Operational guide for implementation and follow-up of the Montevideo Consensus on Population and Development

This document is the contribution of the Presiding Officers of the Regional Conference on Population and Development in Latin America and the Caribbean to the second session of the Regional Conference, to be held in Mexico City, on 6-9 October 2015. It is a technical tool intended to provide the countries of the region with specific guidelines for implementing the priority measures set forth in the Montevideo Consensus on Population and Development, and offers relevant inputs for monitoring that implementation at the national and regional levels.

Phase I clinical trial of cell therapy in patients with advanced chronic obstructive pulmonary disease: follow-up of up to 3 years

BACKGROUND Chronic obstructive pulmonary disease is a major inflammatory disease of the airways and an enormous therapeutic challenge. Within the spectrum of chronic obstructive pulmonary disease, pulmonary emphysema is characterized by the destruction of the alveolar walls with an increase in the air spaces distal to the terminal bronchioles but without significant pulmonary fibrosis. Therapeutic options are limited and palliative since they are unable to promote morphological and functional regeneration of the alveolar tissue. In this context, new therapeutic approaches, such as cell therapy with adult stem cells, are being evaluated.OBJECTIVE This article aims to describe the follow-up of up to 3 years after the beginning of a phase I clinical trial and discuss the spirometry parameters achieved by patients with advanced pulmonary emphysema treated with bone marrow mononuclear cells.METHODS Four patients with advanced pulmonary emphysema were submitted to autologous infusion of bone marrow mononuclear cells. Follow-ups were performed by spirometry up to 3 years after the procedure.RESULTS The results showed that autologous cell therapy in patients having chronic obstructive pulmonary disease is a safe procedure and free of adverse effects. There was an improvement in laboratory parameters (spirometry) and a slowing down in the process of pathological degeneration. Also, patients reported improvements in the clinical condition and quality of life.CONCLUSIONS Despite being in the initial stage and in spite of the small sample, the results of the clinical protocol of cell therapy in advanced pulmonary emphysema as proposed in this study, open new therapeutic perspectives in chronic obstructive pulmonary disease. It is worth emphasizing that this study corresponds to the first study in the literature that reports a change in the natural history of pulmonary emphysema after the use of cell therapy with a pool of bone marrow mononuclear cells.

Tomographic follow-up of bone regeneration after bone block harvesting from the mandibular ramus

Autogenous bone is still considered the gold standard, and the applicability of autogenous bone grafts is well established. However, the possibility of second harvesting from the same donor region remains unclear. The aim of this study was to perform a prospective evaluation of hard tissue deposition in the mandibular ramus after bone block harvesting using cone beam computed tomography (CBCT). Twenty-two patients with indications for augmentation procedures using autogenous bone from the mandibular ramus were selected. Three CBCT scans were performed with a tomographic guide before bone harvesting (T1) and at 14 days (T2) and 6 months (T3) after the surgical procedures. Measurements were obtained in 2D (area, mm(2)) and 3D (volume, mm(3)), and were subsequently compared. In the 2D analysis, the mean bone formation rate was 56%, while for the 3D analysis the mean rate was 9.7%. Despite this difference, there was a significant correlation between area and volume measurements. Our findings demonstrated the presence of hard tissue in the mandibular ramus at 6 months after bone harvesting, which suggests that it would be possible to reuse the same region for a second block harvesting. However, the second bone harvesting would involve less bone for transplantation when compared to the first bone harvesting.

Inactivation of Matrix-bound Matrix Metalloproteinases by Cross-linking Agents in Acid-etched Dentin

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Eight-Year Follow-Up of a Fixed-Detachable Maxillary Prosthesis Utilizing an Attachment System: Clinical Protocol for Individuals With Skeletal Class III Malocclusions

The aim of this article is to describe a successful clinical protocol for prosthodontic rehabilitation of a patient with a skeletal Class III malocclusion using a fixed-detachable maxillary prosthesis supported by 6 implants and the MK1 attachment system. The patient was followed up for 8 years. A 46-year-old edentulous woman with a skeletal Class III malocclusion expressed dissatisfaction with her old existing maxillary denture from an esthetic point of view and frustration regarding its function. A fixed-detachable maxillary prosthesis using the MK1 attachment system was made. The patient was followed up clinically and radiographically for 8 years. No bone loss, fracture of prosthetic components, or fracture of the prosthesis was detected in that period. A fixed detachable maxillary prosthesis using the MK1 attachment system is a treatment option for patients with Class III malocclusions who opt not to undergo orthognathic surgery.

Universality of Three-Body Systems in 2D: Parametrization of the Bound States Energies

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

18-Year Follow-up of Dens Invaginatus: Retrograde Endodontic Treatment

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

Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: a case report and literature review

Odontogenic cysts are considered as nonneoplasic benign lesions. Among the cysts, keratocyst odontogenic tumor (KCOT) is an intra‑osseous tumor characterized by parakeratinized stratified squamous epithelium and a potential for aggressive, infiltrative behavior, and for the possibility to develop carcinomas in the lesion wall. Thus, the aim of this study was to describe a clinical case of KCOT in a young patient and discuss the treatment alternatives to solve this case. A 15‑year‑old male was referred for treatment of a giant lesion in his left side of the mandible. After the biopsy, a diagnostic of KCOT was made, and the following procedures were planned for KCOT treatment. Marsupialization was performed for lesion decompression and consequent lesion size reduction. Afterward, enucleation for complete KCOT removal was performed followed by third mandibular molar extraction. After 5 years, no signs of recurrence were observed. The treatment proposed was efficient in removing the KCOT with minimal surgical morbidity and optimal healing process, and the first and second mandibular molars were preserved with pulp vitality. In conclusion, this treatment protocol was an effective and conservative approach for the management of the KCOT, enabling the reduction of the initial lesion, the preservation of anatomical structures and teeth, allowing quicker return to function. No signs of recurrence after 5 years were observed.

Digital Inline Holographic Microscopy (DIHM) of weakly-scattering subjects

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Peripheral cemento-ossifying fibroma in child. A follow-up of 4 years. Report of a case

Peripheral cement-ossifying fibroma is a relatively common gingival growth of a reactive rather than neoplastic nature, whose pathogenesis is uncertain. It predominantly affects adolescents and young adults, with peak prevalence between 10 and 19 years. We report here the clinical case of a 5-year-old girl with disease duration of 3 years, who was followed up for 4 years, showing a gingival health and normal radiopacity of bone.

Evaluation of the double agar gel immunodiffusion test and of the enzyme-linked immunosorbent assay in the diagnosis and follow-up of patients with chronic pulmonary aspergillosis

Coordenação de Aperfeiçoamento do Pessoal de Nível Superior (CAPES)

Evaluation of effective nucleon-nucleon potential and description of α-cluster type nuclei in restricted dynamics approach

The application of the Restricted Dynamics Approach in nuclear theory, based on the approximate solution of many-particle Schrödinger equation, which accounts for all conservation laws in many-nucleon system, is discussed. The Strictly Restricted Dynamics Model is used for the evaluation of binding energies, level schemes, E2 and Ml transition probabilities as well as the electric quadrupole and magnetic dipole momenta of light a-cluster type nuclei in the region 4 ≤ A ≤ 40. The parameters of effective nucleonnucleon interaction potential are evaluated from the ground state binding energies of doubly magic nuclei 4He, 16O and 40Ca.

Long-Term Follow-Up of Patients after Acute Kidney Injury: Patterns of Renal Functional Recovery

Background and Objectives: Patients who survive acute kidney injury (AKI), especially those with partial renal recovery, present a higher long-term mortality risk. However, there is no consensus on the best time to assess renal function after an episode of acute kidney injury or agreement on the definition of renal recovery. In addition, only limited data regarding predictors of recovery are available. Design, Setting, Participants, & Measurements: From 1984 to 2009, 84 adult survivors of acute kidney injury were followed by the same nephrologist (RCRMA) for a median time of 4.1 years. Patients were seen at least once each year after discharge until end stage renal disease (ESRD) or death. In each consultation serum creatinine was measured and glomerular filtration rate estimated. Renal recovery was defined as a glomerular filtration rate value >= 60 mL/min/1.73 m2. A multiple logistic regression was performed to evaluate factors independently associated with renal recovery. Results: The median length of follow-up was 50 months (30-90 months). All patients had stabilized their glomerular filtration rates by 18 months and 83% of them stabilized earlier: up to 12 months. Renal recovery occurred in 16 patients (19%) at discharge and in 54 (64%) by 18 months. Six patients died and four patients progressed to ESRD during the follow up period. Age (OR 1.09, p < 0.0001) and serum creatinine at hospital discharge (OR 2.48, p = 0.007) were independent factors associated with non renal recovery. The acute kidney injury severity, evaluated by peak serum creatinine and need for dialysis, was not associated with non renal recovery. Conclusions: Renal recovery must be evaluated no earlier than one year after an acute kidney injury episode. Nephrology referral should be considered mainly for older patients and those with elevated serum creatinine at hospital discharge.

The presence of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor on patients with rheumatoid arthritis (RA) does not interfere with the chance of clinical remission in a follow-up of 3 years

Autoantibodies in early rheumatoid arthritis (RA) have important diagnostic value. The association between the presence of autoantibodies against cyclic citrullinated peptide and the response to treatment is controversial. To prospectively evaluate a cohort of patients with early rheumatoid arthritis (< 12 months of symptoms) in order to determine the association between serological markers (rheumatoid factor (RF), anti-citrullinated protein antibodies) such as anti-cyclic citrullinated peptide antibodies (anti-CCP) and citrullinated anti-vimentin (anti-Sa) with the occurrence of clinical remission, forty patients diagnosed with early RA at the time of diagnosis were evaluated and followed for 3 years, in use of standardized therapeutic treatment. Demographic and clinical data were recorded, disease activity score 28 (DAS 28), as well as serology tests (ELISA) for RF (IgM, IgG, and IgA), anti-CCP (CCP2, CCP3, and CCP3.1) and anti-Sa in the initial evaluation and at 3, 6, 12, 18, 24, and 36 months of follow-up. The outcome evaluated was the percentage of patients with clinical remission, which was defined by DAS 28 lower than 2.6. Comparisons were made through the Student t test, mixed-effects regression analysis, and analysis of variance (significance level of 5%). The mean age was 45 years, and a female predominance was observed (90%). At the time of diagnosis, RF was observed in 50% of cases (RF IgA-42%, RF IgG-30%, and RF IgM-50%), anti-CCP in 50% (no difference between CCP2, CCP3, and CCP3.1) and anti-Sa in 10%. After 3 years, no change in the RF prevalence and anti-CCP was observed, but the anti-Sa increased to 17.5% (P = 0.001). The percentage of patients in remission, low, moderate, and intense disease activity, according to the DAS 28, was of 0, 0, 7.5, and 92.5% (initial evaluation) and 22.5, 7.5, 32.5, and 37.5% (after 3 years). There were no associations of the presence of autoantibodies in baseline evaluation and in serial analysis with the percentage of clinical remission during follow-up of 3 years The presence of autoantibodies in early RA has no predictive value for clinical remission in early RA.

Longitudinal follow-up of cavum septum pellucidum and adhesio interthalamica alterations in first-episode psychosis: a population-based MRI study

Background. Neurodevelopmental alterations have been described inconsistently in psychosis probably because of lack of standardization among studies. The aim of this study was to conduct the first longitudinal and population-based magnetic resonance imaging (MRI) evaluation of the presence and size of the cavum septum pellucidum (CSP) and adhesio interthalamica (AI) in a large sample of patients with first-episode psychosis (FEP). Method. FEP patients (n=122) were subdivided into schizophrenia (n=62), mood disorders (n=46) and other psychosis (n=14) groups and compared to 94 healthy next-door neighbour controls. After 13 months, 80 FEP patients and 52 controls underwent a second MRI examination. Results. We found significant reductions in the AI length in schizophrenia FEP in comparison with the mood disorders and control subgroups (longer length) at the baseline assessment, and no differences in any measure of the CSP. By contrast, there was a diagnosis x time interaction for the CSP length, with a more prominent increase for this measure in the psychosis group. There was an involution of the AI length over time for all groups but no diagnosis x time interaction. Conclusions. Our findings suggest that the CSP per se may not be linked to the neurobiology of emerging psychotic disorders, although it might be related to the progression of the disease. However, the fact that the AI length was shown to be shorter at the onset of the disorder supports the neurodevelopmental model of schizophrenia and indicates that an alteration in this grey matter junction may be a risk factor for developing psychosis.