Nephron-sparing surgery for treatment of reninoma: a rare renin secreting tumor causing secondary hypertension

A 25-year-old hypertensive female patient was referred to our institution. Initial workup exams demonstrated a 2.8 cm cortical lower pole tumor in the right kidney. She underwent laparoscopic partial nephrectomy without complications. Histopathologic examination revealed a rare juxtaglomerular cell tumor known as reninoma. After surgery, she recovered uneventfully and all medications were withdrawn. Case hypothesis: Secondary arterial hypertension is a matter of great interest to urologists and nephrologists. Renovascular hypertension, primary hyperadosteronism and pheocromocytoma are potential diagnosis that must not be forgotten and should be excluded. Although rare, chronic pyelonephritis and renal tumors as rennin-producing tumors, nephroblastoma, hypernephroma, and renal cell carcinoma might also induce hypertension and should be in the diagnostic list of clinicians. Promising future implications: Approximately 5% of patients with high blood pressure have specific causes and medical investigation may usually identify such patients. Furthermore, these patients can be successfully treated and cured, most times by minimally invasive techniques. This interesting case might expand knowledge of physicians and aid better diagnostic care in future medical practice.

Supratarsal approach to treatment of zygomatic complex fractures

Many incisions have been described for approaches to zygomatic fractures. Precise repositioning of zygomatic complex fractures is difficult. The traditional approach is through an eyebrow incision, but it can produce a scar that causes aesthetic and psychological problems for the patient. We describe the supratarsal fold approach to expose the frontozygomatic suture and to reduce small displacements of frontal sinus anterior wall; it gives good access and excellent aesthetic results.

Assistência cirúrgico-odontológica a pacientes imunodeprimidos por uso crônico de corticoides

Objective: The objective of this work, and review concepts on the physiology of hormones Adrenals to enhance pre, trans and post-operative care to dentists facing surgical, dental care of immunosuppressed patients. Literature review: The corticosteroids are among the most used drugs in medicine in recent times due to its anti-inflammatory and immunosuppressive activities, especially in transplant patients and patients with chronic autoimmune diseases. However, the continuing use of these drugs leads to a decrease in endogenous production of cortisol by the adrenal. Besides depressing the patient’s immune system, it may generate many parallel undesirable effects like blocking the production of the natural hormone of adrenal cortex, or steroid called cortisol, which may be the cause of a malfunctioning of the adrenal gland, causing hypofunction or hyperfunction of the gland. Final considerations: This fact will lead to changes in the planning of dental surgery, where it will be necessary special actions towards the patients who have this condition.

Efeito do estresse crônico e benzodiazepínicos no reparo ósseo: estudo histológico em ratos

Stress is an environmental factor that may predispose individuals to depression. Benzodiazepines have been prescribed as effective drugs in these situations. The purpose of this study was histological evaluate of the effect of chronic stress and benzodiazepine drugs on bone healing. Bone cavities were created in both tibias of 40 male rats were divided into two groups: Control and Treaty. In this, the stressor stimulus was applied 40 days pre-operative and all post-operative days until sacrifice in the morning for 2 hours, by immobilizing restraint. These animals also received diazepam benzodiazepine group, daily, at a concentration of 5mg/Kg/peso body within 15 days of preoperative. In groups of five animals were sacrificed at 7, 14, 30 and 60 days post-surgery. At 7 days postoperatively, while the control group exhibited tissue rich in fibroblasts, the treated group showed newly formed tissue with few fibroblasts and capillaries along with lymphocytes and macrophages. At 14 days postsurgery, the control group showed newly formed trabecular bone while the treated group progressed to thin trabecular bone with numerous osteoblasts on their borders. At 30 days post-operative bone healing is complete in both groups. At 60 days post-operative characteristics observed in the treated and control groups are similar to the previous period, but with more advanced osteogenesis.

Root reconstructed with mineral trioxide aggregate and guided tissue regeneration in apical surgery: a 5-year follow-up

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

Histological analysis of healing process after rat teeth replantation maintained in Resveratrol dissolved in dimethyl sufoxide (DMSO)

Tissue repair after replantation of avulsed teeth is directly related to the extent of damage to the cells of the periodontal ligament. Thus, immediate replantation is the treatment of choice for avulsed permanent teeth. To achieve more favorable prognostics, adequate storage media must be used to preserve periodontal ligament cells. A series of storage media are studied and show good results, such as saliva, milk, Hank's balanced solution (HBSS) and ViaSpan. However, recent studies were performed using news and promising storage media. Resveratrol has been extensively studied because of its antioxidant properties and its ability to prolong life of many organisms from yeast to mammals. One of its limitations is its poor solubility in aqueous vehicles. For this reason, the aim of this study was to evaluate the healing repair process after replantation of teeth of rats kept in Resveratrol using dimethyl sulfoxide (DMSO) as a vehicle. This study was approved by the Ethics Committee on Research with Animals, of the School of Dentistry of Araçatuba, Univ. Estadual Paulista, UNESP, Araçatuba, SP, Brazil. Were used 40 male rats, under general anesthesia upper right incisor were extracted and replanted. Treatments were done, dividing in four groups, of 10 animals each. In group I, the teeth were be extracted and immediately replanted into their sockets of origin (positive control). In group II, the teeth were immersed in 50 mL of resveratrol in DMSO (0.0512 g / ml) for 60 minutes. In group III teeth were kept for 60 minutes in 50 ml of DMSO. In group IV, the teeth were kept in dry for the same period (negative control). Then the teeth of animals in Groups II, III and IV were replanted in their sockets. Systemic antibiotics were administrated in all groups, and 60 days post-operative the animals were euthanized. The specimens were processed and stained in HE for histomorphological analysis. The results showed that resveratrol as storage media, was not able to improve the rep

Sintomas depressivos e experiência pessoal de pacientes submetidos à cirurgia eletiva de revascularização do miocárdio

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

Visual outcomes and pacient satisfaction follwing implantation of a supplementary multifocal IOL in patients undergoing cataract surgery

Purpose: To assess visual outcomes and patient satisfaction following implantation of the Sulcoflex® multifocal intraocular lens (IOL; Rayner Intraocular Lenses Ltd., Hove, UK) in a procedure combining capsular bag lens implantation with sulcus placement of the Sulcoflex® IOL. Setting: Instituto de Oftalmologia de Assis, Assis, SP, Brazil. Methods: Cataract patients > 45 years, with hyperopia ≥ 1.50 D and potential acuity measurement ≥ 20/30 undergoing Sulcoflex® multifocal IOL implantation were included. Monocular and binocular uncorrected near and distance visual acuity (VA) were evaluated at five days, one month, and three months postoperatively. Contrast sensitivity and refraction were measured in a subset of patients three months postoperatively. Patient satisfaction was assessed one month postoperative. Results: This non-consecutive case series comprised 25 eyes of 13 patients. Eleven eyes (52%) had pre-existing retinal pathologies. Monocular distance VA improved significantly at all follow-up visits. At final follow-up, 88% of eyes had monocular uncorrected distance VA (UDVA) of at least 20/25 and 24% had monocular UDVA of 20/20. All eyes had binocular UDVA of at least 20/25, and 58% had binocular UDVA of 20/20. Monocular uncorrected near vision (UNVA) was J1 in 68% of eyes and all patients had binocular UNVA of J1. Of all eyes studied, 92% and 58% achieved a spherical equivalent within 1 D and −0.5 D, respectively. The majority of patients reported satisfaction with visual outcomes. Complications included a postoperative intraocular pressure spike in four eyes. Conclusion: The Sulcoflex® multifocal IOL improves near and distance VA in cataract patients with retinal abnormalities and good VA potential.