Ameloblastoma demographic, clinical and treatment study - analysis of 40 cases

Dental lesions represent about 1% of oral cavity tumors being ameloblastoma the most common one. It is a tumor of epithelial origin that mainly affects the jaw, and less commonly the maxilla. Its clinical presentation is that of an asymptomatic slow-growing tumor. Despite being a benign tumor, it has an invasive behavior with a high rate of recurrence if not treated properly. Objective: To describe the cases of ameloblastoma in a reference department. Methods: Retrospective analysis of 40 cases. The variables analyzed were: age, gender, ethnicity, tumor location, type of treatment, complications and recurrence. Results: The most affected gender was male - 21 cases (52.5%); with a predominance of Caucasians - 24 cases (60%). The mean age was 35.45 years; the most common location was in.the jaw - 37 cases (92.5%). Facial asymmetry was the most frequent complaint. Of the 40 cases, 33 were submitted to surgery. Of those submitted to surgery, 24 (72.72%) underwent segmental resection, with recurrence in 4 (12.12%) cases. Conclusion: Ameloblastoma may relapse when treatment is not performed with broad surgical resection of the lesion with wide safety margins.

Prognostic significance of the number of lymph nodes in elective neck dissection for tongue and mouth floor cancers

The presence of metastatic lymph nodes is a relevant aspect in the treatment of head and neck cancer, bringing about a 50% reduction in survival. Objective: To assess the number of lymph nodes removed in the neck dissection and their relationship with the prognosis. Methods: A retrospective study involving 143 patients with tongue and mouth floor epidermoid carcinoma, which histological exam showed no lymph node metastases. Among those, 119 were males and 24 females, with mean age of 54 years. As to the primary tumor site, 65 were in the tongue and 78 in the mouth floor. T stage distribution was of four T1, 84 T2, 36 T3 and 19 T4. We carried out 176 neck dissections, unilateral in 110 cases and bilateral in 33. Of these, 78 were radical and 98 selective. The patients were broken down into three groups, according to the 33 and 66 percentiles of the number of lymph nodes resected. Results: The mean number of resected lymph nodes was 27; 24 in selective dissections and 31 in the complete ones. We did not have statistically significant differences when associated to the T and N stages. Conclusions: The larger number of lymph nodes dissected in the neck dissection identifies the group of better prognoses among pN0 cases.

Influence of Pleural Drain Insertion in Lung Function of Patients Undergoing Coronary Artery Bypass Grafting

Background and objectives: Longitudinal, prospective, randomized, blinded Trial to assess the influence of pleural drain (non-toxic PVC) site of insertion on lung function and postoperative pain of patients undergoing coronary artery bypass grafting in the first three days post-surgery and immediately after chest tube removal. Method: Thirty six patients scheduled for elective myocardial revascularization with cardiopulmonary bypass (CPB) were randomly allocated into two groups: SX group (subxiphoid) and IC group (intercostal drain). Spirometry, arterial blood gases, and pain tests were recorded. Results: Thirty one patients were selected, 16 in SX group and 15 in IC group. Postoperative (PO) spirometric values were higher in SX than in IC group (p < 0.05), showing less influence of pleural drain location on breathing. PaO2 on the second PO increased significantly in SX group compared with IC group (p < 0.0188). The intensity of pain before and after spirometry was lower in SX group than in IC group (p < 0.005). Spirometric values were significantly increased in both groups after chest tube removal. Conclusion: Drain with insertion in the subxiphoid region causes less change in lung function and discomfort, allowing better recovery of respiratory parameters.

Excessive iodine intake in schoolchildren

Inadequate iodine intake may result in iodine deficiency disorders (IDD). Thus, for more than 50 years, policies for the regulation of salt fortification with iodine have existed in Brazil. In 2003, a study on 6-14-year-old schoolchildren from regions of the state of So Paulo showed a median urinary iodine concentration of 360 mu g/L. The objective of the present study was to assess the iodine nutrition status among schoolchildren. The study was conducted on 828 schoolchildren aged 4-13 years from eight schools in the interior of the state of So Paulo. A casual urine sample was collected from each volunteer for iodine determination by the adapted method of Sandell-Kalthoff. Only 1.9% (n = 16) of the children evaluated had low values of urinary iodine (< 100 mu g/L), while 24.6% had urinary iodine excretion values between 200 and 300 mu g/L, and 67.1% had values above > 300 mu g/L. The results show that the iodine nutritional status of the schoolchildren studied is characterized by a high urinary iodine excretion, which might reveal an increase in iodine consumption by this population.

Hybrid heuristic-waterfilling game theory approach in MC-CDMA resource allocation

This paper discusses the power allocation with fixed rate constraint problem in multi-carrier code division multiple access (MC-CDMA) networks, that has been solved through game theoretic perspective by the use of an iterative water-filling algorithm (IWFA). The problem is analyzed under various interference density configurations, and its reliability is studied in terms of solution existence and uniqueness. Moreover, numerical results reveal the approach shortcoming, thus a new method combining swarm intelligence and IWFA is proposed to make practicable the use of game theoretic approaches in realistic MC-CDMA systems scenarios. The contribution of this paper is twofold: (i) provide a complete analysis for the existence and uniqueness of the game solution, from simple to more realist and complex interference scenarios; (ii) propose a hybrid power allocation optimization method combining swarm intelligence, game theory and IWFA. To corroborate the effectiveness of the proposed method, an outage probability analysis in realistic interference scenarios, and a complexity comparison with the classical IWFA are presented. (C) 2011 Elsevier B.V. All rights reserved.

Behavioral analysis of the interaction between the spitting spider Scytodes globula (Araneae: Scytodidae) and the harvestman Discocyrtus invalidus (Opiliones: Gonyleptidae)

Spitting spiders (Scytodidae) have a distinct predatory strategy in which they eject a sticky secretion from their cheliceral fangs to immobilize prey. This behavior could potentially allow the spider not only to avoid defensive secretions but also to bite specific vulnerable spots of a potential prey such as a harvestman. We used an ethogram, a fluxogram and an experiment to analyze the interaction between the harvestman Discocyrtus invalidus Piza 1938 (Arachnida: Opiliones) and the syntopic spider Scytodes globula (Nicolet 1849) (Arachnida: Araneae). These spiders, while readily taking crickets as prey, seldom spat at and never bit the harvestmen, which apparently did not exude repugnatorial secretions. We therefore tested, by clogging the glands and using appropriate controls, whether non-visible amounts of secretions could cause the rejection, but the harvestmen were still refused. This is the first detailed and quantified description of an interaction between a spitting spider and a harvestman. The general conclusions are that S. globula avoids preying on D. invalidus, S. globula behaves differently when attacking harvestmen and crickets and the scent gland secretions of D. invalidus do not play a direct role in this predator-prey interaction.

Study of the number of occlusal contacts in maximum intercuspation before orthodontic treatment in subjects with Angle Class I and Class II Division 1 malocclusion

OBJECTIVE: Define and compare numbers and types of occlusal contacts in maximum intercuspation. METHODS: The study consisted of clinical and photographic analysis of occlusal contacts in maximum intercuspation. Twenty-six Caucasian Brazilian subjects were selected before orthodontic treatment, 20 males and 6 females, with ages ranging between 12 and 18 years. The subjects were diagnosed and grouped as follows: 13 with Angle Class I malocclusion and 13 with Angle Class II Division 1 malocclusion. After analysis, the occlusal contacts were classified according to the established criteria as: tripodism, bipodism, monopodism (respectively, three, two or one contact point with the slope of the fossa); cuspid to a marginal ridge; cuspid to two marginal ridges; cuspid tip to opposite inclined plane; surface to surface; and edge to edge. RESULTS: The mean number of occlusal contacts per subject in Class I malocclusion was 43.38 and for Class II Division 1 malocclusion it was 44.38, this difference was not statistically significant (p>0.05). CONCLUSIONS: There is a variety of factors that influence the number of occlusal contacts between a Class I and a Class II, Division 1 malocclusion. There is no standardization of occlusal contact type according to the studied malocclusions. A proper selection of occlusal contact types such as cuspid to fossa or cuspid to marginal ridge and its location in the teeth should be individually defined according to the demands of each case. The existence of an adequate occlusal contact leads to a correct distribution of forces, promoting periodontal health.

RECONHECENDO-SE SEM-RELIGIÃO NAS PERIFERIAS DA CIDADE: LIBERDADE COMPARTILHADA COMO RESISTÊNCIA

Reconhecendo, a partir da constatação empírica, a multiplicidade de escolhas de crenças no Mundo e em particular na periferia urbana paulistana, reconhecemos, também, a emergência criativa de novas possibilidades de crer e não crer. Tal amplitude não apenas aponta para o crer (segundo as ofertas de um sem número de religiões) e o não crer (ateu e agnóstico), mas para uma escolha que poderia vir a ser silenciada e esquecida, neste binômio arcaico e obsoleto, quando alguém se dá à liberdade crer sem ter religião. Reconhecer interessadamente os sem-religião nas periferias urbanas paulistanas é dar-se conta das violências a que estes indivíduos estão submetidos: violência econômica, violência da cidadania (vulnerabilidade) e proveniente da armas (grupos x Estado). Tanto quanto a violência do esquecimento e silenciamento. A concomitância espaço-temporal dos sem-religião nas periferias, levou-nos buscar referências em teorias de secularização e de laicidade, e, a partir destas, traçar uma história do poder violento, cuja pretensão é a inelutabilidade, enquanto suas fissuras são abertas em espaços de resistências. A história da legitimação do poder que se quer único, soberano, de caráter universal, enquanto fragmenta a sociedade em indivíduos atomizados, fragilizando vínculos horizontais, e a dos surgimentos de resistências não violentas questionadoras da totalidade trágica, ao reconhecer a liberdade de ser com autonomia, enquanto se volta para a produção de partilha de bens comuns. Propomos reconhecer a igual liberdade de ser (expressa na crença da filiação divina) e de partilhar o bem comum em reconhecimentos mútuos (expressa pela ação social), uma expressão de resistência não violenta ao poder que requer a igual abdicação da liberdade pela via da fragmentação individualizante e submissão inquestionável à ordem totalizante. Os sem-religião nas periferias urbanas, nossos contemporâneos, partilhariam uma tal resistência, ao longo da história, com as melissas gregas, os profetas messiânicos hebreus, os hereges cristãos e os ateus modernos, cuja pretensão não é o poder, mas a partilha igual da liberdade e dos bens comuns. Estes laicos, de fato, seriam agentes de resistências de reconhecimento mútuos, em espaços de multiplicidade crescente, ao poder violento real na história.

A SENSIBILIDADE CULTURAL DO ADVENTISMO COMO MODELO MISSIOLÓGICO EM GRANDES CENTROS URBANOS: UMA ANÁLISE DE IGREJAS ADVENTISTAS ÉTNICAS NA CIDADE DE SÃO PAULO

Esta pesquisa objetiva analisar o desenvolvimento da missão adventista na cidade de São Paulo em busca de um modelo missiológico para centros urbanos. São Paulo, uma das maiores metrópoles do mundo tem uma formação cultural plural, não apenas pelas forças atuantes da modernização, secularização, globalização e pós-modernidade. A composição da população da cidade possui uma gênese étnica plural. Além da matriz autóctone indígena, do colonizador branco europeu e dos escravos africanos, desde o início do século XIX chegaram outros imigrantes, europeus e asiáticos. Nas primeiras décadas do século XX, o Brasil foi o país que mais recebeu imigrantes em todo o mundo. Estima-se que nos anos de 1920, apenas um terço da população na cidade de São Paulo fosse de brasileiros, o restante era composto por imigrantes. A inserção do adventismo em São Paulo se deu por missionários imigrantes que trabalharam primeiro com outros imigrantes antes de evangelizar e desenvolver a missão adventista com os brasileiros nacionais. De alguma forma, esse início deixou marcas na missão adventista paulistana. São Paulo é hoje a cidade com o maior número total de adventistas no mundo e a única com Igrejas Adventistas étnicas que atendem cinco grupos étnicos distintos: japoneses, coreanos, judeus, árabes e bolivianos/peruanos. Esta pesquisa busca investigar a formação de uma sensibilidade cultural no adventismo paulistano que lhe permitiu dialogar com a pluralidade cultural da metrópole paulistana.

MANDRÁGORAS: MITOS E ASPECTOS DA CULTURA DE ISRAEL A PARTIR DE GÊNESIS 25 A 36

A sexualidade de Lea e Raquel, o útero, as mandrágoras e o corpo de Jacó são fatores que definem o alicerce do nosso texto como espaços de diálogo, mediação e estrutura do cenário. O destaque principal está sob o capítulo 30.14-16 que retrata a memória das mandrágoras. Como plantas místicas elas dominam o campo religioso e como plantas medicinais elas são utilizadas para solucionar problemas biológicos. As instituições e sociedades detentoras de uma ideologia e de leis que regulamentam uma existência apresentam na narrativa, duas irmãs, mas também esposas de um mesmo homem que, manipuladas por essa instituição que minimiza e oprime a mulher, principalmente a estéril, confina-as como simples objeto de sexualidade e mantenedoras da descendência por meio da maternidade. A memória das mandrágoras é sinal de que a prática existente circundava uma religião não monoteísta. Ela existia sociologicamente por meio de sincretismos, força e poderes sócio-culturais e religiosos. Era constituída das memórias de mulheres que manipulavam e dominavam o poder sagrado para controle de suas necessidades. O discurso dessas mulheres, em nossa unidade, prova que o discurso dessa narrativa não se encontra somente no plano individual, mas também se estende a nível comunitário, espaço que as define e lhes concede importância por meio do casamento e dádivas da maternidade como continuidade da descendência. São mulheres que dominaram um espaço na história com suas lutas e vitórias, com atos de amor e de sofrimento, de crenças e poderes numa experiência religiosa dominada pelo masculino que vai além do nosso conhecimento atual. As lutas firmadas na fé e na ideologia dessas mulheres definiram e acentuaram seu papel de protagonistas nas narrativas 9 bíblicas que estudamos no Gênesis. A conservação dessas narrativas, e do espaço teológico da época, definiu espaços, vidas, gerações e tribos que determinaram as gerações prometidas e fecharam um ciclo: o da promessa de Iahweh quanto à descendência desde Abraão. Os mitos e as crenças foram extintos para dar espaço a uma fé monoteísta, mas a experiência religiosa

MANDRÁGORAS: MITOS E ASPECTOS DA CULTURA DE ISRAEL A PARTIR DE GÊNESIS 25 A 36

A sexualidade de Lea e Raquel, o útero, as mandrágoras e o corpo de Jacó são fatores que definem o alicerce do nosso texto como espaços de diálogo, mediação e estrutura do cenário. O destaque principal está sob o capítulo 30.14-16 que retrata a memória das mandrágoras. Como plantas místicas elas dominam o campo religioso e como plantas medicinais elas são utilizadas para solucionar problemas biológicos. As instituições e sociedades detentoras de uma ideologia e de leis que regulamentam uma existência apresentam na narrativa, duas irmãs, mas também esposas de um mesmo homem que, manipuladas por essa instituição que minimiza e oprime a mulher, principalmente a estéril, confina-as como simples objeto de sexualidade e mantenedoras da descendência por meio da maternidade.A memória das mandrágoras é sinal de que a prática existente circundava uma religião não monoteísta. Ela existia sociologicamente por meio de sincretismos, força e poderes sócio-culturais e religiosos. Era constituída das memórias de mulheres que manipulavam e dominavam o poder sagrado para controle de suas necessidades. O discurso dessas mulheres, em nossa unidade, prova que o discurso dessa narrativa não se encontra somente no plano individual, mas também se estende a nível comunitário, espaço que as define e lhes concede importância por meio do casamento e dádivas da maternidade como continuidade da descendência. São mulheres que dominaram um espaço na história com suas lutas e vitórias, com atos de amor e de sofrimento, de crenças e poderes numa experiência religiosa dominada pelo masculino que vai além do nosso conhecimento atual. As lutas firmadas na fé e na ideologia dessas mulheres definiram e acentuaram seu papel de protagonistas nas narrativas 9 bíblicas que estudamos no Gênesis. A conservação dessas narrativas, e do espaço teológico da época, definiu espaços, vidas, gerações e tribos que determinaram as gerações prometidas e fecharam um ciclo: o da promessa de Iahweh quanto à descendência desde Abraão. Os mitos e as crenças foram extintos para dar espaço a uma fé monoteísta, mas a experiência religiosa dessas mulheres definiu um espaço: do poder sagrado e místico que corroborava com suas necessidades e definiam sua teologia.(AU)

Avaliação da eficácia da implementação de um pacote de medidas na prevenção de pneumonia associada à ventilação mecânica em unidade de terapia intensiva adulta

Background: Ventilator-associated pneumonia (VAP) is a health care related infection and the second leading cause of nosocomial infections linked to morbidity and mortality rates. Therefore, the implementation of care guideline protocols has become necessary for critically ill patients in ICUs in order to provide adequate treatment. Objective: To assess the impact of a package called FAST HUG in PAV ; analyze the risk factors for occurrence of VAP in adult patients at an ICU of a private hospital ; analyze the clinical characteristics of patients who were or were not submitted to the FAST HUG ; analyze the etiology of microorganisms related to EPI ; determine the cost of hospitalization in patients with pneumonia and in patients who received the FAST HUG.Methods: The study was performed in a private hospital that has an 8-bed ICU. It was divided into two phases: before implementing FAST HUG, from August 2011 to August 2012 and after the implementation of FAST HUG, from September 2012 to December 2013. An individual form for each patient in the study was filled out by using information taken electronically from the hospital medical records. The following data for each patient was obtained: age, gender, reason for hospitalization, the use of three or more types of antibiotics, length of stay, intubation time and progress. Findings: After the implementation of FAST HUG, there was an observable decrease in the occurrence of VAP (p <0.01), as well as a reduction in mortality rates (p <0.01). It also shows that the intervention performed in the study resulted in a significant reduction in ICU hospital costs (p <0.05).Conclusion: The implementation of FAST HUG reduced the cases of VAP. Thus, decreasing costs, reducing mortality rates and length of stay, which therefore resulted in an improvement to the overall quality of care.

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals

Influence of laparoscopy and laparotomy on gasometry, leukocytes and cytokines in a rat abdominal sepsis model

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals