Carcinoma basocelular de couro cabeludo x alopecia frontal fibrosante: desafio diagnóstico e terapêutico / Basal cell carcinoma of the scalp x frontal fibrosing alopecia: diagnostic and therapeutic challenge

O carcinoma basocelular é considerado a neoplasia mais comum do mundo, tem como principal fator de risco a radiação ultravioleta, pode aparecer em todo o corpo incluindo couro cabeludo. A alopecia frontal fibrosante é uma alopecia cicatricial primária, variante do líquen planopilar. A associação entre as duas patologias não tem relato prévio na literatura. Neste caso apresenta-se paciente feminina, pós-menopausa, atendida por queixa de queda de cabelo, com diagnóstico histopatológico de alopecia frontal fibrosante e carcinoma basocelular de couro cabeludo. A distinção das margens tumorais para exérese completa da neoplasia é complexa apenas pela dermatoscopia e exame físico, devido á presença de áreas de atrofia em comum. Então se optou pela cirurgia micrográfica de Mohs para delimitação histopatológica de margens.

BCC is considered the most common neoplasia in the world, it can appear throughout the body including the scalp. Frontal fibrosing alopecia is a primary scarring alopecia, variant of lichen planopilaris. The association between the two pathologies has not been previously reported in the literature. In this case it is presented a brazilian female patient complaining of hair loss, with histopathological diagnosis of AFF and scalp BCC. The distinction of tumor margins for neoplastic excision is complex only by dermoscopy and physical examination, due to areas of common atrophy. So Mohs micrographic surgery was chosen for histopathological delimitation of margins.

Carcinoma basocelular na vulva: um relato de caso de neoplasia cutânea em área especial / Basal cell carcinoma of the vulva: a case report of cutaneous neoplasia in a special area

O carcinoma basocelular (CBC) é o câncer de pele mais comum.¹ Entre os fatores de risco para seu desenvolvimento estão a exposição a radiações ionizantes e não ionizantes, alguns produtos químicos e cicatrizes prévias.² Porém, o fator mais importante é a exposição à radiação ultravioleta, o que explica a maior incidência dessa neoplasia em áreas fotoexpostas. O CBC em áreas não expostas é incomum. O objetivo deste relato é descrever um caso de CBC recorrente na vulva, demonstrar a importância do exame dermatológico em áreas incomuns e relatar a aplicação da cirurgia micrográfica de Mohs.

Basal cell carcinoma (BCC) is the most common skin cancer¹. Among the risk factors for its development are exposure to ionizing and non-ionizing radiation, some chemicals, and previous scars.² However, the most important factor is exposure to ultraviolet radiation, which explains the higher incidence of this neoplasm in photo-exposed areas.¹ BCC in unexposed areas is uncommon. The purpose of this report is to describe a case of recurrent BCC in the vulva, to demonstrate the importance of dermatological examination in unusual areas, and to report the application of Mohs micrographic surgery

As práticas dos consultórios na rua: perspectivas para o monitoramento e avaliação do campo / The "office in the street" practices: perspectives for field monitoring and evaluation

Os Consultórios na Rua (eCR) são equipes de Atenção Básica (AB) específicas para o atendimento da população em situação de rua (PSR) no Sistema Único de Saúde (SUS). Estas equipes foram criadas em 2011 pela Política Nacional de Atenção Básica. Atualmente, há 171 eCR atuando no território nacional, com aproximadamente 1.500 profissionais. Neste cenário, o conjunto de informações de âmbito nacional sobre o processo de trabalho das eCR é ainda incipiente, sobretudo informações que possam contribuir com a orientação e a organização do processo de trabalho e com os objetivos e a resolutividade esperada da atuação das eCR na AB, além de critérios para o monitoramento e a avaliação da prática destas equipes. Esta tese buscou sistematizar e debater as noções de objetivo, resolutividade e critérios de monitoramento e avaliação presentes na literatura (2009/2020), no registro das práticas das eCR (2019/2020), e junto aos atores envolvidos (pesquisadores, gestores de eCR, trabalhadores de eCR e usuários ­ pessoas em situação de rua) (2020). A metodologia adotada para tal seguiu três passos. Inicialmente foi realizada uma revisão documental e na literatura científica sobre estas equipes específicas, a fim de obter um mapeamento sobre os sentidos e os significados conferidos às noções de objetivo, resolutividade e critérios de monitoramento e avaliação das eCR. Na sequência, foi analisado um conjunto de dados do Cadastro Nacional de Estabelecimentos de Saúde, além de quatro fichas do prontuário eletrônico da AB (e-SUS AB) - fichas de cadastro, atendimento individual, procedimentos e atividade coletiva, para obter um retrato do cenário de implantação das eCR, do perfil profissional das equipes e do mapeamento das práticas das equipes. Por fim, foram realizadas 28 entrevistas com os atores envolvidos diretamente com as práticas das eCR nas cinco regiões do País, para obter a posição e os sentidos e significados dos atores sobre as noções estudadas. A imersão no universo das eCR revelou que ainda é tímida a literatura sobre os objetivos, a resolutividade e os critérios de monitoramento e avaliação para as eCR. Nos documentos oficiais e na literatura científica, o principal tema foi o acesso (da PSR à AB e ao SUS, ampliando a resolutividade da eCR e reforçando a eCR como equipe de AB nas redes locais). A literatura, as práticas mapeadas no e-SUS AB e as entrevistas apontaram para o aumento de enfermeiros e médicos nas equipes como uma questão a ser analisada, com efeitos na organização do processo de trabalho da equipe. Outras questões levantadas foram a necessidade de construção de um olhar específico para as mulheres em situação de rua e para as pessoas com problemas na relação com álcool e outras drogas. No geral, a sistematização dessas noções provoca reflexões sobre as possibilidades e os limites da atuação da eCR e da AB. As trocas com os campos estudados (literatura, prontuário eletrônico e os atores envolvidos) mostraram que as eCR transitam por muitas fronteiras (as fronteiras das políticas públicas, entre a AB e a Saúde Mental, entre os campos do conhecimento e entre a sociedade civil e as políticas públicas). Por esta característica junto à sua trajetória no SUS, mais do que delimitar fronteiras, as eCR podem ser ponte, provocando e sustentando conexões.

Street Offices Teams (eCR) are Primary Health Care (PHC) teams, specific for the care of the homeless population (PSR), in the Unified Health System (SUS). These teams were created in 2011 by the National Primary Care Policy. Currently, we have active 171 eCR in the national territory, with approximately 1,500 professionals. In this scenario, national information about the eCR work process is still incipient, especially those that can contribute to the orientation and organization of the work process, such as the objectives and the expected resolutivity of the eCR's performance in PHC, in addition to criteria for monitoring and evaluating the practice of these teams. This thesis sought to systematize and debate the notions of objective, resolution and monitoring and evaluation criteria from the literature (2009/2020), the registration of eCR practices (2019/2020), and the actors involved (researchers, eCR managers, eCR workers and users - people living on the streets) (2020). The methodology adopted for this followed three steps. Initially, a documental analysis and scientific literature review on these specific teams were carried out, to map the meanings and meaningfulness embedded on the eCR objectives, resolution and monitoring and evaluating criteria. Then, a set of data from the National Register of Health Establishments (CNES, in Portuguese) was analyzed, as well as four forms from the electronic medical record of the AB (e-SUS AB) - registration forms, individual care, procedures and collective activities), to obtain a picture of the eCR implementation scenario, the professional profile of the teams, in addition to the mapping of team practices. Finally, we conducted 28 interviews with the actors directly involved with the eCR practices in five regions of the country to obtain the actors' position and meanings and meaningfulness on the studied notions. Immersion in the eCR universe revealed that the literature on the objectives, resolution and monitoring and evaluation criteria for eCR is still timid. In the official documents and the scientific literature, the central theme was the access (from PSR to AB and SUS, expanding the resoluteness of eCR and reinforcing eCR as a PHC team in local networks). The literature, the practices mapped in e-SUS AB and the interviews pointed to the increase of nurses and doctors in the teams as an issue to be analyzed, with effects on the team's work process. Other issues raised were the need to have a specific approach for women on the street and people with alcohol and other drugs problems. In general, the systematization of these notions provoked reflections on the possibilities and limits of eCR and AB activities. Exchanges with the fields studied (literature, electronic medical records and the actors involved) showed that eCRs travel across many borders (the boundaries of public policies, PHC and Mental Health, between fields of knowledge, between civil society and public policies). Due to this characteristic and its trajectory in SUS, eCR can be a bridge, provoking and sustaining connections more than delimiting borders.

Should COVID-19 be branded to viral thrombotic fever?

Coronaviruses can cause a diverse array of clinical manifestations, from fever with symptoms of the common cold to highly lethal severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS). SARS-CoV-2, the coronavirus discovered in Hubei province, China, at the end of 2019, became known worldwide for causing coronavirus disease 2019 (COVID-19). Over one year's time period, the scientific community has produced a large bulk of knowledge about this disease and countless reports about its immune-pathological aspects. This knowledge, including data obtained in postmortem studies, points unequivocally to a hypercoagulability state. However, the name COVID-19 tells us very little about the true meaning of the disease. Our proposal is more comprehensive; it intends to frame COVID-19 in more clinical terminology, making an analogy to viral haemorrhagic fever (VHF). Thus, we found irrefutable evidence in the current literature that COVID-19 is the first viral disease that can be branded as a viral thrombotic fever. This manuscript points out that SARS-CoV-2 goes far beyond pneumonia or SARS. COVID-19 infections promote remarkable interactions among the endothelium, coagulation, and immune response, building up a background capable of promoting a "thrombotic storm," much more than a "cytokine storm." The importance of a viral protease called main protease (Mpro) is highlighted as a critical component for its replication in the host cell. A deeper analysis of this protease and its importance on the coagulation system is also discussed for the first time, mainly because of its similarity with the thrombin and factor Xa molecules, as recently pointed out by structural comparison crystallographic structures.

Antiparasitic and anti-inflammatory activities of ß-lapachone-derived naphthoimidazoles in experimental acute Trypanosoma cruzi infection

BACKGROUND Chagas disease, which is caused by the protozoan Trypanosoma cruzi, is endemic to Latin America and mainly affects low-income populations. Chemotherapy is based on two nitrocompounds, but their reduced efficacy encourages the continuous search for alternative drugs. Our group has characterised the trypanocidal effect of naphthoquinones and their derivatives, with naphthoimidazoles derived from β-lapachone (N1, N2 and N3) being the most active in vitro. OBJECTIVES In the present work, the effects of N1, N2 and N3 on acutely infected mice were investigated. METHODS in vivo activity of the compounds was assessed by parasitological, biochemical, histopathological, immunophenotypical, electrocardiographic (ECG) and behavioral analyses. FINDINGS Naphthoimidazoles led to a decrease in parasitaemia (8 dpi) by reducing the number of bloodstream trypomastigotes by 25-50% but not by reducing mortality. N1 protected mice from heart injury (15 dpi) by decreasing inflammation. Bradycardia was also partially reversed after treatment with N1 and N2. Furthermore, the three compounds did not reverse hepatic and renal lesions or promote the improvement of other evaluated parameters. MAIN CONCLUSION N1 showed moderate trypanocidal and promising immunomodulatory activities, and its use in combination with benznidazole and/or anti-arrhythmic drugs as well as the efficacy of its alternative formulations must be investigated in the near future.

Valoración de la lordosis lumbar y diámetro foraminal utilizando el Soporte de Cirugía Espinal / Evaluation of lumbar lordosis and foraminal diameter using a Spinal Surgery Table

Introducción Tenemos como objetivo, cuantificar los cambios de la lordosis fisiológica en las distintas posiciones, de pie y en decúbito ventral, sobre el Soporte de Cirugía Espinal (SCE) y evaluar indirectamente los cambios de diámetro de los distintos forámenes, midiendo la distancia interpedicular. Materiales y métodos 20 pacientes de 20 a 40 años. Se tomaron radiografías, en posición de pie y sobre el SCE. Se midió la lordosis lumbar en radiografías de pié, y sobre el SCE en dos posiciones (baja/alta) así como la distancia interpedicular de los forámenes de cada segmento. Resultados Se constata una pérdida de la lordosis en la primera posición de 21,65° (37,00%) y en la segunda posición de 28,75° (49,14%). Encontramos un aumento de la distancia interpedicular en todos los niveles tanto en la posición baja como alta del SCE. Los forámenes que presentaron mayor apertura fueron los segmentos de L4-L5, seguidos por L5-S1. Conclusiones Se encontró una pérdida promedio de la lordosis fisiológica del 37,00% y del 49,14% con la utilización del SCE en las dos posiciones utilizadas. En todos los casos existió un aumento de la distancia interpedicular, que vario entre un 10 y un 15%. Los forámenes que mayor apertura presentaron en las distintas posiciones fueron los segmentos L4-L5 seguido por L5-S1. La cifotización de los segmentos móviles permitirían una mejor liberación sacorradicular al aumentar el diámetro del canal y los forámenes. Nivel de Evidencia: IV

Background The aim of this study is to quantify the changes of the physiological lordosis in the different positions, standing and in ventral decubitus, on a Spinal Surgery Table (SST), and indirectly evaluate the changes in diameter of the different foramina, and measuring the interpedicular distance. Methods The study included 20 patients from 20 to 40 years old. X-rays were taken in standing position and on the SST. Lumbar lordosis was measured using the X-rays in the standing position, and on the SST in two positions (low/high), as well as the interpedicular distance of the foramina of each segment. Results A loss of lordosis was found in the first position of 22.65° (37.00%) and in the second position of 28.75° (49.14%). An increase was found in the interpedicular distance at all levels in both the low and high position of the SST. The foramina with the greatest opening were the L4-L5 segments, followed by L5-S1. Discussion A mean loss of 37.00% and 49.14%, respectively, was found in the physiological lordosis with the use the SST in the two positions used. In all cases there was an increase in the interpedicular distance, which varied between 10% and 15%. The foramina with the greatest openness in the different positions were segments L4-L5 followed by L5-S1. The kyphotisation of the mobile segments would allow a better sacrum-radicular release when increasing the diameter of the channel and the foramina. Evidence Level: IV

Competências para o trabalho nos consultórios na rua / Skill for the work in the street offices

Resumo A criação das equipes de Consultórios na Rua (eCR) recoloca em discussão a questão da formação em saúde, em especial para o trabalho com a população em situação de rua (PSR). Este estudo teve como objetivos: identificar os componentes de competências utilizadas pelos profissionais (conhecimentos, habilidades e atitudes); sistematizar e associar os componentes de tais competências; propor a síntese dos elementos mapeados em competências para o trabalho nas eCR. De abordagem qualitativa, a pesquisa foi realizada em duas fases de coleta e sistematização de dados: a realização de três grupos focais com as eCR do Distrito Federal; a construção de consenso sobre competências para trabalho na eCR em consulta a expertos, das cinco regiões do país, utilizando o Método Delphi. Foram elencados 25 conhecimentos, 37 habilidades e 16 atitudes como componentes das competências para o trabalho nas eCR. A partir dos 30 elementos mais votados pelos expertos, foram propostas três competências: uma no campo da clínica/cuidado, outra no campo do processo de trabalho e a última, sobre o trabalho em rede. Finalmente, discutiram-se os elementos que não foram incluídos na lista principal e como estes podem contribuir para o debate sobre a atuação dos profissionais em saúde para a atuação no Sistema Único de Saúde (SUS) e junto à PSR.

Abstract The creation of the Street Offices teams (eCR), to reassess issues related to the professional training for health, especially to working with people living on the streets (PSR). This study aimed at: identifying components of currently enacted competencies (knowledge, skills and attitudes); framing and associating these elements; proposing the synthesis of the mapped components as the core competencies for working in the eCR. With qualitative approach, this work assumed two phases for collecting and systematizing data: the execution of focus groups with three eCR from the Federal District; and the construction of consensus on competencies for work in the eCR, consulting 20 workers, managers and experts, from the five regions of the country, using the Delphi Method. Were considered as components of the competencies for the work at eCR: 25 knowledge, 37 skills, and 16 attitudes. From the 30 most voted elements by the experts, three competencies were proposed: one related to the clinical care, other related to the work process and the last one on service networking. Finally, the elements that were not included in the main list and how they can contribute to the debate about the health professionals, better qualifying them to work in the Unified Health System (SUS), with PSR.

Characterisation of the vascular pathology in Sigmodon hispidus (Rodentia: Cricetidae) following experimental infection with Angiostrongylus costaricensis (Nematoda: Metastrongylidae)

BACKGROUND Angiostrongylus costaricensis is a nematode that causes human abdominal angiostrongyliasis, a disease found mainly in Latin American countries and particularly in Brazil and Costa Rica. Its life cycle involves exploitation of both invertebrate and vertebrate hosts. Its natural reservoir is a vertebrate host, the cotton rat Sigmodon hispidus. The adult worms live in the ileo-colic branches of the upper mesenteric artery of S. hispidus, causing periarteritis. However, there is a lack of data on the development of vasculitis in the course of infection. OBJECTIVE To describe the histopathology of vascular lesions in S. hispidus following infection with A. costaricensis. METHODS Twenty-one S. hispidus were euthanised at 30, 50, 90 and 114 days post-infection (dpi), and guts and mesentery (including the cecal artery) were collected. Tissues were fixed in Carson’s Millonig formalin, histologically processed for paraffin embedding, sectioned with a rotary microtome, and stained with hematoxylin-eosin, resorcin-fuchsin, Perls, Sirius Red (pH = 10.2), Congo Red, and Azan trichrome for brightfield microscopy analysis. FINDINGS At 30 and 50 dpi, live eggs and larvae were present inside the vasa vasorum of the cecal artery, leading to eosinophil infiltrates throughout the vessel adventitia and promoting centripetal vasculitis with disruption of the elastic layers. Disease severity increased at 90 and 114 dpi, when many worms had died and the intensity of the vascular lesions was greatest, with intimal alterations, thrombus formation, iron accumulation, and atherosclerosis. CONCLUSION In addition to abdominal angiostrongyliasis, our data suggest that this model could be very useful for autoimune vasculitis and atherosclerosis studies.

Forensic dentistry job market in Brazil / Mercado de trabajo de odontologia forense en Brasil

Forensic Odontology is characterized by offer dental knowledge to the Justice system. The Forensic Odontologist, in Brazil, can work in civil, criminal, labor and administrative forums. This research aimed to show the professional profile in the labor market, employability, financial aspects and prospects. The predominant age group comprised from 31 to 40 year-olds and there is a balance between male and females. The Southeast region has the highest rate of professionals and experts believe that the job market is booming in areas that are promising and rewarding. Among the various fields, there is teaching and the position of Forensic Odontologist in police forces through public tenders, the main areas responsible for the increasing interest of dentists for this specialty. It was concluded that there is a heterogeneous distribution of specialists in Forensic Dentistry in the country's different regions however, the labor market appears to be thriving with some branches within the area that can be exploited by professionals.

La Odontología Forense, se caracteriza por ofrecer a la justicia, el conocimiento dental. El Odontólogo Forense en Brasil, puede desempeñarse en materia civil, penal, laboral y administrativa. El objetivo de la investigación fue evaluar el mercado de trabajo para los especialistas en Odontología Forense, tratando de conocer el perfil profesional, aspectos de empleabilidad, remuneración y perspectivas de estos profesionales. El grupo de edad predominante comprende de 31 a 40 años de edad y existe un equilibrio entre hombres y mujeres. La región sudeste tiene el mayor número de profesionales y los expertos consideran que el mercado laboral se está expandiendo en sectores prometedores y bien pagados. Ent re los diversos campos de la actividad, está la docencia y la posición de Odontologo Forense en las fuerzas policiales a través de concursos públicos, son éstas, las principales áreas responsables del creciente interés de los Dentistas por ésta especialidad. Se concluye, que hay una distribución heterogénea de profesionales especialistas en Odontología Forense, entre las regiones de Brasil, sin embargo, el mercado laboral parece estar creciendo, con algunas ramas dentro del area que pueden ser explotadas por los profesionales.

Cynomolgus monkeys (Macaca fascicularis) experimentally infected with B19V and hepatitis A virus: no evidence of the co-infection as a cause of acute liver failure

This study was conducted to analyse the course and the outcome of the liver disease in the co-infected animals in order to evaluate a possible synergic effect of human parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus monkeys were inoculated with serum obtained from a fatal case of B19V infection and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV and B19V, liver enzyme levels, viraemia, haematological changes, and necroinflammatory liver lesions were used for monitoring the infections. Seroconversion was confirmed in all infected groups. A similar pattern of B19V infection to human disease was observed, which was characterised by high and persistent viraemia in association with reticulocytopenia and mild to moderate anaemia during the period of investigation (59 days). Additionally, the intranuclear inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte counts were more evident in the co-infected group. The present results demonstrated, for the first time, the susceptibility of cynomolgus to B19V infection, but it did not show a worsening of liver histopathology in the co-infected group.

Using immunoglobulin Y as an alternative antibody for the detection of hepatitis A virus in frozen liver sections

An increasing amount of research has been conducted on immunoglobulin Y (IgY) because the use of IgY offers several advantages with respect to diagnostic testing, including its easy accessibility, low cost and translatability to large-scale production, in addition to the fact that it can be ethically produced. In a previous work, immunoglobulin was produced and purified from egg yolks (IgY) reactive to hepatitis A virus (HAV) antigens. In the present work, this anti-HAV-specific IgY was used in an indirect immunofluorescence assay to detect viral antigens in liver biopsies that were obtained from experimentally infected cynomolgus monkeys. Fields that were positive for HAV antigen were detected in liver sections using confocal microscopy. In conclusion, egg yolks from immunised hens may be a reliable source for antibody production, which can be employed for immunological studies.

Plant cells in the context of climate change

Global warming and its origins triggered the beginning to considerable discussion in the last century. Studies of climate models presented in multidisciplinary scientific reports suggest that anthropogenic activities, particularly the emission of gases from the greenhouse effect, are greatly responsible for the current climate changes. The increase of carbon dioxide (CO2) atmospheric concentration has been in discussion in the news, scientific meetings and in public policy debates in several countries. Apart from its impact on global warming, the rising atmospheric CO2 has alerted the scientific community to the need to investigate any morpho-physiological alterations in the plants, given their direct influence on photosynthesis. This article aims to discuss cellular aspects related to plant growth, their behavior of cuticular waxes and the responses of the stomatal development arising from the chemical change to the atmosphere, which are the causes of serious concern and discussion.

Estratégias de comunicação e o código de ética odontológica / Communications strategies and the dental code of ethics

A comunicação e a divulgação em Odontologia são relatadas pelo Código de Ética Odontológica, editado pelo Conselho Federal de Odontologia. A adoção pelos cirurgiões-dentistas de técnicas e estratégias de propaganda oriunda de outros mercados, muitas vezes, implica em infrações éticas. Esse trabalho irá analisar as mudanças implementadas pelo novo Código de Ética Odontológica, vigente a partir de 01/01/2013, em especial nos artigos que tratam da comunicação, focando os anúncios e publicidades permitidas, esclarecendo as situações que são consideradas infrações éticas. O cirurgião-dentista que comete alguma infração do código de ética está sujeito a penas que variam da advertência até a cassação do direito de exercer a Odontologia. O comportamento dos cirurgiões-dentistas e das pessoas jurídicas que exercem a Odontologia deve ser no sentido de evitar a mercantilização, zelando pelo bom prestígio e conceito da profissão.

Quando o auxiliar odontológico extrapola os limites / When the dental assistant exceed the limits

A utilização de pessoal auxiliar para realizar tarefas de menor complexidade em Ortodontia tem sido indicada com a finalidade de aumentar a produtividade nos consultórios. O Técnico de Saúde Bucal (TSB) e o Auxiliar de Saúde Bucal (ASB) são as duas profissões auxiliares da Odontologia que podem prestar assistência direta ao paciente, o que só pode ser feito sob a supervisão direta do cirurgião-dentista (CD). A Lei 11.889 de 24/12/2008, ao regulamentar essas profissões auxiliares, estabeleceu uma lista de atribuições clínicas, educativas e administrativas que cada uma delas pode executar. Na hipótese do auxiliar executar qualquer ato não pertencente a esse rol, tais como a realização de moldagens de estudo, colagem direta de braquetes, remoção do aparelho ortodôntico e colagem de contenção fixa, estará cometendo infrações nas áreas penal e ética. Já o CD que permite ou estimula essa conduta também poderá responder nas áreas cível e ética. Esse trabalho faz uma revisão de normas legais que regulam o exercício das profissões de TSB e ASB, focando nas suas atribuições e riscos, inclusive para o CD, da extrapolação das suas funções. A participação do pessoal auxiliar tem muito a contribuir na Ortodontia, porém, devem ser respeitados os limites legais de cada profissão.

Avaliação in vitro da adaptação marginal de restaurações indiretas de resinas compostas e cerâmica feldspática / In vitro evaluation of marginal adaptation of indirected restorations of composite resin and feldspathic ceramics

Objetivo: Avaliar a adaptação marginal de restaurações indiretas inlay de resinas compostas e cerâmica feldspática. Métodos: Foi utilizado um troquel metálico com preparo cavitário oclusoproximal, que foi moldadocom silicona de adição e o molde, vazado com gessopedra tipo IV. Dez restaurações em resinas compostasVita Zeta, Dialog II e Solidex foram confeccionadas pela técnica incremental, com três ciclos de ativaçãode 180s utilizando uma unidade de luz UniXS. Vinte restaurações de cerâmica feldspática Noritake EX-3 foram confeccionadas, sendo dez pela técnica convencional e dez pela técnica de pressão positiva de presa do revestimento refratário. Para verificação da adaptação marginal, as restaurações foram inseridas no troquelmetálico com um peso de 1,0 Kg e realizadas dez leituras na parede gengival da caixa proximal por meiode microscópio comparador MitutoyoTM, sendo os dados submetidos à análise estatística (Anova) para avaliação da adaptação marginal entre as marcas de resina composta e t-student para avaliação da variação técnicas de obtenção do modelo refratário. Resultados e conclusão: Não houve diferença estatisticamente significativana adaptação marginal entre as restaurações de resinas compostas e a cerâmica feldspática (p = 0,279), nem entre a técnica convencional e de pressão positiva de presa do revestimento refratário ( p = 0,385)

Omental and pleural milky spots: different reactivity patterns in mice infected with Schistosoma mansoni reveals coelomic compartmentalisation

In vertebrate animals, pleural and peritoneal cavities are repositories of milky spots (MS), which constitute an organised coelom-associated lymphomyeloid tissue that is intensively activated by Schistosoma mansoni infection. This study compared the reactive patterns of peritoneal MS to pleural MS and concluded from histological analysis that they represent independent responsive compartments. Whole omentum, lungs and the entire mediastinum of 54 S. mansoni-infected mice were studied morphologically. The omental MS of infected animals were highly activated, modulating from myeloid-lymphocytic (60 days of infection) to lymphomyeloid (90 days of infection) and lymphocytic or lymphoplasmacytic (160 days of infection) types. The non-lymphoid component predominated in the acute phase of infection and was expressed by monocytopoietic, eosinopoietic and neutropoietic foci, with isolated megakaryocytes and small foci of late normoblasts and mast cells. Nevertheless, pleural or thoracic MS of infected mice were monotonous, consisting of small and medium lymphocytes with few mast and plasma cells and no myeloid component. Our data indicate that compartmentalisation of the MS response is dependent on the lymphatic vascularisation of each coelomic cavity, limiting the effects or consequences of any stimulating or aggressive agents, as is the case with S. mansoni infection.

Correlação entre índice de massa corporal, distribuição de gordura e composição corporal em funcionários de um hospital universitário da região metropolitana de Belo Horizonte-MG / Correlation between body mass index, body fat distribution and body composition among employees of a university hospital in the metropolitan area of Belo Horizonte-MG / Correlación entre el índice de masa corporal, distribución de grasa y composición corporal en empleados de un hospital universitario de la zona metropolitana de Belo Horizonte-MG

O objetivo com esta pesquisa foi avaliar a correlação entre o índice de massa corporal, a relação cintura-quadril, a circunferência de cintura e o percentual de gordura em adultos. Trata-se de um estudo transversal, realizado em um hospital da Região Metropolitana de Belo Horizonte (RMBH), em 2007, com adultos de idade entre 20 e 59 anos, funcionários técnico-administrativos. Foram aferidos peso, altura, circunferência de cintura, quadril, braço e dobras cutâneas. Com base nessas medidas, foram calculados o índice de massa corporal, a relação cintura-quadril, o percentual de gordura e a área muscular do braço. A análise estatística foi feita com base no programa SPSS v.12.0. Foram realizados testes de Qui-quadrado de Pearson e teste exato de Fisher, com o nível de 5% de significância. Dos indivíduos avaliados (n=193), 66,3 % eram do sexo feminino, com média etária de 34,0 ± 8,4 anos. O índice de massa corporal médio encontrado foi igual em ambos os sexos, correspondendo a 26,4 kg/m2. Verificou-se que a relação cintura-quadril e o percentual de gordura tiveram coeficientes de menor magnitude com o índice de massa corporal (r=0,413 e r=0,502, respectivamente) quando comparada à circunferência de cintura (r=0,88). Comparando-se os indicadores de distribuição de gordura, percebeu-se que, para ambos os sexos, a circunferência de cintura foi o melhor indicador de excesso de peso.

The aim of this study is to evaluate the correlation between body mass index, waist to hip ratio, waist circumference and fat percentage in adults.This is cross-sectional study which was performed in a hospital in the metropolitan area of Belo Horizonte. During 2007, 193 adults from technical and administrative staff aged 20 to 59 years were evaluated. We first measured weight, height, waist, hip and neck circumferences and skin folds and then calculated the body mass index, the waist to hip ratio, the fat percentage and the muscle area of the arm. Statistical analysis was performed using SPSS v.12.0 program. Pearson's chi-square test and Fisher exact test were applied considering a 5% significance level. From a total of 193 patients evaluated, 66.3% were female. The mean age was 34.0 ± 8.4 years. The body mass index average was similar in both sexes, corresponding to 26.4 kg /m2. The waist to hip ratio and the fat percentage had lower coefficients of magnitude with body mass index (r = 0413 r = 0502, respectively) when compared to the waist circumference (r = 0.88).After comparing the indicators of fat distribution, we noticed that the measure of the waist circumference is the best indicator of excessive weight in both sexes.

Evaluar la correlación entre el índice de masa corporal, cintura-cadera, circunferencia de cintura y porcentaje de grasa en adultos. Se trata de un estudio transversal realizado en un hospital de la zona metropolitana de Belo Horizonte en 2007 con adultos de 20 a 59 años, personal técnico y administrativo. Se midió peso, talla, circunferencia de cintura, cadera y cuello y pliegues cutáneos. A partir de allí se calculó el índice de masa corporal, cintura-cadera, porcentaje de grasa y área muscular del brazo. El análisis estadístico se realizó con el programa SPSS v.12.0. Se llevaron a cabo las pruebas chi-cuadrado de Pearson y exacta de Fisher con nivel de significación del 5%. El 66,3% (n = 193) de los individuos evaluados eran mujeres, edad promedio de 34,0 ± 8,4 años. El índice promedio de masa corporal fue el mismo para los dos sexos, es decir, 26,4 kg /m2. Se constató que en la relación cintura-cadera y en el porcentaje de grasa había un coeficiente de menor magnitud con el índice de masa corporal (r = 0,413 r = 0,502, respectivamente) en comparación con la circunferencia de la cintura (r = 0,88).Comparando los indicadores de distribución de grasa se observa que, para ambos sexos, la circunferencia de la cintura es el mejor indicador del exceso de peso.

Morphological and functional characterizations of Schwann cells stimulated with Mycobacterium leprae

Nerve damage, a characteristic of leprosy, is the cause of patient deformities and a consequence of Schwann cells (SC) infection by Mycobacterium leprae. Although function/dysfunction of SC in human diseases like leprosy is difficult to study, many in vitro models, including SC lines derived from rat and/or human Schwannomas, have been employed. ST88-14 is one of the cell lineages used by many researchers as a model for M. leprae/SC interaction. However, it is necessary to establish the values and limitations of the generated data on the effects of M. leprae in these SC. After evaluating the cell line phenotype in the present study, it is close to non-myelinating SC, making this lineage an ideal model for M. leprae/SC interaction. It was also observed that both M. leprae and PGL-1, a mycobacterial cell-wall component, induced low levels of apoptosis in ST88-14 by a mechanism independent of Bcl-2 family members.

Freshwater sponge spicules: a new agent of ocular pathology

In a recent outbreak of human ocular injuries that occurred in the town of Araguatins, at the right bank of Araguaia river, state of Tocantins, Brazil, along the low water period of 2005, two patients (8 and 12-year-old boys) presented inferior adherent leukoma in the left eye (OS), and peripherical uveites, with snowbanking in the inferior pars plana. The third one (13-year-old girl) showed posterior uveites in OS, also with snowbanking. Histopathological analysis of lensectomy material from the three patients and vitrectomy from the last one revealed several silicious spicules (gemmoscleres) of the freshwater sponges Drulia uruguayensis and D. ctenosclera. This work brings material evidences, for the first time in the literature, that freshwater sponge spicules may be a surprising new etiological agent of ocular pathology.