Menstrual irregularity: a possible clinical marker of metabolic dysfunction in women with class III obesity

Purpose. To evaluate whether menstrual irregularity in morbidly obese women is indicative of metabolic dysfunction.Patients and Methods. Fifty-seven women with morbid obesity were evaluated. They were divided into two groups: one comprising women without menstrual dysfunctions or hirsutism (Group 1), and another obese women showing menstrual dysfunction with or without hirsutism (Group 2). The following were evaluated: age, colour, childbirth, marital status, profession, socio-economic level, education, age at menarche, body weight, height, body mass index, presence of hirsutism (Ferriman Gallwey Index), abdominal circumference, hip circumference, waist-to-hip ratio, menstrual cycle, blood pressure, presence of acanthosis nigricans, insulin resistance (IR), fasting glycaemia, total cholesterol, HDL-C, LDL-C, triglycerides, thyroid-stimulating hormone, free T4, luteinising hormone (LH), follicle-stimulating hormone, prolactin, total testosterone, dehydroepiandrosterone sulfate, insulin and the Homeostasis Model Assessment (HOMA test).Results. Clinical and epidemiological aspects did not present statistical differences. Clinical and laboratory parameters did not show statistically significant alterations; however, HOMA test values for Group 2 were significantly higher than those for Group 1.Conclusions. The presence of IR in class III obese women can cause menstrual dysfunctions such as amenorrhoea or oligomenorrhoea even in the absence of hyperandrogenism, suggesting that IR plays an important role in the ovarian mechanisms involved in the menstrual cycle control.

Modelos experimentais de deficiência limbar em coelhos: análise clínica

Objetivo: Comparar em coelhos três modelos experimentais de destruição das células germinativas (CG) do limbo corneano quanto a aspectos clínicos. Métodos: Foram utilizados 54 coelhos, 108 olhos, subdivididos em 3 grupos experimentais: (G1), (G2) e (G3), cada um formado pelos OE de 18 coelhos, submetidos às técnicas experimentais (T1), (T2) e (T3), respectivamente, e um grupo controle, formado pelos 54 olhos contralaterais (OD). Nas três técnicas foi utilizado o n-heptanol. Na T1, o n-heptanol foi aplicado por 5 minutos, para remoção do epitélio límbico. Na T2, além da aplicação do n-heptanol, realizou-se peritomia e remoção da conjuntiva perilímbica até 4 mm do limbo, juntamente com a escarificação do tecido episcleral. Na T3, além dos procedimentos da T2, foi realizada dissecção lamelar do limbo abrangendo aproximadamente 1,5 mm na periferia da córnea e 2 mm na superfície escleral. em todas as córneas dos animais foram estudados seis parâmetros clínicos: neovascularização, perda da transparência, irregularidade da superfície, reparação epitelial, erosão ou defeito epitelial, granuloma e outras lesões corneanas. Resultados: A neovascularização corneana iniciou-se mais precocemente com a T1 e T2; ocorreu em 100% dos casos com as três técnicas, de forma não homogênea, variando de leve a intensa; permaneceu estável a partir do 28º dia até o final do experimento (56º dia), foi maior nos quadrantes superior e inferior e menor nos quadrantes nasal e temporal. A perda da transparência e a irregularidade da superfície corneana foram menores com a T1 que com a T2 e T3, que foram similares entre si. Houve, nas três técnicas experimentais, latência de três dias para o início da reepitelização, que se completou com a T1 no 7º dia e com a T2 e T3 no 14º dia. Erosão epitelial corneana e granuloma corneano foram encontradas de forma similar nas três técnicas experimentais. Conclusões: A T2 e T3 mostraram-se adequadas como possíveis modelos de ampla remoção das CG límbicas, levando a resultados similares nos diversos parâmetros estudados. A T1 se mostrou adequada como modelo de remoção parcial do epitélio límbico. Ocorreu conjuntivalização e neovascularização nas três técnicas experimentais.

A discrepância de tamanho dentário, de Bolton, na oclusão normal e nos diferentes tipos de más oclusões, bem como sua relação com a forma de arco e o posicionamento dentário

Esta pesquisa teve como objetivo geral avaliar a discrepância de tamanho dentário, na oclusão normal e nos diferentes tipos de más oclusões e a sua relação com as medidas que determinam a forma de arco e o posicionamento dentário na região anterior. Para tanto, foram estudados 185 pares de modelos de gesso, divididos em 4 grupos: Grupo 1 (composto por 41 pares com Oclusão Normal, sendo 20 do gênero masculino e 21 do gênero feminino); Grupo 2 (composto por 44 pares com má oclusão de Classe I, divisão 1, sendo 22 do gênero masculino e 22 do gênero feminino); Grupo 3 (composto por 54 pares com má oclusão de Classe II, sendo 28 do gênero masculino e 26 do gênero feminino) e Grupo 4 (composto por 46 pares com Classe III, sendo 23 do gênero masculino e 23 do gênero feminino). Observou-se que não ocorreu dimorfismo sexual entre as discrepâncias de tamanho dentário e os diferentes tipos de oclusão dentária; as proporções estabelecidas por Bolton não se aplicaram ao grupo com Oclusão Normal; na Oclusão Normal, Classe I, Classe II e Classe III, houve um predomínio de excesso dentário total (RAZ12) no arco inferior; na Classe I houve uma igualdade na distribuição de excesso dentário anterior (RAZ6) nos arcos superior e inferior; na Oclusão Normal, Classe II e Classe III, ocorreu um predomínio de excesso dentário anterior (RAZ6) no arco inferior, em relação ao arco superior; os excessos dentários não contribuíram na ocorrência das más oclusões e as discrepâncias total e anterior (RAZ12 e RAZ6) não interferiram diretamente nas larguras e comprimentos dos arcos, bem como no posicionamento dos dentes anteriores.

Immediate reconstruction of frontal sinus fractures: review of 26 cases

Purpose: the purpose of this study was to evaluate complications occurring after immediate reconstruction of severe frontal sinus fractures, including cases where the fracture was not limited to the anterior wall and also involved the posterior wall and/or sinus floor.Patients and Methods: the records of twenty-six patients presently undergoing follow-up for frontal sinus fracture reconstruction were reviewed. Information regarding demographics, fracture characteristics and causes, associated facial fractures, use of grafts or implants, type of fixation used, nasofrontal duct management, use of antibiotics, and complications were noted. Patients were asked to return for clinical and radiographic follow-up to access late complications.Results: the average age of patients with frontal fractures was 29.1 years and 92.3% were male. Mean follow-up was 3.6 years. The most common causes of fracture were motor vehicle accidents and physical aggression. All patients presented with comminuted and dislocated anterior wall fractures, 34.6% presented with posterior wall fractures, and 46% had sinus floor fractures. Complications occurred in 7 patients (26.92%) and included pneumoencephalus, frontal cutaneous fistula, frontal bone irregularity, and sinusitis.Conclusions: Frontal sinus reconstruction is a good procedure for immediate fracture treatment if there is not excessive comminution, dislocation, or instability of the posterior wall and if the frontonasal duct area is intact or can be repaired. Most complications result from incorrect indication for reconstruction. (C) 2004 American Association of Oral and Maxillofacial Surgeons.

Efeito do Paclobutrazol no controle da diferenciação floral natural do abacaxizeiro cv. Smooth Cayenne

O abacaxizeiro é uma planta de grande importância econômica, porém seu florescimento natural causa sérios problemas, tornando seu manejo difícil devido à desuniformidade de frutos e colheitas, elevando o custo de produção. O objetivo deste trabalho foi manipular o florescimento do abacaxizeiro, contribuindo para uma produção uniforme colocada no mercado, nos meses de menor oferta. Utilizou-se o Paclobutrazol (PBZ) nas concentrações de 100; 150 e 200 mg L-1, em 2; 3 ou 4 aplicações via foliar, em plantas de abacaxi cv. Smooth Cayenne, no município de Presidente Alves-SP. O delineamento empregado foi em blocos ao acaso, com 10 tratamentos e três repetições, com 40 plantas por parcela experimental. No período de 100 a 150 dias após a primeira aplicação dos tratamentos, efetuaram-se as contagens de inflorescências presentes no centro da roseta foliar das plantas. Todos os tratamentos com Paclobutrazol inibiram a diferenciação floral natural do abacaxizeiro, recomendando-se a concentração de 150 mg L-1 em duas aplicações, com início em abril, a intervalo de 15 dias.

Florística e fitossociologia em parcelas permanentes da Mata Atlântica do sudeste do Brasil ao longo de um gradiente altitudinal

This paper summarizes floristic and phytossociology data of 11, out of 14 plots of 1 ha, allocated along an altitudinal gradient in the Serra do Mar, Silo Paulo, Brazil. The study was conducted at Serra do Mar State Park and the plots start at the sea level (10 m - plot of Restinga Forest that occurs at Praia da Fazenda, Picinguaba, municipality of Ubatuba) up to 1100 m above sea level (the Montane Ombrophilous Dense occurs alongside the Itamambuca Trail, municipality of Silo Luis do Paraitinga). The Restinga Forest occurs in Pleistocenic Coastal Plain where the soil is classified as a sandy Quartzipsamment (Quartzenic Neosol), while along the slopes of the Serra do Mar, the Ombrophylus Dense Forest grows on the top of a pre-Cambrian crystalline basement with granitic rocks, where the soil is a sandy-loam Dystrophic Inceptisol (Cambisol/Latosol). In all 14 plots soils are acidic (pH 3 - 4), chemically poor, with high dilution of nutrients and high saturation of aluminum. In the Restinga and at the foot of the slope the climate is Tropical/Subtropical Humid (Af/Cfa), with no dry season, an average annual rainfall over 2,200 mm and an average annual temperature of 22 degrees C. Towards the top of the Serra do Mar there is a gradual cooling along the slope, but there is no reduction in rainfall, so at 1,100 m above sea level the climate is classified as Humid Subtropical (Cfa/Cfb), with no dry season and an average annual temperature of 17 degrees C. It is important to remark that, almost daily, from 400 m above sea level up to the top of slopes the mountains are covered by a dense fog. In the 14 plots 21,733 individuals with DBH >= 4.8 cm, including trees, palms and ferns, were marked, measured and sampled. The average number of individuals sampled in each plot was 1264 ind.ha(-1)(+/- 218 SE 95%). Within the parameters considered trees prevailed (71% in the Montane ODF to 90% in the Restinga Forest), followed by palms (10% in the RF and 25% in the Montane Ombrophilous Dense Forest/ODF) and ferns (0% % in the RF and 4% in the Montane ODF). Regarding these proportions the Exploited Lowlands ODF differs from the others with only 1.8% of palm trees and striking 10% of ferns. The forest canopy is irregular with heights ranging from 7 to 9 m, rarely emergent trees reach 18 m, and due to this irregularity of the canopy the amount of light that gets through sets conditions for the development of hundreds of epiphytic species. Aside from Montana ODF, where the number of dead trees was more than 5% of individuals sampled, in the other phytophysiognomies this value was below 2.5%. In the 11 plots where the floristic study was conducted we found 562 species in 195 genera and 68 families. Only seven species - Euterpe edulis Mart. (Arecaceae), Calyptranthes lucida Mart. ex DC. and Marlierea tomentosa Cambess (both Myrtaceae), Guapira opposita (Veil.) Reitz (Nyctaginaceae), Cupania oblongifolia Mart. (Sapindaceae), Cecropia glaziovii Snethl. and Coussapoa microcarpa (Schott) Rizzini (both Urticaceae) - occurred from Restinga to Montane ODF, while 12 other species did not occur only in the Restinga Forest. Families with the greatest number of species are Myrtaceae (133 spp), Fabaceae (47 spp), Rubiaceae (49) and Lauraceae (49) throughout the gradient and Monimiaceae (21) specifically in portions Montane ODF. Only in the F plot, where logging has occurred between 1950 and 1985, the abundance of palm trees has been replaced by Cyatheaceae. The study shows a peak of diversity and richness, Shannon-Weiner index (H') ranging from 3.96 to 4.48 nats.ind(-1), in the intermediate altitudes (300 to 400 m) along the slope. Several explanations for this result are raised here, including the fact that these elevations are within the limits expansions and retractions of the different phytophysiognomies of the Atlantic ODF due to climate fluctuations during the Pleistocene. The results presented in this paper demonstrate the extraordinary richness of tree species of the Atlantic Rainforest from the northeastern coast of the State of São Paulo, reinforcing the importance of its conservation throughout the altitudinal gradient. The richness of this forest justifies a long term commitment to study its dynamics and functioning through permanent plots, and monitor the impacts of climate change in this vegetation.

An intelligent system for pavement management

This paper describes a method for the evaluation of pavement condition through artificial neural networks using the MLP backpropagation technique. Two of the most used procedures for detecting the pavement conditions were applied: the overall severity index and the irregularity index. Tests with the model demonstrated that the simulation with the neural network gives better results than the procedures recommended by the highway officials. This network may also be applied for the construction of a graphic computer environment.

Sharpening of periodontal instruments with different sharpening stones and its influence upon root debridement--scanning electronic microscopy assessment

The objective of this study was to evaluate, through scanning electronic microscopy, the effect of sharpening with different sharpening stones on the cutting angle of periodontal curettes (Gracey 5-6), and the influence on root surfaces after debridement and planing. The experimental model consisted of two different phases. In the first, the cutting angles of fifteen stainless steel Gracey 5-6 curettes were analyzed under a scanning electronic microscope after being sharpened with different types of stones. In the second phase, the root surfaces of 25 newly extracted teeth were evaluated with a scanning electronic microscope after being debrided with curettes sharpened with different stones. Analysis of the results showed that the synthetic stones (aluminum oxide and carborundum) are more abrasive and produce more irregular cutting angles, whereas Arkansas stones are less abrasive and produce smoother and more defined cutting angles. There was no significant statistical differences among the five groups tested with regard to the degree of irregularity of the root surfaces after instrumentation.

Clinical assessment of ethinylestradiol and cyproterone acetate in menstrual irregularities of hyper-androgenic origin

We report on the results of a double-blind, randomized, controlled clinical trial comparing two preparations of ethinylestradiol and cyproterone acetate in the treatment of women of reproductive age presenting menstrual irregularities of hyper-androgenic origin. After obtaining informed consent, subjects were randomized to a 4-month treatment period consisting of one daily dose of 0.035mg ethinylestradiol + 2mg cyproterone acetate. The treatment regimen cycle consisted of one pill, once daily for 21 days, followed by a 7-day pill-free period. We compared the efficacy of two presentations of the drug combination after each treatment cycle (Visits 2, 3, 4, and 5) in establishment and maintenance of menstrual regulation, intensity of menstrual flow, and dysmenorrhea, as well as a comparison of the two presentations in terms of Global Satisfaction and Drug Satisfaction assessments performed by the patients and the investigating physician. At each study visit, drug compliance and use of concomitant medications, as well as incidence, severity and duration of adverse events were recorded. A total of 86 subjects were randomized to treatment, with 43 subjects in each treatment group. At Visit 2 and each subsequent visit, all patients in both treatment groups reported an episode of withdrawal bleeding during the 7-day hormone-free period. We observed a statistically significant (p<0.0001) decrease in the incidence of dysmenorrhea at each study visit in relation to the pretreatment assessment. There was a significant reduction (p<0.0001) in the number of subjects reporting intermenstrual bleeding at each study visit in both treatment groups. Global Satisfaction scores by the patient and physician increased significantly at each successive study visit in both treatment groups. There were no clinically significant changes in vital signs, weight, and body mass index throughout the study period in either group. The number of subjects reporting adverse events at each visit did not vary between treatment groups. The combined oral contraceptive pill containing ethinylestradiol and cyproterone acetate was found to be both effective and safe in the menstrual irregularities of hyper-androgenic origin (amenorrhea, dysmenorrhea, and intermenstrual bleeding) assessed in this study. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Manifestações clínicas, bioquímicas, ultrassonográficas e metabólicas da síndrome dos ovários policísticos em adolescentes

PURPOSE: To evaluate the clinical, ultrasonographic, biochemical and metabolic alterations of adolescents with polycystic ovary syndrome (PCOS). METHODS: Retrospective observational study conducted on 44 adolescents aged 12 to 19 years, diagnosed with PCOS according to the Rotterdam Consensus. Metabolic changes were assessed according to the recommendations of the International Diabetes Federation, considering: waist circumference (WC) ≥90th percentile (10-15 years of age) or >80 cm (age >16 years), fasting glucose >100 mg/dL, triglycerides >150 mg/dL, HDL <40 mg/dL, and blood pressure ≥Hg 130/85 mm. RESULTS: Mean age was 16.7±2.2 years and age at menarche was 11.8±1.4 years. The menstrual irregularity most frequently observed was amenorrhea (72.7%) followed by oligomenorrhea (27.3%); hirsutism was observed in 86.4% and acne in 56.8%. Polycystic ovaries were observed by ultrasound only in 27.3%. Mean BMI was 30.3±6.6 kg/m2. According to BMI, 52.3% of adolescents were obese, 13.6% were overweight and 6.8% had a healthy weight. Increased waist circumference (63.6%, 28/44) and the reduction of HDL-C (34.1%, 15/44) were the metabolic changes most frequently observed. Increased triglycerides were observed in 27.3% (12/44) and increased blood pressure and impaired fasting glucose were found in 9.1% (4/44) and 4.5% (2/44) of cases, respectively. Acanthosis nigricans was observed in 52.3% and insulin resistance in 62.8% of the adolescents with PCOS. Metabolic syndrome was identified in six children (13.6%), all of them obese or overweight. CONCLUSION: In the adolescents with PCOS studied here, menstrual irregularity and hirsutism were the most common clinical manifestations, while the sonographic findings consistent with polycystic ovaries were less prevalent. Obesity associated with insulin resistance predisposes these adolescents to a higher frequency of metabolic disorders.

Exatidão, precisão e reprodutibilidade de medidas dentárias em modelos de gessso e imagem tridimensional

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo do escoamento ao redor de cilindros elípticos

Pós-graduação em Engenharia Mecânica - FEIS

Avaliação radiográfica das articulações dos membros locomotores de cães naturalmente acometidos por leishmaniose visceral no município de Araçatuba-SP

Pós-graduação em Ciência Animal - FMVA

Distração osteogênica médio-sagital da mandíbula: avaliação em modelos de estudo

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

Ética e literatura: uma reflexão sobre a formação de professores a partir do romance Doidinho de José Lins do Rego

Pós-graduação em Educação - FFC