Conservative treatment of patients with periapical lesions associated with extraoral sinus tracts

This paper describes the clinical courses of three cases with extra-oral sinus tract formation, from diagnosis and treatment to short-term follow-up and evaluation. All teeth involved had periradicular radiolucent areas noted on radiographic examination and extra-oral sinus tracts appearing on the chin with exudation and unpleasant aesthetic appearance. The adopted treatment protocol included treating the sinus tract surface simultaneously with the root canal therapy. After root canal shaping using 5.25% sodium hypochlorite solution, calcium hydroxide-based pastes associated with different vehicles were inserted into the root canal for 4 months, and were changed monthly. All the sinus tracts healed in 7 to 10 days. The apical lesions were completely repaired in a maximum period of 24 months. The treatment adopted provided a complete healing of the periapical lesions in a short follow-up period. Surgical repair of the cutaneous sinus tract was therefore unnecessary. © 2007 The Authors. Journal compilation © 2007 Australian Society of Endodontology.

Autoimmunity does not contribute to the highly prevalent glucose metabolism disturbances in a Japanese Brazilian population

The Japanese Brazilian population has one of the highest prevalences of diabetes worldwide. Despite being non-obese according to standard definitions, their body fat distribution is typically central. We investigated whether a subset of these subjects had autoantibodies that would suggest a slowly progressive form of type 1 diabetes. A total of 721 Japanese Brazilians (386 men) in the 30- to 60-year age group underwent clinical examination and laboratory procedures, including a 75-g oral glucose tolerance test and determinations of serum autoantibodies. Antibodies to glutamic acid decarboxylase (GADab) were determined by radioimmunoassay and to thyroglobulin (TGab) and thyroperoxidase (TPOab) by flow-cytometry assays. Mean body mass index was 25.2 ± 3.8 kg/m2, but waist circumference was elevated according to the Asian standards. Diabetes, impaired glucose tolerance, and impaired fasting glycemia were found in 31%, 22%, and 22%, respectively, and 53% of the subjects had metabolic syndrome. Glutamic acid decarboxylase (GADab) was positive in 4.72%, TGab in 9.6%, and TPOab in 10% of the whole sample. When participants were stratified according to the presence of thyroid antibodies, similar frequencies of GADab were found in positive and negative groups. The prevalence rates of glucose metabolism disturbances did not differ between GADab positive and negative groups. Our data did not support the view that autoimmune injury could contribute to the high prevalence of diabetes seen in Japanese Brazilians, and the presence of co-morbidities included in the spectrum of metabolic syndrome favors the classification as type 2 diabetes.

SIG e sensoriamento remoto aplicado ao estudo dos processos de inundação e mapeamento da cobertura vegetal na planície fluvial do alto Rio Paraná

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Uma espécie nova de Neoplecostomus Eigenmann & Eigenmann, 1888 (Siluriformes: Loricariidae: Neoplecostominae) do Sistema do Alto rio Paraná, com uma descrição osteológica completas de Neoplecostomus microps (Steindachner, 1876)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Caracterização das alterações laboratoriais e histopatológicas associadas à obstrução uretral experimentalmente induzida em ratos

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

Doses de NPK no desenvolvimento, produtividade e qualidade de frutos do maracujazeiro ‘Roxinho do Kênia'

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação funcional e histológica do enxerto tubular de matriz acelular arterial heteróloga como substituto da uretra em coelhos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Restauração da parede torácica em cães com cartilagem auricular suína tratada pela glicerina

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Colocação de endoprótese vascular versus cirurgia para coarctação de aorta: revisão sistemática

Pós-graduação em Bases Gerais da Cirurgia - FMB

Reabilitação oral de paciente com síndrome da combinação: relato de caso

The Combination Syndrome represents an important pathologic condition of the masticatory system that requires a complex rehabilitation treatment. The presence of flaccid mucosa is one of the most common features due to bone resorption of the pre-maxilla caused by anterior hyperfunction of the mandibular teeth on the maxillary complete denture, where the impact of oclusal loading in this region results in movement of the maxillary prosthesis into the ridge, resulting in increased resorption of the residual ridge, internal misfit and loss of the retention of the maxillary complete denture. The presence of flaccid mucosa, in such cases, leads to problems of support and stability of the maxillary complete denture, which can be treated by surgical reduction of the thickness of the tissue or using specific techniques of fabrication of prostheses. This article describes the oral rehabilitation of a patient with the Combination Syndrome where the surgical reduction of flaccid mucosa was not performed, using a modified technique of functional impression in two steps, with the objective of generating forces and less distortion in flaccid mucosa during functional impression.

Surgical interventions for treating pectus excavatum

Background: Pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual's life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1997 a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objectives: To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Search methods: With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual's condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. Additionally we searched yet reference lists of articles and conference proceedings. All searches were done without language restriction. Date of the most recent searches: 14 January 2014. Selection criteria: We considered randomized or quasi-randomized controlled trials that compared traditional surgery with minimally invasive surgery for treating pectus excavatum. Data collection and analysis: Two review authors independently assessed the eligibility of the trials identified and agreed trial eligibility after a consensus meeting. The authors also assessed the risk of bias of the eligible trials. Main results: Initially we located 4111 trials from the electronic searches and two further trials from other resources. All trials were added into reference management software and the duplicates were excluded, leaving 2517 studies. The titles and abstracts of these 2517 studies were independently analyzed by two authors and finally eight trials were selected for full text analysis, after which they were all excluded, as they did not fulfil the inclusion criteria. Authors' conclusions: There is no evidence from randomized controlled trials to conclude what is the best surgical option to treat people with pectus excavatum.

Surgical interventions for treating pectus excavatum

Pectus excavatum is characterized by a depression of the anterior chest wall (sternum and lower costal cartilages) and is the most frequently occurring chest wall deformity. The prevalence ranges from 6.28 to 12 cases per 1000 around the world. Generally pectus excavatum is present at birth or is identified after a few weeks or months; however, sometimes it becomes evident only at puberty. The consequence of the condition on a individual’s life is variable, some live a normal life and others have physical and psychological symptoms such as: precordial pain after exercises; impairments of pulmonary and cardiac function; shyness and social isolation. For many years, sub-perichondrial resection of the costal cartilages, with or without transverse cuneiform osteotomy of the sternum and placement of a substernal support, called conventional surgery, was the most accepted option for surgical repair of these patients. From 1997 a new surgical repair called, minimally invasive surgery, became available. This less invasive surgical option consists of the retrosternal placement of a curved metal bar, without resections of the costal cartilages or sternum osteotomy, and is performed by videothoracoscopy. However, many aspects that relate to the benefits and harms of both techniques have not been defined. Objectives To evaluate the effectiveness and safety of the conventional surgery compared with minimally invasive surgery for treating people with pectus excavatum. Search methods With the aim of increasing the sensitivity of the search strategy we used only terms related to the individual’s condition (pectus excavatum); terms related to the interventions, outcomes and types of studies were not included. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, LILACS, and ICTPR. Additionally we searched yet reference lists of articles and conference proceedings. All searches were done without language restriction.

Hip fracture in a developing country: a picture in need of change

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Studio sull'applicazione della piattaforma ForcetriadTM con sistema LigasureTM nella chirurgia oncologica e dei tessuti molli nel cane

Questo studio prospettico valuta l’efficacia e i vantaggi del sistema LigasureTM rispetto alle tecniche chirurgiche tradizionali, in quattro differenti procedure eseguite su 77 cani. I soggetti sono stati suddivisi in 4 gruppi, a seconda della chirurgia eseguita: Gruppo 1, 25 pazienti sottoposti a Splenectomia “aperta” semplice; Gruppo 2, 15 pazienti sottoposti a Splenectomia “aperta” complessa; Gruppo 3, 22 pazienti sottoposti ad Ovariectomia “aperta”. Gruppo 4: 18 pazienti sottoposti a Linfoadenectomia. Ciascun gruppo è stato a sua volta suddiviso in due sottogruppi: a (LigasureTM) e b (Tradizionale), a seconda della metodica utilizzata. Sono stati analizzati: il segnalamento, i parametri ematologici, le condizioni cliniche, le informazioni riguardanti l’intervento chirurgico e l’outcome. In tutti i gruppi il ricorso all’utilizzo di garze nonché dei fili da sutura sono risultati statisticamente inferiori nei pazienti operati con il sistema a radiofrequenza (Gruppo 1, P < 0.0001; Gruppo 2, P < 0,0014; Gruppo 3, P = 0,0001; Gruppo 4, P = 0,0148). Anche i tempi per la rimozione dell’organo sono significativamente ridotti in tutti i gruppi in cui è stato utilizzato il sistema LigasureTM (Gruppo 1 P < 0.0001; Gruppo 2 P < 0,0014; Gruppo 3 P = 0,0009; Gruppo 4 P = 0,0008), come i tempi chirurgici nei gruppi 1, 2 e 3 (P = 0,0287; P = 0,0064; e P = 0,0124) ed anestesiologici nei gruppi 1a e 2a (P = 0,0176; P = 0,0043). Tra le variabili analizzate, l’utilizzo del sistema di sintesi vascolare a radiofrequenza, è l’unico ad influenzare i tempi necessari per l’esecuzione della procedura. Questo studio dimostra, quindi, come il sistema LigasureTM sia sicuro ed efficace per le procedure chirurgiche esaminate, riducendo i tempi della chirurgia e limitando, quindi, i rischi per il paziente, indipendentemente dall’operatore, dall’esecuzione di altre procedure contemporanee e dalla natura della patologia splenica o linfonodale.

Leukocyte- and Platelet-Rich Fibrin (L-PRF) for Long-Term Delivery of Growth Factor in Rotator Cuff Repair: Review, Preliminary Results and Future Directions

Surgical repair of the rotator cuff repair is one of the most common procedures in orthopedic surgery. Despite it being the focus of much research, the physiological tendon-bone insertion is not recreated following repair and there is an anatomic non-healing rate of up to 94%. During the healing phase, several growth factors are upregulated that induce cellular proliferation and matrix deposition. Subsequently, this provisional matrix is replaced by the definitive matrix. Leukocyte- and platelet-rich fibrin (L-PRF) contain growth factors and has a stable dense fibrin matrix. Therefore, use of LPRF in rotator cuff repair is theoretically attractive. The aim of the present study was to determine 1) the optimal protocol to achieve the highest leukocyte content; 2) whether L-PRF releases growth factors in a sustained manner over 28 days; 3) whether standard/gelatinous or dry/compressed matrix preparation methods result in higher growth factor concentrations. 1) The standard L-PRF centrifugation protocol with 400 x g showed the highest concentration of platelets and leukocytes. 2) The L-PRF clots cultured in medium showed a continuous slow release with an increase in the absolute release of growth factors TGF-β1, VEGF and MPO in the first 7 days, and for IGF1, PDGF-AB and platelet activity (PF4=CXCL4) in the first 8 hours, followed by a decrease to close to zero at 28 days. Significantly higher levels of growth factor were expressed relative to the control values of normal blood at each culture time point. 3) Except for MPO and the TGFβ-1, there was always a tendency towards higher release of growth factors (i.e., CXCL4, IGF-1, PDGF-AB, and VEGF) in the standard/gelatinous- compared to the dry/compressed group. L-PRF in its optimal standard/gelatinous-type matrix can store and deliver locally specific healing growth factors for up to 28 days and may be a useful adjunct in rotator cuff repair.