovines

In this experiment, 18 hybrid steers, from the ages between 16 and 20 months, were submitted to the removal of the penis apical ligament to provoke a penis deviation. After passed 30 days, to be tested, the animals were put together to the females that were in heat. It was verified the formation of the ventral and right lateral penis deviation with incapacity of the copula. The bovines were submitted to the autologous implant from the one following superficial portion tendon from the superficial flexor fingers muscle, on the top of albuginea tunic, replacing the apical penis ligament removed. The material implanted was well tolerated, appearance a few inflammatory cells and formation of the fibrous conjunctive tissue, causing resistant adherence and capacity of sustaining the free penis extremity. The bovines, when were among the females that were in heat, did not show a penis deviation nor sexual behavior modification. The method revealed itself satisfactory and it can be indicated to correct ventral and right lateral penis deviation in bovines.

Lombalgia em eqüinos

Back pain, whether they have a primary or secondary origin, is a important cause to the drop of the equine performance, but the size and the complex biomechanics make it difficult to diagnosis and treat the injury. As it is, the knowledge of this anatomic site is of great importance to the thoracolumbar examination. The diagnosis of back pain is done through physical examination and complementary exams, represented by the image methods of diagnosis, such as radiography, ultrasonography and thermography. The most important lesions that cause the back pain in an equine are impingement of the dorsal spinous processes, desmopathy of the supraespinous ligament, osteoarthritis of the articular processes and lesions of the vertebral discs and body. The most common treatments to back pain are the non-steroidal anti-inflammatory drugs, local injections, acupuncture, physiotherapy, training management and surgery.

Orthognathic Surgery in the Young Cleft Patient: Preliminary Study on Subsequent Facial Growth

Purpose: This study evaluated the long-term effects of orthognathic surgery on subsequent growth of the maxillomandibular complex in the young cleft patient. Patients and Methods: We evaluated 12 young cleft patients (9 male and 3 female patients), with a mean age of 12 years 6 months (range, 9 years 8 months to 15 years 4 months), who underwent Le Fort I osteotomies, with maxillary advancement, expansion, and/or downgrafting, by use of autogenous bone or hydroxyapatite grafts, when indicated, for maxillary stabilization. Five patients had concomitant osteotomies of the mandibular ramus. All patients had presurgical and postsurgical orthodontic treatment to control the occlusion. Radiographs taken at initial evaluation (T1) and presurgery (T2) were compared to establish the facial growth vector before surgery, whereas radiographs taken immediately postsurgery (T3) and at longest follow-up (T4) were used to determine postsurgical growth. Each patient's lateral cephalograms were traced, and 16 landmarks were identified and used to compute 11 measurements describing presurgical and postsurgical growth. Results: Before surgery, all patients had relatively normal growth. After surgery, cephalograms showed statistically significant growth changes from T3 to T4, with the maxillary depth decreasing by -3.3° ± 1.8°, Sella-nasion-point A by -3.3° ± 1.8°, and point A-nasion-point B by -3.6° ± 2.8°. The angulation of the maxillary incisors increased by 9.2° ± 11.7°. Of 12 patients, 11 showed disproportionate postsurgical jaw growth. Maxillary growth occurred predominantly in a vertical vector with no anteroposterior growth, even though most patients had shown anteroposterior growth before surgery. The distance increased in the linear measurement from nasion to gnathion by 10.3 ± 7.9 mm. Four of 5 patients operated on during the mixed dentition phase had teeth that erupted through the cleft area. A variable impairment of postoperative growth was seen with the 2 types of grafting material used. No significant difference was noted in the effect on growth in patients with unilateral clefts versus those with bilateral clefts. The presence of a pharyngeal flap was noted to adversely affect growth, whereas simultaneous mandibular surgery did not. After surgery, 11 of 12 patients tended toward a Class III end-on occlusal relation. Conclusions: Orthognathic surgery may be performed on growing cleft patients when mandated by psychological and/or functional concerns. The surgeon must be cognizant of the adverse postsurgical growth outcomes when performing orthognathic surgery on growing cleft patients with the possibility for further surgery requirements. Performing maxillary osteotomies on cleft patients would be more predictable after completion of facial growth. © 2008 American Association of Oral and Maxillofacial Surgeons.

Study of entrance surface skin dose in veterinary radiology

This study aims the evaluation of the radiation dose levels involved in veterinary radiology and to contribute to review the procedures for performing radiographic exams in animals in the Department of Veterinary Radiology of Faculdade de Medicina Veterinária e Zootecnia of Universidade Estadual Paulista (FMVZ-UNESP/Brazil). The obtained results has shown to be extremely important the assessment of doses involved in veterinary diagnostic radiology procedures both to protect the occupationally exposed workers and to optimize the delivered doses to the animals. © 2009 Springer-Verlag.

Preemptive dexamethasone and etoricoxib for pain and discomfort prevention after periodontal surgery: A double-masked, crossover, controlled clinical trial

Background: Several anti-inflammatory drugs have been used to reduce pain and discomfort after periodontal surgeries. This study evaluates the efficacy of using etoricoxib and dexamethasone for pain prevention after open-flap debridement surgery. Methods: For this prospective, double-masked, crossover, placebo-controlled, randomized clinical trial, open-flap debridement surgeries were performed on 15 patients (eight males and seven females, age range 20 to 56 years: mean age ± SD: 40 ± 9.7 years) who presented with chronic periodontitis after nonsurgical periodontal therapy at three quadrants. Each patient underwent three surgical procedures at intervals of 30 days and received one of the following premedication protocols 1-hour before surgery: group 1 = placebo, group 2 = 8 mg dexamethasone, and group 3 = 120 mg etoricoxib. Rescue medication (750 mg acetaminophen) was given to each patient who was instructed to take it when necessary. Pain intensity and discomfort were evaluated by a 101-point numeric rate scale and a four-point verbal rate scale, respectively, hourly for the first 8 hours after surgery and three times a day on the following 3 days. Results: The results demonstrate that groups 2 and 3 present reduced postoperative pain-intensity levels compared to group 1. There were statistically significant differences at the 4, 5, 6, 7, and 8 hour-periods after surgery (Friedman test; P<0.05). Furthermore, rescue-medication intake was significantly lower for groups 2 and 3 than for group 1 (analysis of variance; P<0.02). Conclusion: The adoption of a preemptive medication protocol using etoricoxib or dexamethasone may be considered effective for pain and discomfort prevention after open-flap debridement surgeries.

Use of rubber tree (Hevea brasiliensis) latex biomembrane in diaphragmatic injuries in rabbits - an experimental study

The aim of this study was to evaluate the surgical use of the natural latex biomembrane in diaphragmatic injuries produced experimentally in rabbits. Fifteen healthy adult male and female New Zealand rabbits were employed. The rabbits were assigned to the experimental groups I, II, III, IV and V and analyzed on the 15th, 30th, 45th, 60th and 90th days post surgery, respectively. The surgical procedure consisted in the access to the diaphragm at the eighth right intercostal space, removal of a circle portion of approximately 1.5 cm in diameter following surgical repair with a latex membrane. Macroscopically, it was observed an excellent healing process during the experimental period. The clinical observations, complemented by the histological analysis, indicate that the latex membrane is useful for repair of traumatic inuries of the diaphragm of rabbits.

Partial external mitral annuloplasty in dogs with myxomatous mitral valve degeneration and congestive heart failure: Outcome in 9 cases

Objective: To report the outcome of partial external mitral annuloplasty in dogs with congestive heart failure (CHF) due to mitral regurgitation caused by myxomatous mitral valve degeneration (MMVD). Animals, materials and methods: Nine client-owned dogs with CHF due to mitral regurgitation caused by MMVD. Surgery consisted of a double row of pledget-butressed continuous suture lines placed into the left ventricle parallel and just ventral to the atrioventricular groove between the subsinuosal branch of the left circumflex coronary artery and the paraconal branch of the left coronary artery. Results: Two dogs died during surgery because of severe hemorrhage. Two dogs died 12 and 36 h after surgery because of acute myocardial infarction. Three dogs were euthanized 2 and 4 weeks after surgery because of progression of CHF, 1 was euthanized 30 days after surgery for non-cardiac disease, and 1 survived for 48 months. In the 5 dogs that survived to discharge there was no significant change in the left atrium to aortic ratio with surgery (3.6 ± 0.56 before surgery; 3.1 ± 0.4 after surgery; p = 0.182), and no significant change in mitral regurgitant fraction in 4 dogs in which this measurement was made (78.7 ± 2.0% before surgery; 68.7 ± 7.5% after surgery; p = 0.09). Conclusions: Partial external mitral annuloplasty in dogs with CHF due to MMVD was associated with high perioperative mortality and most dogs that survived to discharge failed to show clinically relevant palliation from this procedure. Consequently, partial external mitral annuloplasty is not a viable option for dogs with mitral regurgitation due to MMVD that has progressed to the stage of CHF. © 2011 Elsevier B.V. All rights reserved.

Preoperative upper limb lymphatic function in breast cancer surgery

Objective: To describe the preoperative upper limb lymphoscintigraphic pattern in women with breast cancer. Methods: Thirty-seven patients undergoing lymphoscintigraphy within 30 days of surgery were investigated. Lymphoscintigraphic studies of 37 upper limbs ipsilateral to surgery and 32 contralateral upper limbs were performed. The examination protocol consisted in obtaining static images of the upper limb in semi-flexion after 10 minutes, and 1 and 2 hours after subcutaneous injection of 1 mCi (37 MBq) of Tc-99m-dextran in the dorsum of the hand. The velocity of axillary lymph node visualization (I, visible at 10 minutes; II, 1 hour; III, 2 hours; and IV, invisible) and degree (intensity) of nodal uptake (a, marked; b, moderate; c,mild; and d, absent) were analyzed. Results: Optimal lymphatic functional pattern (Ia) was observed in four (11%) patients, in the ipsilateral upper limb, and six (19%), in the contralateral upper limb. Worse condition was observed in three (8%) patients (IVd) in the ipsilateral upper limb and two (6%) patients in the contralateral upper limb. The remaining patients showed intermediate states of velocity and uptake intensity. Conclusion: This study found relevant changes in preoperative lymphoscintigraphy, demonstrating preexisting functional differences in the lymphatic system. © 2011 Elsevier Editora Ltda.

Preoperative upper limb lymphatic function in breast cancer surgery.

To describe the preoperative upper limb lymphoscintigraphic pattern in women with breast cancer. Thirty-seven patients undergoing lymphoscintigraphy within 30 days of surgery were investigated. Lymphoscintigraphic studies of 37 upper limbs ipsilateral to surgery and 32 contralateral upper limbs were performed. The examination protocol consisted in obtaining static images of the upper limb in semi-flexion after 10 minutes, and 1 and 2 hours after subcutaneous injection of 1 mCi (37 MBq) of Tc-99m-dextran in the dorsum of the hand. The velocity of axillary lymph node visualization (I, visible at 10 minutes; II, 1 hour; III, 2 hours; and IV, invisible) and degree (intensity) of nodal uptake (a, marked; b, moderate; c,mild; and d, absent) were analyzed. Optimal lymphatic functional pattern (Ia) was observed in four (11%) patients, in the ipsilateral upper limb, and six (19%), in the contralateral upper limb. Worse condition was observed in three (8%) patients (IVd) in the ipsilateral upper limb and two (6%) patients in the contralateral upper limb. The remaining patients showed intermediate states of velocity and uptake intensity. This study found relevant changes in preoperative lymphoscintigraphy, demonstrating preexisting functional differences in the lymphatic system.

Utilização de implantes para o manejo de cavidades anoftálmicas

The implants are usually used after removal of the eye or its internal content, in order to maintain the orbital volume or, as in medicine, provide also the subsequent placement of ocular prosthesis. Considering prosthetic surgery procedures of high relevance in human and veterinary ophthalmology, this paper seek to review the main types of implants described in national and international literature, as well as describe the main complications when they are used in humans and veterinary patients.

Use of a type IIB external skeletal fixator in experimental tarsocrural arthrodesis in dogs

The aim of the present study was to evaluate the usefulness of type IIb external skeletal fixators with a transarticular pin in experimental tarsocrural arthrodesis. Twelve adult mongrel dogs of both sexes, ranging in age from two to five years and weighing 12 to 25kg, were used. The configuration of the fixator consisted in the application of a transarticular Steinmann pin and of centrally threaded pins to the proximal portion of the tibia and calcaneus and to the distal portion of the metatarsal bones. In addition, Schanz pins were inserted into the medial and lateral side of the tibia and into the medial side of the metatarsal bones. Radiographs were taken 15; 30 and 45 days after surgery. Bone fusion of the treated joints were observed at 30 days in all animals, and the implants were removed after 45 days. Loosening of the centrally threaded pins was observed in all groups, especially for those applied to the calcaneus. The configuration of the external fixator proposed here was found to be satisfactory in terms of bone union for all joints during the same period, irrespective of the weight of the animal.

Tomographic index as auxiliary criteria for surgery indication in fracture dislocation of acetabulum posterior wall

There are situations which the tomographic exam is done on the affected hip or situations where the contralateral hip presents abnormalities that make it impossible to compare. In this study we aimed to evaluate a tomographic index that does not require comparison between the both hips. Twenty two patients with unilateral acetabular fracture dislocation with fracture of posterior wall were studied. We established the relationship between the remaining posterior wall and the femoral head diameter (head/wall index-H/W index). We evaluated 45 two-dimensional computed tomography scan in normal hips and established the H/W index. In 45 normal hips we simulated a posterior wall fracture with involvement of 25% and 30% of the posterior wall and calculated the H/W index. We divided into five groups with five different H/W index (fractured group with non surgical treatment; fractured group; normal group; normal group with simulated fracture of 25% and; 30% of the posterior wall). 2.4 was the lowest limit of confidence interval of the group with 25% of the posterior wall fracture. When we analyzed the confidence interval of the 30% fracture group the upper limit of the confidence interval was 2.7, close to the lower limit of the surgical group that was 2.9. Thus, we suggest the 2.4 the H/W index limit as an auxiliary criteria to indicate whether or not to operate. H/W index is helpful to decide whether or not surgery indication in the fracture dislocation of the posterior wall of the acetabulum. © 2012 Fujiki et al.; licensee BioMed Central Ltd.

Deep venous thrombosis prophylaxis in oral and maxillofacial surgery: a Brazilian survey

Background : Deep venous thrombosis (DVP) is a frequent disease. Prophylaxis is the best means to reduce its incidence, for lowering morbidity and mortality rates and treatment costs caused by its complications. Objective : To evaluate the knowledge and use of any kind of DVT prophylaxis by Brazilian Oral and Maxillofacial surgeons. Materials and Methods : A questionnaire was sent to all Oral and Maxillofacial surgeons associated to the Brazilian College of Oral and Maxillofacial Surgeons that have a valid e-mail address. The data retrieved was evaluated and tabulated. Results : Of the 1100 questionnaires sent, only 4% were retrieved. The 42 retrieved were included in the study. Twenty six of the surgeons do not use any kind of deep venous thrombosis (DVT) prophylaxis, 11 use mechanical means as elastic compressive stockings or pneumatic compressive devices for prophylaxis, and 5 uses low-molecular weight heparins (LMWH) as the choice for prophylaxis. Conclusion : The data collected, despite the low rate of participation (4%) by the surgeons, shows that this subject still does not receive proper attention. Whereas other medical specialties make routine use of prophylactic means maybe the maxillofacial surgeons lack concern on that matter.

Intussuscepção ileocólica associada a torção mesentérica em um cão: Relato de caso

Mesenteric torsion is a rare disease in dogs whereas it is more common to affect large animals. The main clinical signs observed are acute, such as prostration and abdominal distension which evolve to a state of shock and death. This paper reports the mesenteric torsion in a dog that was presented to veterinary care with generalized acute abdominal pain of sudden onset. At the physical examination, signs of acute abdomen, rectal temperature of 35 oC, moderate dehydration, congested mucous membrane, and prostration were detected. Emergency therapy was instituted and radiographic and ultrasound examinations were requested. The radiography showed increase in the bowel diameter and an image suggestive of intussusception. The patient was referred to emergency exploratory laparotomy and obtained a definite diagnosis of ileocolic intussusception associated to mesenteric torsion. Due to the extent of intestinal dysfunction, the patient was euthanized on the operating table.