Efeito do raloxifeno sobre a densidade mamográfica em mulheres na pós-menopausa

PURPOSE: to evaluate changes in mammographic breast density in postmenopausal women using raloxifene. METHODS: in this clinical trial, 80 women (mean age=61.1 years) were studied prospectively. Forty patients received 60 mg/day raloxifene, and 40 women comprised the non-treated group (control), paired by age and time of menopause. The treated group was composed of patients with osteoporosis of the lumbar spine. Those with history of breast surgery and users of hormone therapy up to six months prior to the study were excluded. The breast density was assessed qualitatively (subjective) and quantitatively (objective) in two moments, initial and final, after a 6-month follow-up. The 320 mammograms (craniocaudal and oblique) were interpreted qualitatively by the Breast Imaging Reporting and Data System (BI-RADS) classification and quantitatively by digital scanning and computer-assisted segmentation. For statistical analysis t-test, Wilcoxon Mann-Whitney, Spearman correlation and the kappa index were used. RESULTS: on the initial statistical comparison, the groups were considered homogenous for the variables: analyzed age, time of menopause, parity, breast feeding, previous hormonal therapy and body mass index. Baseline breast density, by qualitative and quantitative methods, correlated negatively with the age in both groups (p<0.05). Concerning the other variables, there was no correlation. After six months, no alteration was observed in the mammographic breast density in 38 women of raloxifene group and 38 of the control group, by qualitative method. However, by quantitative method, no alteration was observed in 30 women of the raloxifene group and 27 controls (p>0.05). It was observed a weak agreement rate (kappa=0.25) between the BI-RADS classification and digital scanning/computer-assisted segmentation. CONCLUSIONS: in post-menopausal women with osteoporosis, submitted to raloxifene treatment for six months, no alterations were observed on the mammographic breast density.

Influence of resin composite insertion technique in preparations with a high C-factor

Objective: To evaluate the marginal microleakage in enamel and dentin/cementum walls in preparations with a high C-factor, using 3 resin composite insertion techniques. The null hypothesis was that there is no difference among the 3 resin composite insertion techniques. Method and Materials: Standardized Class 5 cavities were prepared in the lingual and buccal aspects of 30 caries-free, extracted third molars. The prepared teeth were randomly assigned to 3 groups: (1) oblique incremental placement technique, (2) horizontal incremental placement technique, and (3) bulk insertion (single increment). The preparations were restored with a 1-bottle adhesive (Single Bond, 3M ESPE) and microhybrid resin composite (Z100, 3M ESPE). Specimens were isolated with nail varnish except for a 2-mm-wide rim around the restoration and thermocycled (1,000 thermal cycles, 5°C/55°C; 30-second dwell time). The specimens were immersed in an aqueous solution of 50 wt% silver nitrate for 24 hours, followed by 8 hours in a photo-developing solution and evaluated for microleakage using an ordinal scale of 0 to 4. The microleakage scores obtained from occlusal and gingival walls were analyzed with Wilcoxon and Kruskal-Wallis nonparametric tests. Results: The null hypothesis was accepted. The horizontal incremental placement technique, the oblique incremental technique, and bulk insertion resulted in statistically similar enamel and dentin microleakage scores. Conclusion: Neither the incremental techniques nor the bulk placement technique were capable of eliminating the marginal microleakage in preparations with a high C-factor.

Arquitetura da parede vascular de segmentos torácico e abdominais da aorta de macaco prego (Cebus apella)

The intimal layer of the thoracic and abdominal aortic segments of Cebus apella monkey presented an evident inner elastic lamina. The medial layer of the thoracic aorta segment showed a basic lamellar elastic pattern having a medium average of 23.12 lamellae per analyzed cut sections, which appeared disposed circular and oblique relatively to the aortic lumen. The aortic adventitial layer, at this level, was formed mainly by collagen fibers, irregularly disposed between elastic fibers and smooth muscle cells. The aortic abdominal portion, in this monkey, at the suprarenal level presented a medium number of 19.12 elastic lamellae which showed a relatively disorganized and broken up pattern. At the infrarenal level the aortic medium layer showed a medium average of 11.75 elastic lamellae and next to the emission of the internal iliac arteries it was found only a middle average of 8.37 elastic lamellae intermingled with smooth muscle cells and collagen fibers whose concentration seemed to be increased next to the adventitial layer. The external elastic lamina was only present in the more distal aortic segment near to the emission of the internal iliac arteries.

On the photonic dispersion of periodic superlattices made of left-handed materials

Studies of the band gap properties of one-dimensional superlattices with alternate layers of air and left-handed materials are carried out within the framework of Maxwell's equations. By left-handed material, we mean a material with dispersive negative electric and magnetic responses. Modeling them by Drude-type responses or by fabricated ones, we characterize the n(ω) = 0 gap, i.e., the zeroth order gap, which has been predicted and detected. The band structure and analytic equations for the band edges have been obtained in the long wavelength limit in case of periodic, Fibonacci, and Thue-Morse superlattices. Our studies reveal the nature of the width of the zeroth order band gap, whose edge equations are defined by null averages of the response functions. Oblique incidence is also investigated, yielding remarkable results. © 2010 Springer Science+Business Media B.V.

Effect of unilateral misfit on preload of retention screws of implant-supported prostheses submitted to mechanical cycling

Purpose: The aim of this study was to evaluate the effect of different levels of unilateral angular misfit on preload maintenance of retention screws of single implant-supported prostheses submitted to mechanical cycling. Materials and methods: Premachined UCLA abutments were cast with cobalt-chromium alloy to obtain 48 crowns divided into four groups (n=12). The crowns presented no misfit in Group A (control group) and unilateral misfits of 50μm, 100μm and 200μm in the groups B, C and D, respectively. The crowns were attached to external hexagon implants with a titanium retention screw with torque of 30N/cm. Oblique loading of 130N at 2Hz was applied on each replica, totalizing 5×104 and 1×106cycles. Detorque values were measured initially and after each cycling period. Data were evaluated by analysis of variance and Tukey's HSD test (p<0.05). Results: All groups presented reduced initial detorque values (p< 0.05) in comparison to the insertion torque (30. ± 0.5. N/cm) and Group A (25.18. N/cm) exhibited the lowest reduction. After mechanical cycling, all groups presented detorque values from 19.5. N/cm to 22.38. N/cm and the mechanical cycling did not statistically influence the detorque values regardless the misfit level of the replicas. Conclusion: The unilateral misfit influenced the preload maintenance only before mechanical cycling. The mechanical cycling did not influence the torque reduction. © 2010 Japan Prosthodontic Society.

Wavelets and decision trees for target detection over sea surface using cosmo-skymed SAR data

We are investigating the combination of wavelets and decision trees to detect ships and other maritime surveillance targets from medium resolution SAR images. Wavelets have inherent advantages to extract image descriptors while decision trees are able to handle different data sources. In addition, our work aims to consider oceanic features such as ship wakes and ocean spills. In this incipient work, Haar and Cohen-Daubechies-Feauveau 9/7 wavelets obtain detailed descriptors from targets and ocean features and are inserted with other statistical parameters and wavelets into an oblique decision tree. © 2011 Springer-Verlag.

Patellofemoral pain syndrome: Electromyography in a frequency domain analysis

The Patellofemoral Pain Syndrome (PFPS), has a multifactorial etiology and affects approximately 7 to 15% of the population, mostly women, youth, adults and active persons. PFPS causes anterior or retropatelar pain that is exacerbated during functional motor gestures, such as up and down stairs or spending long periods of time sitting, squatting or kneeling. As the diagnostic evaluation of this syndrome is still indirect, different mechanisms and methodologies try to make a classification that distinguishes patients with PFPS in relation to asymptomatic. Thereby, the purpose of this investigation was to determine the characteristics of the electromyographic (EMG) signal in the frequency domain of the vastus medialis oblique (VMO) and vastus lateralis (VL) in patients with PFPS, during the ascent of stairs. 33 young women (22 control group and 11 PFPS group), were evaluated by EMG during ascent of stairs. The VMO mean power frequency (MPF) and the VL frequency 95% (F95) were lower in symptomatic individuals. This may be related to the difference in muscle recruitment strategy exerted by each muscle in the PFPS group compared to the control group.

Influence of microthreads and platform switching on stress distribution in bone using angled abutments

Purpose: To evaluate the stress distribution in peri-implant bone by simulating the effect of an implant with microthreads and platform switching on angled abutments through tridimensional finite element analysis. The postulated hypothesis was that the presence of microthreads and platform switching would reduce the stress concentration in the cortical bone. Methods: Four mathematical models of a central incisor supported by an implant (5.0mm×13mm) were created in which the type of thread surface in the neck portion (microthreaded or smooth) and the diameter of the angled abutment connection (5.0 and 4.1mm) were varied. These models included the RM (regular platform and microthreads), the RS (regular platform and smooth neck surface), the SM (platform switching and microthreads), and the SS (platform switching and smooth neck). The analysis was performed using ANSYS Workbench 10.0 (Swanson Analysis System). An oblique load (100N) was applied to the palatine surface of the central incisor. The bone/implant interface was considered to be perfectly integrated. Values for the maximum (σmax) and minimum (σmin) principal stress, the equivalent von Mises stress (σvM), and the maximum principal elastic strain (e{open}max) for cortical and trabecular bone were obtained. Results: For the cortical bone, the highest σmax (MPa) were observed for the RM (55.1), the RS (51.0), the SM (49.5), and the SS (44.8) models. The highest σvM (MPa) were found for the RM (45.4), the SM (42.1), the RS (38.7), and the SS models (37). The highest values for σmin were found for the RM, SM, RS and SS models. For the trabecular bone, the highest σmax values (MPa) were observed in the RS model (6.55), followed by the RM (6.37), SS (5.6), and SM (5.2) models. Conclusion: The hypothesis that the presence of microthreads and a switching platform would reduce the stress concentration in the cortical bone was partially rejected, mainly because the microthreads increased the stress concentration in cortical bone. Only platform switching reduced the stress in cortical bone. © 2012 Japan Prosthodontic Society.

Semiautomatic dental recognition using a graph-based segmentation algorithm and teeth shapes features

Dental recognition is very important for forensic human identification, mainly regarding the mass disasters, which have frequently happened due to tsunamis, airplanes crashes, etc. Algorithms for automatic, precise, and robust teeth segmentation from radiograph images are crucial for dental recognition. In this work we propose the use of a graph-based algorithm to extract the teeth contours from panoramic dental radiographs that are used as dental features. In order to assess our proposal, we have carried out experiments using a database of 1126 tooth images, obtained from 40 panoramic dental radiograph images from 20 individuals. The results of the graph-based algorithm was qualitatively assessed by a human expert who reported excellent scores. For dental recognition we propose the use of the teeth shapes as biometric features, by the means of BAS (Bean Angle Statistics) and Shape Context descriptors. The BAS descriptors showed, on the same database, a better performance (EER 14%) than the Shape Context (EER 20%). © 2012 IEEE.

Association between energy cost of walking, muscle activation, and biomechanical parameters in older female fallers and non-fallers

Objective: To determine the nervous activation, muscle strength, and biomechanical parameters that influence the cost of walking in older fallers and non-fallers. Methods: Maximal voluntary isokinetic torque was measured for the hip, knee and ankle of older women. Oxygen consumption was measured at rest and during 8 min of walking at self-selected speed. An additional minute of walking was performed to collect kinematic variables and the electromyographic signal of trunk, hip, knee, and ankle muscles, which was analyzed by the linear envelope. Cost of walking was calculated by subtracting resting body mass-normalized oxygen consumption from walking body mass-normalized oxygen consumption. Stride time and length, and ankle and hip range of motion were calculated from kinematic data. Findings: Older adult fallers had 28% lower knee extensor strength (p = 0.02), 47% lower internal oblique activation at heel contact (p = 0.03), and higher coactivation between tibialis anterior and gastrocnemius lateralis in each of the gait phases (p < 0.05). For fallers, a higher activation of gluteus maximus was associated with a higher cost of walking (r = 0.55, p < 0.05 and r = 0.71, p < 0.01, before and after heel contact, respectively). For non-fallers, an association between cost of walking and age (r = 0.60, p = 0.01) and cost of walking and thigh muscle coactivation (r = 0.53, p = 0.01) existed. Interpretation: This study demonstrated that there may be links between lower-extremity muscle weakness, muscle activation patterns, altered gait, and increased cost of walking in older fallers. © 2013 Elsevier Ltd. All rights reserved.

Stress distribution in implant-supported prosthesis with external and internal implant-abutment connections

Objective. This study aimed to investigate the stress distribution in screwed implant-supported prostheses with different implant-abutment connections by using a photoelastic analysis. Materials and methods. Four photoelastic models were fabricated in PL-2 resin and divided according to the implant-abutment connection (external hexagon (EH) and Morse taper (MT) implants (3.75 × 11.5 mm)) and the number crowns (single and 3-unit piece). Models were positioned in a circular polariscope and 100-N axial and oblique (45) loading were applied in the occlusal surface of the crowns by using a universal testing machine. The stresses were photographically recorded and qualitatively analyzed using software (Adobe Photoshop). Results. Under axial loading, the MT implants exhibited a lower number of fringes for single-unit crowns than EH implants, whereas for a 3-unit piece the MT implants showed a higher number of fringes vs EH implants. The oblique loading increased the number of fringes for all groups. Conclusion. In conclusion, the MT implant-abutment connection reduced the amount of stress in single-unit crowns, for 3-unit piece crowns the amount of stress was lower using an external hexagon connection. The stress pattern was similar for all groups. Oblique loading promoted a higher stress concentration than axial loading. © Informa Healthcare.

Identifying financial crises in real time

Following the thermodynamic formulation of a multifractal measure that was shown to enable the detection of large fluctuations at an early stage, here we propose a new index which permits us to distinguish events like financial crises in real time. We calculate the partition function from which we can obtain thermodynamic quantities analogous to the free energy and specific heat. The index is defined as the normalized energy variation and it can be used to study the behavior of stochastic time series, such as financial market daily data. Famous financial market crashes-Black Thursday (1929), Black Monday (1987) and the subprime crisis (2008)-are identified with clear and robust results. The method is also applied to the market fluctuations of 2011. From these results it appears as if the apparent crisis of 2011 is of a different nature to the other three. We also show that the analysis has forecasting capabilities. © 2012 Elsevier B.V. All rights reserved.

EMG activity of trunk stabilizer muscles during Centering Principle of Pilates Method

This study aimed to analyze the electromyographic (EMG) activity of iliocostalis lumborum (IL), internal oblique (IO) and multifidus (MU) and the antagonist cocontraction (IO/MU and IO/IL) during the performance of Centering Principle of Pilates Method. Participating in this study were eighteen young and physically fit volunteers, without experience in Pilates Method, divided in two groups: low back pain group (LBPG, n = 8) and control group (CG, n = 10). Two isometric contractions of IO muscles (Centering Principle) were performed in upright sitting posture. EMG signal amplitude was calculated by Root Mean Square (RMS), which was normalized by RMS maximum value. The common area method to calculate the antagonist cocontraction index was used. MU and IO activation and IO/MU cocontraction (. p < 0.05) were higher in CG. The CG therefore showed a higher stabilizer muscles recruitment than LBPG during the performance of Centering Principle of Pilates Method. © 2012 Elsevier Ltd.

Comparison of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible - A computed tomography-based three-dimensional finite element analysis

A finite element analysis was used to compare the effect of different designs of implant-retained overdentures and fixed full-arch implant-supported prosthesis on stress distribution in edentulous mandible. Four models of an human mandible were constructed. In the OR (O'ring) group, the mandible was restored with an overdenture retained by four unsplinted implants with O'ring attachment; in the BC (bar-clip) -C and BC groups, the mandibles were restored with overdentures retained by four splinted implants with bar-clip anchor associated or not with two distally placed cantilevers, respectively; in the FD (fixed denture) group, the mandible was restored with a fixed full-arch four-implant-supported prosthesis. Models were supported by the masticatory muscles and temporomandibular joints. A 100-N oblique load was applied on the left first molar. Von Mises (σvM), maximum (σmax) and minimum (σmin) principal stresses (in MPa) analyses were obtained. BC-C group exhibited the highest stress values (σvM=398.8, σmax=580.5 and σmin=-455.2) while FD group showed the lowest one (σvM=128.9, σmax=185.9 and σmin=-172.1). Within overdenture groups, the use of unsplinted implants reduced the stress level in the implant/prosthetic components (59.4% for σvM, 66.2% for σmax and 57.7% for σmin versus BC-C group) and supporting tissues (maximum stress reduction of 72% and 79.5% for σmax, and 15.7% and 85.7% for σmin on the cortical and trabecular bones, respectively). Cortical bone exhibited greater stress concentration than the trabecular bone for all groups. The use of fixed implant dentures and removable dentures retained by unsplinted implants to rehabilitate edentulous mandible reduced the stresses in the periimplant bone tissue, mucosa and implant/prosthetic components. © 2013 Elsevier Ltd.

Antagonist coactivation of trunk stabilizer muscles during Pilates exercises

The purpose of this study was to compare the antagonist coactivation of the local and global trunk muscles during mat-based exercises of Skilled Modern Pilates. Twelve women performed five exercises and concurrently, surface EMG from internal oblique (OI), multifidus (MU), rectus abdominis (RA) and iliocostalis lumborum (IL) muscles was recorded bilaterally. The percentage of antagonist coactivation between local (OI/MU) and global muscles (RA/IL) was calculated. Individuals new to the practice of these exercises showed differences in coactivation of the trunk muscles between the exercises and these results were not similar bilaterally. Thus, in clinical practice, the therapist should be aware of factors such as compensation and undesirable rotation movements of the trunk. Moreover, the coactivation of global muscles was higher bilaterally in all exercises analyzed. This suggests that the exercises of Skilled Modern Pilates only should be performed after appropriate learning and correct execution of all principles, mainly the Centering Principle. © 2013 Elsevier Ltd. All rights reserved.