Predictors of Right Ventricle Dysfunction After Anterior Myocardial Infarction

Background: Regardless significant therapeutic advances, mortality and morbidity after myocardial infarction (MI) are still high. For a long time, the importance of right ventricle (RV) function has been neglected. Recently, RV dysfunction has also been associated with poor outcomes in the setting of heart failure. The shape, location, and contraction conditions make the RV chamber assessment technically challenging.Methods: Our study identified clinical characteristics and left ventricle (LV) echocardiographic data performed 3-5 days after MI that could be associated with RV dysfunction (RV fractional area change [FAC] < 35%) 6 months after MI.Results: The RV dysfunction group consisted of 11 patients (RV FAC 29.4% +/- 5.2) and the no RV dysfunction group of 71 patients (RV FAC 43.7% +/- 5.1); (P < 0.001). Both groups presented the same baseline clinical characteristics. Left atrium (LA), interventricular septum (IVS), and left ventricular posterior wall (LVPW) were larger in RV dysfunction than in no RV dysfunction. Conversely, E wave deceleration time (EDT) was lower in RV dysfunction when compared with no RV dysfunction. Left atrium(adj) (adjusted by gender, age, infarct size, and body mass index) (odds ratio [OR], 1.22; confidence interval [CI], 1.016-1.47; P = 0.032), interventricular septum(adj) (OR, 1.49; CI, 1.01-2.23; P = 0.044), and E wave deceleration time(adj) (OR, 0.98; CI, 0.97-0.98; P = 0.029) assessed soon after MI predicted RV failure after 6-months.Conclusions: LV diastolic dysfunction, resulting from anterior MI and assessed 3-5 days after the event, may play an important role in predicting RV dysfunction 6 months later.

Avaliação da contaminação da câmara anterior na cirurgia de facoemulsificação com implante de lente intra-ocular

Objetivo: Avaliar a existência de contaminação da câmara anterior durante a facectomia por facoemulsificação com implante de lente intra-ocular. Método: Foi realizado estudo prospectivo, avaliando-se 30 pacientes submetidos a facectomia por facoemulsificação com implante de lente intra-ocular, colhendo-se duas amostras de humor aquoso, uma obtida no início e outra no final da cirurgia. As amostras foram semeadas em meio de cultura para germes aeróbios, anaeróbios e fungos. Resultado: Todas as amostras avaliadas resultaram negativas. Conclusão: A contaminação da câmara anterior na cirurgia de facoemulsificação com implante de lente intra-ocular, usando os cuidados necessários, é infreqüente.

Prova de Trabalho de Parto Após uma Cesárea Anterior

Objetivo: estudar a validade da prova de trabalho de parto (PTP) em gestantes com uma cesárea anterior. Métodos: estudo retrospectivo, tipo coorte, incluindo 438 gestantes com uma cesárea anterior ao parto em estudo e seus 450 recém-nascidos (RN), divididas em dois grupos - com e sem PTP. O tamanho amostral mínimo foi de 121 gestantes/grupo. Considerou-se variável independente a PTP e as dependentes relacionaram-se à ocorrência de parto vaginal e à freqüência de complicações maternas e perinatais. Foram efetuadas análises uni e multivariada, respectivamente. A comparação entre as freqüências (%) foi analisada pelo teste do qui-quadrado (chi²) com significância de 5% e regressão logística com cálculo do odds ratio (OR) e do intervalo de confiança a 95% (IC95%). Resultados: a PTP associou-se a 59,2% de partos vaginais. Foi menos indicada nas gestantes com mais de 40 anos (2,7% vs 6,5%) e nas portadoras de doenças associadas e complicações da gravidez: síndromes hipertensivas (7,0%) e hemorragias de 3º trimestre (0,3%). A PTP não se relacionou às complicações maternas e perinatais. As gestantes que tiveram o parto por cesárea, independente da PTP, apresentaram maior risco de complicações puerperais (OR = 3,53; IC95% = 1,57-7,93). A taxa de mortalidade perinatal foi dependente do peso do RN e das malformações fetais e não se relacionou à PTP. Ao contrário, as complicações respiratórias foram mais freqüentes nos RN de mães não testadas quanto à PTP (OR = 1,92; IC95% = 1,20-3,07). Conclusões: os resultados comprovaram que a PTP em gestantes com uma cesárea anterior é estratégia segura - favoreceu o parto vaginal em 59,2% dos casos e não interferiu com a morbimortalidade materna e perinatal. Portanto, é recurso que deve ser estimulado.

Electromyographic analysis of the superior belly of the omohyoid muscle and anterior belly of the digastric muscle in tongue and head movements

The participation of the superior belly of the omohyoid muscle and anterior belly of the digastric muscle in tongue and head movements was studied eletromyographically in 20 normal young volunteers. A pair of monopolar electrodes was used in each muscle for simultaneous recording of their actions. The muscles act in the following tongue movements: protrusion, right and left lateral movements, placement of the tip of the tongue on soft and hard palates and on the floor of the mouth. The strongest levels of activity of the superior belly of the omohyoid muscle were observed in the placement of the tip of the tongue on the soft palate, coincidentally with a greater dislocation of hyoid bone. Both of the muscles studied did not participate in the head's kinesiology. (C) 1999 Elsevier B.V. Ltd. All rights reserved.

Anterior Tooth Rehabilitation With Frozen Homogenous Bone Graft and Immediately Loaded Titanium Implant Using Computer-Guided Surgery

Computed tomographic scanning is a precise, noinvasive surveying technique that enables the professionals to improve the precision of implant placement by building a prototype that allows the confection of surgical guides. The authors present a clinical case of anterior tooth rehabilitation with frozen homogenous bone graft and immediately loaded titanium implant using computer-guided surgery. A multislice computed tomography was realized, and a prototype was built. All the procedures were previously realized in the prototype before started in the patient. This technique allows a better surgical planning, makes the procedures more accurate, and reduces surgery time.

Effect of implant connection and restoration design (screwed vs. cemented) in reliability and failure modes of anterior crowns

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação do efeito da expansão rápida da maxila no padrão respiratório, por meio da rinomanometria anterior ativa: descrição da técnica e relato de caso

A finalidade deste artigo é avaliar o efeito da expansão rápida da maxila (ERM) no padrão respiratório. Por intermédio de um caso clínico, será relatado como indivíduos com atresia da maxila e problemas respiratórios podem se beneficiar com a expansão rápida da maxila. Outro aspecto que deve-se salientar é como profissionais da área da saúde, principalmente ortodontistas e otorrinolaringologistas, têm à sua disposição exames complementares para o diagnóstico do paciente com Respiração Bucal

Combined periodontal, orthodontic, and restorative treatment of pathologic migration of anterior teeth: A case report

Pathologic tooth migration related to periodontal disease is a common chief complaint of periodontal patients. This paper describes the treatment of a case of severe periodontal disease and disfiguring pathologic migration of maxillary central incisors, which required a multidisciplinary approach. After conventional pert. odontal treatment was performed, the anterior diastema was closed using a combination of orthodontic therapy and restorative treatment. A 6-month follow-up examination of this case revealed resolution of the anterior pathologic migration, with gains in clinical attachment levels and a successful esthetic and functional final result.

Avaliação radiográfica da altura mandibular anterior após vestibuloplastia por inversão de retalhos: estudo em humanos

A proposta do presente estudo foi de analisar, através de análise cefalométrica por telerradiografias de perfil, a altura óssea na região mandibular anterior após a realização de vestibuloplastia pela técnica de inversão de retalhos. Foram avaliados 13 pacientes (8 mulheres e 5 homens), com média igual a 54,3 anos que apresentavam, em média, 25,01 mm de altura mandibular anterior. As medidas foram obtidas utilizando-se traçado cefalométrico e comparando-se o período pré-operatório com os períodos pós-operatórios, que consistiram de 30, 90 e 180 dias. Durante o período analisado, houve uma redução da altura mandibular anterior, estatisticamente não significante, de 0,6 mm.

Analysis of mechanical behavior of implant-supported prostheses in the anterior maxilla: analysis by speckle pattern interferometry

The use of implants to rehabilitation of total edentulous, partial edentulous or single tooth is increasing, it is due to the high rate of success that this type of treatment present. The objective of this study was to analyze the mechanical behavior of different positions of two dental implants in a rehabilitation of 4 teeth in the region of maxilla anterior. The groups studied were divided according the positioning of the implants. The Group 1: Internal Hexagonal implant in position of lateral incisors and pontic in region of central incisors; Group 2: Internal Hexagonal implant in position of central incisors and cantilever of the lateral incisors and Group3 - : Internal Hexagonal implants alternate with suspended elements. The Electronic Speckle Pattern Interferometry (ESPI) technique was selected for the mechanical evaluation of the 3 groups performance. The results are shown in interferometric phase maps representing the displacement field of the prosthetic structure.

CORRELATING THE CURVE DISTANCE BETWEEN THE DISTAL of THE CANINES TO THE COMBINED WIDTH of THE SIX ANTERIOR TEETH WHEN SELECTING DENTURE TEETH FOR DIFFERENT ETHNIC GROUPS

Statement of problem. To select the width of denture teeth, the distance between the marks indicating the location of the canines is usually measured around the curvature of the wax occlusal rim; however, most manufacturers' mold charts provide the measurements of the artificial 6 anterior teeth as if they were on a straight line.Purpose. The purpose of this study was to investigate whether the curve distance between the distal surfaces of the maxillary canines can be related to the combined width (straight measurement) of the 6 anterior teeth in 4 ethnic groups.Material and methods. Maxillary stone casts were obtained for 160 dentate subjects of 4 ethnic groups (40 whites, 40 blacks, 40 multiracial - descendants of white and black parents, and 40 Asians). The width of each maxillary anterior tooth was measured on the casts with sliding calipers. The combined width of the 6 anterior teeth (CW) corresponded to the sum of the width of each anterior tooth. The curve distance between the distal surfaces of the canines (CD) was measured by using dental tape and sliding calipers. The Pearson correlation coefficient and regression analysis were used to evaluate the relationship between CD and CW in each ethnic group (alpha=.05).Results. The mean CD and CW values (in mm) obtained were: whites (CD=52.12; CW=45.65); blacks (CD=56.10; CW=48.13); multiracial (CD=53.58; CW=46.54); and Asians (CD=53.29; CW=46.60). Significant (P<.001) correlations between CD and CW measurements were observed for all ethnic groups studied (whites, r=0.957; blacks, r=0.803; multiracial, r=0.917; and Asians, r=0.881). The following linear regression equations were obtained: whites [CD=1.1(CW)+0.3]; blacks [CD=0.95(CW)+9.3]; multiracial [CD=1.2(CW)-1.1]; and Asians [CD=1.0(CW)+5].Conclusions. The curve distance between the distal surfaces of the maxillary canines can be accurately related to the combined width of the 6 anterior teeth in the selection of denture teeth for the studied ethnic groups. (J Prosthet Dent 2012;107:400-404)

The center of the incisive papilla for the selection of complete denture maxillary anterior teeth in 4 racial groups

Objectives: To evaluate the use of the center of the incisive papilla as a guide for the selection of the proper width of maxillary dentures in 4 racial groups. Method and Materials: One hundred sixty stone casts were obtained from impressions of the maxillary arch of white, black, mixed, and Asian subjects. The occlusal surfaces of the casts were photocopied and the images placed on a digitizer. The most anterior and posterior points of the papilla and cusp tips of the canines were digitized. Dentofacial Planner Plus software was used to calculate the distance from a line passing through the cusp tips of the canines to the center of the papilla, defined as the midpoint of the anterior and posterior points of the papilla. The selection error (in millimeters) due to the clinical application of the method of the incisive papilla was calculated and analyzed. Results: In all studied racial groups, there was no coincidence between the center of the incisive papilla and the canine line. The utilization of the center of the papilla would lead to the selection of wider artificial teeth. In 24.9% of the white, 19.3% of the mixed, 32.9% of the black, and 15.5% of the Asian populations, errors greater than 4 mm would be present with the utilization of the papilla. Conclusion: The method of the center of the incisive papilla is not accurate, but may aid in initial artificial teeth selection for the racial groups studied. (Quintessence Int 2008;39:841-845)

Assessment of the Ability to Relate Anterior Tooth Form and Arrangement to Gender

Purpose: This study evaluated the assumption that there are morphological differences between the natural anterior dentition of men and women. The goal of the study was to determine the gender of patients based on the appearance of the anterior teeth in photographs. Materials and Methods: Laymen and observers from different specialties were asked to determine the gender of individuals based on the shape and arrangement of anterior teeth. Forty anterior dentition photographs of dental students of both genders (20 women, 20 men) between 18 and 26 years old were selected, coded, and randomly arranged in an album. The albums were delivered to five groups of observers: general practitioners (recently graduated dentists), prosthodontists, orthodontists, restorative dentists (specialists in cosmetic and restorative dentistry), and laymen (control group). The observers evaluated the photographs twice at 1-week intervals. Results: The average correctly identified values in women and men were 57.6% and 58.8%, respectively. There was no statistical difference between observers and between each group of professionals and the laymen group (p > 0.05). An intraobserver agreement was not observed between the evaluations (kappa =-0.01). Conclusion: The results of this limited study indicated that it was not possible to differentiate gender by viewing photographs of anterior teeth.

The Effects of a 785-nm AlGaInP Laser on the Regeneration of Rat Anterior Tibialis Muscle After Surgically-Induced Injury

Objective: This study aims to investigate the effects of low-level laser therapy (LLLT) on muscle regeneration. For this purpose, the anterior tibialis muscle of 48 male Wistar rats received AlGaInP laser treatment (785 nm) after surgically-induced injury.Background Data: Few studies have been conducted on the effects of LLLT on muscle regeneration at different irradiation doses.Materials and Methods: The animals were randomized into four groups: uninjured rats (UN); uninjured and laser-irradiated rats (ULI); injured rats (IN); and injured and laser-irradiated rats (ILI). The direct contact laser treatment was started 24 h after surgery. An AlGaInP diode laser emitting 75 mW of continuous power at 785 nm was used for irradiation. The laser probe was placed at three treatment points to deliver 0.9 J per point, for a total dose of 2.7 J per treatment session. The animals were euthanized after treatment sessions 1, 2, and 4. Mounted sections were stained with hematoxylin and eosin and used for quantitative morphological analysis, in which the number of leukocytes and fibroblasts were counted over an area of 4480 mu m(2). The data were statistically analyzed by analysis of variance (ANOVA) and the Bonferroni t-test.Results: Quantitative data showed that the number of both polymorphonuclear and mononuclear leukocytes in the inflammatory infiltrate at the injury site was smaller in the ILI(1), ILI(2), and ILI(4) subgroups compared with their respective control subgroups (IN(1), IN(2), and IN(4)) for sessions 1, 2, and 4, respectively (p < 0.05). on the other hand, the number of fibroblasts increased after the fourth treatment session (p < 0.05). With regard to the regeneration of muscle fibers following injury, only after the fourth treatment session was it possible to find muscle precursor cells such as myoblasts and some myotubes in the ILI(4) subgroup.Conclusion: During the acute inflammatory phase, the AlGaInP laser treatment was found to have anti-inflammatory effects, reducing the number of leukocytes at the injury site and accelerating the regeneration of connective tissue.

Controle postural em pacientes com lesão do ligamento cruzado anterior

A lesão do ligamento cruzado anterior (LCA) do joelho acarreta alterações somatosensoriais em função da perda de informações provenientes dos mecanorreceptores presentes no LCA. Esses receptores constituem importante fonte de informação sensorial, afetando o desempenho de vários atos motores, dentre os quais o controle postural. O estudo objetivou analisar o controle postural de indivíduos com joelhos normais e com lesão unilateral do LCA. Participaram 15 voluntários com lesão do LCA (grupo lesado) e 15 voluntários com joelhos normais (grupo controle). O controle postural foi analisado por plataforma de força, sendo o voluntário instruído a assumir a situação experimental em apoio unipodal direito e esquerdo, posicionado no centro da plataforma de modo estático e com os olhos fechados. A plataforma de força forneceu informações de forças e momentos no eixo vertical e horizontal, a partir das quais foi obtida a área de deslocamento do centro de pressão nas direções ântero-posterior e médio-lateral. Os resultados mostram que indivíduos com lesão do LCA apresentaram maior amplitude média de oscilação comparados aos do grupo controle, sugerindo que o deficit no controle postural seja devido à perda de informações proprioceptivas nos indivíduos com LCA. Esses resultados têm implicações para a abordagem clínica de indivíduos com lesão do LCA.