A university extension course in leprosy: telemedicine in the Amazon for primary healthcare

There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. Tele-educational resources were mediated by professors and coordinators, and included the use of theoretical content available through the web, discussion lists, Internet chat, activity diaries, 3-D video animations (Virtual Human on Leprosy), classes in video streaming and case simulation. Sixty-five FHT staff members were enrolled. All of them completed the course and 47 participants received a certificate at the end of the course. At the end of the course, 48 course-evaluation questionnaires were answered. A total of 47 participants (98%) considered the course as excellent. The results demonstrate the feasibility of an interactive, tele-education model as an educational resource for staff in isolated regions. Improvements in diagnostic skills should increase diagnostic suspicion of leprosy and may contribute to early detection.

On Fuzzy Implication Classes - Towards Extensions of Fuzzy Rule-Based Systems

Atualmente, há diferentes definições de implicações fuzzy aceitas na literatura. Do ponto de vista teórico, esta falta de consenso demonstra que há discordâncias sobre o real significado de "implicação lógica" nos contextos Booleano e fuzzy. Do ponto de vista prático, isso gera dúvidas a respeito de quais "operadores de implicação" os engenheiros de software devem considerar para implementar um Sistema Baseado em Regras Fuzzy (SBRF). Uma escolha ruim destes operadores pode implicar em SBRF's com menor acurácia e menos apropriados aos seus domínios de aplicação. Uma forma de contornar esta situação e conhecer melhor os conectivos lógicos fuzzy. Para isso se faz necessário saber quais propriedades tais conectivos podem satisfazer. Portanto, a m de corroborar com o significado de implicação fuzzy e corroborar com a implementação de SBRF's mais apropriados, várias leis Booleanas têm sido generalizadas e estudadas como equações ou inequações nas lógicas fuzzy. Tais generalizações são chamadas de leis Boolean-like e elas não são comumente válidas em qualquer semântica fuzzy. Neste cenário, esta dissertação apresenta uma investigação sobre as condições suficientes e necessárias nas quais três leis Booleanlike like — y ≤ I(x, y), I(x, I(y, x)) = 1 e I(x, I(y, z)) = I(I(x, y), I(x, z)) — se mantém válidas no contexto fuzzy, considerando seis classes de implicações fuzzy e implicações geradas por automorfismos. Além disso, ainda no intuito de implementar SBRF's mais apropriados, propomos uma extensão para os mesmos

Biocompatibility in vitro tests of mineral trioxide aggregate and regular and white Portland cements

Mineral trioxide aggregate (MTA) and Portland cement are being used in dentistry as root end-filling materials. However, biocompatibility data concerning genotoxicity and cytotoxicity are needed for complete risk assessment of these compounds. In the present study, genotoxic and cytotoxic effects of MTA and Portland cements were evaluated in vitro using the alkaline single cell gel (comet) assay and trypan blue exclusion test, respectively, on mouse lymphoma cells. The results demonstrated that the single cell gel (comet) assay failed to detect DNA damage after a treatment of cells by MTA and Portland cements for concentrations up to 1000 mu g/ml. Similarly, results showed that none of the compounds tested were cytotoxic. Taken together, these results seem to indicate that MTA and Portland cements are not genotoxins and do not induce cellular death.

Short Implant to Support Maxillary Restorations: Bone Stress Analysis Using Regular and Switching Platform

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

Regular and Platform Switching: Bone Stress Analysis Varying Implant Type

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

Evaluation of Different Retention Systems on a Distal Extension Removable Partial Denture Associated With an Osseointegrated Implant

The aim of this study was to evaluate the biomechanical behavior of a mandibular distal extension removable partial denture (DERPD) associated with an implant and different retention system, by bidimensional finite element method. Five hemimandible models with a canine and external hexagon implant at second molar region associated with DERPD were simulated: model A, hemimandible with a canine and a DERPD; model B, hemimandible with a canine and implant with a healing abutment associated to a DERPD; model C, hemimandible with a canine and implant with an ERA attachment associated to a DERPD; model D, hemimandible with a canine and implant with an O'ring attachment associated to a DERPD; and model E, hemimandible with a canine and implant-supported prosthesis associated to a DERPD. Cusp tips were loaded with 50 N of axial or oblique force (45 degrees). Finite element analysis was performed in ANSYS 9.0. model E showed the higher displacement and overload in the supporting tissues; the patterns of stress distribution around the dental apex of models B, C, and D were similar. The association between a DERPD and an osseointegrated implant using the ERA or O'ring systems shows lower stress values. Oblique forces showed higher stress values and displacement. Oblique forces increased the displacement and stress levels in all models; model C displayed the best stress distribution in the supporting structures; healing abutment, ERA, and O'ring systems were viable with RPD, but DERPD association with a single implant-supported prosthesis was nonviable.

Effects of Regular and Low-fluoride Dentifrices on Plaque Fluoride

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

Tunnel technique with a surgical maneuver to increase the graft extension: Case report with a 3-year follow-up

Background: This article reports a clinical case with a 3-year follow-up in which a subepithelial connective tissue graft (SCTG) was used with the tunnel technique to treat multiple gingival recessions, and describes a technique used to enlarge the extension of the graft.Methods: A 41 -year-old female patient was referred for evaluation and treatment of maxillary multiple recessions. Following basic therapy, the plaque index was 23%, and the gingival index was 12%. Thus, SCTG with the tunnel technique was proposed to provide root coverage of Miller Class I recession on teeth #8 through #11 and a Miller Class III recession on tooth #12. After the donor area had been prepared, SCTG was removed and split cross-sectionally to lengthen it. The graft was placed through the tunnel and sutured.Results: Two weeks after the surgical procedure, the tissue color was nearly homogeneous with some reddish regions where the connective tissue was left uncovered, and there were no signs of incisions or suture marks. After 3 years of follow-up, the mean coverage of the recessions was 2.2 +/- 0.7 mm (74.2%), which corresponded to the gain of keratinized tissue. In addition, a gain in tissue thickness was observed.Conclusion: In a long-term evaluation, the tunnel technique with the elongated SCTG was used successfully for treatment of multiple gingival recessions with an increase of the soft tissue volume and gain of keratinized tissue.

Reptilia, Squamata, Dipsadidae, Xenodontinae, Taeniophallus brevirostris (Peters, 1863): distribution extension and new state record.

Taeniophallus brevirostris is a dipsadid snake widely distributed in Amazon. Here we report a new Brazilian state record for the species, improving our knowledge of its geographic distribution. 0n 15 May of 2008, one female specimen was collected do Serra do Santo Expediot, Aripuana municipality, state of Mato Grosso, Brazil. This is the first record of this species for the state of Mato Grosso and extends its distribution ca. 300 kilometers from the nearest localities presented in literature.