Particularities in the technique of calvaria graft

Calvaria grafts provide good bone quantity for the reconstruction of the atrophic maxilla, and have lower morbidity and resorption rates when compared to iliac crest. The aim of this paper is to present the technique for obtaining a graft of the skull. Initially, the depth of the osteotomy is determined by a manually conducted bur, which establishes the limits of the structures of the skull (outer table, diploe and inner table), making the removal of bone blocks easier and safer. Thus, osteotomies of the blocks are made with greater security, avoiding the complications inherent to surgical technique. The case that will be presented it is from a male patient of 65 years who refused to submit to the iliac crest graft, opting for the calvaria, despite being bald, that is a contraindication for this treatment modality. A delicate suture associated with placement of titanium mesh to maintain the conformation of the patient's skull in the region of the bone defect, created after removal of the graft, provided a good cosmetic result at the donor site. The use of titanium mesh for re-anatomization of bone defects created in the grafts is well indicated for bald patients.

O impacto das próteses implantossuportadas na harmonia facial

Many patients seeking dental care wish to improve facial and smile aesthetics to be accepted in modern day society. In denture wearers, the physiological resorption causes atrophy mainly in the maxilla, being necessary to carry out reconstruction techniques and sometimes orthognathic surgery to improve occlusal stability and facial harmony. The aim of this study is to discuss the features related to the rehabilitation of edentulous patients with indication for reconstruction of the maxilla using bone grafts and orthognathic surgery by means of a clinical case. In the present case, after the prosthetic rehabilitation, the patient was full satisfied with obtained results and dismissed the initially proposed surgical protocol. Therefore, professionals should provide therapeutic options but the patient’s opinion should prevail provided its clinical feasibility.

Oclusão em prótese sobre implante - parte I

Osseointegrated implants have specific nature distinguish them from natural teeth making them more susceptible to the efforts generated by mastication. The absence of periodontal ligament, which absorbs the masticatory forces and allows the movement of the teeth interfere with the reception of occlusal loads and therefore the predictability of implants. In the boneimplant interface did not occur the phenomena of dissipation of impact, even the movement induced. Thus, during planning and installation of implant prosthesis, the type and characteristics of occlusal pattern adopted should be established with criteria to be no grounds for future failures. In this regard we highlight the occlusal overload generated by several reasons like the presence of premature contacts, interference during motion excursive, deleterious habits and inappropriate extensions on cantilevers. Thus, the objective is to provide a review of the literature regarding the importance of occlusion in oral rehabilitation with implants. Factors to be considered in establishing a favorable occlusion, consistent with prostheses on implants will be described

Oclusão em prótese sobre implante - parte II

In part I of this article, the factors related to the establishment of a favourable occlusion for the implant prosthodontics as well as its real importance in this kind of rehabilitation were showed up. However, it is known that the occlusal characteristics adopted in implant prosthodontics show specific patterns which must be different between each other in accordance to the type of prosthesis installed. The objective of the second part of this work is to present to the reader, by a literature review, those characteristics, justifying the reason because they must be associated to specific kind of prosthesis for favor the treatment established.

Long-term multimodal exercise program enhances mobility of patients with Parkinson's disease

Objective. This study aimed to evaluate the effect of a long-period multimodal exercise program on balance, mobility and clinical status of patients with Parkinson’s disease (PD). Methods. Thirty-three PD patients were assigned into two groups: a training group (TG—n = 22; aged 67.23 ± 8.39 years) and a control group (CG—n = 9; aged 71.56 ± 8.50 years). The TG patients were enrolled in a 6-month multimodal exercise program. This program was designed to improve physical capacity components and to reduce PD impairments. Balance and mobility were assessed immediately before and after the training protocol using the Berg Balance Scale (BBS), the “Timed up and go” (TUG), and the Posture Locomotion Test (PLM). Also, clinical variables were assessed (disease stage and impairments). Results. The TG showed an improvement in the TUG (P = 0.006) while CG were not influenced by the 6-months period. Both groups showed no differences for BBS and PLM and for their disease impairments—assessed through the Unified Parkinson’s disease Scale. Conclusions. Long-term multimodal exercise programs are able to improve mobility of patients with Parkinson’s disease and therefore should be used on clinical day life.

Long duration exercise program in individuals with parkinson´s disease: effects on functional capacity

The aim of this study was to investigate the effects of long duration exercise program on physical fitness components of functional capacity in individuals with Parkinson disease (PD) and to evaluate ongoing effects of exercise after 8 to 10-week follow-up without exercise. Twenty-four individuals with PD were randomly assigned to two groups: generalized exercise program and stretching exercise program (control group). The generalized exercise program provided training in physical fitness components of functional capacity. The stretching exercise program was characterized by low intensity and volume, mainly with static exercises. Both groups were evaluated before (BI) and after the 4-month (AI) exercise program. In addition, the individuals of generalized exercise program were also evaluated after 8-month exercise program and after 8 to 10- week follow-up without exercise. The generalized exercise program improved flexibility (BI - 38.50±12.42 cm; AI - 44.00±12.74 cm) and agility (BI - 30.59±7.54 s; AI - 28.56±8.20 s) while the stretching exercise program worsened coordination (BI - 23.27±6.58 s; AI - 28.06±7.37 s) and aerobic resistance (BI- 13.64±3.76 min; AI - 17.27±5.15 min) and improved balance (BI - 44.00±7.79 pts; AI - 46.57±6.53 pts). Lower-limb strength and UPDRS-motor scale scores were better at 8 months (14.75±2.92 rep and 26.25±13.97 pts, respectively) compared to baseline (13.13±2.59 rep and 31.63±12.82 pts, respectively) and 4 months (13.50±1.93 rep and 30.38±14.52 pts, respectively) for generalized exercise program. However, the benefits of 8 months of exercise were lost after 8 to 10-week follow-up without exercise (lower-limb strength - 12.43±3.15 rep and UPDRS-motor scale - 32.57±14.05 pts). In conclusion, generalized exercise program improved the functional capacity in individuals with PD, differently of stretching exercise program. In addition, a long duration exercise program promoted benefits for functional capacity and disease progression in individuals with PD. However, benefits were lost after a short period without exercise.

Diagnóstico de conflitos em áreas de preservação permanente na bacia do Rio Capivara - Botucatu (SP)

The permanent preservation areas (PPA) established by Brazilian law are there to protect the natural environment. With the expansion of space occupied by man and development of economic activities in these areas were engaged in conflicts characterized PPA, where the use is other than the natural vegetation. According to these paradigms work aims to raise these conflict areas in the River Basin Capivara, Botucatu (SP) with the help of GIS Ilwis 3.4, topographic maps of IBGE and satellite images CBERS 2B. The map was generated from PPA in the GIS by distance calculation in relation to drainage, springs and break line on Cuesta de Botucatu. The classes of land use and natural vegetation were determined by interpretation of satellite images and field visits to check their veracity. With the cutting of the map of land use and natural vegetation in relation to PPA unit it was determined that the total 44,63% PPA is in conflict occupied by pasture, forest plantation, orange, annual crops, farms and irrigated rice project in lowland. This diagnostic characterizes the degradation of the environment and highlights the need to harmonize the economic and urban development with the preservation of the environment to ensure sustainability of the region.

Capacidad de uso de la tierra en la cuenca de la Corriente del Lobo, Itatinga, São Paulo, Brasil

The objective of the research was to define the classes of use capacity of 2403.25 ha in the basin of the Corriente del Lobo - Itatinga (SP), (22°03'56" to 22°59'12" of latitude S and 48°38'47" to 48°41'25" of longitude W Gr.). The soil use capacity was obtained by using the SIG IDRISI 32 crossing the documents of steepness and soils and the document of judgment of classes of soil use capacity and of the utilitarian rising of the physical milieu. The classes and subclasses areas of use capacity presented the following values: IIIa - 68.60 ha (2.85%), IIIe,s - 1919.15 ha (79.86%); IIIe - 210.60 ha (8.76%); IVe - 3.38ha (0.14%); IVe,s - 157.42 ha (6.55%) and VIe,s - 44.10 ha (1.84%). The lands of the basin were distributed in three classes (III, IV and VI) and six subclasses but the biggest extension (79.9%) belonged to the subclass IIIe,s. The modules of the IDRISI allowed to discriminate, mapping and to quantify quickly the soil use capacity of the areas of classes and subclasses in the basin.

Geoprocessamento aplicado na avaliação morfométrica da microbacia do Ribeirão Tabuleta - Piquete (SP)

A análise morfométrica de uma microbacia é uma importante ferramenta de diagnóstico da susceptibilidade à degradação ambiental, pois os resultados nortearão o planejamento, o manejo e a implementação de medidas mitigadoras para conservação dos recursos hídricos. O presente trabalho teve como objetivo a caracterização morfométrica da microbacia do Ribeirão Tabuleta – Piquete (SP) através do Sistema de Informações Geográficas Arcview e da Carta Planialtimétrica de Lorena – SP e Delfim Moreira - MG, editadas pelo IBGE (1970), em escala 1:50000. As variáveis avaliadas foram as dimensionais, da composição da rede de Drenagem e do padrão de drenagem. As bases cartográficas utilizadas foram a carta planialtimétrica de Lorena – SP e Delfim Moreira - MG, editadas pelo IBGE (1970), em escala 1:50000, para a hierarquização da rede de drenagem e a análise morfométrica. Os resultados permitiram concluir que a microbacia apresenta altos riscos de susceptibilidade a erosão e degradação ambiental, sendo fundamental a manutenção da cobertura vegetal e as zonas ripárias para conservação dos serviços ambientais. O fator de forma e a densidade de drenagem alta permitiram inferir que o substrato tem permeabilidade baixa com menor infiltração e maior escoamento da água. A alta declividade das encostas (montanhoso) indica se não for conservada pode haver alteração na regulação do sistema hidrológico e consequentemente na produção de água. O Sistema de Informações Geográficas ArcGis 9.3 foi excelente na digitalização e análise dos dados.

Uso inadequado de áreas de preservação permanente

O grande desafio da população mundial é a conservação ambiental, pois as Áreas de Preservação Permanentes, que têm papel vital dentro de uma microbacia, por serem responsáveis pela manutenção, preservação e conservação dos ecossistemas ali existentes. O presente trabalho visou analisar os conflitos de uso do solo em áreas de preservação permanentes (APPs) da microbacia do Alto Capivara - Botucatu (SP) através do uso de Sistema de Informações Geográficas e de imagem de satélite digital. A área com 4551,19ha, situa-se entre as coordenadas geográficas: 22o 51’ 57” a 22o 57’ 55” de latitude S e 48o 21’ 58” a 48o 26’ 38” de longitude WGR. O mapa de uso do solo de 2006 foi obtido a partir da classificação supervisionada em imagem de satélite digital de 23/10/2006. Na identificação digital dos alvos foram utilizadas as chaves de interpretação para imagens e as áreas foram determinadas através do software SIG – IDRISI. Os conflitos de uso nas áreas de preservação permanente foram analisados ao longo da rede de drenagem e das nascentes, conforme itens dos artigos 2º e 3º da Resolução nº 303 do CONAMA. A área de APP discriminada ao longo da rede de drenagem foi de 416,5ha (9,15%) . No entanto, 201,15ha da área de APP está ocupada com pastagem (48,3%), reflorestamento (1,23%) e 0,48% por área urbana de forma inadequada (conflito). Portanto, quase 50% de área de APP vem sendo parcialmente utilizada adequadamente.

Agrupamentos de amostras circulares em função das unidades de solo

The objective of the study was to analyze the features of the relief through the variables: maximum altitude (HM); mean altitude (Hmd); minimum altitude (Hm); altitude range (H); average slope length (CVm); minimum length of run-off (Cd) and average steepness of circular samples (I) of the Capivara River Watershed – Botucatu (SP). A total of 4 circular samples were obtained per unit of soil (Quartzipsamment alfisol oxisol - RQ, Udox - LVA and Udorthent - RL). Multivariable analysis and aerial color photographs of 2000, Brazilian Chart and Soil Chart of Botucatu city-SP were used for data analyses. Soil differentiation was performed using the Student-t Test for analyzes of orthogonal contrasts among means of the three soils and analysis of groupings and major components. The grouping analysis of the variables of relief differentiated 75% of LVA and 100% of RL and RQ soil circular samples. The most efficient parameters of relief for differentiation of soils according to their order of importance were as follows: HM, Hm, Hmd and H.

Diagnóstico de potenciliade das unidades ambientais na bacia do Rio Capivara, Botucatu - SP

This work has the objective to elaborate the potentialities of the farming expand diagnosis of the Capivara River Hydrographic basin, in the Botucatu – SP municipal district, to obtain an interpretation of the system actual situation through the historical trajectory and possible evolution with the assistance of the SIG Ilwis 3.4 and orbital images CBERS 2B, in the pancromatics bands, obtained in 12/07/2008. The potentialities of the farming expand diagnosis was obtained through the physical mean modeling, of the farming expand presents in the studied environment and shows possible line actions to minimize the impacts e reach a sustainable development to the region. The Capivara river basin presents more than 70% of your areas occupied by the anthropic expanding, with the extensive farming predominance, forestall planting, orange and sugar cane. In the potentiality diagnostic analyses notes the good quality of the basin to the farming expand, except the region comprehended by the Botucatu Cuesta and the meadows area. The basin until has a good environmental quality and this diagnosis must serve for a start point to the realization of the territorial ordination as quick as possible to the environment conditions finds remains the same, granting the recovery capability.

Using GIS to Locate Areas for Growing Quality Coffee in Honduras

Abstract Small-scale coffee producers worldwide remain vulnerable to price fluctuations after the 1999-2003 coffee crisis. One way to increase small-scale farmer economic resilience is to produce a more expensive product, such as quality coffee. There is growing demand in coffee-producing and coffee-importing countries for user-friendly tools that facilitate the marketing of quality coffee. The purpose of this study is to develop a prototypical quality coffee marketing tool in the form of a GIS model that identifies regions for producing quality coffee in a country not usually associated with quality coffee, Honduras. Maps of areas for growing quality coffee were produced with information on climate, soils, topography, areas vulnerable to environmental degradation, the location of current quality coffee farms, and infrastructure. The maps depict suitable coffee-growing land in portions of eight western Honduran departments.

Cardiac Rhythm Disturbances Associated with Amlodipine Acute Intoxication

Amlodipine is a dihydropyridine calcium channel antagonist extensively used for the treatment of arterial hypertension, with predominant effect on the peripheral vascular territory. In most cases of severe intoxication, important hypotension and reflex tachycardia are usually observed. We report a case of young man with severe amlodipine intoxication that developed important bradyarrhythmias, such as low atrial rhythm, prolonged PR interval, atrioventricular block, and left bundle branch block. These rhythm disturbances suggest that, during acute intoxication, dihydropyridine loses its selective action on the vascular territory and can depress automatism and conduction of cardiac electrical stimulus.

Behaviour of grouted dowels used in precast concrete connections

This research deals with the behaviour of grouted dowels used in beam-to-column connections in precast concrete structures. The research focuses primarily on the theoretical and experimental analysis of the resistance mechanism of the dowels. The experimental programme included 15 models for analysing the following variations in dowel parameters: a) dowel diameters of 16, 20 and 25 mm, b) dowel inclinations of 0 degrees (i.e. perpendicular to the interface), 45 degrees and 60 degrees, c) compressive strength of classes C35 and C50 for the concrete adjacent to the dowels, and d) the absence or presence of compressive loads normal to the interface. The experimental results indicate that the ultimate capacity and shear stiffness of the inclined dowels are significantly higher than those of the perpendicular dowels. Based on these results, an analytical model is proposed that considers the influence of the parameters studied regarding the capacity of the dowel.