Efeito do treinamento aquático no perfil lipídico e na hipertrofia ventricular esquerda de camundongos hiperlipidêmicos

This study assessed the effects of Water training on the lipid profile and left ventricular structures in hyperlipidemic mice. Twenty-eight male LDLr-/- mice were randomly separated into 4 groups: sedentary, fed a standard diet (C); exercising, fed a standard diet (C+TRE); sedentary, fed a hyperlipidic diet (C+HL); and exercising, fed a hyperlipidic diet (E+HL). The exercising mice trained daily for 60 minutes during 60 days. After 48 hours of the end of the training period and 12 hours of rest fasting the animals were underwent euthanasia and the blood was collected for measuring the plasma levels of triglycerides, total cholesterol and its fractions (LDL, HDL, VLDL). The heart was removed and the left ventricle was weighed fresh to calculate the ratio left-ventricle weight (mg)/body weight (g). The results showed that the training was more effective in improving lipid plasma levels when combined with a balanced diet, thereby confirming that it is essential to associate physical exercise and diet. The training protocol resulted in eccentric left ventricular hypertrophy in the standard-diet group and decreased interstitial collagen deposition in the myocardium of the high-fat-diet animals, which may indicate an improved diastolic function with consequent improvement in the systolic function. It was concluded that regular moderate aerobic exercise induce beneficial and prophylactic adaptations to heart which promoted a better health condition and prevention to diseases.

Determinação do teor de glicose em bagaço de cana-de-açúcar hidrolizado pelo processo de conversão enzimática

The production of ethanol and sugar from sugarcane juice generate as byproduct, the bagasse. Currently, the bagasse, an industrial lignocellulosic biomass, can be used for production of second-generation ethanol, since when it is submitted to hydrolytic processes generates fermentable sugars. The objective of this study was to produce fungal enzymes capable of hydrolyzing this lignocellulosic biomass to generate glucose. For this, we used the mushroom species Lentinula edodes, Pleurotus ostreatus, Pleurotus eryngii, and Pycnoporus sanguineus as potential sources of laccase, manganese peroxidase and lignin peroxidase enzymes, capable of hydrolyzing the crushed sugarcane. The hydrolysis process was performed with the highest enzymatic activities observed from laccase in L. edodes (39.23 U-mL after 25 day incubation), P. ostreatus (2.5 U U-mL after 27 day incubation), P. sanguineus (80 U-mL after 27 days of incubation) and P. eryngii (16.45 U-mL 15 days incubation). MnP and LiP showed no significant results. The enzymatic hydrolysis of sugarcane bagasse in natura (32,17% hemicellulose, cellulose 52,45% and 10,62% lignin) and bagasse hydrolyzate with 7,0% H2SO4 (0,20% hemicellulose, 68,82% to 25,33% cellulose and lignin) were evaluated for each enzymatic obtained. Compared to others, the enzymes produced by P. sanguineus incubated in sugarcane bagasse showed better efficiency resulting in glucose with an average content of 0,14 g-L. Although the levels of glucose determined in this work were low in relation to the literature, it can be stated that the laccase, manganese peroxidase and lignin peroxidase enzymes demonstrated good hydrolytic potential, especially those produced by the fungus P. sanguineus.

Indicadores de qualidade assistencial e Nursing Activities Score análise correlacional em um Hospital Especializado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Spatial and temporal patterns in size and maturation of Loligo plei and Loligo sanpaulensis (Cephalopoda: Loliginidae) in southeastern Brazilian waters, between 23 degrees S and 27 degrees S

Patterns of population dynamics of Loligo plei and Loligo sanpaidensis in Southeastern Brazil were investigated with samples obtained from commercial catches and research cruises from 1999 to 2000 and from 2002 to 2003. Size and maturity Structure of the two species varied according to depth and season. Body size decreased with depth for L plei, whereas for L. sanpaidensis size increased with depth LIP to 100 m and decreased again in deeper areas. GSI and incidence of mature animals decreased with depth in both species. L. plei females matured at a larger size in summer, while size at maturity in L. sanpaulensis was greater in autumn. For L. plei, reproductive events Occurred in the late winter and spring, in depths up to 40 m, and during summer in inshore waters. L. sanpaidensis increased reproductive activity ill Summer, winter and spring between depths of 30 and 80 Ill. The presence of high proportions of immature Squid offshore Suggests that juveniles might develop in these areas and, upon maturation, migrate back to inshore waters to spawn, particularly in spring and Summer. However, differences found in aggregation patterns in different depth strata, as well as the seasonal differences found in the size structure of L. plei and L. sanpaidensis, Could ultimately be due to Changes in the water Column related to food availability. Considering that L. plei and L. sanpaidensis are both caught as by-catch by shrimp trawlers throughout file year, we also discuss hypotheses on the life cycle of the species and its implications for fishery management. We recommend measures to protect squid spawning grounds by creating spring and summer protected areas where trawling would be prohibited until 60 m depth, i.e. in the area and time of year when mature individuals concentrate.

Photodynamic therapy in actinic cheilitis: clinical and anatomopathological evaluation of 19 patients

BACKGROUND: Actinic cheilitis, a common disease caused by chronic solar exposure and tobacco use, is considered a premalignant lesion with potential to develop into squamous cell carcinoma. Some of the available treatments are invasive, have unaesthetic results and require multiple sessions. OBJECTIVE: To assess the efficacy of a therapy and its cosmetic results. METHODS: In this uncontrolled clinical trial a single photodynamic therapy (PDT) session using 16% methyl-aminolevulinate was performed on actinic cheilitis of the lower lip. A standardized questionnaire was applied in order to assess the clinical improvement from the patients' point of view and the satisfaction with the treatment. Anatomopathological evaluation was performed before the treatment and two months afterwards. RESULTS: The sample was composed of 19 patients (10 males and 9 females), phototypes I to III, with average age of 62 years. Main adverse effects were: sudden pain, scabs, herpes flare-up, and edema. The average score of pain during the procedure was 5,8+2,9. At the final assessment the patients reported improvement of 80% and satisfaction of 85% (p<0.01). Anatomopathological analysis showed a significant decrease of dysplasia (p=0.03) in spite of its presence in 84% of cases. There was no significant correlation between the level of dysplasia with either the subjective impression of clinical improvement (p=0.82) or with the patients' final satisfaction (p=0.96). CONCLUSION: PDT is effective in the treatment of actinic cheilitis, but it is associated with a significant level of pain. Due to the persistence of dysplasia, more research needs to be done in order to define the ideal number of sessions for the effective treatment of these lesions.

Timing of Alveolar Bone Grafting Determines Different Outcomes in Patients With Unilateral Cleft Palate

The objective of the current study was to assess the outcome of the alveolar bone grafting (ABG) in patients with cleft palate. Thirty-one patients with complete unilateral cleft lip and palate were prospectively divided into 2 groups according to the timing of surgery: (1) secondary ABG (SABG), undertaken during mixed dentition (n = 16); and (2) tertiary ABG (TABG), undertaken during permanent dentition (n = 15). Septum height was assessed using cone beam computed tomography in 3 views (buccal, intermediate, palatal) and classified according to the modified Bergland Index, which scores the results into 5 types according to the height of the neoformed bone septum (excellent: septum with a normal height; good: septum with minor deficiency; regular: marginal defect of >25% of the root length; bad: bone deficiency on the nasal aspect; and failure). In the SABG group, 6 to 12 months postoperatively, 75% of the patients were classified as having excellent/good conditions and 25% as having regular/bad conditions. No patients were observed as having failure conditions. In the TABG group, 53% of the patients were classified as having excellent/good, 21% were classified as having regular/bad conditions, and 26% were classified as having failure conditions. Significantly better outcomes were observed for the SABG group when compared with the TABG group. In conclusion, the age at which ABG is performed is a factor that impacts on the surgical outcome. Specifically, increasing age is associated with worse outcomes.

Oral Lesions in Renal Transplant

To prevent rejection of kidney transplants, patients must be kept in immunosuppressive therapy for a long time, which includes the use of drugs such as cyclosporine, azathioprine, cyclophosphamide, and prednisone. The action of these drugs reduces the general immune response of transplant patients and thus increases their susceptibility to infections. Moreover, these drugs increase the potential of developing lesions. Therefore, oral hygiene in kidney transplant recipients contributes to maintenance of the transplanted organ and its function. Thus, an investigation of oral lesions could be counted as a notable work. The aim of this study was to investigate oral lesions in a group of 21 kidney transplant patients under immunosuppressive therapy attended during a 1-year period in the Nephrology Department of the Federal University of Sergipe, Brazil. Data related to sex, age, etiology of renal disease, types of renal transplant, time elapsed after transplantation, immunosuppressive treatment, use of concomitant agents, and presence of oral lesions were obtained. All patients received a kidney transplant from a living donor, and the mean posttransplantation follow-up time was 31.6 months; 71.5% used triple immunosuppressive therapy with cyclosporine A, azathioprine, and prednisone. Ten patients were also treated with calcium-channel blockers. Of the 21 transplant patients, 17 (81%) presented oral lesions. Gingival overgrowth was the most common alteration, followed by candidiasis and superficial ulcers. One case of spindle cell carcinoma of the lower lip was observed. Oral cavity can harbor a variety of manifestations related to renal transplantation under immunosuppressive therapy.

Analysis of MLL2 gene in the first Brazilian family with Kabuki syndrome

Most patients with Kabuki syndrome (KS) are the only person in their family with the condition. However, familial cases of KS have been described showing evidence that this syndrome can be inherited as a dominant trait with variable expressivity. We report on two related individuals with facial findings characteristic of KS. The proposita had arched eyebrows, long and upward slanting palpebral fissures, cleft lip and palate, retromicrognathia, brachydactyly of hands and feet, stubby fingers, nail hypoplasia, and prominent finger pads. Her mother had eyebrows with dispersed lateral half, long and upward slanting palpebral fissures, retrognathia, abnormal and posteriorly rotated ears, prominent finger pads, brachydactyly of feet, learning difficulties, and psychomotor development delay. DNA sequencing revealed a novel missense mutation in the MLL2 gene in both the proposita and her mother. The mutation (p.R5432Q) was found in the exon 51, within the SET domain of the gene, which confers methyltransferase activity on the protein. Therefore, the epigenetic and transcriptional regulatory properties of this protein may be altered and this suggests that the mutation is the cause of phenotype observed in both the patient and her mother. The clinical signs and the molecular evidence in this family further support the notion that KS is an autosomal dominant condition with variable expressivity. To our knowledge this is the first report of a Brazilian family with recurrence of this syndrome. (C) 2012 Wiley Periodicals, Inc.

Retrolabyrinthine approach for surgical placement of auditory brainstem implants in children

Conclusion: The extended retrolabyrinthine approach (RLA) is a safe and reliable approach for auditory brainstem placement in children. The surgical landmarks to reach cochlear nucleus are adequately exposed by this approach. Objective: To describe a new approach option for auditory brainstem implants (ABIs) in children, highlighting the anatomical landmarks to appropriately expose the foramen of Luschka. Methods: Three prelingually deafened children consecutively operated for ABIs via the RLA. Results: ABI placement via the RLA was successfully performed in all children without any further complications except multidirectional nystagmus in one child. The RLA we employed differed from that used for vestibular schwannoma only in the removal of the posterior semicircular canal. The lateral and superior semicircular canals and the vestibule remained intact, and there was no need to expose the dura of the internal auditory meatus. The jugular bulb was completely exposed to allow adequate visualization of the ninth cranial nerve and cerebellar flocculus.

Comparison of the Anesthetic Efficacy between Bupivacaine and Lidocaine in Patients with Irreversible Pulpitis of Mandibular Molar

Introduction: The purpose of this study was to compare the anesthetic efficacy of 0.5% bupivacaine with 1:200,000 epinephrine with that of 2% lidocaine with 1:100,000 epinephrine during pulpectomy in patients with irreversible pulpitis in mandibular posterior teeth. Methods: Seventy volunteers, patients with irreversible pulpitis admitted to the Emergency Center of the School of Dentistry at the University of Sao Paulo, randomly received a conventional inferior alveolar nerve block containing 3.6 mL of either 0.5% bupivacaine with 1:200,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine. During the subsequent pulpectomy, we recorded the patients subjective assessments of lip anesthesia, the absence/presence of pulpal anesthesia through electric pulp stimulation, and the absence/presence of pain through a verbal analog scale. Results: All patients reported lip anesthesia after the application of either inferior alveolar nerve block. By measuring pulpal anesthesia success with the pulp tester, lidocaine had a higher success rate (42.9%) than bupivacaine (20%). For patients reporting none or mild pain during pulpectomy, the success rate of bupivacaine was 80% and lidocaine was 62.9%. There were only statistically significant differences to the success of pulpal anesthesia. Conclusions: Neither of the solutions resulted in an effective pain control during irreversible pulpitis treatments of mandibular molars. (J Endod 2012;38:594-597)

Region 8q24 Is a Susceptibility Locus for Nonsyndromic Oral Clefting in Brazil

BACKGROUND: Nonsyndromic cleft lip with or without cleft palate is a relatively common craniofacial defect with multifactorial inheritance. The association of the rs987525 single nucleotide variant, located in a gene desert at 8q24.21 region, has been consistently replicated in European populations. We performed a structured association approach combined with transcriptional analysis of the MYC gene to dissect the role of rs987525 in oral clefting susceptibility in the ethnically admixed Brazilian population. METHODS: We performed the association study conditioned on the individual ancestry proportions in a sample of 563 patients and 336 controls, and in an independent sample of 221 patients and 261 controls. The correlation between rs987525 genotypes and MYC transcriptional levels in orbicularis oris muscle mesenchymal stem cells was also investigated in 42 patients and 4 controls. RESULTS: We found a significant association in the larger sample (p = 0.0016; OR = 1.80 [95% confidence interval {CI}, 1.21-2.69], for heterozygous genotype, and 2.71 [95% CI, 1.47-4.96] for homozygous genotype). We did not find a significant correlation between rs987525 genotypes and MYC transcriptional levels (p = 0.14; r = -0.22, Spearman Correlation). CONCLUSIONS: We present a positive association of rs987525 in the Brazilian population for the first time, and it is likely that the European contribution to our population is driving this association. We also cannot discard a role of rs987515 in MYC regulation, because this locus behaves as an expression quantitative locus of MYC in another tissue. Birth Defects Research (Part A) 94:464-468, 2012. (C) 2012 Wiley Periodicals, Inc.

Taxonomic study on the molluscs collected in Marion-Dufresne expedition (MD55) to SE Brazil: Xenophoridae, Cypraeoidea, mitriforms and Terebridae (Caenogastropoda)

The deep-water molluscs collected during the expedition MD55 off SE Brazil have been gradually studied in some previous papers. The present one is focused on samples belonging to caenogastropod taxa Xenophoridae Troschel, 1852, Cypraeoidea Rafinesque, 1815, mitriforms and Terebridae Morch, 1852. Regarding the Xenophoridae, Onustus aquitanus n. sp. is a new species, collected off the littoral of Espirito Santo and Rio de Janeiro, Brazil, 430-637 m depth (continental slope). The main characters of the species include the small size (c. 20 mm), the proportionally wide shell, the white colour, the short peripheral flange, the oblique riblets weakly developed and a brown multispiral protoconch. This appears to be the smallest living species of the family, resembling in this aspect fossil species. In respect to the Cypraeoidea, the following results were obtained: family Cypraeidae Rafinesque, 1815: Erosaria acicularis (Gmelin, 1791) and Luria cinerea (Gmelin, 1791) had the deepest record, respectively 607-620 m and 295-940 m, although the samples were all dead, eroded shells. Family Lamellariidae d'Orbigny, 1841: a total of three lots were collected, provisionally identified as Lamellaria spp. as the samples consist of only vestigial shells; possibly each lot represents a different species. Family Pediculariidae Gray, 1853: a sample of Pedicularia tibia Simone, 2005 was found, expanding the range c. 1000 km southwards, from Ceara to Espirito Santo. Family Ovulidae Fleming, 1822: Pseudosimnia lacrima n. sp., collected off Espirito Santo, 607-620 m depth, is described here and is mainly characterised by its strong biconic outline, small size (c. 7 mm), and a thick peripheral callus. Family Triviidae Troschel, 1863: Cleotrivia antillarum (Schilder, 1922) is recorded for the first time as deep as 620 m, and its distribution expanded from Rio Grande do Norte to Espirito Santo; Dolichupis akangus n. sp. with rounded outline and c. 15 transverse ribs; D. pingius n. sp. with the outer lip expanded posteriorly and c. 10 ribs. In respect to the mitriform neogastropods, the following species are emphasised: family Costellariidae MacDonald, 1860: Vexillum sp., 607-620 m depth; Turricostellaria amphissa n. sp., 295 m depth; T. jukyry n. sp.; T. apyrahi n. sp., both 790-1575 m depth; T. ovir n. sp., 1200 m depth; Nodicostellaria crassa (Simone, 1995), 240-600 m depth, with extension northwards of the range up to Espirito Santo; Austromitra decresca n. sp., 60-105 m depth. Family Mitridae Swainson, 1829: Subcancilla joapyra n. sp., 295 m depth; S. cf. straminea (Adams, 1853), 607-620 m depth. Family Volutomitridae Gray, 1854: Microvoluta corona n. sp., 1500-1575 m depth. Family Mitromorphidae Casey, 1904: Mitromorpha sama n. sp., 607-940 m depth; M. mirim n. sp., 60105 m depth. Regarding the conoidean Terebridae, this paper is a complement of a previous study. It deals with a new species Terebra assu Simone n. sp., from the Abrolhos Bank, 295 m depth, characterised by its narrow outline, yellowish colour, weak sculpture on the last whorls, and a proportionally broad, paucispiral protoconch. A second finding of Terebra alagoensis Lima, Tenorio & Barros, 2007 expands the geographic range from Alagoas to north Espirito Santo. A discussion on the systematics of the "complex Terebra doellojuradoi" in South American coast is also provided, highlighting the improbability of synonymy between T. leptapsis Simone, 1999 and T doellojuradoi Carcelles, 1953. Differences in size, sculpture, spire angulation, aperture, and mainly in protoconch, indicate specific separations. The presently studied terebrids belong to the "complex Terebra doellojuradoi", which encompasses closely related, deep-water, small species, possessing a relatively high degree of endemicity.

Facial Profile Evaluation of Isolated Pierre Robin Sequence

Objective: To evaluate numerically the facial profile of children with isolated Pierre Robin sequence (PRS) and to compare them with a control group that has no pathologies and exhibits regular and balanced facial growth, with no skeletal alterations. Patients: Eighty-three children aged 5 to 10 years (PRS group, n = 60; control group, n = 23) were selected. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo (HRAC-USP). Children from the control group were taken from the program of Interceptive Orthodontics at HRAC-USP. Design: Angular and ratio analyses of the facial profiles in both groups were realized through digital photographs. The PRS group was subdivided into two groups-complete and incomplete-according to the sagittal extension of the cleft palate, to investigate the possible influence of cleft extension on the face. Results: The facial convexity angle and the facial inferior third angle were considerably higher in the PRS groups than in the control group and were not significantly different between PRS groups. Nasolabial angle did not differ between groups. Conclusion: The facial profile was more convex in individuals with PRS than in those with regular facial growth and with no pathology. The mandible was responsible for the convexity of the profile in PRS because of its lack off anterior projection. An important relationship between the extension of the cleft palate and alterations in facial profile in PRS was not observed.

The Role of Keratinized Mucosa in Peri-Implant Health

Objective: To evaluate the role of keratinized mucosa around dental implants, correlating with other clinical parameters related to the success of dental implants. Design: Cross-section. Setting: Institutional tertiary referral hospital. Patients: A total of 202 dental implants fixed in the cleft area of 109 patients with cleft lip and/or palate were evaluated. Interventions: The evaluated clinical parameters were probing depth and gingival and plaque indexes on the buccal surface (three sites). Main Outcome Measures: All clinical parameters were correlated with the width of keratinized mucosa around the implants. Results: The largest probing depths were detected when the width of keratinized mucosa was 2 mm or more, with a statistically significant difference between the means of the probing depth and keratinized mucosa width. Conclusion: Even though the present results suggest that peri-implant health can be observed in areas with keratinized mucosa width under 2 mm provided an adequate oral hygiene control is performed, longitudinal randomized studies are necessary to analyze the relationship between the width of keratinized mucosa and the health of peri-implant tissues.

RHYTHM-AF: design of an international registry on cardioversion of atrial fibrillation and characteristics of participating centers

Background: Atrial fibrillation is a serious public health problem posing a considerable burden to not only patients, but the healthcare environment due to high rates of morbidity, mortality, and medical resource utilization. There are limited data on the variation in treatment practice patterns across different countries, healthcare settings and the associated health outcomes. Methods/design: RHYTHM-AF was a prospective observational multinational study of management of recent onset atrial fibrillation patients considered for cardioversion designed to collect data on international treatment patterns and short term outcomes related to cardioversion. We present data collected in 10 countries between May 2010 and June 2011. Enrollment was ongoing in Italy and Brazil at the time of data analysis. Data were collected at the time of atrial fibrillation episode in all countries (Australia, Brazil, France, Germany, Italy, Netherlands, Poland, Spain, Sweden, United Kingdom), and cumulative follow-up data were collected at day 60 (+/- 10) in all but Spain. Information on center characteristics, enrollment data, patient demographics, detail of atrial fibrillation episode, medical history, diagnostic procedures, acute treatment of atrial fibrillation, discharge information and the follow-up data on major events and rehospitalizations up to day 60 were collected. Discussion: A total of 3940 patients were enrolled from 175 acute care centers. 70.5% of the centers were either academic (44%) or teaching (26%) hospitals with an overall median capacity of 510 beds. The sites were mostly specialized with anticoagulation clinics (65.9%), heart failure (75.1%) and hypertension clinics (60.1%) available. The RHYTHM-AF registry will provide insight into regional variability of antiarrhythmic and antithrombotic treatment of atrial fibrillation, the appropriateness of such treatments with respect to outcomes, and their cost-efficacy. Observations will help inform strategies to improve cardiovascular outcomes in patients with atrial fibrillation.