Medicaid bulletin MB# 12-062

The South Carolina Department of Health and Human Services publishes Medicaid Bulletins to clarify existing policies or explain new policies of the Medicaid program.

Dyspareunia And Lubrication In Premature Ovarian Failure Using Hormonal Therapy And Vaginal Health.

To evaluate vaginal microbiological and functional aspects in women with and without premature ovarian failure (POF) and the relationship with sexual function. A cross-sectional study of 36 women with POF under hormonal therapy who were age-matched with 36 women with normal gonadal function. The vaginal tropism was assessed through hormonal vaginal cytology, vaginal pH and vaginal health index (VHI). Vaginal flora were assessed by the amine test, bacterioscopy and culture for fungi. Sexual function was evaluated through the questionnaire Female Sexual Function Index (FSFI). Women in both groups were of similar age and showed similar marital status. The two groups presented vaginal tropic scores according to the VHI but the tropism was worse among women in the POF group. No difference was observed with respect to hormonal cytology and pH. Vaginal flora was similar in both groups. Women with POF showed worse sexual performance with more pain and poorer lubrication than women in the control group. The VHI, the only parameter evaluated showing statistical difference between the groups, did not correlate with the domains of pain and lubrication in the FSFI questionnaire. These findings suggest that the use of systemic estrogen among women with POF is not enough to improve complaints of lubrication and pain despite conferring similar tropism and vaginal flora. Other therapeutic options need to be evaluated.

Analysis Of Cellular Adhesion On Superhydrophobic And Superhydrophilic Vertically Aligned Carbon Nanotube Scaffolds.

We analyzed GFP cells after 24h cultivated on superhydrophilic vertically aligned carbon nanotube scaffolds. We produced two different densities of VACNT scaffolds on Ti using Ni or Fe catalysts. A simple and fast oxygen plasma treatment promoted the superhydrophilicity of them. We used five different substrates, such as: as-grown VACNT produced using Ni as catalyst (Ni), as-grown VACNT produced using Fe as catalyst (Fe), VACNT-O produced using Ni as catalyst (NiO), VACNT-O produced using Fe as catalyst (FeO) and Ti (control). The 4',6-diamidino-2-phenylindole reagent nuclei stained the adherent cells cultivated on five different analyzed scaffolds. We used fluorescence microscopy for image collect, ImageJ® to count adhered cell and GraphPad Prism 5® for statistical analysis. We demonstrated in crescent order: Fe, Ni, NiO, FeO and Ti scaffolds that had an improved cellular adhesion. Oxygen treatment associated to high VACNT density (group FeO) presented significantly superior cell adhesion up to 24h. However, they do not show significant differences compared with Ti substrates (control). We demonstrated that all the analyzed substrates were nontoxic. Also, we proposed that the density and hydrophilicity influenced the cell adhesion behavior.

Fibrodysplasia ossificans progressiva: case report

Fibrodysplasia ossificans progressiva is a rare genetic disease characterized by widespread soft tissue ossification and congenital stigmata of the extremities. We report on a male child followed for ten years since the age of 3 years and 9 months, when the diagnosis was made. He was born with bilateral hypoplasic hallux valgus and ventricular septal defect, corrected by transsternal approach when 32 months old. Restriction of neck mobility followed and foci of ectopic ossification appeared. Four crises of disease exacerbation were treated with oral prednisone and/or other antiinflammatory drugs. Sodium etidronate 5 to 10 mg/kg/day was prescribed intermittently during about six years but was discontinued due to osteopenia. The disease course has been relentless, with severe movement restriction including the chest wall. A review showed few similar case reports in the Brazilian literature. We revisit the criteria for diagnosis and the essentials of management and treatment.

Neuropsychological and phonological evaluation in the Apert's syndrome: study of two cases

This study evaluated two cases of Apert's syndrome, through phonological, cognitive, and neuropsychological instruments and correlated the results to complementary exams. In short, this study reveals the necessity of application of neuropsychological, cognitive and phonological evaluation and correlation of the results with complementary testings because significant differences can be present in the Apert's syndrome.

Whipple's disease with neurological manifestions: case report

Whipple's disease (WD) is an uncommon multisystem condition caused by the bacillus Tropheryma whipplei. Central nervous system involvement is a classical feature of the disease observed in 20 to 40% of the patients. We report the case of a 62 yeards old man with WD that developed neurological manifestations during its course, and discuss the most usual signs and symptoms focusing on recent diagnostic criteria and novel treatment regimens.

Pragmatics: an introduction

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Abnormally increased iron concentration in basal ganglia in Shy-Drager syndrome MR imaging and autonomic study: RM imagem e estudo autonômico

Report of an early case of Shy-Drager syndrome in a 67 year-old woman patient. Autonomic failure was diagnosed by functional evaluation as well as laboratory tests. MR imaging disclosed a prominent putamina hypodensity in T2-weighted images at high field strength due to iron increased depositing in this basal ganglia. MR imaging evidences confirm Shy-Drager syndrome diagnosis, and contributes for differential diagnosis of idiopathic hypotension (pure autonomic failure) in special in SDS early cases.

Electromyographic activity of masticatory muscles in women with osteoporosis

The purpose of this study was to analyze the electromyographic (EMG) activity and the maximal molar bite force in women diagnosed with osteoporosis in the maxillary and mandibular regions, considering the habits and conditions that lead to development of generalized skeletal bone loss, including on face bones, can disturb the functional harmony of the stomatognathic system. Twenty-seven women with mandibular and maxillary osteoporosis and 27 healthy controls volunteered to participate in the study. A 5-channel electromyographer was used. Muscle activity was evaluated by means of EMG recordings of the masticatory musculature (masseter and temporalis muscles, bilaterally) during the following clinical conditions: rest (5 s); right and left lateral excursions (5 s); protrusion (5 s); maximal dental clenching on Parafilm™ (4 s) and maximal voluntary contraction (4 s). This latter clinical condition was used as the normalization factor of the sample data. It was observed that individuals with osteoporosis presented greater EMG activity when maintaining mandible posture conditions and less activity during dental clenching and when obtaining maximal molar bite force. It may be concluded that facial osteoporosis can interfere on the patterns of masticatory muscle activation and maximal bite force of the stomatognathic system.

Atividade de plasmina e plasminogênio no leite longa vida com alta e baixa contagem de células somáticas durante o armazenamento

O objetivo deste estudo foi avaliar o efeito da contagem de células somáticas (CCS) do leite na atividade de plasmina e plasminogênio durante o período de armazenamento do leite longa vida integral. Os leites crus foram categorizados em grupos de CCS de baixa (342.000-487.000 células mL-1) e alta contagem (603.000-808.000 células mL-1). Dois lotes de leite longa vida em cada categoria de CCS foram analisados para determinação de plasmina e plasminogênio após 10, 30, 60, 90 e 120 dias de armazenamento em temperatura ambiente. Para a fabricação do leite longa vida, o leite cru foi submetido à pasteurização rápida seguida da esterilização industrial do leite por injeção de vapor pelo método direto e embalagem asséptica do produto. A CCS não apresentou efeitos sobre as características físico-químicas do leite cru, e nem sobre a atividade de plasmina e plasminogênio nos leites cru e longa vida, armazenados por 120 dias. Entretanto, independentemente da CCS, a atividade de plasmina e plasminogênio aumentou no leite longa vida ao longo do armazenamento, indicando a possibilidade de aumento da proteólise no produto durante sua vida de prateleira.

A new species of Sickesia (Laniatores: Stygnidae: Opiliones) and new records for the State of Piauí, Brazil

Sickesia tremembe sp. nov. is described from Piauí, Northeast Brazil (type-locality: Sete Cidades National Park, Brasileira and Piracuruca municipalities). It differs from S. usta and S. helmuti by the clavate male femur IV and chelicerae segment I with a pair of large tubercles on retrolateral surface. The Stygnidae Stygnus polyacanthus (Mello-Leitão, 1923); the Cosmetidae, Gryne pluriarcuata Mello-Leitão, 1936 and undetermined species of Paecilaema and Gryne and also representatives of Escadabiidae and Sclerosomatidae (Gagrellinae) are recorded from this state, for the first time.

Processo de maturação das gônadas de pintado (Pseudoplatystoma corruscans) alimentado com dois níveis proteicos e suplementados com óleo de milho

Investigou-se o efeito da adição de C18:2n6, por meio da inclusão de óleo de milho em dietas com dois níveis de proteína bruta, sobre o processo de maturação de gametas de pintado, Pseudoplatystoma corruscans, mantidos em tanques-rede. Foram avaliados: taxa de sobrevivência, relação peso x comprimento, fator de condição (K) e índice gonadossomático (IGS). O experimento foi realizado entre março de 2004 e fevereiro de 2006, em 12 tanques-rede, distribuídos em seis viveiros-escavados de 600m² e densidade de estocagem de 20 peixes/tanque-rede. Utilizaram-se três tratamentos (T) com duas repetições/viveiro: T1 com 28% de PB; T2 com 28% de PB + 5% óleo de milho e T3 com 40% de PB. O crescimento foi ligeiramente mais alto nos peixes do T3. As taxas de sobrevivência foram acima de 77%. Pode-se inferir que as rações ofertadas não causaram alterações histomorfológicas durante o processo de maturação gonadal dessa espécie. O IGS e o K foram ligeiramente mais altos nos animais alimentados com a ração enriquecida com óleo de milho.

Aleiphaquilon Martins (Coleoptera, Cerambycidae, Cerambycinae, Neocorini): novas ocorrências, nova espécie e chave

São apresentados novos registros para Aleiphaquilon plumanni e A. castaneum. Aleiphaquilon tasyba sp. nov. é descrita da Bolívia (Santa Cruz). Acrescenta-se chave para espécies com faixa clara, coplanar com o restante da superfície elitral.

Evaluation of left ventricular diastolic echocardiographic parameters in healthy dogs by pulsed-wave Doppler

Left ventricular diastolic dysfunction plays an important role on heart failure progression. In order to obtain additional reference values of left ventricular diastolic parameters and investigate influence of common variables, peak E wave (peak E), peak A wave (peak A), E/A ratio (E/A), E wave deceleration time (EDT) and isovolumic relaxation time (IRVT) were studied in 40 clinically healthy dogs, by pulsed wave Doppler. The following values were obtained: peak E = 0.747 ± 0.117 m/s, peak A = 0.487 ± 0.062 m/s, E/A = 1.533 ± 0.198, EDT = 88.7 ± 9.2 ms and IRVT = 0.080 ± 0.009 s. Some parameters were influenced by heart rate (peak E, peak A and IRVT), by age (peak A and E/A) and by body weight (TRIV). Gender influence was absent. Values obtained can be used as reference for canine specimens but its interpretation should consider on the influence of related variables.

Chemical characterization and oxidative stability of the oils from three morphotypes of Mauritia flexuosa L.f, from the Peruvian Amazon

Three morphotypes of aguaje Mauritia flexuosa were tested, classified by the color of their mesocarpium: ""color"", ""shambo"" and ""amarillo"", collected from different areas near the city of Iquitos, Peru. Also, physical-chemical analyses of the mesocarpium were performed, such as the characterization of fatty acids by gas chromatography, determination of beta- carotene y alpha tocopherol by high efficiency liquid chromatography system in normal and reverse phase and the determination of oxidation induction time in the Rancimat apparatus. Proximate, mineral and fatty acid analyses were done on the seeds. The aguaje mesocarpium is rich in oleic oil (""amarillo"": 75.63% +/- 0.31), (beta-carotene (""amarillo"": 342.42ug/g 0.71) and alpha- tocopherol (""color"": 685.81mg/L +/- 1.04), plus the morphotype ""color"" has a superior oxidation induction time compared to other morphotypes with 6.91 +/- 0.01. The aguaje seed contains significant amounts of (06 (linoleic oil) in ""shambo"" with 36.04 +/- 0.09%. The results indicate that these oils, regardless their classification, contain important chemical compounds that give them a special nutritive value.