Avaliação experimental dos efeitos do anestésico local ropivacaína em nervos ciáticos

This study was undertaken to investigate the effects of ropivacaine after intrafascicular injection into the sciatic nerves of albino rabbits. Twenty adult albine rabbits were used, following sedation with intramuscular ketamine (50 mg/kg) for nerve exposure by lateral incision. We considered three experimental groups: Group I:sciatic nerve control; Group II: intrafascicular injection with 0.2 mL of physiologic saline solution in the left nerves and intrafascicular injection with 0.2 mL of local anesthetic ropivacaine into the rigth nerves. The specimens were colected at 48 h after drugs administration; Group III. intrafascicular injection with 0.2 mL of physiologic saline solution in the left nerves and intrafascicular injection with 0.2 mL of local anesthetic ropivacaine in the rigth nerves. The specimens were colected at 7 days after drugs administration. The sciatic nerves were removed from these animals and fixed in Karnowisky solution for 24 hours. After partial dehydration up to 95% ethanol, they were embedded in historesin (Leica). The tissue was then sectioned at 1-2μm. Sections were stained with haematoxylin-eosin (HE); toluidine blue (TB) or picrosirius-haematoxylin (PSH). Comparing with control group the histological evidence of inflammatory reaction (migration of macrophagic cells and eosinophils-appeared soon after injection, with intense proliferation of perineurial cells. The results show that after 7 days of intrafascicular injection there was a severe fibrosis and an increase on perineurial vascularization. In group 2 the inflammatory reaction was noted near the local of the injection. Furthermore in this experiment we observed an increase on the number of epineurial lipoblasts and adipocytes. This study demonstrated that the toxic effects of ropivacaine are transient. In many cases there was an initial fascicular recover and axonal regeneration after 7 days of the injection.

Psychiatric disorders and psychiatric consultation in a general hospital: A case- control study

Introduction: Psychiatric consultation (PC) has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH) inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence). Methods: A case-control patient study was conducted (47 cases and 94 controls) to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures), and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD- 10 criteria. The Self Report Questionnaire (SRQ), the CAGE and Brief Psychiatric Rating Scale (BPRS) were used as well as a specifically designed questionnaire to collect clinical and demographic data. Results: Behavioral alterations, either of elation or of depression, were the main for requesting a PC; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases), while anxiety, depressive and alcohol-related disorders were predominant in group II (controls). Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals). Discussion: The SRQ and CAGE were quite useful in the screening of possible patients and might be important for medical students to learn and use as generalists. Further research is needed to verify if and how the newly-established service will improve the diagnostic and treatment skills of our students.

Behavioral evaluation during dental care in children ages 0 to 3 years

Purpose: Many studies concluded that the behavior of babies complicated dental care because of child immaturity or the difficulty of establishing acceptable communication and comprehension. Methods: The records of 696 babies were randomly selected from the baby clinic of Araçatuba in Brazil. Patient age ranged from 0 to 36 months. They were divided into 6 groups according to age: Group I-0 to 6 months; Group II-7 to 12 months; Group III-13 to 18 months; Group IV-19 to 24 months; Group V-25 to 30 months; Group VI-31 to 36 months. The behavior of the child was evaluated upon entrance in the dental office and during the first 4 clinical appointments with a clinical exam and oral physiotherapy. The baby was classified as collaborator (C) or noncollaborator (NC). Statistical analysis was performed using Pearson's chi-square method (P< .05). Results: The percentage of NC for Groups II, III, IV, and V (66%), was significantly higher than for groups I (30%) and VI (50%). Conclusions: Babies from 0 to 6 months showed a collaborative behavior; babies from 7 to 30 months showed noncollaborative behavior; and babies from 31 to 36 months showed no statistically significant difference between the percentage of C and NC.

Histological study of hamster buccal mucosa following topical application of DMBA and exposition to low power 337 nm laser light

The aim of the present work is to analyze the histological changes on hamster buccal mucosa caused by the topical use of 7,12-dimethylbenzanthracene (DMBA) and exposition to a 220 μJ/pulse nitrogen laser light (@ 337 nm) at an average power of 2,3 mW. Twenty-one hamsters divided into two experimental groups were treated six times with DMBA. One hamster was kept as control. Group I was composed by ten hamsters and was submitted only to DMBA. Group II, also with ten hamsters, received the same treatment as group I and was exposed to the laser radiation. The time duration of each irradiation section was 10 seconds. All the treatment happened in alternated days. The histological analysis took place twice, after the end of the treatment and after sixty days. Both experimental groups presented dilatation of vessels, thickening of the epithelial tissue and the presence of inflammatory infiltrates. The preliminary results indicates that in group II the number of dilated vessels and its new area are much more significant than in group I.

Effectiveness of EDTA and EDTA-T brushing on the removal of root surface smear layer.

The purpose of this study was to compare the removal of root surface smear layer following active application of EDTA gel and EDTA-T (texapon) gel in different concentrations (5%, 10%, 15%, 20% and 24%), using scanning electron microscopy. A total of 220 dentin blocks obtained from the root surfaces of extracted teeth were divided into 3 groups: Group I - (control) application of saline solution (n = 20); Group II - EDTA gel (pH 7.0) was applied in the following concentrations: 5%, 10%, 15%, 20% and 24% (n = 100); Group III - EDTA-T gel (pH 7.0) applied in the same concentrations described above (n = 100). The photomicrographs were evaluated by one calibrated examiner using a smear layer removal index and following statistical analysis (Kruskal-Wallis test). The results demonstrated that the specimens treated with EDTA and EDTA-T gel presented a better smear layer removal than the control group (p < 0.01); no statistically significant differences were observed between the EDTA and EDTA-T groups and between the concentrations tested (Mann-Whitney, p > 0.05). Within the limits of this study, it can be concluded that all treatment modalities effectively removed the smear layer from the root surface. The addition of texapon into the EDTA gel formulation did not increase its effectiveness.

Evaluation of motivation methods used to obtain appropriate oral hygiene levels in schoolchildren.

The aim of the present study is to assess the behaviour of different motivation methods on levels of oral hygiene among schoolchildren aged from 7 to 9 years in Araraquara, SP, Brazil. The methods tested were: indirect instruction using 'The Smiling Robot' (group I), indirect instruction through class presentation (group II) and direct instruction with macromodels (group III). A control group was also constituted, which received no kind of motivation (group IV). The O'Leary Plaque Index was used as the evaluation method, applied before the instruction and 30 days after application of the different methods. It was noted that the plaque index had not decreased in group IV only. In conclusion, all the motivation methods promoted significant decrease of plaque index and among these methods, the 'The Smiling Robot' was the one that provided the best results.

Standardization of platelet parameters determination in blood samples collected with EDTA

The Abbott Cell-Dyn 3000 automated hematological analyzer prepares a histogram of platelet volume, which is measured by a technique using electrical impedance, inferring from its platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW). This equipment also calculates the plateletcrit (PCT). These platelet parameters may be important to evaluate platelet function, but they require standardization, because platelets swell when in contact with ethylenediaminetetra-acetic acid salts, hence an increase in blood sample storage time produces artificially increased results. To assess the effect of storage time on MPV, PLT, PDW and PCT, blood samples from 23 sickle cell anemia patients during steady state (Group I) and 50 from healthy controls (Group II) were placed in Vacutainer® tubes with dipotassium ethylenediaminetetra-acetic acid and measured over a period of 1440 minutes (24 h) at the following times: immediately after the venipuncture (time 0), 15, 30, 60, 120, 240, 360, 480 and 1440 minutes. The mean values of MPV and PCT were significantly increased (p<0.00001) along the storage time in both groups. The mean values of PLT and PDW were practically stable (p>0.05) throughout the storage time in both groups.

Systemic use of metronidazole in the treatment of chronic periodontitis: a pilot study using clinical, microbiological, and enzymatic evaluation

The aim of the present parallel, double-blind investigation was to evaluate the effect of using systemic metronidazole alone or associated to scaling and root planing on adult chronic periodontal disease, monitored at baseline, 30, 60 and 90 days. Twelve subjects were divided into three groups: the first group (Group I - 22 sites) was submitted to scaling and root planing (SRP) alone; the second group (Group II - 30 sites) received SRP and 250 mg of metronidazole (3 times a day for 10 days), and the third group (Group III - 31 sites) was treated with metronidazole alone. The clinical parameters evaluated were probing depth (PD), clinical attachment level (CAL), plaque index (PlI), gingival index (GI) and bleeding upon probing (BP). Microbiological (BANA test) and enzymatic (Pocket Watch) tests were also performed. All three proposed treatments produced significant improvements in clinical conditions of subjects, from baseline, 30, 60 and 90-day period, except for clinical attachment level. The results obtained by microbiological and enzymatic tests did not show statistical differences among the groups for the 90-day period (r = 0.7924 and r = 0.7757, respectively). In relation to clinical parameters, statistical differences among groups were observed only for the gingival index (p = 0.0261) between Groups I and II, and probing depth (p = 0.0124) between Group I and the others. We conclude that the use of systemic metronidazole did not produce additional effects on the microbiological conditions of these patients with chronic periodontal disease.

Electromyographic muscle EMG activity in mouth and nasal breathing children

Mouth breathing may cause changes in muscle activity, because an upper airway obstruction leads may cause a person to extend his/her head forward, demanding a higher inspiratory effort on the accessory muscles (sternocleidomastoids). This purpose of this study is to compare, using electromyography (EMG), the activity pattern the sternocleidomastoid and upper trapezius muscles in mouth breathing children and nasal breathing children. Forty-six children, ages 8-12 years, 33 male and 13 female were included. The selected children were divided into two groups: Group I consisted of 26 mouth breathing children, and Group II, 20 nasal breathing children. EMG recordings were made using surface electrodes bilaterally in the areas of the sternocleidomastoideus and upper trapezius muscles, while relaxed and during maximal voluntary contraction. The data were analyzed using the Kruskall-Wallis statistical test. The results indicated higher activity during relaxation and lower activity during maximal voluntary contraction in mouth breathers when compared to the nasal breathers. It is suggested that the activity pattern of the sternocleidomastoid and upper trapezius muscles differs between mouth breathing children and nasal breathing children. This may be attributed to changes in body posture which causes muscular imbalance. Because of the limitations of surface EMG, the results need to be confirmed by adding force measurements and repeating the experiments with matched subjects. Copyright © 2004 by CHROMA, Inc.

Desempenho de escolares com distúrbio específico de leitura em programa de remediação.

BACKGROUND: Specific reading disability is caused by disruptions in the language abilities. AIM: To characterize the neurological, cognitive and phonological performances of scholars with specific reading disabilities pre and post a remediation program. METHOD: Group I consisted of ten scholars with specific reading disability who did not undergo the remediation program. Group II consisted of ten scholars with specific reading disabilities who took part in the proposed program. Neurological, psychological and phonological evaluations were made, as well as a test of scholastic performance and of reading and writing before and after the program. RESULTS: The scholars who underwent the remediation program demonstrated improvements in their neurological and cognitive performances and also in the processing of phonological information. CONCLUSION: Favoring of the emergence of phonological and syntactic awareness after the remediation program.

Relation between speaking space of the /s/ sound and freeway space in dentate and edentate subjects.

The purpose of this study is to assess the relation between the speaking space of the /s/ sound and the freeway space in two subject groups. One group had natural dentition (Group I, n = 61) and the other comprised complete denture wearers (Group II, n = 33). The analysis was done by means of a jaw-tracking device (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, USA). Freeway space was determined by asking the subjects to occlude from the postural rest position. Speaking space of /s/ was measured during the pronunciation of the word seis and comprised the mean distance from the /s/ speaking position to maximal intercuspation. A weak correlation was found between the speaking space of /s/ and the freeway space in Group I (r = 0.41, p < 0.01), but in Group II, the correlation was stronger (r = 0.75, p < 0.01). The speaking space of /s/ and freeway space were different in Group I, but statistically similar in Group II (paired t-test, alpha = 0.05). It can be suggested that anatomic changes following prosthetic procedures caused a functional adaptation which resulted in more similar values for the speaking space of /s/ and the freeway space.

Rigid internal fixation with titanium versus bioresorbable miniplates in the repair of mandibular fractures in rabbits

The purpose of this study was to compare by qualitative histology the efficacy of rigid internal fixation with titanium system and the Lacto Sorb® system in mandibular fractures in rabbits. Thirty male adult rabbits Oryctolagus cuniculus were used. Unilateral mandibular osteotomies were performed between the canine and first premolar. The animals were divided into two groups: for Group I - rigid internal fixation was performed with titanium system 1.5 mm (Synthes, Oberdorf, Switzerland), with two screws of 6 mm (bicortical) on each side of the osteotomy. For Group II-rigid internal fixation was performed with PLLA/PGA system 1.5 mm (Lacto Sorb®, WLorenz, Jacksonville, FL, USA). The histological analysis evaluated the presence of inflammatory reaction, degree of bone healing and degree of resorption of the Lacto Sorb® screws. The results of both fixation systems were similar, only with a small difference after 15 and 30 days. In Group I a faster bony healing was noted. But after 60 days, bony healing was similar in both groups. It is concluded that both PLLA/PGA and titanium plates and screws provide sufficient strength to permit mandibular bone healing. The resorption process of PLLA/PGA osteosynthesis material did not cause acute or chronic inflammatory reaction or foreign body reaction during the studied period. © 2004 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Effect of microwave treatments on dimensional accuracy of maxillary acrylic resin denture base

Microwave energy has been used as an alternative method for disinfection and sterilization of dental prostheses. This study evaluated the influence of microwave treatment on dimensional accuracy along the posterior palatal border of maxillary acrylic resin denture bases processed by water-bath curing. Thirty maxillary acrylic bases (3-mm-thick) were made on cast models with Clássico acrylic resin using routine technique. After polymerization and cooling, the sets were deflasked and the bases were stored in water for 30 days. Thereafter, the specimens were assigned to 3 groups (n=10), as follows: group I (control) was not submitted to any disinfection cycle; group II was submitted to microwave disinfection for 3 min at 500 W; and in group III microwaving was done for 10 min at 604 W. The acrylic bases were fixed on their respective casts with instant adhesive (Super Bonder®) and the base/cast sets were sectioned transversally in the posterior palatal zone. The existence of gaps between the casts and acrylic bases was assessed using a profile projector at 5 points. No statistically significant differences were observed between the control group and group II. However, group III differed statistically from the others (p<0.05). Treatment in microwave oven at 604 W for 10 min produced the greatest discrepancies in the adaptation of maxillary acrylic resin denture bases to the stone casts.

Evaluation of microcurrent electrical nerve stimulation (mens) effectiveness on muscle pain in temporomandibular disorders patients

The effect of Microcurrent Electrical Nerve Stimulation (MENS) was evaluated and compared with occlusal splint therapy in temporomandibular disorders (TMD) patients with muscle pain. Twenty TMD patients were divided into four groups. One received occlusal splint therapy and MENS (I); other received splints and placebo MENS (II); the third, only MENS (III) and the last group, placebo MENS (IV). Sensitivity derived from muscle palpation was evaluated using a visual analogue scale. Results were submitted to analysis of variance (p<0.05). There was reduction of pain level in all groups: group I (occlusal splint and MENS) had a 47.7% reduction rate; group II (occlusal splint and placebo MENS), 66.7%; group III (MENS), 49.7% and group IV (placebo MENS), 16.5%. In spite of that, there was no statistical difference (analysis of variance / p<0.05) between MENS and occlusal splint therapy regarding muscle pain reduction in TMD patients after four weeks.

Effects of tissucol™ and epsilon aminocaproic acid in the healing process following dental extraction in dehydrated rats

A histological study was conducted of the alveolar bone healing process following tooth extraction of dehydrated rats after the implantation of fibrin adhesive (TISSUCOL™) associated to previous irrigation of the wound with a 5% epsilon aminocaproic acid solution (EACA). Seventy two rats were used, divided into three groups receiving different treatments after the surgical procedure. In group I, the gingival mucosa was sutured after extraction of the right upper incisor. In groups II and III, chronic dehydration was produced by water deprivation for 9 days (3 days in the preoperative period and 6 days in the postoperative period). In the animals of Group II, after tooth extraction, the gingival mucosa was sutured in the same way as performed in group I. In group III, after extraction, the dental socket was irrigated with 5% EACA, followed by implantation of the fibrin adhesive (TISSUCOL™). The mucosa was sutured in the same way as performed in the other groups. At 3, 7, 15 and 21 postoperative days, the animals were sacrificed in number of 6 for each group. Specimens containing the dental socket were removed and fixed in 10% formalin and decalcified in an equal part formic acid and sodium citrate solution. After routine processing, the specimens were embedded in paraffin for microtomy. We obtained 6 μm semi-serial slices that were stained with hematoxylin and eosin for histological evaluation. The results showed that the water deprivation in the pre- and postoperative periods caused a delay in the alveolar bone healing process. The use of the fibrin adhesive (TISSUCOL™) produced an improvement in the fibrinolytic picture caused by dehydration.