An esthetics rehabilitation with computer-aided design/ computer-aided manufacturing technology

This paper describes a case of a rehabilitation involving Computer Aided Design/Computer Aided Manufacturing (CAD-CAM) system in implant supported and dental supported prostheses using zirconia as framework. The CAD-CAM technology has developed considerably over last few years, becoming a reality in dental practice. Among the widely used systems are the systems based on zirconia which demonstrate important physical and mechanical properties of high strength, adequate fracture toughness, biocompatibility and esthetics, and are indicated for unitary prosthetic restorations and posterior and anterior framework. All the modeling was performed by using CAD-CAM system and prostheses were cemented using resin cement best suited for each situation. The rehabilitation of the maxillary arch using zirconia framework demonstrated satisfactory esthetic and functional results after a 12-month control and revealed no biological and technical complications. This article shows the important of use technology CAD/CAM in the manufacture of dental prosthesis and implant-supported.

Clinical study on survival rate of short implants placed in the posterior mandibular region: resonance frequency analysis

Short implants are increasingly used, but there is doubt about their performance being similar to that of regular implants. The aim of this study was to compare the mechanical stability of short implants vs. regular implants placed in the edentulous posterior mandible. Twenty-three patients received a total of 48 short implants (5 × 5.5 mm and 5 × 7 mm) and 42 regular implants (4 × 10 mm and 4 × 11.5 mm) in the posterior mandible. Patients who received short implants had <10 mm of bone height measured from the bone crest to the outer wall of the mandibular canal. Resonance frequency analysis (RFA) was performed at time intervals T0 (immediately after implant placement), T1 (after 15 days), T2 (after 30 days), T3 (after 60 days), and T4 (after 90 days). The survival rate after 90 days was 87.5% for the short implants and 100% for regular implants (P < 0.05). There was no significant difference between the implants in time intervals T1, T2, T3, and T4. In T0, the RFA values of 5 × 5.5 implants were higher than values of 5 × 7 and 4 × 11.5 implants (P < 0.05). A total of six short implants that were placed in four patients were lost (three of 5 × 5.5 mm and three of 5 × 7 mm). Three lost implants started with high ISQ values, which progressively decreased. The other three lost implants started with a slightly lower ISQ value, which rose and then began to fall. Survival rate of short implants after 90 days was lower than that of regular implants. However, short implants may be considered a reasonable alternative for rehabilitation of severely resorbed mandibles with reduced height, to avoid performing bone reconstruction before implant placement. Patients need to be aware of the reduced survival rate compared with regular implants before implant placement to avoid disappointments.

Compreensão e produção oral de sentenças em crianças com deficiência auditiva pré-lingual usuárias de implante coclear

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

Deficiência auditiva: estudos clínicos sobre o narcisismo materno

The diagnosis of hearing loss (HL) in a child constitutes a crisis, includinga possible crash in parental narcissism, requiring an individual, matrimonial andfamiliar reorganization process. The mother is the main figure to devote herselfattending the baby and generally takes the most responsibilities in the processof habilitation or rehabilitation of the child, while still having to deal with her frustratedexpectations and narcissism. This study aims to investigate the effects of a deaf child’s birth on the mother’s narcissism. Here understood as a normal stage of psychosexual development of the human being, needed for life preservation, nota pathology. Five different clinical pratical studies were developed with mothers of deaf children that were diagnosed less than one year ago. The data were collected using individual semi-structured interviews and Thematic Apperception Test (TAT). Based on these studies it was found that the birth of a deaf child makes it difficult to obtain the expected narcissist satisfaction. The mother, investing all her affection and longing almost only on her child, hopes to rebuild her dream obtaining the "cure" and "normality" of her baby by submitting him/her to a cochlear implant.

Contextos comunicacionais adequados e inadequados à inclusão de alunos com deficiência visual em aulas de mecânica

This article is inserted in a study aimed at the identification of the main barriers for the inclusion of visually-impaired students in Physics classes. It focuses on the understanding of the communication context which facilitates or hardens the effective participation of students with visual impairment in Mechanics activities. To do so, the research defines, from empirical - sensory and semantic structures, the language to be applied in the activities, as well as, the moment and the speech pattern in which the languages have been used. As a result, it identifies the rela tion between the uses of the interdependent audio-visual empirical lan guage structure in the non-interactive episodes of authority; the decrease in the use of this structure in interactive episodes; the creation of educa tional segregation environments within the classroom and the frequent use of the interdependent tactile-hearing empirical language structure in such environments.

Ecóico e nomeação de figuras em crianças com deficiência auditiva pré-lingual com implante coclear

The aim of this work was to verify the effect of teaching the echoic behavior over the pictures naming in four children between eight and nine years old with prelingual hearing impaired, users of cochlear implants. The design adopted was: (a) pre-training that taught the matching-to-sample task; (b) pre-tests that selected three words to teach; (c) teaching of auditory-visual conditional relations; (d) naming pos-test; (e) the teaching of echoic with orofacial clues and, (f) the second naming pos-test. In the pre-test all participants achieved smaller percentage of correct on naming (60%-80%) and echoic (20%-50%) when compared to percentages word recognition (86%-93%). All participants learned the auditory-visual relations. The improvement on naming test occurred after auditory training select based for two participants; for other two participants the improvement on naming test occurred just after the training of echoic. Analysis of data showed that the listening and speaking performances are independent in their establishment and require specific conditions of teaching; in the case of this study, even though the result is not generalized to all participants, the highest correspondence into point to point naming was obtained following the teaching of echoic.

Integrated biomarker responses as environmental status descriptors of a coastal zone (Sao Paulo, Brazil)

Sao Paulo state (Brazil) has one of the most overpopulated coastal zones in South America, where previous studies have already detected sediment and water contamination. However, biological-based monitoring considering signals of xenobiotic exposure and effects are scarce. The present study employed a battery of biomarkers under field conditions to assess the environmental quality of this coastal zone. For this purpose, the activity of CYP 450, antioxidant enzymes, DNA damage, lipid peroxidation and lysosomal membrane were analysed in caged mussels and integrated using Factorial Analysis. A representation of estimated factor scores was performed in order to confirm the factor descriptions characterizing the studied areas. Biomarker responses indicated signals of mussels` impaired health during the monitoring, which pointed to the impact of different sources of contaminants in the water quality and identified critical areas. This integrated approach produced a rapid, sensitive and cost-effective assessment, which could be incorporated as a descriptor of environmental status in future coastal zones biomonitoring. (C) 2011 Elsevier Inc. All rights reserved.

Ear and electrode effects reduce within-group variability in middle latency response amplitude measures

Objectives: To establish normative amplitude values for relative difference measurements of the middle latency response (MLR) in normal-hearing pediatrics and to determine if these measurements provided a significant reduction of within-group variability when compared to raw, absolute amplitude measures. A relative amplitude difference is defined in the present paper as the difference in Na-Pa amplitude between two electrodes (e.g. vertical bar Na-Pa at C3 minus Na-Pa at C4 vertical bar, or electrode effects) or between two ears (e.g. vertical bar Na-Pa on left ear stimulation minus Na-Pa on right ear stimulation vertical bar, or ear effects). In contrast, an absolute amplitude is defined as a single Na-Pa measurement made at one electrode for stimulation of one ear (e.g. Na-Pa measured at C3 on left ear stimulation). Design: Cross-sectional study. Study sample: 155 pediatrics with normal peripheral and central hearing, and no history of psychological, neurological, or learning disability issues. Results: Within-group variability was significantly smaller for relative differences when compared to absolute amplitude measures. Electrode effects showed significantly less variability than ear effects. Normative values for ear and electrode effects were reported. Conclusions: Relative differences may provide better utility in the clinical diagnosis of central auditory pathology in pediatrics when compared to absolute amplitude measures because these difference measures show significantly lower variability when examined across subjects.

Quantitative comparison of mobility and gross motor function in Brazilian children with cerebral palsy

Background: Cerebral palsy (CP) presents changes in posture and movement as a core characteristic, which requires therapeutic monitoring during the habilitation or rehabilitation of children. Besides clinical treatment, it is fundamental that professionals use systems of evaluation to quantify the difficulties presented to the individual and assist in the organization of a therapeutic program. The aim of this study was to quantitatively verify the performance of children with spastic di-paresia type CP. Methods: The Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Classification System (GMFM) tests were used and classification made through the GMFCS in the assessment of 7 patients with CP, 4 females and 3 males, average age of 9 years old. Results: According to GMFCS scales, 17% (n=1) were level II and 83% (n=6) were level III. The PEDI test and 88 GMFM items were used in the area of mobility. We observed that there was high correlation between mobility and gross motor function with Pearson's correlation coefficient =0.929) showing the likely impact of these areas in the functional skills and the quality of life of these patients. Conclusion: We suggest the impact of the limitation of the areas in functional skills and quality of life of these patients.

Educational levels and the functional dependence of ischemic stroke survivors

We evaluated the functional dependence of stroke survivors from the Study of Stroke Mortality and Morbidity, using the Rankin Scale. Out of 355 ischemic stroke survivors (with a mean age of 67.9 years), 40% had some functional dependence at 28 days and 34.4% had some functional dependence at 6 months. Most predictors of physical dependence were identified at 28 days. These predictors were: low levels of education [illiterate vs. >= 8 years of education, multivariate odds ratio (OR) = 3.7; 95% confidence interval (95%CI): 1.60-8.54] and anatomical stroke location (total anterior circulation infarct, OR = 16.9; 95%CI: 2.93-97.49). Low levels of education and ischemic brain injury influenced functional dependence in these stroke survivors. Our findings reinforce the necessity of developing strategies for the rehabilitation of stroke patients, more especially in formulating specific strategies for care and treatment of stroke survivors with low socioeconomic status.

Cochlear implant in postlingual children: functional results 10 years after the surgery

The benefits of cochlear implants (CI) for communication skills are obtained over the years. There are but a few studies regarding the long-term outcomes in postlingual deaf children who grew up using the electronic device. Aim: To assess the functional results in a group of postlingual children, 10 years after using a CI. Methods: Ten postlingual deaf children, implanted before 18 years of age, participated in this study. We assessed: sentence recognition and speech intelligibility. We documented: device use and function and the patient's academic/occupational status. Study design: series. Results: The mean scores were 73% for sentence recognition in silence and 40% in noise. The average write-down intelligibility score was 92% and the average rating-scale intelligibility score was 4.15. There were no cases of device failure. Regarding educational/vocational status, three subjects graduated from the University. Five quit education after completing high school. Eight subjects had a professional activity. Conclusion: This study showed that cochlear implantation is a safe and reliable procedure. The postlingual profoundly hearing-impaired children after 10 years of CI use developed satisfactory levels regarding speech perception and intelligibility, and completed at least high school and were inserted in the labor market. Clinical Trials Registry: NCT01400178.

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.

Evaluation of an educational handbook as a knowledge-acquisition strategy for mastectomized women

This descriptive, cross-sectional and quantitative study presents an analysis of knowledge acquired by mastectomized women concerning breast cancer after reading an educational handbook. The sample was composed of 125 women. Data were collected in a specialized cancer facility in three phases: preparatory, operational I and operational II. As to the knowledge acquired, the posttest showed an 11% increase in the number of correct answers compared to the pretest. The most frequent correct answer regarded a question asking the name of the surgery (97.60%) while the question concerning breast reconstruction obtained the lowest number of correct answers (58.40%). Answers to all the questions significantly improved in the posttest, with the exception of a question addressing breast reconstruction (p=0.754). The assessment of knowledge showed positive results after reading, suggesting that cognition is essential to understanding and adhering to guidance, thus the handbook is a favorable resource to be used in the rehabilitation of mastectomized women.

Survival and movements of Magellanic penguins rehabilitated from oil fouling along the coast of South America, 2000-2010

Oil pollution is a significant conservation concern. We examined data from six institutions along the coast of South America: Emergency Relief Team of the International Fund for Animal Welfare, Fundacion Mundo Marino, Centro de Recuperacao de Animais Marinhos, Natura Patagonia, Associacao R3 Animal, and Mar del Plata Aquarium and data from resightings in Argentina, Brazil, Chile and Falkland/Malvinas Islands. From 2000 to 2010, 2183 oiled Magellanic penguins were rehabilitated as part of the routine activities of these institutions or during emergency responses to eight oil spills in which they were involved; all rehabilitated penguins were flipper banded and released. Since their release, 41 penguins were resighted until 31 December 2011. The results demonstrate that, when combined with other prevention strategies, the rehabilitation of Magellanic penguins is a strategy that contributes to the mitigation of adverse effects of oil spills and chronic pollution to the species. (C) 2012 Elsevier Ltd. All rights reserved.

Characterization of anti-silencing factor 1 in Leishmania major

Anti-silencing factor 1 (ASF1) is a histone chaperone that contributes to the histone deposition during nucleosome assembly in newly replicated DNA. It is involved in chromatin disassembly, transcription activation and in the cellular response to DNA damage. In Leishmania major the ASF1 gene (LmASF1) is located in chromosome 20 and codes for a protein showing 67% of identity with the Trypanosoma brucei TbASF1a. Compared to orthologous proteins, LmASF1 conserves the main residues relevant for its various biological functions. To study ASF1 in Leishmania we generated a mutant overexpressing LmASF1 in L. major. We observed that the excess of LmASF1 impaired promastigotes growth rates and had no impact on cell cycle progress. Differently from yeast, ASF1 overproduction in Leishmania did not affect expression levels of genes located on telomeres, but led to an upregulation of proteins involved in chromatin remodelling and physiological stress, such as heat shock proteins, oxidoreductase activity and proteolysis. In addition, we observed that LmASF1 mutant is more susceptible to the DNA damaging agent, methyl methane sulphonate, than the control line. Therefore, our study suggests that ASF1 from Leishmania pertains to the chromatin remodelling machinery of the parasite and acts on its response to DNA damage.