An evolutionary radiation of beeflies in semi-arid Australia: systematics of the Exoprosopini (Diptera : Bombyliidae)

Almost half of the 4822 described beeflies in the world belong to the subfamily Anthracinae, with most of the diversity found in three cosmopolitan tribes: Villini, Anthracini, and Exoprosopini. The Australian Exoprosopini previously contained three genera, Ligyra Newman, Pseudopenthes Roberts and Exoprosopa Macquart. Pseudopenthes is an Australian endemic, with two species including Ps. hesperis, sp. nov. from Western Australia. Two new species of the exoprosopine Atrichochira Hesse, Atr. commoni, sp. nov. and Atr. paramonovi, sp. nov., are also described from Australia, extending the generic distribution from Africa. Cladistic analysis clarified the phylogenetic relationships between the recognised groups of the Exoprosopini and determined generic limits on a world scale. Inclusion of 18 Australian exoprosopines placed the Australian species in the context of the world fauna. The Exoprosopini contains six large groups. The basal group I contains species previously included in Exoprosopa to which the name Defilippia Lioy is applied. Group II contains Heteralonia Rondani, Atrichochira, Micomitra Bowden, Pseudopenthes, and Diatropomma Bowden. Colossoptera Hull is newly synonymised with Heteralonia. Group III is a paraphyletic assemblage of Pterobates Bezzi and Exoprosopa including the Australian Ex. sylvana ( Fabricius). Ligyra is paraphyletic, forming two well-separated clades. The African clade is described as Euligyra Lambkin, gen. nov., which, together with Litorhina Bezzi and Hyperalonia Rondani, form group IV. The Australian group V is true Ligyra. The remaining monophyletic lineage of exoprosopines, group VI, the Balaana-group of genera, shows evidence of an evolutionary radiation of beeflies in semi-arid Australia. Phylogenetic analysis of all 42 species of the Balaana-group of genera formed a basis for delimiting genera. Seven new genera are described by Lambkin & Yeates: Balaana, Kapua, Larrpana, Munjua, Muwarna, Palirika and Wurda. Four non-Australian species belong to Balaana. Thirty two new Australian species are described: Bal. abscondita, Bal. bicuspis, Bal. centrosa, Bal. gigantea, Bal. kingcascadensis, K. corusca, K. irwini, K. westralica, Lar. collessi, Lar. zwicki, Mun. erugata, Mun. lepidokingi, Mun. paralutea, Mun. trigona, Muw. vitreilinearis, Pa. anaxios, Pa. basilikos, Pa. blackdownensis, Pa. bouchardi, Pa. cyanea, Pa. danielsi, Pa. decora, Pa. viridula, Pa. whyalla, W. emu, W. impatientis, W. montebelloensis, W. norrisi, W. patrellia, W. skevingtoni, W. windorah, and W. wyperfeldensis. The following new combinations are proposed: from Colossoptera: Heteralonia latipennis (Brunetti); from Exoprosopa: Bal. grandis (Pallas), Bal. efflatounbeyi (Paramonov), Bal. latelimbata ( Bigot), Bal. obliquebifasciata ( Macquart), Bal. tamerlan (Portschinsky), Bal. onusta ( Walker), Def. busiris (Jaennicke), Def. efflatouni ( Bezzi), Def. eritreae (Greathead), Def. gentilis ( Bezzi), Def. luteicosta ( Bezzi), Def. minos (Meigen), Def. nigrifimbriata ( Hesse), Def. rubescens ( Bezzi), K. adelaidica ( Macquart), Lar. dimidiatipennis ( Bowden), Muw. stellifera ( Walker), and Pa. marginicollis ( Gray); from Ligyra: Eu. enderleini ( Paramonov), Eu. mars ( Bezzi), Eu. monacha (Klug), Eu. paris ( Bezzi), Eu. sisyphus ( Fabricius), and Eu. venus (Karsch).

Local geometric changes in left ventricular remodeling post-infarction can lead to apparent reduction in scar thickness

Serial reduction in scar thickness has been shown in animal models. We sought whether this reduction in scar thickness may be a result of dilatation of the left ventricle (LV) with stretching and thinning of the wall. Contrast enhanced magnetic resonance imaging (CMRI) was performed to delineate radial scar thickness in 25 patients (age 63±10, 21 men) after myocardial infarction. The LV was divided into 16 segts and the absolute radial scar thickness (ST) and percentage scar to total wall thickness (%ST) were measured. Regional end diastolic (EDV) and end systolic volumes (ESV) of corresponding segments were measured on CMRI. All patients underwent revascularization and serial changes in ST, %ST, and regional volumes were assessed with a mean follow up of 15±5 months. CMRI identified a total of 93 scar segments. An increase in EDV or ESV was associated with a serial reduction inST(versusEDV, r =−0.3, p = 0.01; versusESV, r =−0.3, p = 0.005) and%ST(versusEDV, r =−0.2, p = 0.04; versus ESV, r =−0.3, p = 0.001). For segts associated with a positive increase in EDV (group I) or ESV (group II) there was a significant decrease in ST and %ST, but in those segts with stable EDV (group III) or ESV (group IV) there were no significant changes in ST and %ST (Table).

AVALIAÇÃO DAS ALTERAÇÕES DENTÁRIAS E ESQUELÉTICAS APÓS A DISTALIZAÇÃO DE MOLARES SUPERIORES COM APARELHO PÊNDULO SOB A INFLUÊNCIA DO LASER DE BAIXA INTENSIDADE

O presente estudo avaliou a velocidade da movimentação ortodôntica e as alterações dentárias e esqueléticas na distalização de molares superiores sob influência do laser de baixa intensidade por meio de telerradiografias laterais. A amostra foi constituída por 18 pacientes, portadores de maloclusão Classe II, com idade média inicial de 14,4 anos e divididos em dois grupos: Grupo I - laser e Grupo II - controle. Os pacientes foram tratados com um dispositivo ortodôntico denominado Pêndulo de Hilgers modificado, concomitantemente foi realizado a aplicação do laser de baixa intensidade na região radicular dos primeiros e segundos molares superiores, dos lados direito e esquerdo, nos pacientes do grupo I, sob o seguinte protocolo: 780nm de comprimento de onda, 40mW de potência, 10J/cm² de densidade de energia, 0,4J de energia por ponto durante 10 segundos cada e resultando em energia total de 20,8J. Foram distribuídos 52 pontos por vestibular e palatina dos primeiros e segundos molares superiores. A aplicação do laser foi realizada no dia da ativação da mola de TMA e repetida a cada mês até a sobrecorreção da relação molar. As telerradiografias laterais foram realizadas no início do tratamento (T1), ao final do terceiro mês (T2) e ao final da distalização (T3) com a relação molar sobrecorrigida em aproximadamente 1mm. Após análise cefalométrica foram realizadas comparações das alterações obtidas entre as fases Inicial (T1) e Final (T3) e Inicial (T1) e terceiro mês (T2) e comparadas entre os grupos. Os resultados mostraram inclinação para distal dos primeiros e segundos molares superiores, inclinação vestibular dos incisivos centrais superiores acentuada pela presença dos segundos molares e ausência de alterações dentárias verticais significativas, rotação do plano mandibular no sentido horário e o consequente aumento da altura facial anterior inferior. Concluiu-se que os efeitos do Pêndulo de Hilgers modificado sob a metodologia realizada provocaram alterações predominantemente dentoalveolares e que a movimentação dos primeiros e segundos molares superiores sob efeito da laserterapia, não apresentou diferença estatisticamente significante na velocidade de movimentação ortodôntica e em nenhuma das variáveis estudadas.

Avaliação cefalométrica de valores angulares em telerradiografias laterais e estimadas em posição natural da cabeça de indivíduos com má oclusão

Neste estudo o objetivo foi determinar a variável dos valores cefalométricos angulares entre linhas intracranianas com relação à linha de referência M, por meio de telerradiografias em norma lateral realizadas com o PF paralelo ao solo, em indivíduos com má oclusão de Classe I, Classe II (divisão 1 e 2) e Classe III de Angle, e estimar os valores obtidos em telerradiografia lateral com a cabeça na posição natural (PNC). A amostra consistiu de 240 telerradiografias em norma lateral direita, sendo 120 de indivíduos do sexo masculino e 120 do feminino, classificadas em três faixas etárias: 12 à 15 anos; 15 anos e um mês à 17 anos e 11 meses; 18 anos à 21 anos e 11 meses; e um grupo controle com 61 telerradiografias em norma lateral direita em PNC sendo 24 indivíduos do sexo masculino e 37 do sexo feminino, na faixa etária entre 12 anos e 5 meses à 21 anos e 5 meses e portadores de oclusão normal natural. Em todas as telerradiografias foram traçadas as linhas intracranianas Sela-Násio (SN), Básio-Násio (BaN), Pório-Orbitário (PoOr) e Linha M, para que estes ângulos tivessem os seus valores estimados em PNC. As variáveis idade e sexo foram correlacionadas com os ângulos, reais e estimados, nos grupos experimentais. Após a análise estatística dos resultados pode-se concluir que: 1) Os valores cefalométricos angulares médios, reais e estimados obtidos nos quatro grupos experimentais foram: Grupo I Reais: M.SN =102,58°; M.BaN = 121,39°; M.PoOr = 94,08°. Estimados: HV.SN = 8,24° (sexo feminino) e 3,44° (sexo masculino); HV.BaN = 24,65°; HV.PoOr = -2,47°. Grupo II Reais: M.SN = 102,59°; M.BaN = 121,29°; M.PoOr = 93,13°. Estimados: HV.SN = 5,86°; HV.BaN = 24,55°; HV.PoOr = -3,43°. Grupo III Reais: M.SN = 104,38°; M.BaN = 122,25°; M.PoOr = 95,99°. Estimados: HV.SN = 7,65°; HV.BaN = 25,51°; HV.PoOr = -0,56°. Grupo IV Reais: M.SN = 104,63°; M.BaN = 123,63°; M.PoOr = 94,80°. Estimados: HV.SN = 10,14° (sexo feminino) e 5,66° (sexo masculino); HV.BaN = 26,88°; HV.PoOr = - 1,75°. 2) Não houve relação estatisticamente significante entre os valores angulares cefalométricos com relação à faixa etária; 3) Em relação ao sexo, somente o ângulo HV.SN apresentou diferenças estatisticamente significantes, nos Grupos I e IV, sendo para o Grupo I: 8,24° para o sexo feminino e 3,44° para o masculino; e Grupo IV: 10,14° para o sexo feminino e 5,66° para o masculino).

AVALIAÇÃO IN VITRO DA RESISTÊNCIA DA COLAGEM DE BRAQUETES LINGUAIS COM DIFERENTES ESPESSURAS DE RESINA

Este estudo avaliou a colagem de braquetes linguais nas faces linguais de pré-molares superiores com diferentes espessuras de PADs, confeccionados com a resina fotopolimerizável Transbond XT nas espessuras de 1,0 mm e 2,0 mm e comparando-os com a menor espessura possível. Foi utilizado o adesivo Sondhi Rapid Set para a colagem indireta. Avaliou-se a força de resistência sob cisalhamento cinco minutos após a colagem em uma máquina de ensaios mecânicos Kratos, com velocidade de cruzeta de 1,0 mm/min. A força média da resistência da colagem sob cisalhamento para o Grupo I foi de 9,69 MPa (DP 4,02 MPa), para o Grupo II foi de 6,15 MPa (DP 2,69 MPa) e para o Grupo III foi de 5,73 MPa (DP 1,62 MPa). O Grupo I, com menor espessura do PAD, apresentou força de resistência da colagem sob cisalhamento significativamente maior do que os Grupos II e III (PADs com 1,0 e 2,0 mm respectivamente). Estes por sua vez, não apresentaram diferença estatisticamente significante ao nível de p<0,05. O índice 1 de Adesivo Remanescente predominou nos Grupos I e II, caracterizando um maior número de fraturas do tipo adesiva. No Grupo 3 predominou o Índice 2, com fraturas do tipo coesiva.(AU)

Cellular interaction with novel biomaterials

The objective of this thesis is to report the behaviour of mammalian cells with biocompatible synthetic polymers with potential for applications to the human body. Composite hydrogel materials were tested as possible keratoprosthetic devices. It was found that surface topography is an important consideration, pores, channels and fibres exposed on the surface of the hydrogels tested can have significant effects on the extent of cell adheson and proliferation. It is recommended that the core component is fabricated out of one of the following to provide a non cell adhesive base; A8, A11, A13, A22, A23. The haptic periphery fabricated out of one of the following would provide a cell adhesive composite; A16, A30, A33, A37, A38, A42, A43, A44. The presence of vitronectin in the ocular tissue appears to lead to higher cell adhesion to the posterior surface of a contact lens when compared to the anterior surface. Group IV contact lenses adhere more cells than Group II contact lenses - this may indicate that more protein (including vitronectin) is able to adhere to the contact lens due to the Group IV contact lenses high water content and ionic hydrogel matrix. Artificial lung surfactant analogues were found to be non cytotoxic but also decreased cell proliferation when tested at higher concentrations. Poly(lysine ethyl ester adipamide) [PLETESA] had the most favourable response on cell proliferation and commercial styrene/maleic anhydride (pMA/STY sp2) the most pronounced inhibitory response. The mode of action that decreases cell proliferation appears to be through membrane destabilization. Tissue culture well plates coated with PLETESA allowed cells to adhere in a concentration dependent manner, multilaminar liposomes possibly of PLETESA were observed in solution in PLETESA coated wells. Polyhydroxybutryate (PHB) and polyhydroxyvalerate (PHV) blends that contained hydroxyapatite were found to be the most cell adhesive material of those materials tested. The blends that were most susceptible to degradation adhered the most cells in initial stages of degradation. The initial slight increase in cell adhesion may be due to the increased rugosity of the material. As the degradation continued the number of cells adhering to the samples decreased, this may indicate that the polarity was inhibitory to cell adhesion during the later stages of degradation.

Hydrogels containing linear and cyclic polyethers

Hydrogels are a unique class of polymer which swell, but do not dissolve in, water. A range of 2-hydroxyethyl methacrylate based copolymer hydrogels containing both cyclic and linear polyethers have been synthesised and are described in this thesis. Initially, cyclic polyethers were occluded within the polymer matrix and the transport properties investigated. The results indicated that the presence of an ionophore can be used to modulate ion transport and that ion transport is described by a dual-sorption mechanism. However, these studies were limited due to ionophore loss during hydration. Hence, the synthesis of a range of acrylate based crown ether monomers was considered. A pure sample of 4-acryolylaminobenzo-15-crown-5 was obtained and a terpolymer containing this monomer was prepared. Transport studies illustrated that the presence of a `bound' ionophore modulates ion transport in a similar way to the occluded systems. The transport properties of a series of terpolymers containing linear polyethers were then investigated. The results indicated that the dual-sorption mechanism is observed for these systems with group II metal cations while the transport of group I metal cations, with the exception of sodium, is enhanced. Finally, the equilibrium water contents (EWC) surface and mechanical properties of these terpolymers containing linear polyethers were examined. Although subtle variations in EWC are observed as the structure of the polyether side chain varies, generally EWC is enhanced due to the hydrophilicity of the polyether side chain. The macroscopic surface properties were investigated using a sessile drop technique and FTIR spectroscopy. At a molecular level surface properties were probed using an in vitro ocular spoilation model and preliminary cell adhesion studies. The results indicate that the polyethylene oxide side chains are expressed at the polymer surface thus reducing the adhesion of biological species.

Algorithms for Finding Unitals and Maximal Arcs in Projective Planes of Order 16

The paper has been presented at the International Conference Pioneers of Bulgarian Mathematics, Dedicated to Nikola Obreshkoff and Lubomir Tschakalo ff , Sofia, July, 2006.

Effects of nursing interventions for fever in acutely ill adults

Fever has both beneficial and detrimental effects. There is evidence that antipyretics and physical cooling methods, when used in combination, are more effective than antipyretics alone. This randomized controlled study examined 45 acutely ill adults with fever ${\ge}102.5\sp\circ\rm F$ where three nursing interventions were used. Group I received acetaminophen 650 mgs., Group II received acetaminophen 650 mgs. and tepid sponging, and Group III received acetaminophen 650 mgs. and hypothermia blanket. The purpose of this study was to evaluate which nursing intervention reduced temperature most effectively with respect to eight biobehavioral variables. Research hypotheses were tested statistically using the chi-square test and repeated measures analysis of variance. The study found statistically significant results for fever reduction overall, but no difference for the groups. Therefore, we suggest that acetaminophen alone be used in the treatment of fever in order to decrease cost, nursing time, and increase patient comfort. ^

Biomimetic modeling of the nitrogen-centered radical postulated to occur during the inhibition of ribonucleotide reductases by 2'-azido-2'-deoxynucleotides

Ribonucleotide reductases (RNR) are essential enzymes that catalyze the reduction of ribonucleotides to 2'-deoxyribonucleotides, which is a critical step that produces precursors for DNA replication and repair. The inactivation of RNR, logically, would discontinue producing the precursors of the DNA of viral or cancer cells, which then would consequently end the cycle of DNA replication. Among different compounds that were found to be inhibitors of RNR, 2'-azido-2'-deoxynucleotide diphosphates (N3NDPs) have been investigated in depth as potent inhibitors of RNR. Decades of investigation has suggested that the inactivation of RNR by N3NDPs is a result of the formation of a nitrogen-centered radical (N·) that is covalently attached to the nucleotide at C3' and cysteine molecule C225 [3'-C(R-S-N·-C-OH)]. Biomimetic simulation reactions for the generation of the nitrogen-centered radicals similar to the one observed during the inactivation of the RNR by azionuclotides was investigated. The study included several modes: (i) theoretical calculation that showed the feasibility of the ring closure reaction between thiyl radicals and azido group; (ii) synthesis of the model azido nucleosides with a linker attached to C3' or C5' having a thiol or vicinal dithiol functionality; (iii) generation of the thiyl radical under both physiological and radiolysis conditions whose role is important in the initiation on RNR cascades; and (iv) analysis of the nitrogen-centered radical species formed during interaction between the thiyl radical and azido group by electron paramagnetic resonance spectroscopy (EPR). Characterization of the aminyl radical species formed during one electron attachment to the azido group of 2'-azido-2'-deoxyuridine and its stereospecifically labelled 1'-, 2'-, 3'-, 4'- or 5,6-[2H 2]-analogues was also examined. This dissertation gave insight toward understanding the mechanism of the formation of the nitrogen-centered radical during the inactivation of RNRs by azidonucleotides as well as the mechanism of action of RNRs that might provide key information necessary for the development of the next generation of antiviral and anticancer drugs.

Isolation and characterization of the U1 and U2 snRNAs in the silk gland of the 5th instar larval stage silk moth Bombyx mori

In isolation and characterization studies, expression level U1 and U2 snRNA isoforms were obtained from the 5th instar larval stage silk gland (SG). The DNA content of the SG cells is approximately 200,000-fold higher compared to the usual (2N) somatic cells of B. mori due to endoreduplication. In this study, the existence of U1 and U2 snRNA isoforms in the SG of the organism is investigated. Bombyx mori U1 and U2-specific RT-PCR libraries from the silk gland were generated. Five U1 and eight U2 isoforms were isolated and characterized. Nucleotide differences, structural alterations, as well as protein and RNA interaction sites were analyzed in these variants. For the U1 snRNA variants, they were compared to the previously reported BmN isoforms. In all these U-snRNA variants, polymorphic sites do not predominate at the core of known functional sequences, which were interspecifically conserved. Variant sites and inter-species differences are located in moderately conserved regions. Free energy (ΔG) values for the entire U1 and U2 snRNA secondary structures and for the individual stem/loops domains of the isoforms were generated and compared to determine their structural stability. This will be the first time that U1 and U2 variants are shown specific for a development stage (larval) other than embryonic or adult. ^ Using phylogenetic analysis, evolutionary trees were generated for the U1 and U2 snRNAs using animal, plant, protista and fungal species. The resulting trees were boostrapped for robustness and rooted with the self-splicing RNA group II intron sequence from the cyanobacterium Calothrix. Using phylogenetic analyses, possible structural and functional evolutionary interdependence between the U1 and U2 snRNAs was investigated. ^

The effect of music listening maps on second grade music students' preference for and understanding of orchestral music

This study investigated the use of music listening maps to help learning and the preferences of second graders for orchestral music. Subjects were a population of four 2nd grade classes, and were randomly divided into two groups. The investigation was a counterbalanced, post-test only design, lasting for three consecutive classes. Two treatments/lessons were presented and a third lesson was a review. In Treatment 1 Group I used listening maps first, while Group II received instruction without listening maps. In Treatment 2, the order was reversed. Two post-tests and a comprehensive test were administered. An affective survey was administered after the treatments, measuring student preference and attitude. When listening maps were presented, scores were significantly higher. It did not matter whether the listening maps were presented first or not. Results of the survey show student preference will increase with music listening maps.

A influência da perda de peso no perfil inflamatório de mulheres com síndrome dos ovários policísticos

The polycystic ovary syndrome (PCOS) is considered the most common endocrine disorder in reproductive age women, with a prevalence ranging from 15 to 20%. In addition to hormonal and reproductive changes, it is common in PCOS the presence of risk factors for developing cardiovascular disease (CVD) and diabetes mellitus, insulin resistance (IR), visceral obesity, chronic low-grade inflammation and dyslipidemia. Due to the high frequency of obesity associated with PCOS, weight loss is considered as the first-line treatment for the syndrome by improving metabolic and normalizes serum androgens, restoring reproductive function of these patients. Objectives: To evaluate the inflammatory markers and IR in women with PCOS and healthy ovulatory with different nutritional status and how these parameters are displayed after weight loss through caloric restriction in with Down syndrome. Methods: Tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were assessed in serum samples from 40 women of childbearing age. The volunteers were divided into four groups: Group I (not eutrophic with PCOS, n = 12); Group II (not eutrophic without PCOS, n = 10), Group III (eutrophic with PCOS, n = 08) and Group IV (eutrophic without PCOS, n = 10). The categorization of groups was performed by body mass index (BMI), according to the World Health Organization (WHO) does not eutrophic, overweight and obesity (BMI> 25 kg / m²) and normal weight (BMI <24.9 kg / m²). IR was determined by HOMA-IR index. In the second phase of the study a controlled dietary intervention was performed and inflammatory parameters were evaluated in 21 overweight and obese women with PCOS, before and after weight loss. All patients received a low-calorie diet with reduction of 500 kcal / day of regular consumption with standard concentrations of macronutrients. Results: Phase 1: PCOS patients showed increased levels of CRP (p <0.01) and HOMAIR (p <0.01). When divided by BMI, both not eutrophic group with PCOS (I) as eutrophic with PCOS (III) showed increased levels of CRP (I = 2.35 ± 0,55mg / L and 2.63 ± III = 0,65mg / L; p <0.01) and HOMA-IR (I = 2.16 ± 2.54 and III = 1.07 ± 0.55; p <0.01). There were no differences in TNF-α and IL-6 between groups. Step 2: After the weight loss of 5% of the initial weight was reduced in all of the components of serum assessed inflammatory profile, PCR (154.75 ± 19:33) vs (78.06 ± 8.9) TNF α (10.89 ± 5.09) vs (6:39 ± 1:41) and IL6 (154.75 ± 19:33) vs (78.06 ± 08.09) (p <0:00) in association with improvement some hormonal parameters evaluated. Conclusion: PCOS contributed to the development of chronic inflammation and changes in glucose metabolism by increasing CRP, insulin and HOMA-IR, independent of nutritional status. The weight loss, caloric restriction has improved the inflammatory condition and hormonal status of the evaluated patients.

Prevention of oral lesions in children with acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children and is responsible for severe stomatologic complications. Treatment consists of four phases of chemotherapy, the main side effect of methotrexate, the drug most used during the intensification phase, is oral mucositis. OBJECTIVE: To evaluate the clinical aspects of the oral mucosa of children with ALL and to determine the effect of 0.12% chlorhexidine gluconate on the prevention of stomatologic complications in these patients. PATIENTS AND METHODS: Thirty-three children treated for ALL ranging in age from 2 to 15 years, without distinction of gender or race, were submitted to visual examination, digital palpation of the oral mucosa and cytologic examination of the buccal mucosa, and divided into two groups: group I consisted of 23 children using an oral solution of 0.12% chlorhexidine gluconate twice a day, and group II consisted of 10 children who did not receive this solution. All children received daily oral hygiene care guided by the dentist throughout treatment. RESULTS: Mucositis was observed in six children of group I and eight of group II, and was characterized by erythema, edema and ulcers. Uniform cytologic findings were obtained for the two groups, with a clear predominance of cells of the intermediate layer in all smears, in addition to a perinuclear halo in 18% of the smears. CONCLUSION: The present results suggest that systematic preventive treatment with 0.12% chlorhexidine gluconate and oral hygiene care reduce the occurrence of oral complications in children with ALL undergoing antineoplastic chemotherapy.

Prevention of oral lesions in children with acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children and is responsible for severe stomatologic complications. Treatment consists of four phases of chemotherapy, the main side effect of methotrexate, the drug most used during the intensification phase, is oral mucositis. OBJECTIVE: To evaluate the clinical aspects of the oral mucosa of children with ALL and to determine the effect of 0.12% chlorhexidine gluconate on the prevention of stomatologic complications in these patients. PATIENTS AND METHODS: Thirty-three children treated for ALL ranging in age from 2 to 15 years, without distinction of gender or race, were submitted to visual examination, digital palpation of the oral mucosa and cytologic examination of the buccal mucosa, and divided into two groups: group I consisted of 23 children using an oral solution of 0.12% chlorhexidine gluconate twice a day, and group II consisted of 10 children who did not receive this solution. All children received daily oral hygiene care guided by the dentist throughout treatment. RESULTS: Mucositis was observed in six children of group I and eight of group II, and was characterized by erythema, edema and ulcers. Uniform cytologic findings were obtained for the two groups, with a clear predominance of cells of the intermediate layer in all smears, in addition to a perinuclear halo in 18% of the smears. CONCLUSION: The present results suggest that systematic preventive treatment with 0.12% chlorhexidine gluconate and oral hygiene care reduce the occurrence of oral complications in children with ALL undergoing antineoplastic chemotherapy.