Use of skin graft punch graft type for the healing of leg ulcers in treated Hansen's disease patients

Hansen's disease is an infectious illness caused by Mycobacterium leprae. It affects preferentially the skin and the peripheral nervous system leading to incapacities, such as leg ulcers, which happens due to the direct action of the bacillus on the organs or its indirect action on the peripheral nervous system. Leg ulcers can occur by two physiopathologic processes. There are many treatments for general leg ulcers, which include the ones caused by Hansen's disease sequels. Among them, surgical treatment shows to be effective when using skin graft, which can be performed by several techniques. Considering the low number of techniques known for treating leg ulcers in Hansen's disease sequels, the aims of this work were to standardize alternative techniques, to detect the main bacteria found in ulcer secretion cultures, to analyze the patients profile and the ulcers, to describe the histophatologies found, and to correlate these data with those of literature from all over the world. Skin graft punch type was carried out and analyzed; males had a mean age of 59.4 years old and females, 54.2 years old. Patients were 73.6% male and 26.3% female. Lepromatous type was present in 89.4% patients and tuberculoid type was seen in 10.5% of them. Associated systemic diseases were observed in 26.3% patients. Mean time of ulcers evolution was 11.6 years in male and 12.8 years in women. The average diameter of ulcers in the pre-treatment period was 8.5 X 9.5 cm in male and 10.2 X 6.8 cm in women. After the graft, their average diameters were 3.2 X 2.7 cm in male and 5.1 X 5.6 cm in women. Statistical analysis showed that there was no significant correlation between the ulcer diameter and its reduction or not in the post-surgery period (p=0.269732). The mean age of patients whose ulcers diameter did not change or reduced by only 20% was 63.5 years. Using the Spearman's coefficient, it was possible to observe that there was no significant correlation between the patients' age and the ulcers diameter reduction after the skin graft (p=0.222531). Evolution time of ulcers that did not present any satisfactory result in the post-surgery period was 12.1 years. The Spearman's coefficient showed that there was no significant correlation between the ulcers evolution time and the ulcers diameter reduction in the post-surgery period (p=0.191655). Cultures presented 50% of cases with Pseudomonas aeruginosa. Statistical analysis showed there is no correlation between the bacterial types found and the ulcer evolution in the post-surgery period (p=0.697531). The average of the ulcers diameter reduction was 42.4%, and in 26.3% of the patients the lesions disappeared after the skin graft.

Densidade das células do endotélio corneano em olhos de cães à microscopia especular

The aim of this study was to examine the endothelial surface and to perform a morphometric analysis of the corneal endothelial cells in normal eyes of dogs using specular microscopy. Morphometric analysis with regard mean cell area and cell density was performed. Both eyes of ten mixed-breed, males and females, with 6 years of age, weighing about 15 kg euthanatized for reasons unrelated to this study were evaluated. Eyes were examined to determine that they did not have visible ocular disease and transported to the laboratory in moist chamber. Using a contact specular microscope the corneal endothelium was examined. Three images of the central corneal endothelium of each eye were obtained. The mean cell area and the cell density of the corneal endothelial cells were obtained using software for corneal endothelium analysis and density measurement. The mean cell area was 395 ± 36 μm 2 and the endothelial cell density was 2555 ± 240 cells/mm2. The present work demonstrates that the normal corneal endothelium of dog is similar to those described in human.

Detection of Streptococcus mutans and Streptococcus sobrinus in dental plaque samples from Brazilian preschool children by polymerase chain reaction

The purposes of this study were to detect S. mutans and S. sobrinus by polymerase chain reaction (PCR) amplification, and to relate their presence to the incidence of dental caries in 42 Brazilian preschool children. Dental plaque samples were collected from the cervical margin of all erupted teeth of 5-6 years old children with primary dentition, using a sterile explorer. Examination of the dmft (decayed, missing, filled teeth) index, performed following the World Health Organization (WHO) caries diagnostic criteria, showed a 2.71 score. Prevalence of S. mutans and S. sobrinus was respectively, of 85.7% and 14.3%; no dental plaque sample was either positive or negative for both bacterial species. Children harboring either S. mutans or S. sobrinus presented the same caries prevalence. PCR showed good discriminative ability for differentiation between these species, and suggested that it is a technique suitable for epidemiological studies on mutans streptococci.

Fluoride intake from regular and low fluoride dentifrices by 2-3-year-old children: Influence of the dentifrice flavor

This study evaluated the fluoride intake from dentifrices with different fluoride concentrations ([F]) by children aged 24-36 months, as well as the influence of the dentifrice flavor in the amount of fluoride ingested during toothbrushing. Thirty-three children were randomly divided into 3 groups, according to the [F] in the dentifrices: G-A (523 μgF/g), G-B (1,062 μgF/g) and G-C (1,373 μgF/g). Dentifrices A and B are marketed for children, while dentifrice C is a regular product. The amount of F ingested was indirectly obtained, subtracting the amount expelled and the amount left on the toothbrush from the amount initially loaded onto the brush. The results were analyzed by ANOVA, Tukey's test and linear regression analysis (p < 0.05). Children ingested around 60% of the dentifrice loaded onto the brush, but no significant differences were seen among the groups (p > 0.05). Mean daily fluoride intake from dentifrice for G-A, G-B and G-C was 0.022 a, 0.032 a and 0.061 b mg F/kg body weight, respectively (p < 0.01). There was a strong positive correlation (r = 0.86, p < 0.0001) between the amount of dentifrice used and the amount of fluoride ingested during toothbrushing. The results indicate the need for instructing children's parents and care givers to use a small amount of dentifrice (< 0.3 g) to avoid excessive ingestion of fluoride. The use of low-[F] dentifrices by children younger than 6 years also seems to be a good alternative to minimize fluoride intake. Dentifrice flavor did not influence the percentage of fluoride intake.

El tratamiento fisioterapéutico ¿es efectivo en el mantenimiento físico y en la reducción del declive cognitivo de las demencias?

Introduction. Dementia is a chronic and neurodegenerative disease responsible for a progressive decline of cognition and physical capacity. Objective: To verify the effectiviness of three months of physiotherapy intervention on cognitive functions and balance of institutionilized elderly people with dementia. Patients and methods. This study has comprised thirty subjects, divided in two groups: EG (experimental group) and CG (control group). EG was composed by 15 participants with mean age of 71,6 ± 8,5 years and scholarity of 4,7 ± 4,2 years. CG was formed by 15 subjects with mean age of 78,5 ± 7,6 years and scholarity of 2,2 ± 1,8 years. The sample was evaluated by means of the following instruments: Mini-Mental State Examination, Semantic Verbal Fluency test, Clock Drawing test, Berg Balance Scale and Timed Get Up and Go test. The statistical procedures were done by means of Multivariate Analisis of Variance (MANOVA), with significance of 5 % (p < 0,05). Results. The results has shown a heterogeneity of both groups related to age (F = 0,2, p < 0,05) and scholarity (F = 2,6, p < 0,05). MANOVA pointed beneficts of physiotherapy on balance (F = 7,3, p < 0,01) but not on cognitive functions (F = 0,3, p > 0,05). Conclusions. Three months of physiotherapy were effective to improuve physical capacity of institucionilized elderly people with dementia. Neverthless, it was not able to minimize cognitive decline commonly seen on dementia. The question if a prolonged intervention could propitiate cognitive beneficts remains, specially in a more homogeneous groups.

Propriedades físicas de um latossolo vermelho cultivado no sistema plantio direto

The pressure caused by agricultural machinery traffic many result in soil compactation in no-tillage system. The aim of this work was to evaluate no-tillage system onset,time on some physical properties, index S and organic matter (OM) of an oxysol located in Jaboticabal, Sao Paulo State, Brazil. The experiment had completely randomized split-splot design. The treatments consisted of four no-tillage systems: no-tillage for 2 years, no-tillage for 4 years, no-tillage for 6 years and one natural wooded area. The evaluated layers were: Q-0.10m, 0.10-0.20m and 0.20-030m. The following were determined: soil porosity, soil aggregates, bulk density, index S and organic matter. The results were submitted to variance analysis and when there was a difference between averages, Tukey's test was used to compare them. The natural wooded area showed higher organic matter, macroporosity, hydraulic conductivity and Index S. There was no difference between the studied parameters, showing that the no-tillage system for six years was not enough to change the soil physical property.

Analysis of culling probability in dairy buffalo using survival models

In order to contribute to the genetic breeding programs of buffaloes, this study aimed to determine the influence of environmental effects on the stayability (ST) of dairy female Murrah buffalo in the herd. Data from 1016 buffaloes were used. ST was defined as the ability of the female to remain in the herd for 1, 2, 3, 4, 5 or 6 years after the first calving. Environmental effects were studied by survival analysis, adjusted to the fixed effects of farm, year and season of birth, class of first-lactation milk yield and age at first calving. The data were analyzed using the LIFEREG procedure of the SAS program that fits parametric models to failure time data (culling or ST = 0), and estimates parameters by maximum likelihood estimation. Breeding farm, year of birth and first-lactation milk yield significantly influenced (P < 0.0001) the ST to the specific ages (1 to 6 years after the first calving). Buffaloes that were older at first calving presented higher probabilities of being culled 1 year after the first calving, without any effect on culling at older ages. Buffaloes with a higher milk yield at first calving presented a lower culling probability and remained for a longer period of time in the herd. The effects of breeding farm, year of birth and first-lactation milk yield should be included in models used for the analysis of ST in buffaloes. Copyright © The Animal Consortium 2010.

Comparison between protocols for the determination of anaerobic threshold in adolescent swimmers

Aim. The purpose of this study was to compare the anaerobic threshold speed (AT) obtained from fixed lactate blood concentrations (AT 4 mM and AT 3.5 mM), lactate minimum speed (LM) and critical speed (CS), determined from different distances in fifteen Brazilian national level swimmers (10 boys = 14.8 ± 0.6 years old and 5 girls = 14.6 ±0.8 year-old). Methods. The tests to determine the AT 4 mM, AT 3.5 mM, LM and CS were performed in a 25 m swimming pool and consisted of 7 or 8 evaluations separated by 24-48 h intervals. Data were submitted to analysis of variance (ANOVA) for repeated measures, followed by the post hoc Scheffé test and Pearson correlation coefficients. Significance was set at P<0.01. Results. There were no significant differences among the values for AT 4 mM and CS1 (1.34 ± 0.05 vs. 1.33 ± 0.05 m.s -1, respectively). However, AT 4 mM and CS1 were significantly higher than AT 3.5 mM (1.28 ± 0.04 m.s -1), LM (1.27 ± 0.05 m.s -1), CS2 (1.26 ± 0.06 m.s -1), CS3 (1.27 ± 0.06 m.s -1) and CS4 (1.25 ± 0.07 m.s -1). There were no significant differences among the values for AT 3.5 mM, LM, CS2, CS3 and CS4. Conclusion. The results obtained in this study suggest that the anaerobic threshold determined by a fixed lactate concentration of 3.5 mM, as well as the LM and the CS methods determined by different distances, seem to be the most appropriate indexes for the evaluation of aerobic capacity in adolescent swimmers.

Avaliação de grupo de intervenção para as mães/cuidadores de crianças pré-escolares com problemas de comportamento externalizantes

Negative parental practices may influence the onset and maintenance of externalizing behavior problems, and positive parenting seem to improve children's social skills and reduce behavior problems. The objective of the present study was to describe the effects of an intervention designed to foster parents' social skills related to upbringing practices in order to reduce externalizing problems in children aged 4 to 6 years. Thirteen mothers and two care taker grandmothers took part in the study with an average of four participants per group. To assess intervention effects, we used a repeated measure design with control, pre, and post intervention assessments. Instruments used were: (a) An interview schedule that evaluates the social interactions between parents and children functionally, considering each pair of child's and parent's behaviors as context for one another; (b) A Social Skills Inventory; (c) Child Behavior Checklist - CBCL. Intervention was effective in improving parent general social skills, decreasing negative parental practices and decreasing child behavior problems.

Evaluation of transverse changes in the dental arches according to growth pattern: a longitudinal study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Síndrome metabólica em mulheres na pós-menopausa tratadas de câncer de mama

PURPOSE: To assess the occurrence of metabolic syndrome (MetS) in postmenopausal breast cancer survivors. METHODS: A total of 158 breast cancer survivors were included in this cross-sectional study. Eligibility criteria were: women with amenorrhea >12 months and age ≥45 years, treated for breast cancer and no metastasis for at least five years. Clinical history and anthropometric indicator data (body mass index (BMI), and waist circumference, (WC) were collected. Biochemical parameters, including total cholesterol, HDL, LDL, triglycerides (TG), glucose and C-reactive protein (CRP), were measured. MetS was diagnosed as the presence of at least three of the following diagnostic criteria: WC>88 cm, blood pressure≥130/85 mmHg, triglycerides≥150 mg/dl, HDL <50 mg/dL,and glucose≥100 mg/dL. The Student's t-test and χ 2 test were used for statistical analysis. RESULTS: The mean age of breast cancer survivors was 63.1±8.6 years, with a mean follow-up of 9.1±4.0 years. MetS was diagnosed in 48.1% (76/158) and the most prevalent diagnostic criterion was abdominal obesity (WC>88 cm), affecting 54.4% (86/158) of the women. The patients without MetS had a longer follow-up compared those with MetS (p<0.05). Regarding the current BMI, PN average, those without MetS were overweight, and those with MetS were obese (p<0.05). Among the latter, comparison of BMI at the time of cancer diagnosis and current BMI (27.8±5.4 versus 33.4±5.4 kg/m2) showed a significant weight gain (p<0.05). Mean CRP values were higher in women with MetS (p<0.05). In the comparison of tumor characteristics and cancer treatments there was no difference between groups (p>0.05). CONCLUSION: Postmenopausal breast cancer survivors had a higher risk of developing metabolic syndrome and central obesity.

Principal components and factor analytic models for birth to mature weights in Nellore cattle

A total of 61,528 weight records from 22,246 Nellore animals born between 1984 and 2002 were used to compare different multiple-trait analysis methods for birth to mature weights. The following models were used: standard multivarite model (MV), five reduced-rank models fitting the first 1, 2, 3, 4 and 5 genetic principal components, and five models using factor analysis with 1, 2, 3, 4 and 5 factors. Direct additive genetic random effects and residual effects were included in all models. In addition, maternal genetic and maternal permanent environmental effects were included as random effects for birth and weaning weight. The models included contemporary group as fixed effect and age of animal at recording (except for birth weight) and age of dam at calving as linear and quadratic effects (for birth weight and weaning weight). The maternal genetic, maternal permanent environmental and residual (co)variance matrices were assumed to be full rank. According to model selection criteria, the model fitting the three first principal components (PC3) provided the best fit, without the need for factor analysis models. Similar estimates of phenotypic, direct additive and maternal genetic, maternal permanent environmental and residual (co)variances were obtained with models MV and PC3. Direct heritability ranged from 0.21 (birth weight) to 0.45 (weight at 6 years of age). The genetic and phenotypic correlations obtained with model PC3 were slightly higher than those estimated with model MV. In general, the reduced-rank model substantially decreased the number of parameters in the analyses without reducing the goodness-of-fit. © 2013 Elsevier B.V.

Risk of metabolic syndrome in postmenopausal breast cancer survivors

The aim of this study was to assess the risk of metabolic syndrome (MetS) in postmenopausal breast cancer survivors as compared with postmenopausal women without breast cancer. METHODS: In this cross-sectional study, 104 postmenopausal breast cancer survivors were compared with 208 postmenopausal women (controls) attending a university hospital. Eligibility criteria included the following: amenorrhea longer than 12 months and aged 45 years or older, treated for breast cancer, and metastasis-free for at least 5 years. The control group consisted of women with amenorrhea longer than 12 months and aged 45 years or older and without breast cancer, matched by age and menopause status (in a proportion of 1:2 as sample calculation). Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, and C-reactive protein, were measured. Women showing three or more diagnostic criteria were diagnosed as having MetS: waist circumference of 88 cm or larger, blood pressure of 130/85 mm Hg or higher, triglycerides level of 150 mg/dL or higher, high-density lipoprotein cholesterol level lower than 50 mg/dL, and glucose level of 100 mg/dL or higher. For statistical analysis, Student's t test, χ2 test, and logistic regression (odds ratio [OR]) were used. RESULTS: The mean (SD) age of breast cancer survivors was 60.6 (8.6) years, with a mean (SD) follow-up of 9.4 (4.4) years. A higher percentage of breast cancer survivors (46.2%) were obese as compared with controls (32.7%; P < 0.05), and a smaller percentage showed optimal values for low-density lipoprotein cholesterol, glucose, and C-reactive protein versus controls (P < 0.05). MetS was diagnosed in 50% of breast cancer survivors and in 37.5% of control group women (P < 0.05). Among the MetS diagnostic criteria, the most prevalent was abdominal obesity (waist circumference >88 cm), affecting 62.5% and 67.8% of the participants, respectively. In the control group, breast cancer survivors had a higher risk for MetS (OR, 1.66; 95% CI, 1.04-2.68), dysglycemia (OR, 1.05; 95% CI, 1.09-3.03), and hypertension (OR, 1.71; 95% CI, 1.02-2.89). CONCLUSIONS: Postmenopausal breast cancer survivors present a higher risk of developing MetS as compared with women without breast cancer. © 2012 by The North American Menopause Society.

How narrow is the spectrum of submaximal speeds in swimming?

The purpose of this study was to identify the boundary of submaximal speed zones (i.e., exercise intensity domains) between maximal aerobic speed (S-400) and lactate threshold (LT) in swimming. A 400-m all-out test, a 7 × 200 m incremental step test, and two to four 30-minute submaximal tests were performed by 12 male endurance swimmers (age = 24.5 ± 9.6 years; body mass = 71.3 ± 9.8 kg) to determine S-400, speed corresponding to LT, and maximal lactate steady state (MLSS). S-400 was 1.30 ± 0.09 m·s -1 (400 m-5:08 minutes:seconds). The speed at LT (1.08 ± 0.02 m·s-1; 83.1 ± 2.2 %S-400) was lower than the speed at MLSS (1.14 ± 0.02 m·s-1; 87.5 ± 1.9 %S-400). Maximal lactate steady state occurred at 26 ± 10% of the difference between the speed at LT and S-400. Mean blood lactate values at the speeds corresponding to LT and MLSS were 2.45 ± 1.13 mmol·L-1 and 4.30 ± 1.32 mmol·L-1, respectively. The present findings demonstrate that the range of intensity zones between LT and MLSS (i.e., heavy domain) and between MLSS and S-400 (i.e., severe domain) are very narrow in swimming with LT occurring at 83% S-400 in trained swimmers. Precision and sensitivity of the measurement of aerobic indexes (i.e., LT and MLSS) should be considered when conducting exercise training and testing in swimming. © 2013 National Strength and Conditioning Association.

Associação entre fatores de risco cardiovascular e capacidade funcional de idosos longevos

Study design: cross-sectional study. Objective: To assess the association between the presence of cardiovascular risk factor (CRP) and functional capacity of the oldest old. Methods: The sample 9onsisted of 91 elderly aged 80 and 90 years (83.0 ± 2.5 years) with 60 women (82.2 ± 2.1 years) and 31 men (83.2 ± 2,6 years) residing in the city of Presidente Prudente - SP. The FRC were analyzed: arterial hypertension (AH) and excess body fat (total and trunk). The presence of hypertension was verified by means of self-reported questionnaire based on the Standard Health Questionnaire (SHQ). Assessment of body was made by absorpiometria dual energy X-ray absorptiometry (DXA) and functional capacity was assessed by the functional tests (static balance, normal walking speed and force of the lower limbs). For statistical analysis we carried out the chi-square test, the software used was SPSS (13.0) and the significance level was set at 5%. Results. In males, with hypertension and the presence of excess %BF had lower performance in the lower limbs (83.3% lower and 16.7% higher), p = 0.011 compared to those with only a VCF. The elderly women with hypertension and the presence of excess GTron% also had lower performance on the same test (80.6% lower and 19.4% higher), p = 0.018 and the test of walking speed (80.6% lower and 19.4% higher), p = 0.034. Conclusion: Arterial hypertension and excess body fat (total and trunk) aggregated are FRC, which are associated with reduced functional capacity of the oldest old.