Dental erosion patterns from intrinsic acid regurgitation and vomiting

Background: The distribution of lesions from dental erosion due to intrinsic acid regurgitation and vomiting may be different from patterns of dental erosion due to extrinsic acids. To date studies have failed to validate this assumption. This study described the sites and nature of lesions from dental erosion in cases of intrinsic acid regurgitation, and compared them with the distribution of lesions occurring in age and sex matched controls, whose lesions are due to extrinsic acids. Methods: The University of Queensland tooth wear clinic patients were screened to select 30 cases, 21 self-identified bulimics and nine medically diagnosed chronic gastric acid regurgitators, and 30 controls. Epoxy resin models of the subjects' dentition were examined under stereoscopic light microscope at magnification 16 to 40. The patterns and sites of tooth wear were recorded for teeth representative of 20 tooth sites in every subject. Results: While the incisal edges of maxillary and mandibular anterior teeth of acid regurgitators were more frequently affected by erosion, incisal attrition was more common on controls' teeth. Cervical lesions were more commonly found in association with incisal attrition in the controls, and in association with incisal erosion in the cases. In 10 per cent of sites in case subjects, cervical lesions associated with incisal erosion were found on the lingual aspects of their mandibular incisors, canines and premolars. These lesions were almost exclusive to the case subjects. Conclusions: These results validate that lingual cervical lesions associated with incisal erosion on the mandibular anterior teeth are strong discriminators between tooth wear in patients with bulimia nervosa or chronic gastro-oesophageal reflux and those whose dental erosion is due to extrinsic acids.

Dental erosion in asthma: A case-control study from south east Queensland

Background: Asthma medication places patients at risk of dental erosion by reducing salivary protection against extrinsic or intrinsic acids. But patterns of lesions in asthmatics may differ from patterns in non-asthmatics, because gastro-oesophageal reflux (GOR) is found in 60 per cent of asthmatics. Methods: The lesions in 44 asthma cases were compared to those of age and sex match controls with no history of asthma or medications drawn from the dental records of 423 patients referred concerning excessive tooth wear. The subjects were 70 males age range 15 to 55 years and 18 females age range 18 to 45. Anamnestic clinical data were compared between the two groups. Models of all 88 subjects were examined by light microscopy, and wear patterns were recorded on permanent central incisor, canine, premolar and first molar teeth. Results: Clinical differences were a higher incidence of tooth hypersensitivity; xerostomia, salivary gland abnormalities, gastric complaints, and self induced vomiting in the cases. No differences were found between the cases and controls on citrus fruit and acid soft drink consumption. More occlusal erosion sites were found in cases, whereas more attrition sites were found in the controls. There were no significant differences in palatal erosion on maxillary anterior teeth found between cases and controls. Lingual erosion of the mandibular incisors, found only in GOR patients, was not observed. Conclusions: A higher incidence of erosion was found in asthmatics. Gastro-oesophageal reflux symptoms were not associated with the sign of lingual mandibular incisor erosion. The clinical significance is that asthmatics are at risk of dental erosion from extrinsic acid, but GOR does not appear to contribute in a site-specific manner.

Early reoperation for acute dysphagia following laparoscopic fundoplication

Background: A small number of patients develop acute severe dysphagia for which reoperation is necessary within 10 days of laparoscopic fundoplication. The aim of this study was to identify clinical variables that might predict the likelihood of this condition occurring, such that it could be avoided in the future. Methods: This was a prospective cohort study from three tertiary referral centres, using reoperation for acute dysphagia as the main outcome variable. Gastrointestinal symptom rating scale, and psychological well-being index questionnaires were undertaken before laparoscopic fundoplication, and dysphagia scores were determined before operation and 1 year later. Standard preoperative assessment included gastroscopy, oesophageal manometry and pH studies. Results: Twelve (1.9 per cent) of the 617 patients suffered acute dysphagia, which was predicted by older age and female sex, and resulted in a longer duration of hospital stay. This condition was not predicted by any other demographic, clinical, investigative or operative variables. Conclusions: The study did not identify useful criteria by which severe acute dysphagia could be anticipated and thereby avoided following laparoscopic fundoplication.

Molybdenum Complexes Bearing the Tris(1-pyrazolyl)methanesulfonate Ligand: Synthesis, Characterization and Electrochemical Behaviour

The tris(1-pyrazolyl)methanesulfonate lithium salt Li(Tpms) [Tpms = SO3C(pz)(3)-] reacts with [Mo(CO)(6)] in NCMe heated at reflux to yield Li[Mo(Tpms)(CO)(3)] (1), which, upon crystallization from thf, forms the coordination polymer [Mo(Tpms)(CO)(2)(mu-CO)Li(thf)(2)](n) (2). Reaction of 1 with I-2, HBF4 or AgBF4 yields [Mo(Tpms)I(CO)(3)] (3), (Mo(Tpms)-H(CO)(3)] (5) or (Mo(Tpms)O-2](2)(mu-O) (7), respectively. The high-oxidation-state dinuclear complexes [{Mo(Tpms)O(mu-O)}(2)] (4) and [{Mo(tpms)OCl)(2)](mu-O) (6) are formed upon exposure to air of solutions of 3 and 5, respectively. Compounds 1-7, which appear to be the first tris(pyrazolyl)methanesulfonate complexes of molybdenum to be reported, were characterized by IR, H-1 and C-13 NMR spectroscopy, ESI-MS, elemental analysis, cyclic voltammetry and, in the cases of Li(Tpms) and compounds 2, 4.2CH(3)CN, 6.6CHCl(3) and 7, by X-ray diffraction analyses. Li(Tpms) forms a 1D polymeric structure (i.e., [Li(tpms)](n)} with Tpms as a tetradentate N2O2 chelating ligand that bridges two Li cations with distorted tetrahedral coordination. Compound 2 is a 1D coordination polymer in which Tpms acts as a bridging tetradentate N3O ligand and each Li(thf)(2)(+) moiety is coordinated by one bridging CO ligand and by the sulfonyl group of a contiguous monomeric unit. In 4, 6 and 7, the Tpms ligand is a tridentate chelator either in the NNO (in 4) or in the NNN (in 6 and 7) fashion. Complexes 1, 3 and 5 exhibit, by cyclic voltammetry, a single-electron oxidation at oxidation potential values that indicate that the Tpms ligand has an electron-donor character weaker than that of cyclopentadienyl.

Synthesis, characterization and redox behaviour of benzoyldiazenido- and oxorhenium complexes bearing N,N- and S,S-type ligands

The reactions of [ReCl2{eta(2)-N2C(O)Ph}(PPh3)(2)](1) with 2-aminopyrimidine (H(2)Npyrm), 2,2'-bipyridine (bpy) and tetraethylthiuram disulfide (tds), in MeOH upon reflux, lead to the new eta(1)-(benzoyldiazenido)-rhenium(III) complexes [ReCl{eta(1)-N2C(O)Ph}(HNpyrm)(PPh3)(2)](2)and [ReCl2{eta(1)-N2C(O)Ph}(bpy)(PPh3)] (3), and the known oxo(diethyldithiocarbamato)dirhenium(v)complex [Re2O2(mu O){Et2NC(S)S}(4)](4), respectively. The Et2NC(S)S ligands in 4 result from S-S bond rupture of tds molecules. The obtained compounds have been characterized by IR, H-1, P-31{H-1} and C-13{H-1} NMR spectroscopies, FAB(+)-MS, elemental and single-crystal X-ray diffraction (for 2 and 4)analyses. Complex 2 represents the first structurally characterized Re compound derived from 2-aminopyrimidine. Besides, the redox behaviour of 2-4 in CH2Cl2 solution has been studied by cyclic voltammetry, and the Lever electrochemical ligand parameter (E-L)has been estimated, for the first time, for HNpyrm. The electrochemical results are discussed in terms of electronic properties of the Re centres and the ligands.

Associação entre o nível de actividade física e o refluxo venoso dos membros inferiores

Objectivo: Verificar a associação entre o nível de actividade física e o refluxo venoso dos membros inferiores e a existência de um nível profilático. Métodos: A 49 estudantes, aplicouse o Questionário Internacional Actividade Física, avaliou-se o refluxo venoso pelo ecodoppler e a resistência do tricípite sural por um teste de fadiga local. Resultados: O nível de actividade física e o refluxo venoso dos membros inferiores estão associados (p=0,013). Estudantes com menores índices físicos apresentaram piores resultados. Conclusão: O nível de actividade física e o refluxo venoso estão associados. Não foi possível inferir acerca do nível de actividade física mais adequado.

Avaliação radiológica do refluxo vesico – ureteral em crianças

O Refluxo Vesico – Ureteral (RVU) é uma patologia frequente na idade pediátrica. A detecção precoce de RVU é fundamental na orientação terapêutica, de modo a permitir um crescimento renal adequado e prevenir infecções urinárias recorrentes. A investigação radiológica de RVU baseia-se na ecografia e cistouretrografia miccional seriada (CUMS), sendo este último procedimento, o método de eleição, efectuado sob controlo fluoroscópico. Este trabalho tem como objectivo dar a conhecer o papel CUMS na avaliação de RVU e abordar os parâmetros técnicos de aquisição, posicionamento e critérios de qualidade de imagem.

Recuperação do isopentano da gasolina leve

Mestrado em Engenharia Química

Development of TNBS-induced colitis: animal model to test new pharmacological approaches

IBD is a gastro-intestinal disorder marked with chronic inflammation of intestinal epithelium, damaging mucosal tissue and manifests into several intestinal and extra-intestinal symptoms. Currently used medical therapy is able to induce and maintain the patient in remission, however no modifies or reverses the underlying pathogenic mechanism. The research of other medical approaches is crucial to the treatment of IBD and, for this, it´s important to use animal models to mimic the characteristics of disease in real life. The aim of the study is to develop an animal model of TNBS-induced colitis to test new pharmacological approaches. TNBS was instilled intracolonic single dose as described by Morris et al. It was administered 2,5% TNBS in 50% ethanol through a catheter carefully inserted into the colon. Mice were kept in a Tredelenburg position to avoid reflux. On day 4 and 7, the animals were sacrificed by cervical dislocation. The induction was confirmed based on clinical symptoms/signs, ALP determination and histopathological analysis. At day 4, TNBS group presented a decreased body weight and an alteration of intestinal motility characterized by diarrhea, severe edema of the anus and moderate morbidity, while in the two control groups weren’t identified any alteration on the clinical symptoms/signs with an increase of the body weight. TNBS group presented the highest concentrations of ALP comparing with control groups. The histopathology analysis revealed severe necrosis of the mucosa with widespread necrosis of the intestinal glands. Severe hemorrhagic and purulent exsudates were observed in the submucosa, muscular and serosa. TNBS group presented clinical symptoms/signs and histopathological features compatible with a correct induction of UC. The peak of manifestations became maximal at day 4 after induction. This study allows concluding that it’s possible to develop a TNBS induced colitis 4 days after instillation.

Simulação da produção de Paraxileno

O trabalho tem como objectivo a simulação e verificação do funcionamento de 3 colunas de destilação, a T-0303, a T-0306 e a T-0307, integrantes do processo de produção de p-xileno, baseado nos dados relativos ao ano de 2008, existente na refinaria da Galp no Porto. A abordagem consistiu em utilizar o AspenPlus quer para a simulação quer para a optimização, sendo esta última complementada com um planeamento experimental e optimização no Minitab15. O critério de optimização foi estabelecido a partir de uma análise ao processo actual, na qual se averiguou que se poderia, no limite: produzir mais 15,30ton.ano-1 de p-xileno no conjunto de colunas T-0306 e T-0307; remover mais 1,36ton.ano-1 de dessorvente na coluna T-0303 e diminuir a energia necessária para o processo. Da optimização à coluna T-0303, obteve-se uma melhoria de remoção de 0,34ton.ano-1 de dessorvente, e uma diminuição na energia necessária para 333,24.106kWh por ano. Para obter esta optimização houve necessidade de ultrapassar em 109,852kW a potência da bomba P0306A/S e alterou-se a razão de refluxo na base para 46,1. A optimização conjunta das colunas T-0306 e T-0307 apenas possibilita uma melhoria de p-xileno de 3,4ton.ano-1. De uma optimização individual da coluna T-0307, mantendo a coluna T-0306 nas condições actuais, obteve-se uma melhoria na produção de p-xileno de 14,62ton.ano-1. Neste ensaio as potências do condensador E-0314, do reebulidor E-0306 e da bomba P0314A/S excedem, as actuais em, respectivamente, 35,71kW, 35,74kW e 0,12kW. Enquanto para a situação actual o custo de p-xileno equivale a 722,17€.ton-1, para a optimização simultânea da coluna T-0303 e T-0307, é de 723,39€.ton-1 e para a optimização de apenas da coluna T-0307 é de 722,81€.ton-1. Perante um preço de venda actual de pxileno de 749,10€.ton-1 todas as situações são favoráveis. Em suma, é possível uma optimização processual mas o custo por tonelada de pxileno fica superior ao actual.

Construção de curvas binodais para sistemas ternários, contendo biodiesel, álcool e água

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia Química

Unusual cause for smoldering dysphagia

A 30-year-old black woman presented with heartburn and odynophagia. She had a 2-year history of Behçet’s disease and systemic lupus erythematosus and had been treated with colchicine, hydroxychloroquine, and sucralfate. Odynophagia was not related to the presence of oral ulcers as they were painless and when they were in remission the patient would still intermittently complain of substernal pain. The patient underwent upper digestive endoscopy that revealed only small mucosal irregularities in the upper third of the esophagus. Biopsies of these segments showed marked acanthosis and papillomatosis of the squamous epithelium as well as intense lymphoplasmacytic infiltrate with an increased number of intraepithelial lymphocytes (IEL). There were neither granulocytes nor signs of viral infection. The endoscopic findings were then attributed to regenerative changes of the epithelium and the patient was started on a proton pump inhibitor (PPI), assuming gastroesophageal reflux disease (GERD). During the following years there were flare-ups of rheumatologic disease activity due to the patient’s lack of adherence to therapy. However, there was no correlation of the patient’s maintained (although scarce) complaints of transitory dysphagia and substernal pain.

Disfunção Vesical, Infecção Urinária e Refluxo Vesico-Ureteral na Criança

Tem sido descrita uma correlação estreita entre infecção urinária, refluxo vesico-ureteral e disfunção miccional na criança. A obstrução funcional causada pela disfunção vesical/uretral representa um elevado risco de recorrência de infecção urinária, indução e perpetuação do refluxo (mesmo após correcção cirúrgica) é de lesão renal permanente. A normalização da alteração da micção como problema primário, é crítica na resolução de problemas secundários tais como a infecção urinária e o refluxo vesico-ureteral. Trinta e sete crianças com refluxo vesicoureteral secundário a disfunção miccional foram detectadas, avaliadas e tratadas entre 1990 e 1995 (5 anos). Foram estudados 49 ureteres. A infecção urinária foi o sintoma revelador em todas as crianças, ocorrendo entre 1 mês e os 13 anos de idade (mediana de 3,5 anos). Todas as crianças eram neurologicamente e estruturalmenle normais, detectando-se sintomatologia sugestiva de instabilidade ou imaturidade vesical em 34 (91,9%) e sugestiva de obstrução esfiocteriana funcional em três (8,1 %). Os estudos ecográfico e cistográfico efectuado em todas as crianças, com o apoio do estudo urodinâmico em 17 (45,9%) confirmaram o diagnóstico clínico. Em 29 (78,4%) das crianças foi efectuada cintigrafia com DMSA (Addo Dimercaptosuccínico), revelando cicatriz renal em 26 (89,6%) dos exames. Foi incentivado um programa de reeducação vesical e regularização dos hábitos intestinais em todas as crianças, associado a terapêutica anticolinérgica em 23 (62,2%) e/ou relaxantes musculares em três (8,1%) e fenoxibenzamina e algaliação intermitente (1,5 mês) em uma (2,7%), para além da quimioprofilaxia da infecção urinária instituida em 34 (91,9%) das crianças. Houve resolução completa da infecção urinária em 35 (94,6%) com redução da sua frequência nas outras duas (5,4%), cura do RVU em 32 (86,5%) e melhoria em quatro (10,8%). Verificou-se desaparecimento dos sinais de disfunção vesical em 22 (59,5%) casos com redução na intensidade e frequência em 14 (37,8%), mantendo-se uma criança (2,7%) com síndrome de urgência e refluxo vesico-ureteral inalterado. Estes dados implicam que a detecção e traramento da disfunção vesical/esfincteriana, são essenciais em todas as crianças com o complexo infecção urinária recorrente e refluxo vesicoureteral.

Intraocular Pressure in Eyes Receiving Intravitreal Antivascular Endothelial Growth Factor Injections

PURPOSE: The aim of the this study was to determine the effect of intravitreal antivascular endothelial growth factor injections on intraocular pressure (IOP) and identify possible risk factors for the development of increased IOP. MATERIALS AND METHODS: This prospective study included a total of 106 eyes receiving intravitreal injection of bevacizumab as treatment for macular edema or active choroidal neovascularization. IOP was measured by Goldmann applanation tonometry immediately before the intravitreal injection and 5 min, 1 h and 15 days after the procedure. The records of the study patients were reviewed for age, gender, history of glaucoma, diabetes mellitus, phakic status, systemic and topical medication and number of previous injections. Subconjunctival reflux was registered. IOP elevation was defined as IOP ≥21 mm Hg and/or a change from baseline of ≥5 mm Hg recorded at least on two or more measurements on the same visit. RESULTS: Mean preoperative IOP was 15.31 ± 3.90 mm Hg and postoperative IOP values were 27.27 ± 11.87 mm Hg (after 5 min), 17.59 ± 6.24 mm Hg (after 1 h) and 16.86 ± 3.62 mm Hg (after 15 days). The IOP variation was statistically significant between pre- and postoperative measurements (p < 0.05). Subconjunctival reflux was recorded in 11.3%, and in this subgroup the IOP at 5 min and at 1 h was lower than preoperative IOP (p < 0.05). CONCLUSIONS: More than one third of the eyes achieved IOPs >30 mm Hg 5 min after injection. Subconjunctival reflux contributed to a lower mean postoperative IOP (p < 0.05). Considerations for the management include prophylactic IOP lowering with medical therapy and/or preinjection ocular decompression for patients with a history of glaucoma or ocular hypertension and switching to an as-needed injection protocol in patients suffering a marked IOP rise in previous injections. © 2015 S. Karger AG, Basel.

Urinary Tract Effects of HPSE2 Mutations

Urofacial syndrome (UFS) is an autosomal recessive congenital disease featuring grimacing and incomplete bladder emptying. Mutations of HPSE2, encoding heparanase 2, a heparanase 1 inhibitor, occur in UFS, but knowledge about the HPSE2 mutation spectrum is limited. Here, seven UFS kindreds with HPSE2 mutations are presented, including one with deleted asparagine 254, suggesting a role for this amino acid, which is conserved in vertebrate orthologs. HPSE2 mutations were absent in 23 non-neurogenic neurogenic bladder probands and, of 439 families with nonsyndromic vesicoureteric reflux, only one carried a putative pathogenic HPSE2 variant. Homozygous Hpse2 mutant mouse bladders contained urine more often than did wild-type organs, phenocopying human UFS. Pelvic ganglia neural cell bodies contained heparanase 1, heparanase 2, and leucine-rich repeats and immunoglobulin-like domains-2 (LRIG2), which is mutated in certain UFS families. In conclusion, heparanase 2 is an autonomic neural protein implicated in bladder emptying, but HPSE2 variants are uncommon in urinary diseases resembling UFS.