Análise da pevalência da osteoporose e dos principais fatores associados á perda óssea em portadores de cirrose

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Influence of irrigation and intracanal dressing on the healing process of dogs' teeth with apical periodontitis.

Dogs' teeth with apical periodontitis were treated endodontically, Dakin's solution being used in an experimental group as the irrigation solution, and camphorated paramonochlorophenol as an intracanal dressing. For a second group of teeth, the irrigation solution used was physiologic saline, dry cotton only being placed into the pulpal chamber to take the place of an intracanal dressing. In a second visit, overinstrumentation and a new application of the same kind of dressing were performed, the root canals being then filled with gutta-percha cones and zinc oxide-eugenol cement. Other specimens were treated, in one visit, where physiologic saline or Dakin's solution were the irrigation solutions. The animals were sacrificed 6 months after the obturation of the root canals. Histologic exams showed better results for the experimental group where Dakin's solution and camphorated paramonochlorophenol had been used, with signs of repair characterized by newly formed cementum and bone tissue, as well as a marked reduction in size of the periapical lesions. No differences were seen in the results with physiologic saline or Dakin's solution as irrigants.

O aleitamento materno e sua relação com a prevenção das oclusopatias

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

A dental caries preventive program applied to children aged 5 to 8 years attending since the first year of age at the Baby Clinic of the Araçatuba Dental School, Brazil

Objective: Tooth decay is one of the more common diseases of childhood. Several studies recommend that early preventive measures must be implemented since the first years of life and continue throughout childhood and adolescence. The aim of the this study was to present results of a preventive dental program considering oral health maintenance, dental caries experience and the prevalence of dental caries relation with follow-up compliance visits. Material end method: Intraoral and interproximal radiographic exams were performed on 171 patients participants of a preventive dental program. Data regarding age, gender, previous caries experience and the frequency at which the patients attended return visits were obtained from the records. The data were analyzed statistically by the McNemar test, with the level of significance set at 1%. Result: Clinical and radiographic examination revealed that most children participating in the program had sound teeth (77.2 and 84.8%, respectively). The past dental history of the dental caries from patients included in this study showed statistical relevance when associated with the present dental caries experience and a statistical relationship was found from the absence of compliance to clinical visits and the dental caries presence. Conclusion: The preventive strategy had a positive influence on oral health maintenance in the children examined. Previous caries experience and the lack of compliance with return visits influenced the clinical oral condition of the children during participation in the preventive program.

A influência da prática do aleitamento materno na aquisição de hábitos de sucção não nutritivos e prevenção de oclusopatias

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

Programa de diagnóstico e prevenção de câncer da boca: uma estratégia simples e eficaz

The program of diagnosis and prevention of oral cancer of Univag - University Center aims to increase preventive and early oral diseases with emphasis on oral cancer, aiming to reduce the morbidity and mortality through educative actions, spreading of the auto-examination, performed by dental students of UNIVAG since the second half of 2005 to the present day. The dental students of 1st, 2nd, 3rd and 4th semesters were trained using practice-theoretical classes, for realization the exams preventives and diagnostics, such as self-examination, exfoliative cytology and biopsy of oral mucosa, and even present educative actions. Analyzing the preliminary results were observed increase in the number of diagnoses and referral of diagnosed with oral cancer for treatment in referral services. It was concluded that the program of diagnosis and prevention of oral cancer can make possible early diagnosis and adoption of preventive measures, consequently improving survival rates and life quality in population.

Carcinoma de lábio com prognóstico sombrio devido conduta médica inadequada

The Squamous Cell Carcinoma is what more happens among the oral cancers, being considered sweats incidence in more than 90%. As important prognostic factor competes the early diagnosis and the immediate institution of the treatment, that it can involve radiotherapy and chemotherapy besides the surgery. The initial lesions don’t offer great diagnostic difficulties and now complemental laboratory exams define the diagnosis quickly, In the present report, the initial medical conduct was inadequate, with incomplete interpretation of the laboratorial result and adoption of inadequate therapeutic conduct, what resulted in constant evolution of the lesion. The patient came to the consultation with that medical history, after six months of the first attendance accomplished in another center. To the physical exam, infiltrative ulcerated lesion was observed in the lower lip, with having accentuated tissue loss superficially. The patient accused spontaneous pain and she did use an ointment, recommended six months ago for occasion of the first attendance. As diagnostic conduct was indicated the accomplishment of cytology and biopsy, being defined the diagnosis of Squamous Cell Carcinoma. The patient was immediately guided to the medical service of its municipal district for manegement of the specialized oncologic treatment. The patient was submitted the surgery followed by radiotherapy, being verified involvement of another structures by contiguity. Now, the patient meets abed, without viable perspectives of cure. The present report emphasizes the importance of the clinical knowledge and professional responsibility in attendance of cases of that nature.

Manifestación bucal de paracoccidiodomicosis asociada a aspergilosis: presentación de caso

Paracoccidioidomycosis and aspergillosis are, respectively, mycosis caused by Paracoccidioides brasiliensis and Aspergillus fumigatus fungi, which, most frequently, attack the lungs and later spread to other body regions. The association between both mycosis is rare in patients that do not present immunosuppression. A 49-year-old man presented with oral lesion, besides lesions on palatum, retromolar and oropharyngeal regions. Histopathological and microbiological exams confirmed the diagnosis of paracoccidioidomycosis associated to aspergillosis. Historically, fungi have been considered as the cause of relatively important infections, but, in the last years, a significant increase of diseases caused by fungi is evidenced. The recognition of the etiological agent in culture is important for the suitable treatment, once these fungi can cause irreversible damages or even death. The purpose of this study was to demonstrate, through the case of a patient who presented both mycosis associated, the need of complementary exams for the diagnosis of oral diseases, when routine laboratorial exams indicate the presence of another disease associated.

Transmissão congênita em cabras reinfectadas com Toxoplasma gondii

This study evaluated the potential of congenital transmission in goats experimentally infected and reinfected with Toxoplasma gondii, in three gestational stages (initial, intermediate and final). Of the 25 non-pregnant females negative for T. gondii, 20 were orally inoculated with 2.5 x 103 T. gondii ME49 oocysts. Of these, 15 pregnant females chronically infected were reinoculated, via oral, with 2.5 x 103 T. gondii VEG oocysts. Five experimental groups were formed (n=5): I, II and III (reinoculations in the initial, intermediate and final gestational stage, respectively), IV (inoculation) and V (no inoculation). Clinical and serological exams (IgG IFAT [indirect immunofluorescence antibody test]) in different days of evaluation, and bioassay and PCR were performed in all goats. In the infected goats with T. gondii a peak of 40.2°C (IV) at nine, seroconversion (IgG≥64) at 21 and stabilization (IgG<1024) at 119 days postinoculation were observed. In the reinfected goats with T. gondii occurred an increase in IgG titers (≥1,024) at 28 (I), 7 (II) and 3 (III) days post-reinoculation. During kidding were observed only in the reinfected groups: dystocia, malformation body, stillbirth and weakness, and IgG anti-Toxoplasma were detected in all and in some offsprings of the reinfected and infected goats, respectively. Tissue parasitism by T. gondii was diagnosed by bioassay and PCR in infected and reinfected goats and in their offspring. The congenital toxoplasmosis was possible in goats chronically infected and reinfected with T. gondii. The primary infection with T. gondii did not protect the pregnant goats against congenital disease resulting from toxoplasmic reinfection, in different gestational stages (initial, intermediate and final).

Acesso aos níveis de atenção à saúde em um município do Estado de São Paulo: perspectivas de gestores, profissionais e usuários

Pós-graduação em Saúde Coletiva - FMB

Determinação simultânea de biomarcadores de função renal em urina utilizando dispositivo analítico microfluídico em papel

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação da resposta inflamatória local após aplicação de células tronco mesenquimais alogênicas em tendão flexor digital superficial de equinos

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

Ultrassonografia modo b e elastografia arfi pulmonar e hepática fetal como método preditivo para a maturidade dos conceptos em fase final de gestação de cadelas

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Diagnosis and management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

Pancreatic hemangioma manifesting as variceal gastroesophageal bleeding during pregnancy: case report

There are only 10 reported cases of pancreatic hemangiomas in adults, only one of them causing digestive bleeding. We present a case of variceal bleeding and portal hypertension caused by a pancreatic hemangioma. The patient had 19 year-old and was received at her 16th week of pregnancy. She had massive hematemesis, controlled after variceal band ligation. Her image exams revealed a cystic lesion of 164 cm³ in the pancreas tail and signs of portal hypertension. Two months after, the ultrassonographic exam documented the lesion growth, achieving 200 cm³ at that time. The patient was submitted to distal pancreatectomy, and the histopathological analysis revealed a pancreatic hemangioma of 11 x 9 x 8 cm. Therefore, we report the second case of digestive bleeding caused by a pancreatic hemangioma, which had a well documented growth during the pregnancy. Additionally, we review the previous reports of pancreatic hemangiomas and discuss the hypothesis of hormonal infl uence on the natural history of these tumors.