An alternative maneuver to treat gingival recession

This article reports a clinical case in which was applied autologous bone graft associated with subepithelial connective tis- sue graft, harvested by gingivectomy procedure with technical modifications to increase gingival graft extension, also to be used as guided tissue regeneration, to treat a single gingival recession. After 1 year and 2 months of follow-up, the cover- age of the recession was 4.0 mm, which corresponded to the gain of attached keratinized gingival tissue. An increase in the gingival tissue thickness was observed, without significant probing depth. The procedures applied to treat this case may be biologically and clinically useful to treat gingival recession.

Restauração transcirúrgica como alternativa na resolução das perfurações endodônticas

The endodontic perforations are iatrogenic communications that result in a communication between the endodonto and periodontium. This occurrence represents about 10 % of cas- es of failure in endodontic treatment. The management may vary and is related to the drilling site endodontic. This paper aims to report a case of iatrogenic perforation and one of the possible alternatives for the treatment of endodontic perforations -level cervical tooth. During the opening coronary perforation occurred due to improper slope cervical penetration drill. Considering the drilling site, we opted for sealing com- posite resin after surgical access and absolute isolation. After sealing, the channel was filled with medication and instru- mented based on calcium hydroxide. Later the canal was obturated by lateral condensation technique with Sealapex. The radiographic follow-up showed regression of the lesion and the clinical silence confirmed the success of the treatment.

Lichenoid reaction: case report

Lichenoid lesions are mucocutaneous disease of chronic inflammatory origin. Can produce side effects to drugs, dental materials, affecting 0.5 to 1% of the world population mainly in women in the fourth decade of life. The history and meticulous clinical servation may clarify the reactive nature, but the clinical diagnosis will only be conclusive when associated with tests such as histopathology. Therefore the objective of the study is to report a case of a woman of 55 years old, complaining of "white spots sore". Reported being allergic to metals, chocolate, acidic foods and certain types of clothes. From accurate intraoral clinical examination, white plaques were found in the dorsum of the tongue, hard palate and buccal mucosa, inaccurate and rough limits, and ulcerations throughout the labial edge and upper palate. Histopathology revealed a lichenoid reaction. Was instituted as pharmacological treatment, the use of systemic corticosteroids. Clinical follow-up of one year showed reduction of clinical symptoms, allowing to conclude that the clinical follow-up of this disease is necessary since its dubious malignant potential and diagnostic difficulty. Thus, early recognition of this disease allows instituting appropriate treatment with relief of anxiety of the patient and their family.

Influência de gênero e do ciclo estral no reflexo auditivo de sobressalto em ratos Wistar

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

Combination of noninvasive brain stimulation with pharmacotherapy

Noninvasive brain stimulation (NIBS) techniques are being increasingly investigated as a therapeutic approach for neuropsychiatric disorders. One method is to combine NIBS with pharmacotherapy to enhance the clinical effects or avoid an increase in drug dosages to decrease the incidence of side effects. However, few studies to date have investigated the relative and combined efficacy of NIBS with pharmacotherapy. Based on a literature review of previous studies and meta-analyses for major depression, we identified four randomized, controlled trials that tested the combination of NIBS with a new drug and two trials that directly compared NIBS versus pharmacotherapy. There was no study designed to address the relative efficacy of each intervention against placebo and against combined therapy. We discuss the methods and rationale of NIBS-pharmacotherapy trials, addressing some methodological aspects, including factorial design, recruitment, blinding, blinding assessment, placebo effect and quantitative aspects, such as power analysis, statistics and interaction effects. Our review of the methodology underlying NIBS-drug trials provides insights for the further clinical research development of NIBS in major depression.

Risk factors for magnetic resonance imaging-detected patellofemoral and tibiofemoral cartilage loss during a six-month period: The Joints On Glucosamine study

Objective To assess several baseline risk factors that may predict patellofemoral and tibiofemoral cartilage loss during a 6-month period. Methods For 177 subjects with chronic knee pain, 3T magnetic resonance imaging (MRI) of both knees was performed at baseline and followup. Knees were semiquantitatively assessed, evaluating cartilage morphology, subchondral bone marrow lesions, meniscal morphology/extrusion, synovitis, and effusion. Age, sex, and body mass index (BMI), bone marrow lesions, meniscal damage/extrusion, synovitis, effusion, and prevalent cartilage damage in the same subregion were evaluated as possible risk factors for cartilage loss. Logistic regression models were applied to predict cartilage loss. Models were adjusted for age, sex, treatment, and BMI. Results Seventy-nine subregions (1.6%) showed incident or worsening cartilage damage at followup. None of the demographic risk factors was predictive of future cartilage loss. Predictors of patellofemoral cartilage loss were effusion, with an adjusted odds ratio (OR) of 3.5 (95% confidence interval [95% CI] 1.39.4), and prevalent cartilage damage in the same subregion with an adjusted OR of 4.3 (95% CI 1.314.1). Risk factors for tibiofemoral cartilage loss were baseline meniscal extrusion (adjusted OR 3.6 [95% CI 1.310.1]), prevalent bone marrow lesions (adjusted OR 4.7 [95% CI 1.119.5]), and prevalent cartilage damage (adjusted OR 15.3 [95% CI 4.947.4]). Conclusion Cartilage loss over 6 months is rare, but may be detected semiquantitatively by 3T MRI and is most commonly observed in knees with Kellgren/Lawrence grade 3. Predictors of patellofemoral cartilage loss were effusion and prevalent cartilage damage in the same subregion. Predictors of tibiofemoral cartilage loss were prevalent cartilage damage, bone marrow lesions, and meniscal extrusion.

Cross-national differences in questionnaires do not necessarily reflect comparable differences in disorder prevalence

To examine whether the widely used Strengths and Difficulties Questionnaire (SDQ) can validly be used to compare the prevalence of child mental health problems cross nationally. We used data on 29,225 5- to 16-year olds in eight population-based studies from seven countries: Bangladesh, Brazil, Britain, India, Norway, Russia and Yemen. Parents completed the SDQ in all eight studies, teachers in seven studies and youth in five studies. We used these SDQ data to calculate three different sorts of "caseness indicators" based on (1) SDQ symptoms, (2) SDQ symptoms plus impact and (3) an overall respondent judgement of 'definite' or 'severe' difficulties. Respondents also completed structured diagnostic interviews including extensive open-ended questions (the Development and Well-Being Assessment, DAWBA). Diagnostic ratings were all carried out or supervised by the DAWBA's creator, working in conjunction with experienced local professionals. As judged by the DAWBA, the prevalence of any mental disorder ranged from 2.2% in India to 17.1% in Russia. The nine SDQ caseness indicators (three indicators times three informants) explained 8-56% of the cross-national variation in disorder prevalence. This was insufficient to make meaningful prevalence estimates since populations with a similar measured prevalence of disorder on the DAWBA showed large variations across the various SDQ caseness indicators. The relationship between SDQ caseness indicators and disorder rates varies substantially between populations: cross-national differences in SDQ indicators do not necessarily reflect comparable differences in disorder rates. More generally, considerable caution is required when interpreting cross-cultural comparisons of mental health, particularly when these rely on brief questionnaires.

Infantile Encephaloneuromyopathy and Defective Mitochondrial Translation Are Due to a Homozygous RMND1 Mutation

Defects of mitochondrial protein synthesis are clinically and genetically heterogeneous. We previously described a male infant who was born to consanguineous parents and who presented with severe congenital encephalopathy, peripheral neuropathy, myopathy, and lactic acidosis associated with deficiencies of multiple mitochondrial respiratory-chain enzymes and defective mitochondrial translation. In this work, we have characterized four additional affected family members, performed homozygosity mapping, and identified a homozygous splicing mutation in the splice donor site of exon 2 (c.504+1G>A) of RMND1 (required for meiotic nuclear division-1) in the affected individuals. Fibroblasts from affected individuals expressed two aberrant transcripts and had decreased wild-type mRNA and deficiencies of mitochondrial respiratory-chain enzymes. The RMND1 mutation caused haploinsufficiency that was rescued by overexpression of the wild-type transcript in mutant fibroblasts; this overexpression increased the levels and activities of mitochondrial respiratory-chain proteins. Knockdown of RMND1 via shRNA recapitulated the biochemical defect of the mutant fibroblasts, further supporting a loss-of-function pathomechanism in this disease. RMND1 belongs to the sif2 family, an evolutionary conserved group of proteins that share the DUF155 domain, have unknown function, and have never been associated with human disease. We documented that the protein localizes to mitochondria in mammalian and yeast cells. Further studies are necessary for understanding the function of this protein in mitochondrial protein translation.

Muscle lesion treatment in Brazilian soccer players: theory vs. practice

Background: In this study we evaluated the rehabilitation profile of Brazilian soccer players which underwent lower limb muscle lesions. Methods: This is a descriptive investigation. We evaluated 139 professional soccer players (1724 years old). We evaluated the following variables: muscle lesion diagnosis, symptoms, non steroidal anti-inflammatory used, physiotherapy treatment, which physiotherapy recourses was used if treated and train adaptation. Results: In great part of the athletes muscle lesion remained between 2 weeks and 1 month. Around 54% were diagnosed by a physician; the other part was diagnosed by a physical therapist. Non steroidal anti-inflammatory were prescribed by physicians in 42% of the cases; in 7% the physical therapist prescribed the medication while in 49% of the cases the masseur prescribed the drug. More than 1/4 of the athletes received physiotherapy treatement between 48 hours and 5 days. Isometric exercise therapy was applied in 15% of the cases. 63% were not accompanied by the physiotherapist on their return to the field. 48% received massages immediately after injury. Conclusion: We presented discrepancy between the recommended theory described by several researches and the practice. We indicate the necessity of recycling in a general context the rehabilitation of muscle injuries.

Different approaches, one target: understanding cellular mechanisms of Parkinson's and Alzheimer's diseases

Neurodegenerative disorders are undoubtedly an increasing problem in the health sciences, given the increase of life expectancy and occasional vicious life style. Despite the fact that the mechanisms of such diseases are far from being completely understood, a large number of studies; that derive from both the basic science and clinical approaches have contributed substantial data in that direction. In this review, it is discussed several frontiers of basic research on Parkinson's and Alzheimer's diseases, in which research groups from three departments of the Institute of Biomedical Sciences of the University of Sao Paulo have been involved in a multidisciplinary effort. The main focus of the review involves the animal models that have been developed to study cellular and molecular aspects of those neurodegenerative diseases, including oxidative stress, insulin signaling and proteomic analyses, among others. We anticipate that this review will help the group determine future directions of joint research in the field and, more importantly, set the level of cooperation we plan to develop in collaboration with colleagues of the Nucleus for Applied Neuroscience Research that are mostly involved with clinical research in the same field.

The biopsychosocial processes in autism spectrum disorder

Abstract Background Autism is a disorder characterized by pervasive social and communicative impairments, repetitive and stereotyped behaviors and restricted interests. Its causes and effects have been researched from various neurocognitive theoretical perspectives and with the aid of neuroimaging technology. We aimed to describe biopsychosocial processes characteristic of the Autism Spectrum Disorders. Method Literature review using Medline and Scopus databases published between 2001 and 2011, with the keywords "autism", "theory of mind", "executive functions", "central coherence" and “fMRI”. Results The studies found were plotted and organized into tables and an explanatory diagram of the main findings was produced. Conclusions The most popular neurocognitive theories are still unable to fully explain the characteristics of the complications that autistic spectrum disorder causes to the quality of life of individuals living with autism. The association of clinical research and neuroimaging may contribute to a better understanding of the functioning of the brain affected by the disorder.

Dahlberg formula: a novel approach for its evaluation

INTRODUCTION: The accurate evaluation of error of measurement (EM) is extremely important as in growth studies as in clinical research, since there are usually quantitatively small changes. In any study it is important to evaluate the EM to validate the results and, consequently, the conclusions. Because of its extreme simplicity, the Dahlberg formula is largely used worldwide, mainly in cephalometric studies. OBJECTIVES: (I) To elucidate the formula proposed by Dahlberg in 1940, evaluating it by comparison with linear regression analysis; (II) To propose a simple methodology to analyze the results, which provides statistical elements to assist researchers in obtaining a consistent evaluation of the EM. METHODS: We applied linear regression analysis, hypothesis tests on its parameters and a formula involving the standard deviation of error of measurement and the measured values. RESULTS AND CONCLUSION: we introduced an error coefficient, which is a proportion related to the scale of observed values. This provides new parameters to facilitate the evaluation of the impact of random errors in the research final results.

Synthesis and evaluation of 18-F-radiopharmaceuticals within the serotonergic receptor system for molecular imaging

Molecular imaging technologies as Positron Emission Tomography (PET) are playing a key role in drug discovery, development and delivery due to the possibility to quantify e.g. the binding potential in vivo, non-invasively and repetitively. In this context, it provides a significant advance in the understanding of many CNS disorders and conditions. The serotonergic receptor system is involved in a number of important physiological processes and diseases such as depression, schizophrenia, Alzheimer’s disease, sleep or sexual behaviour. Especially, the 5-HT2A and the 5-HT1A receptor subtypes are in the focus of fundamental and clinical research due to the fact that many psychotic drugs interact with these neuronal transmembrane receptors. This work describes the successful development, as well as in vitro and in vivo evaluation of 5-HT2A and 5-HT1A selective antagonistic PET-radiotracers. The major achievements obtained in this thesis are: 1. the development and in vitro evaluation of several 5-HT2A antagonistic compounds, namely MH.MZ (Ki = 9.0 nM), (R)-MH.MZ (Ki = 0.72 nM) and MA-1 (Ki = 3.0 nM). 2. the 18F-labeling procedure of these compounds and their optimization, whereby radiochemical yields > 35 % in high specific activities (> 15 GBq/µmol) could be observed. Synthesis time inclusive secondary synthon synthesis, the radioactive labeling procedure, separation and final formulation took no longer than 120 min and provided the tracer in high radiochemical purity. 3. the in vivo µPET evaluation of [18F]MH.MZ and (R)-[18F]MH.MZ resulting in promising imaging agents of the 5-HT2A receptor status; from which (R)-[18F]MH.MZ seems to be the most promising ligand. 4. the determination of the influence of P-gp on the brain biodistribution of [18F]MH.MZ showing a strong P-gp dependency but no regional alteration. 5. the four-step radiosynthesis and evaluation of [18F]MDL 100907 resulting in another high affine tracer, which is, however, limited due to its low radiochemical yield. 6. the development and evaluation of 3 novel possible 5-HT2A imaging agents combining structural elements of altanserin, MDL 100907 and SR 46349B demonstrating different binding modes of these compounds. 7. the development, the labeling and in vitro evaluation of the novel 5-HT1A antagonistic tracer [18F]AH1.MZ (Ki = 4.2 nM).