Estudo cefalométrico das alturas faciais anterior e posterior, em crianças brasileiras, portadoras de má oclusão Classe I de Angle, na fase de dentadura mista

Realizou-se um estudo das alturas faciais anterior e posterior em 79 crianças brasileiras, sendo 46 do gênero feminino e 33 do masculino, com idades de 8 a 11 anos, portadoras de má oclusão Classe I de Angle, na fase de dentadura mista, não submetidas a tratamento ortodôntico. Esta investigação utilizou duas radiografias cefalométricas em norma lateral, de cada criança, com intervalo de 8 a 16 meses entre uma radiografia e outra, para comparação dos dados cefalométricos. Foram estudadas as proporções faciais anteriores, ou seja, a relação entre as dimensões N-Me (AFT), N-ENA (AFS), ENA-Me (AFI) e o relacionamento entre as dimensões Ar-GO (AFP) e a distância entre o plano palatino ao mento (AFA) , isto é, o Índice da Altura Facial (IAF). Os resultados obtidos, possibilitaram constatar que as tendências de crescimento foram equilibradas em todas as situações estudadas; a dimensão altura facial inferior, contribuiu de forma mais significativa, nas alterações observadas na altura facial total; as proporções faciais anteriores se mantiveram em torno de 42% para a altura facial superior e 58% para a altura facial inferior; o índice da altura facial ou se manteve constante em torno de 0,66 ou apresentou uma tendência a aumentar com a idade; não ocorreu dimorfismo sexual com relação às proporções faciais e índice da altura facial.

Efeitos da expansão rápida da maxila com aparelho expansor tipo Hyrax: avaliação cefalométrica póstero-anterior e em modelos de estudo

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aparelho expansor Haas com molas digitais para correção da mordida cruzada anterior e posterior

As mordidas cruzadas anteriores e posteriores podem ser tratadas desde as dentaduras decídua e mista. Embora a literatura descreva diversas técnicas para a correção individualizada desses problemas, o tratamento de pacientes com as duas alterações é pouco documentado. O presente artigo relata o tratamento desses problemas com o expansor tipo Haas associado a molas digitais. Essa alternativa apresenta boa previsibilidade, fácil confecção e instalação, e ótima eficiência.

Aplicação da análise de jarabak, no estudo da relação entre a altura total facial anterior e posterior, em pacientes portadores de má-oclusão de classe I e classe II divisão 1 de angle, por meio de radiografias cefalométricas

ln order to predict the facial growth using Jarahak's analysis, cephalometric radiographies of 120 subjects during the mixed dentition and between 6 and 10 years of age were studied. From the total, 60 subjects (30 males and 30 females) were classified as Angle's Class I and 60 subjects (30 males and 30 females) were classified as Angle's Class II, Division 1. AIl subjects did not receive any orthodontic treatment. The proportion between anterior and posterior facial heigth (SGo-NMe) was studied, which is determined by the formula PFH x 100/ AFH = %, neither being straight (> 62% < 65), clockwise ( > 58% < 62%) and anti-clockwise ( > 65% - 80%). Mean average, standard deviation and facial height proportion (SGo - NMe) were determined for males and females according to Angle's classification of malocc!usion. Sexual dimorphism was examined with regard to different types of Angle's malocclusion and the direction of the facial growth, and the correlation of four cephalometrics measurements were analvsed

Posterior versus anterior circulation strokes: comparison of clinical, radiological and outcome characteristics

Physicians treating patients with posterior circulation strokes (PCS) tended to debate more on whether or not to introduce anticoagulation rather than performing investigations to identify stroke aetiology, as in patients with anterior circulation strokes (ACS). Recent findings suggest that stroke aetiologies of PCS and ACS are more alike than dissimilar, suggesting that PCS deserve the same investigations as ACS. The characteristics and current diagnostic evaluation between patients with PCS and ACS were compared.

Outcomes of Intravenous Thrombolysis in Posterior Versus Anterior Circulation Stroke

Intravenous thrombolysis is an approved treatment for anterior (ACS) and posterior (PCS) circulation stroke. However, no randomized controlled trial has investigated safety and efficacy of intravenous thrombolysis according to stroke territory, although PCS is assumed to differ from ACS in many ways. We aimed to compare the safety and clinical outcome of intravenous thrombolysis applied to patients with PCS and ACS.

No difference in anterior tibial translation with and without posterior cruciate ligament in less invasive total knee replacement

The relative advantages of cruciate retaining or cruciate resecting total knee replacement are still controversial. If the posterior cruciate ligament (PCL) is preserved, it should be properly balanced. In a previous study, it was demonstrated that increasing the flexion gap leads to an anterior translation of the tibia relative to the femur. Based on these results, we hypothesized that cutting the PCL increases the flexion gap and lessens anterior tibial translation.

The feasibility, efficacy and functional outcome of local anaesthetic repair of anterior and posterior vaginal wall prolapse

INTRODUCTION: Urogenital prolapse is a very common condition in women with a prevalence of 30%. If conservative therapy fails or is not desired by the patient, prolapse repair is usually performed under general or regional anaesthetic. The aim of the study was to evaluate feasibility, efficacy and functional outcome after fascial prolapse repairs under local anaesthetic (LA). PATIENTS AND METHODS: Between November 1999 and December 2000, 130 consecutive patients presenting with anterior or posterior prolapse or both were invited to have their procedure performed under LA. All patients with a symptomatic minimum stage II prolapse were included. Prior to surgery all women completed a standardized questionnaire examining the specific and non-specific symptoms of prolapse and their situation was classified using the ICS Pelvic Organ Prolapse (POP-Q) system. Follow up was 30 months. Objective success was defined as a stage 1 or less and no symptoms of bulge, subjective success was defined as lack of specific or non-specific symptoms of prolapse. RESULTS: There were 128 patients who agreed to have their operations performed under LA: 68 in the anterior group, 52 in the posterior group and 8 with a combined anterior and posterior repair. Objective cure rate was 88% for posterior repair, 87% for anterior repair and 63% for combined repair. Success rates were no different in primary from recurrent cases. There were no intraoperative complications and operating time was 21 min (anterior repair) or 23 min (posterior repair). There was no de novo postoperative urinary or stool incontinence and all patients but two would have the operation performed again under the same circumstances. The two remaining refused due to embarrassment but for no other reason. CONCLUSION: Local anaesthetic prolapse repair is feasible and effective in middle term results. It is well accepted by the patients who benefit from less side effects and short hospital stay.

Shell brace for stage II posterior tibial tendon insufficiency

BACKGROUND: The nonoperative treatment of posterior tibial tendon insufficiency (PTTI) can lead to unsatisfactory functional results. Short-term results are available but the impact on the evolution of the deformity is not known. To address these problems, a new brace for the flexible Stage II deformity was developed, and midterm followup was obtained. MATERIALS AND METHOD: In a prospective case series, eighteen patients (mean age 64.2 years; range, 31 to 82; four male, 14 female) with flexible Stage II PTTI were fitted with the new custom-molded foot orthosis. At latest followup of a mean of 61.4 (range, 20 to 87) months, functional results were assessed with the AOFAS ankle hindfoot score and clinical or radiographic progression was recorded. RESULTS: The score improved significantly from a mean of 56 points (range, 20 to 64) to a mean of 82 points (range, 64 to 100, p < 0.001). Three patients (3/18, 16%) had a clinical progression to a fixed deformity (Stage III) and a radiographic increase of their deformity. All the other patients were satisfied with the brace's comfort and noted an improvement in their mobility. Complications were seen in three patients (3/18, 16%), and consisted of the development of calluses. CONCLUSION: The "shell brace" is a valuable option for nonoperative treatment of the flexible Stage II PTTI. Hindfoot flexibility was conserved throughout the observation period in all but three patients. Functional outcome and patient acceptance was above average. Problems were few, and closely associated with a progression to a fixed, Stage III deformity.

Validation of the DRAGON score in 12 stroke centers in anterior and posterior circulation

BACKGROUND AND PURPOSE The DRAGON score predicts functional outcome in the hyperacute phase of intravenous thrombolysis treatment of ischemic stroke patients. We aimed to validate the score in a large multicenter cohort in anterior and posterior circulation. METHODS Prospectively collected data of consecutive ischemic stroke patients who received intravenous thrombolysis in 12 stroke centers were merged (n=5471). We excluded patients lacking data necessary to calculate the score and patients with missing 3-month modified Rankin scale scores. The final cohort comprised 4519 eligible patients. We assessed the performance of the DRAGON score with area under the receiver operating characteristic curve in the whole cohort for both good (modified Rankin scale score, 0-2) and miserable (modified Rankin scale score, 5-6) outcomes. RESULTS Area under the receiver operating characteristic curve was 0.84 (0.82-0.85) for miserable outcome and 0.82 (0.80-0.83) for good outcome. Proportions of patients with good outcome were 96%, 93%, 78%, and 0% for 0 to 1, 2, 3, and 8 to 10 score points, respectively. Proportions of patients with miserable outcome were 0%, 2%, 4%, 89%, and 97% for 0 to 1, 2, 3, 8, and 9 to 10 points, respectively. When tested separately for anterior and posterior circulation, there was no difference in performance (P=0.55); areas under the receiver operating characteristic curve were 0.84 (0.83-0.86) and 0.82 (0.78-0.87), respectively. No sex-related difference in performance was observed (P=0.25). CONCLUSIONS The DRAGON score showed very good performance in the large merged cohort in both anterior and posterior circulation strokes. The DRAGON score provides rapid estimation of patient prognosis and supports clinical decision-making in the hyperacute phase of stroke care (eg, when invasive add-on strategies are considered).

Morphological descriptions from the recent bivalve of the genus Calyptogena (Vesicomyidae)

The genus Calyptogena (Bivalvia: Vesicomyidae) comprises highly specialized bivalves living in symbiosis with sulphur-oxidizing bacteria in reducing habitats. In this study, the genus is revised using shell and anatomical features. The work is based on type material, as well as on the extensive collection of vesicomyids obtained during twelve expeditions to the Pacific and Indian Oceans. Nine Recent species are ascribed to the genus Calyptogena, four of which are new: C. pacifica Dall, 1891, C. fausta Okutani, Fujikura & Hashimoto, 1993, C. rectimargo Scarlato, 1981, C. valdiviae (Thiele & Jaeckel, 1931), C. gallardoi Sellanes & Krylova, 2005, C. goffrediae n. sp., C. starobogatovi n. sp., C. makranensis n. sp. and C. costaricana n. sp. The characteristic features of Calyptogena are: shell up to 90 mm in length, elongate-elliptical or elongate; presence of escutcheon; presence of broad posterior ramus (3b) of right subumbonal cardinal tooth as well as right posterior nymphal ridge; absence of pallial sinus as a result of attachment of intersiphonal septal retractor immediately adjacent to ventral surface of posterior adductor; absence of processes on inner vulva of inhalant siphon; presence of inner demibranch only, with descending and ascending lamellae with interlamellar septa not divided into separate tubes. The most closely related taxa to Calyptogena are probably the genus Isorropodon Sturany, 1896, and the group of species represented by 'Calyptogena' phaseoliformis Métivier, Okutani & Ohta, 1986. These groups have several characters in common, namely absence of pallial sinus, presence of single inner pair of demibranchs and absence of processes on inner vulva of inhalant siphon. The worldwide distribution of the genus Calyptogena suggests that methane seeps at continental margins are the major dispersal routes and that speciation was promoted by geographical isolation. Recent species diversity and fossil records indicate that the genus originated in the Pacific Ocean. Sufficient data to discuss the distribution at species level exist only for C. pacifica, which has a remarkably narrow bathymetric range. Published studies on the physiology of C. pacifica suggest that adaptation to a specific geochemical environment has led to coexisting vesicomyid genera. The bacteria-containing gill of C. pacifica and other Calyptogena species is one of the most specialized in the family Vesicomyidae and may reflect these ecological adaptations.

Estudio de los efectos en el viñedo de la modificación del déficit hídrico continuo en los periodos anterior y posterior al envero (cv. Cabernet Sauvignon; Vitis vinifera L.)

En regiones semiáridas, con veranos cálidos, evapotranspiraciones elevadas, humedades relativas bajas, además de precipitaciones intermitentes y escasas (400 mm al año) que reducen la recarga del perfil en invierno, se puede ver afectada la productividad y sostenibilidad de los viñedos. Por eso en estas zonas puede ser necesario utilizar el riego suplementario para mantener la calidad y aumentar la productividad. En este marco de circunstancias es en el que se desarrolla la mayoría de la viticultura española, y en concreto en la zona centro donde se realizó el estudio. Con este trabajo se pretende estudiar la influencia del agua del riego, con distintas dosis y aplicada en diferentes fases de crecimiento y maduración de la baya, en la producción y calidad de la uva. Se estudió la influencia del déficit moderado continuo aplicado antes y después de envero, en el aprovechamiento de los recursos ambientales y en la respuesta del cv. Cabernet Sauvignon. El ensayo se desarrolló en 2010 y 2011 en la finca “La Alcoholera”, perteneciente a bodegas LICINIA S.L., ubicada en la localidad de Chinchón, Comunidad de Madrid, España. Durante 2010 y 2011 se realizaron estudios en cepas del cv. Cabernet Sauvignon (clon 15), injertadas sobre 41B y plantadas en 2005. Con poda corta en Cordón Royat unilateral de 80 cm de altura, y cuya vegetación alcanzó una altura de 97 cm. Las cepas del ensayo fueron conducidas verticalmente en espaldera (VSP), con 10 yemas por metro lineal. Las plantas dentro de la fila fueron separadas 1 m y la distancia de la calle fue de 3 m. La orientación de las filas norte – sur. Se plantearon cuatro tratamientos experimentales con diferentes dosis y momento de aplicación del riego. - T: Testigo. Déficit ligero, con un aporte continuado de agua desde floración (420 mm). - DMc: Déficit moderado continuo. Manejo del riego convencional, empezando en pre-envero (154 mm) - DM1: Déficit moderado a partir de pre-envero. Aporte de riego continuado desde floración reduciéndose la dosis de riego en pre-envero (312 mm). - DM2: Déficit moderado hasta pre-envero. Se empezó a regar a partir de preenvero (230 mm). Se observó que bajo condiciones de estrés hídrico leve, el crecimiento se reduce disminuyendo la migración de fotoasimilados hacia los órganos vegetativos. Generando menor área foliar en las plantas sometidas a déficit hídrico moderado entre floración y cuajado. Disminuyendo su consumo. En maduración la humedad del suelo dependió principalmente del riego aplicado y del consumo de la planta; dicho consumo dependió a la vez del desarrollo foliar del canopy y de la necesidad hídrica de la vid. El aumento del déficit hídrico disminuyó el contenido de agua en el suelo, lo que provocó diferencias en el estado hídrico y en el intercambio gaseoso de las hojas. En condiciones de déficit moderado, la fotosíntesis se encontró altamente correlacionada con el potencial hídrico foliar medido a mediodía solar. Además en condiciones de déficit moderado continuo la disponibilidad hídrica, la demanda atmosférica y el nivel de hidratación de las hojas, interaccionaron de forma compleja en la regulación estomática de las hojas, condicionando el intercambio gaseoso y la eficiencia en el uso del agua. Al aumentar el volumen de agua aplicado el peso de madera de poda por metro de fila fue superior. Las diferencias encontradas en el rendimiento fueron debidas a las diferencias en el peso de baya. El cual estuvo condicionado por la estrategia de riego, ya que, el déficit hídrico moderado antes de envero fue más crítico para el rendimiento que el déficit impuesto durante la madurez. Por otro lado, la biomasa dependió de la actividad fisiológica de la planta, la cual fue altamente dependiente de la disponibilidad hídrica. Déficit hídrico moderado aplicado de cuajado a envero, generó bayas más pequeñas y aumentó la relación hollejo:pulpa. El déficit moderado aplicado después de envero favoreció la acumulación de IPT y antocianos extraíbles, mejorando la calidad de la uva, pero disminuyó la acidez de la baya. El riego aplicado de envero a vendimia desaceleró la concentración de azúcares en bayas que fueron sometidas a déficit antes de pre-envero. ABSTRACT Mediterranean climate is characterized by hot summers, high evapotranspiration rates, and scarce precipitations (400 mm per year) during grapevine cycle. These extremely dry conditions affect vineyard productivity and sustainability. Supplementary irrigation is needed practice in order to maintain yield and quality. Almost all Spanish grape growing regions are characterized by these conditions, especially in the center region, where this trial was performed. The main objective of this work is to study the influence of water irrigation on yield and quality. For this aim, different levels of irrigation (mm of water applied) were applied during different stages of growth and berry maturity of Caberent Sauvignon grapevines. The work was conducted from 2010 to 2011 and located in Licinia (40º 12´ N, 3º 28´ W), Madrid, Spain. The cultivar utilized was Cabernet Sauvignon, clone 15 grafted onto rootstock 41B, planted in 2005. The vineyard was oriented north-south, with spacing on 3 meters between rows and 1 meter between plants. Vines were spurpruned to 10 buds per meter and trained in unilateral cordon with a height of 80 cm. Shoots were positioned vertically (VSP). Considering the amount of water and the moment of the application, four experimental treatments were applied: - T: Control sample. Slight deficit (420 mm) applied from bloom to maturity. - DMc: Continuous moderate deficit. Traditional irrigation: application of 154 mm of water from pre-veraison to maturity. - DM1: Deficit moderate from pre-veraison. Irrigation of 312 mm of water from bloom to pre-veraison. - DM2: Deficit moderate to pre-veraison. Irrigation of 230 mm of water from preveraison to maturity Under moderated water stress conditions it was seen than leaf growth decreases due to the reduction of migration of photo-assimilates to vegetative organs. Vines with moderate water deficit between flowering and ripening develop less leaf area and decrease its water consumption. During maturation of berries, soil moisture depends on irrigation and plant consumption. This consumption further depends on vegetation development and on the vine needs for water. By increasing water deficit, the water content in the soil decreases. This causes differences in leaf water status and in the gases exchange. Under moderate deficit conditions, photosynthesis was found highly correlated with midday leaf water potential. Further, atmospheric demand and the level of leaves hydration interact in complex ways in the stomatal regulation, which affects leaf gas exchange and the efficiency of water use. The amount of water applied is directly proportional to pruning weight. Changes in berry weight cause differences in yield ratios. The differences in berry weights are conditioned by the irrigation strategy, the moderate water deficit before veraison influences more than the deficit applied from veraison. Biomass generated for the plant depends on its physiological activity, which is highly related to the water availability. Moderate water deficit applied from fruit set to ripening generates smaller berries, increasing the pulp/skin ratio. Moderate deficit applied after veraison promotes the accumulation of extractables anthocyans and TPI. Despite this treatment improves color parameters of the grapes, it decreases its total acidity. Irrigation applied from veraison to harvest slows down sugar accumulation in berries compared to those under deficit before veraison conditions.