Perception Of Oral And Maxillofacial Surgeons, Orthodontists And Laypersons In Relation To The Harmony Of The Smile.

Harmony is one of the main objectives in surgical and orthodontic treatment and this harmony must be present in the smile, as well as in the face. The aim of the present study was to assess the perceptions of professionals and laypersons in relation to the harmony of the smile of patients with or without vertical maxillary alterations. Sixty observers (oral and maxillofacial surgeons, orthodontists and laypersons) reported the degree of harmony of six smiles using an objective questionnaire and the participants indicated if there was a need for corrective surgery or not. The classification of observers was recorded on a Likert scale from 1 to 5. Mixed regression was used to determine differences between the three groups. Statistically significant differences were found only for the harmony of the smile between the oral and maxillofacial surgeons and laypersons, with laypersons being more critical when assessing the smile. There was no statistical difference between the other groups for the harmony of the smile or the indication of corrective surgery. The patterns of greater or lesser harmony determined by observers during the smile were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. Laypersons had a tendency to be more critical in relation to facial harmony than surgeons, although no statistical differences were found in the other groups in relation to the harmony of the smile or indication for the corrective surgery. In addition, the patterns of greater or lesser harmony of the smile determined by the participants were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. Overall, the present study demonstrates that adequate interaction between surgeons, orthodontists and laypersons is essential in order to achieve facial harmony with orthodontic and/or surgical treatment. Opinion of specialists and laypersons about the smile in relation to the vertical positioning of the maxilla.

Occurrence of skeletal malocclusions in Brazilian patients with dentofacial deformities

Este estudo avaliou a ocorrência de más oclusões esqueléticas apresentadas pelos pacientes do Centro de Pesquisa e Tratamento das Deformidades Bucofaciais (CEDEFACE), na cidade de Araraquara, SP, Brasil. Foram avaliados prontuários de 381 pacientes com deformidades dentoesqueléticas, que fizeram tratamento combinado ortodôntico-cirúrgico no período entre 2000 e 2006. Após a seleção da amostra (método de conveniência), baseado nos dados da documentação pré e pós-cirúrgica, o número de pacientes foi reduzido para 171. Para classificação do levantamento, considerou-se a discrepância ântero-posterior (Classe I, II e III), raça, idade, gênero, ausência ou presença de assimetria, excesso vertical maxilar e biprotrusão maxilar, além de determinar em qual base óssea o procedimento cirúrgico foi realizado. As documentações dos pacientes foram analisadas por um examinador previamente calibrado pelo processo de repetição até que o método fosse considerado adequado (correlação intraclasse >0,94). A idade média dos pacientes foi de 23,59 anos (DP 6,93), a maioria do gênero feminino (102 pacientes) e leucoderma (160 pacientes). A má oclusão mais prevalente foi a Classe III (81 pacientes). A assimetria, o excesso maxilar vertical e biprotrusão maxilar estavam presentes em 54, 33, e 7 pacientes, respectivamente. Na maioria dos casos, as cirurgias para correção de deformidades dentoesqueléticas foram combinadas, envolvendo os dois maxilares. Com base nos resultados, conclui-se que a Classe III foi a deformidade esquelética mais prevalente e a Classe I a menos prevalente. em geral, a prevalência de deformidades esqueléticas foi maior entre as mulheres e a maioria dos pacientes apresentou uma combinação de problemas maxilares e mandibulares, o que interfere diretamente na decisão sobre o plano de tratamento mais adequado. Houve uma maior incidência de assimetria na Classe III esquelética; o excesso vertical ocorreu de forma semelhante na Classe II e III e a biprotrusão teve baixa incidência entre as más oclusões avaliadas.

Prevalence of long face pattern in brazilian individuals of different ethnic backgrounds

Conclusions: Black individuals had greater prevalence of long face pattern, followed by Brown, White and Yellow individuals. The prevalence of long face pattern was 14.06% in which 13.39% and 0.68% belonged to moderate and severe subtypes, respectively.

Boron extraction and vertical mobility in Paraná State oxisol, Brazil

The deficiency or excess of micronutrients has been determined by analyses of soil and plant tissue. In Brazil, the lack of studies that would define and standardize extraction and determination methods, as well as lack of correlation and calibration studies, makes it difficult to establish limits of concentration classes for analysis interpretation and fertilizer recommendations for crops. A specific extractor for soil analysis is sometimes chosen due to the ease of use in the laboratory and not in view of its efficiency in determining a bioavailable nutrient. The objectives of this study were to: (a) evaluate B concentrations in the soil as related to the fertilizer rate, soil depth and extractor; (b) verify the nutrient movement in the soil profile; (c) evaluate efficiency of Hot Water, Mehlich-1 and Mehlich-3 as available B extractors, using sunflower as test plant. The experimental design consisted of complete randomized blocks with four replications and treatments of five B rates (0, 2, 4, 6, and 8 kg ha-1) applied to the soil surface and evaluated at six depths (0-0.05, 0.05-0.10, 0.10-0.15, 0.15-0.20, 0.20-0.30, and 0.30-0.40 m). Boron concentrations in the soil extracted by Hot Water, Mehlich-1 and Mehlich-3 extractors increased linearly in relation to B rates at all depths evaluated, indicating B mobility in the profile. The extractors had different B extraction capacities, but were all efficient to evaluate bioavailability of the nutrient to sunflower. Mehlich-1 and Mehlich-3 can therefore be used to analyze B as well as Hot Water.

Effect of sulfide concentration on autotrophic denitrification from nitrate and nitrite in vertical fixed-bed reactors

Autotrophic denitrification coupled with sulfide oxidation represents an interesting alternative for the simultaneous removal of nitrate/nitrite and sulfide from wastewaters. The applicability of such bioprocess is especially advantageous for the post treatment of effluents from anaerobic reactors, since they usually produce sulfides, which can be used as endogenous electron donor for autotrophic denitrification. This study evaluated the effect of sulfide concentration on this bioprocess using nitrate and nitrite as electron acceptors in vertical fixed-bed reactors. The results showed that intermediary sulfur compounds were mainly produced when excess of electron donor was applied, which was more evident when nitrate was used. Visual evidences suggested that elemental sulfur was the intermediary compound produced. There was also evidence that the elemental sulfur previously formed was being used when sulfide was applied in stoichiometric concentration relative to nitrate/nitrite. Nitrite was more readily consumed than nitrate. For both electron acceptors and sulfide concentrations tested, autotrophic denitrification was not affected by residual heterotrophic denitrification via endogenic activity, occurring as a minor additional nitrogen removal process. (C) 2012 Elsevier Ltd. All rights reserved.

Abdominoplastia vertical para tratamento do excesso de pele abdominal após perdas ponderais maciças

INTRODUÇÃO: As cirurgias bariátricas são cada vez mais frequentes no tratamento dos pacientes portadores de obesidade mórbida. A grande perda ponderal decorrente desses procedimentos causa excesso de pele e de tecido subcutâneo em todo o corpo, especialmente na região abdominal. O objetivo deste trabalho é apresentar a técnica de abdominoplastia vertical como alternativa para a ressecção do excesso de pele nesses pacientes. MÉTODO: Foram avaliados, retrospectivamente, os prontuários de 40 pacientes submetidos ao procedimento entre 2004 e 2009. O grau de satisfação dos pacientes foi avaliado através de escala subjetiva, com notas variando de 0 a 10. RESULTADOS: Vinte e cinco por cento dos pacientes apresentaram pequenas complicações, sendo 3 seromas, 3 pequenas deiscências e 5 cicatrizes hipertróficas, todas tratadas ambulatorialmente. Dois terços dos pacientes relataram alto grau de satisfação, considerando seus resultados bons (notas 7 ou 8) ou ótimos (notas 9 ou 10). CONCLUSÕES: A técnica de abdominoplastia vertical aparece como uma nova opção para o tratamento do excesso de pele abdominal em pacientes ex-obesos.

Resultados da cirurgia bariátrica e metabólica: gastrectomia vertical versus gastroplastia vertical com derivação em Y-de-Roux. Ensaio clínico prospectivo

Objetivos: Avaliar a equivalência da operação gastrectomia vertical com anel (GVA), em relação à operação gastroplastia vertical com anel e derivação gástrica em Y-de-Roux (DGA), na indução de perda ponderal e modificação da composição corporal em obesas mórbidas. Verificar os impactos laboratoriais e clínicos da GVA sobre as principais doenças associadas à obesidade mórbida, e a ocorrência de complicações, em comparação à DGA. Métodos: Ensaio clínico prospectivo não-randomizado, incluindo 65 mulheres obesas mórbidas, distribuídas em dois grupos, GVA (n = 33) e DGA (n = 32). Operadas consecutivamente, pelo mesmo cirurgião, por via laparotômica. Os parâmetros avaliados foram antropométricos; composição corporal, por meio de bioimpedância elétrica; laboratoriais; efeitos sobre as doenças pré-existentes e complicações. Resultados: Ocorreu perda de peso expressiva (p = 0,0000), redução do índice de massa corporal - IMC (p = 0,0000) e cintura abdominal (p = 0,0000) em ambos grupos. O índice cintura/quadril diminuiu (p = 0,0000) após ambas intervenções. A perda do excesso de IMC foi de 86,05% ± 14,2 no grupo GVA e 85,91 ± 15,71 no grupo DGA. A variação da gordura corporal foi de -35,84% ± 8,66 no grupo GVA e de -37,64% ± 9,62 no grupo DGA. A redução dos níveis de triglicerídios (p = 0,0222) foi mais expressiva no grupo DGA. O grupo DGA atingiu os alvos terapêuticos para o colesterol-LDL com maior freqüência (p = 0,0005), que o grupo GVA. Intolerância à glicose, diabetes mellitus tipo 2, hipertensão arterial sistêmica, esteatose hepática e síndrome metabólica, foram controladas de forma semelhante entre as técnicas. Anemia foi mais prevalente no grupo DGA (p=0,0033) e a esofagite erosiva, no grupo GVA (p = 0,0032). Não houve diferença na formação de cálculos biliares entre os grupos. Conclusões: A GVA é tão efetiva quanto a DGA em induzir perda ponderal e modificação favorável da composição corporal. A GVA é menos efetiva no controle da dislipidemia, em relação à DGA. GVA acarreta anemia em menor freqüência e, esofagite erosiva de maneira mais freqüente, que a DGA. GVA não é mais segura que a DGA, mas deve ser considerada intervenção bariátrica efetiva como segunda opção.

[Mason vertical gastroplasty in treatment of morbid obesity. Results of a prospective clinical study]

Morbid obesity (body mass index > 40 kg/m2) is a risk factor for cardiovascular, pulmonary, metabolic, neoplastic, and psychologic sequelae. In the present prospective clinical study 65 patients (11 men, 54 women) underwent vertical banded gastroplasty (Mason procedure) from June 1994 to October 1997. The median age was 41 +/- 5.3 years (range 18-69; n = 65). Preoperative body weight was 135 +/- 23 kg (96-229; n = 65), excess body weight in kg was 75 +/- 6.9 (44-155; n = 65) or in % 126 +/- 10 (78-223; n = 65) and BMI was 49 +/- 7.4 kg/m2 (39-69; n = 65). Mean hospital stay was 9.7 +/- 2.4 days (6-18; n = 65). Hospital mortality was 0% (0/65). Early complications were vomiting (30%) and problems in wound healing (15%; n = 65). Late complications (> 30 days) were incisional hernias (13.8%) and staple-line disruptions (12.3%; n = 65) with a reoperation rate of 23% (15/65). Median follow-up was 15.0 +/- 5.2 months (2-42) with a follow up rate of 100%. Mean weight loss after 12 months was 38.5 +/- 17 kg (30-98; n = 34) (P < 0.0001) and loss of excessive body weight 65 +/- 10% (57-86; n = 34), respectively (P < 0.0001). Cardiovascular risk factors (hypertension, diabetes, hyperlipidemia) were significantly improved within 12 months (n = 34). Vertical banded gastroplasty (Mason procedure)--well established for 20 years--is a good, safe therapy for morbid obesity if strict indications for operation are observed and if there is multidisciplinary long-term follow-up. Comorbid risk factors are considerably reduced and a long-term weight loss of more than 50% can be achieved without the risk of pathological metabolic changes.

Vertical flux reconstruction for sediment cores off Chile

Biogenic opal and organic carbon vertical rain rates in sediment cores reveal a strong cyclicity in the productivity of the upwelling system off presently arid northern Chile during the last 100,000 years. Changes in productivity are found to be in phase with the precessional cycle (~20,000 years) and with inputs of iron from the continent. During austral summer insolation maxima, increased precipitation and river runoff in the region appear to have brought high inputs of iron, mainly from the Andes, to the coastal ocean enhancing primary productivity there. We interpret our results as providing evidence for iron control of past productivity in this upwelling system and for a tight link between productivity and orbital forcing at midlatitudes.

Concentrations of total organic carbon on vertical profiles in waters of the Weddell Sea measured on water bottle sample during POLARSTERN cruise ANT-X/6

Concentrations of dissolved organic carbon (DOC) and nitrogen (DON) were measured during early austral Spring 1992 at a number of stations along the 6°W meridian between 47° and 60°S. This included the Polar Front in the north, the zone of melting sea-ice in the south, and waters of the Antarctic Circumpolar Current in between. Concentrations of DOC were low in deep water (34-38 ?M) with generally similar or slightly higher values in the surface mixed layer (38-55 ?M). DOC:DON ratios are wider in surface water than in deep water, i.e. surface accumulations contain relatively C-rich dissolved organic matter. The highly variable distribution of the surface DOC was not related to hydrographic or biotic features (fronts, plankton development) indicating the lability and transient occurrence of this material. Growth rates of bacteria were determined in subsamples from 51 0.8-?m-filtered batches of seawater incubated in the dark at in-situ temperature. Thymidine and leucine uptake and bacterial biomass change as well as changes in dissolved organic carbon in the batches, and oxygen consumption in parallel incubations correlated linearly over 2 weeks of incubation which allowed extrapolation to in-situ conditions. Bacterial growth in these experiments depended strongly on the amount of initial DOC. Growth in water from greater depth (1000 m) containing 38 ?M DOC was minimal, as were DOC-decrease and oxygen consumption. Higher rates were observed in surface water slightly enriched with DOC, and highest rates in surface water amended with DOC-rich melted sea ice. Bacterial growth efficiencies (biomass C-increase vs DOC consumed) were about 30%. The experiments showed that at least 40-60% of the DOC in excess of deep water concentrations was available to bacteria.

Discussion of “Initial Pore Pressure from Vertical Surface Loads” by Jacobo Bielak (September, 1982)

The author presents a very interesting application of the ideas developed by Scott to determine the initial pore pressure in excess of the hydrostatic pore pressure in linear, elastic, homogeneous and isotropic soil-skeleton. Scott demonstrates that under vertical surface loads the problem is governed by Laplace's equation. Nevertheless the writers' think that it could be interesting to state clearly the conditions under which this analogy can be applied.

Radon 222 excess measured on water bottle samples during HEINCKE cruise HE153

In the years 2000 and 2001 we measured methane concentrations exceeding up to two orders of magnitude the equilibrium with the atmosphere in the water column on the SW-Spitsbergen continental shelf. This methane anomaly extended from its centre on the shelf westwards over the upper slope and eastwards well into the inner basins of the two southernmost Spitsbergen fjords, the Hornsundfjord and the van Mijenfjord. Methane concentrations and stable carbon isotopic ratios varied between 2 and 240 nM, and between -53 per mill and -20 per mill VPDB, respectively. Methane in high concentrations was depleted in 13C whereas in low concentrations d13CCH4 values were highly variable. On the continental shelf we found that methane discharged from seeps on top of sandy and gravelly banks is isotopically heavier than methane escaping from troughs filled with silty and clayey sediments. These distinct isotopic signatures suggest that methane is gently released from several inter-granular seepages or micro-seepages widely spread over the shelf. A potential migration path for thermogenic or hydrate methane may be the Hornsund Fracture Zone, a south-north running reactivated fault system created by stretching of the continental crust. After discharge into the water column, local water currents fed by Atlantic water, coastal water, and freshwater outflows from the fjords further determine pathways and fate of the methane. We used d18Owater and 222Rn data to trace origin and advection of the local water masses and water mixing processes. Methane spreads predominantly along pycnoclines and by vertical mixing. During transport methane is influenced simultaneously by oxidation and dilution, as well as loss into the atmosphere. Together these processes cause the spatial variability of the anomaly and heterogeneity in d13CCH4 in this polar shelf environment.