Is Periodontal and Peri- Implant Disease Associated with Fixed Partial Denture Use? A 25-year Prospective Case Series.

INTRODUCTION: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs). METHODS: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05). RESULTS: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses. CONCLUSIONS: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success.

Effect of iodine supplementation in pregnancy on neurocognitive development on offspring in iodine deficiency areas: a systematic review.

OBJECTIVE: To investigate the effect of iodine supplementation during gestation on the neurocognitive development of children in areas where iodine deficiency is common. METHODS: Based on the PRISMA methodology, we conducted the search for articles in the PubMed, LILACS and Scopus databases, between March and April 2020, without limitation of dates. We used descriptors in English, Portuguese, and Spanish, without filters. Four clinical trials and four cohort articles were included in the review. RESULTS: The maximum supplementation was 300 µg of potassium iodide per day. The Bayley scale and Children's Communication Checklist-Short were used to assess neurodevelopment in children. There was no significant improvement in the children's mental development index and behavioural development index in the supplemented group; however, the psychomotor development index (PDI) showed improvement in the poorer gross motor skills. We found differences in the response time to sound in the supplemented group living in mild deficiency areas. CONCLUSION: Daily supplementation with iodine can improve poor psychomotor development of children living in mild to moderate iodine deficiency areas. Thus, it is necessary to perform further studies to assess the effect of supplementation on neurodevelopment before, during and after gestation in mild to moderate iodine deficiency areas.

Effect of iodine supplementation in pregnancy on neurocognitive development on offspring in iodine deficiency areas: a systematic review

ABSTRACT Objective: To investigate the effect of iodine supplementation during gestation on the neurocognitive development of children in areas where iodine deficiency is common. Materials and methods: Based on the PRISMA methodology, we conducted the search for articles in the PubMed, LILACS and Scopus databases, between March and April 2020, without limitation of dates. We used descriptors in English, Portuguese, and Spanish, without filters. Four clinical trials and four cohort articles were included in the review. Results: The maximum supplementation was 300 μg of potassium iodide per day. The Bayley scale and Children's Communication Checklist-Short were used to assess neurodevelopment in children. There was no significant improvement in the children's mental development index and behavioural development index in the supplemented group; however, the psychomotor development index (PDI) showed improvement in the poorer gross motor skills. We found differences in the response time to sound in the supplemented group living in mild deficiency areas. Conclusion: Daily supplementation with iodine can improve poor psychomotor development of children living in mild to moderate iodine deficiency areas. Thus, it is necessary to perform further studies to assess the effect of supplementation on neurodevelopment before, during and after gestation in mild to moderate iodine deficiency areas.

Atypical hemolytic uremic syndrome: An unusual postoperative complication. / Síndrome urémico hemolítico atípico: una complicación postoperatoria infrecuente.

INTRODUCTION AND OBJECTIVES: Thrombotic thrombocytopenic purpura and atypical haemolytic uremic syndrome (aHUS) are acute, rare, life-threatening thrombotic microangiopathies that require swift management. We report a case of acute microangiopathic haemolytic anaemia (MAHA) presenting in perioperative setting. CLINICAL CASE: After hepatic pericystectomy for hydatid cyst, a 46-year-old female developed MAHA, thrombocytopenia and acute renal failure in the immediate postoperative period. "aHUS" was considered and immediate plasma exchange was initiated. Plasma exchange was performed for 2 weeks with remission of renal dysfunction. Further evaluation of genetic mutations and immunological causes for MAHA were sought. Mutations in complement factor H associated with factor H deficiency were identified, which are associated with increased risk of aHUS. CONCLUSION: MAHA is a rare postoperative condition, requiring rapid differential diagnosis and treatment. Anaesthetists should bear in mind aHUS as a possible cause of MAHA, especially concerning immediate care for these patients.

Relationship between periodontics and restorative procedures: surgical treatment of the restorative alveolar interface (rai)--case series.

Maintenance of a healthy periodontium is fundamental for the long term success of prosthetic restorations. Thus, prosthetic procedures with subgingival margins may affect the periodontal health if the distances between the junctional epithelium and supracrestal connective tissue attachment aren't respected, or if there is insufficient space to maintain the health of the interproximal tissues, leading to gingival inflammation, connective tissue attachment loss and bone resorption. The restorative alveolar interface (RAI) technique was described as the portion of the root surface extending from the alveolar crest apically to the restorative margin coronally. RAI consists of modifying the restorative margin position into a healthier environment, respecting the biological width and therefore allowing effective plaque control. This paper describes four clinical cases with indication for the RAI technique for maintenance of periodontal health. The cases were associated with prostheses. All cases were evaluated at 90 days and exhibited a healthy periodontal tissue. Successful outcomes were observed in the different indications for the RAI technique.

Caracterização citogenética para identificação dos níveis de ploidia em cinco espécies do gênero Mentha L / Citogenetic characterization to determination of ploidy level on five Mentha L. species

Neste trabalho foi feita a caracterização citogenética da: microsporogênese, tétrades, estimativa da viabilidade do pólen pelo método de coloração e contagem do número máximo de nucléolos por célula interfásica, para identificação dos níveis de ploidia, em cinco espécies do gênero Mentha L. Foram coletadas inflorescências em 30 plantas de cada espécie, em duas florações sucessivas, nos anos 2006 e 2007. As inflorescências foram tratadas em etanol-ácido acético (3:1), em temperatura ambiente durante seis horas, transferidas para álcool 70% (v/v) e conservadas em geladeira até análise. Nas análises da microsporogênese, tétrades e pólen o corante usado foi carmin propiônico 2% e na identificação dos nucléolos nitrato de prata (AgNO3). Os resultados demonstraram que as cinco espécies são poliplóides. M. crispa heptaplóide (2n=7x=84) com 11 nucléolos, M. spicata tetraplóide (2n=4x=48) com 8 nucléolos, M.x gentilis pentaplóide (2n=5x=60) com 12 nucleólos, M. piperita e M.x piperita ambas hexaplóides (2n=6x=72) com 8 e 9 nucléolos respectivamente. M. spicata e M. crispa mantiveram as mais altas porcentagens de células normais na microsporogênese, na formação de tétrades e na estimativa da viabilidade do pólen por coloração, sugerindo maior estabilidade meiótica quando comparados aos demais poliplóides estudados.

The cytogenetic characterization of five species of Mentha L. genus, including the data: regularity of microsporogenesis and tetrads, and polen viability, using the coloration method and the counting of the maximum number of nucleolus by interphasic cell were carried out in this study to identify the ploid levels. These analyses were performed from inflorescences collected in 30 plants of each species, during two successive florations in 2006 and 2007. Inflorescences were treated in 3:1 ethanol:acetic acid mixture at room temperature during six hours, then transferred to 70%(v/v) ethanol solution and refrigerated until the analysis. For microsporogenis, tetrad and pollen analysis, we used carmine propionic 2% (m/v) and for nucleolus identification, we used AgNO3 solution. It was possible to observe that all five species were polyploids. M. crispa heptaploid (2n=7x=84) with 11 nucleolus, M. spicata tetraploid (2n=4x=48) with 8 nucleolus, M. x gentilis pentaploid (2n=5x=60) with 12 nucleolus, M. piperita and M. x piperita both hexaploid (2n=6x=72) with 8 and 9 nucleolus respectively. M. spicata and M. crispa kept the highest percentual values of normal cells in microsporogenesis as well as in tetrads formation and pollen viability, suggesting a higher meiotic stability when compared to the other polyploids studied.

Anal canal mucinous adenocarcinoma with invasion of gluteus and perineum treated with surgery and hyperbaric oxygen therapy.

The case of a 66-year-old female patient with late diagnosis of giant anal canal mucinous adenocarcinoma invading the gluteal and vulvar regions is reported. Because of the patient's severe clinical status and disease morbidity, surgical resection of the lesion was accomplished, with no adjuvant chemo- or radiotherapy. In the postoperative period, the patient received hyperbaric oxygen therapy, which facilitated and even accelerated local healing. Total closure of the raw flesh area was achieved, with no recurrence signals of cancer being detected after one-year follow-up. We are convinced that, in this difficult case, hyperbaric oxygen therapy played a crucial role in patient recovery and wound healing, allowing for early closure with good progression.

Development of a disposable amperometric biosensor for salicylate based on a plastic electrochemical microcell.

The use of an amperometric biosensor for rapid salicylate determination in blood is described. Photolitography was used to make gold electrodes on a polyester film. The plastic microcell was characterized using cyclic voltammetry to demonstrate the electrochemical performance of the system. The biosensor was constructed by immobilizing salicylate hydroxylase onto the working electrode of the plastic electrochemical microcell. The optimized working conditions were 0.1 mol L(-1) phosphate buffer at pH 7.6 with 0.5 mmol L(-1) of NADH and 300 mV vs. Au as the applied potential. The resulting biosensor exhibited a high sensitivity (97.4 nA/mmol L(-1) salicylate) and an adequate linear response range (1.2x10(-4) to 1.0x10(-3)mol(-1)). The biosensor performance was verified by determining salicylate in spiked blood samples and the results were statistically equivalent to the values obtained from the standard Trinder spectrophotometric method, with a 95% confidence level. This study shows the potential development of a portable, inexpensive and disposable device for point-of-care monitoring.

Equilibrium and kinetic analysis of methyl orange sorption on chitosan spheres.

Chitosan can be used as adsorbent in the treatment of effluents from the textile industry, especially for negatively charged dyes, due to its cationic polyelectrolyte nature. In this work, the sorption of a model dye, methyl orange, on chitosan hydrobeads is analyzed in terms of equilibrium and kinetic approaches. Equilibrium studies showed that dye adsorption had a mixed Freundlich-Langmuir behavior that had its Langmuir character increased as the pH was increased. In terms of adsorption kinetics, it was found to be of nth-pseudo-order, with fractional n increasing from approximately 2 to approximately 2.5 as pH and initial dye concentration in the continuous phase were increased. The increase in the apparent pseudo-order was related to changes in mathematical approximation for the solution of the sorption rate equation, which were the result of the decrease in the ratio (number of active sites for adsorption)/(number of adsorbate molecules).

Evaluation of the presence or absence of papilla between tooth and implant.

OBJECTIVE: The purpose of this study was to evaluate the papilla level adjacent to single-tooth implants in the maxillary anterior region in individuals with cleft lip, alveolus, and palate to verify whether there is correlation among the vertical distance, horizontal distance, dental/prosthetic crown shape, and periodontal/peri-implant biotype with the presence of interproximal papilla. DESIGN: Cross-sectional. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP). PATIENTS: 77 papillae in 40 patients. INTERVENTIONS: The periodontal/peri-implant biotype was clinically evaluated and characterized as thin or thick. Intraoral photographs were used to evaluate the presence or absence of papilla. MAIN OUTCOME MEASURES: Classification in scores (0 to 3) and determination of length (CL) and width (CW) of crowns adjacent to papillae. The CW/CL ratio was calculated for each crown in order to characterize it as square-shaped or triangular-shaped. The vertical and horizontal distances were obtained by radiographic evaluation. RESULTS: The correlations between vertical distance and papilla score and horizontal distance and papilla score were statistically significant (p = .02 and p = .01). There was no significant difference between crown shape and periodontal/peri-implant biotype in distinct correlations with the papilla score (p = .41 and p = .07). CONCLUSION: The results suggest that the vertical and horizontal distances may have independent or combined relationship with the existence of interproximal papilla; the periodontal/peri-implant biotype (phenotype) was not correlated with the presence or absence of papilla, as well as the shape of the dental/prosthetic crown.

Effects of a 30-km race upon salivary lactate correlation with blood lactate.

Blood lactate has been used to determine the aerobic capacity and long distance performance. Recently, a new methodology has been suggested to supplant the invasive blood lactate techniques. Salivary lactate has received attention because it shows high correlation to blood lactate in progressive overload test. We evaluated the correlation between salivary and blood lactate during a long distance run and assessed possible changes in salivary lactate concentration. Fifteen expert marathon racers ran 30 km as fast as possible. Saliva and 25 muL of blood were collected at rest and at each 6 km for lactate determination. Blood lactate concentration increased in the 6th km and then remained constant until the end of the race. Salivary lactate increased after 18 km in relation to basal. We found high correlations between blood and saliva absolute lactate (r=0.772, p<0.05) and the blood lactate relative concentration corrected by protein (r=0.718, p<0.05). The highest correlation found between absolute and relative salivary lactate was r=0.994 (p<0.001). Our results show that it is possible to use salivary lactate with absolute values or relative protein concentration. In addition, salivary lactate showed a high correlation with blood lactate in endurance events.

Aurapten, a coumarin with growth inhibition against Leishmania major promastigotes

Several natural compounds have been identified for the treatment of leishmaniasis. Among them are some alkaloids, chalcones, lactones, tetralones, and saponins. The new compound reported here, 7-geranyloxycoumarin, called aurapten, belongs to the chemical class of the coumarins and has a molecular weight of 298.37. The compund was extracted from the Rutaceae species Esenbeckia febrifuga and was purified from a hexane extract starting from 407.7 g of dried leaves and followed by four silica gel chromatographic fractionation steps using different solvents as the mobile phase. The resulting compound (47 mg) of shows significant growth inhibition with an LD50 of 30 æM against the tropical parasite Leishmania major, which causes severe clinical manifestations in humans and is endemic in the tropical and subtropical regions. In the present study, we investigated the atomic structure of aurapten in order to determine the existence of common structural motifs that might be related to other coumarins and potentially to other identified inhibitors of Leishmania growth and viability. This compound has a comparable inhibitory activity of other isolated molecules. The aurapten is a planar molecule constituted of an aromatic system with electron delocalization. A hydrophobic side chain consisting of ten carbon atoms with two double bonds and negative density has been identified and may be relevant for further compound synthesis.

Aurapten, a coumarin with growth inhibition against Leishmania major promastigotes.

Several natural compounds have been identified for the treatment of leishmaniasis. Among them are some alkaloids, chalcones, lactones, tetralones, and saponins. The new compound reported here, 7-geranyloxycoumarin, called aurapten, belongs to the chemical class of the coumarins and has a molecular weight of 298.37. The compound was extracted from the Rutaceae species Esenbeckia febrifuga and was purified from a hexane extract starting from 407.7 g of dried leaves and followed by four silica gel chromatographic fractionation steps using different solvents as the mobile phase. The resulting compound (47 mg) of shows significant growth inhibition with an LD50 of 30 microM against the tropical parasite Leishmania major, which causes severe clinical manifestations in humans and is endemic in the tropical and subtropical regions. In the present study, we investigated the atomic structure of aurapten in order to determine the existence of common structural motifs that might be related to other coumarins and potentially to other identified inhibitors of Leishmania growth and viability. This compound has a comparable inhibitory activity of other isolated molecules. The aurapten is a planar molecule constituted of an aromatic system with electron delocalization. A hydrophobic side chain consisting of ten carbon atoms with two double bonds and negative density has been identified and may be relevant for further compound synthesis.

Root trunk concavities as a risk factor for regenerative procedures of class II furcation lesions in dogs.

BACKGROUND: The purpose of this study was to evaluate the influence of root trunk concavities on guided tissue regeneration. METHODS: The second, third, and fourth mandibular bicuspids of 4 healthy mongrel dogs were used. Full flaps were elevated and furcation lesions (5 mm in height and 2 mm in depth) were surgically created. One mm deep concavities were prepared on the root trunks and part of the crown of all teeth. The second bicuspids remained as controls (C); the left third and fourth bicuspids received normal expanded polytetrafluoroethylene (ePTFE) membranes (NM) and the right bicuspids received modified ePTFE membranes (MM). The MM were made by removing the collar from an NM, cutting it into 2 mm segments, and suturing each of the segments to the collar of each MM. Normal and modified membranes were sutured to their corresponding teeth and the flaps sutured. After the healing period, the mandibles were removed and the teeth processed for histomorphometry. RESULTS: The results showed that the junctional epithelium measured a mean of 0.71 mm for C, 0.64 mm for NM, and 0.14 mm for MM. The differences between C and MM and between NM and MM were both statistically significant at the 5% level (Kruskal-Wallis test). Mean bone height measurements for the buccal surfaces from the furcation roofs were 2.79 mm for C, 2.60 mm for NM, and 1.06 mm for MM and for the mid-portion 1.10 mm for C, 1.23 mm for NM, and 0.30 mm for MM. Differences were statistically significant at the 1% level between C and MM and between NM and MM for the buccal measurements, and at the 5% level between NM and MM for the mid-portion measurements. CONCLUSIONS: Root trunk concavities are important risk factors for regenerative procedures. The collars of the membranes should be modified to improve results when concavities are present.

Comparative biological activities of alpha-MSH antagonists in vertebrate pigment cells.

We have previously reported that melatonin was an effective lightening agonist in the teleost Synbranchus marmoratus, the amphibians Rana pipiens and Bufo ictericus, and in the lizard Anolis carolinensis. The hormone, previously applied to the preparations, effectively inhibited alpha-MSH darkening activity in a dose-independent manner, and was also able to reverse MSH-induced darkening. We presently describe the inhibitory effect of the indoleamine on the murine melanoma cell proliferation. Interestingly, the hormone also stimulated tyrosinase activity, with a correlated increase in melanin content. We also demonstrate that in a diverse lizard species, Urosaurus ornatus, the indoleamine was totally ineffective. The competitive MSH antagonistic activity of H-His-D-Arg-Ala-Trp-D-Phe-Lys-NH2 has been demonstrated previously in R. pipiens and U. ornatus. Herein, its inhibitory activity is also reported in another lizard species, A. carolinensis. However, this MSH analogue was inactive in S. marmoratus, and in murine melanoma cells. On the other hand, the 7 thru 10 alpha-MSH fragment, Ac-Phe-Arg-Trp-Gly-NH2, although ineffective in S. marmoratus and R. pipiens, was an alpha-MSH antagonist in A. carolinensis. Surprisingly, in the melanoma cell line, the MSH fragment exhibited no agonist or antagonist activity, but dramatically potentiated the MSH-induced increase in tyrosinase activity. These data might suggest that the fragment is participating either in the process of facilitation or in positive cooperativity. The present results, taken together with our previously reported data, demonstrate a major interspecies diversity of the MC1 subtype of melanocortin receptor, and point out the relevance of the membrane microenvironment for the final receptor configuration.

Asymptomatic perianal shedding of herpes simplex virus in patients with acquired immunodeficiency syndrome.

OBJECTIVE: To determine the frequency of asymptomatic perianal shedding of herpes simplex virus (HSV) in adult patients with acquired immunodeficiency syndrome (AIDS). DESIGN: Cross-sectional study. SETTING: A 1000-bed, state-supported hospital in Brazil that provides comprehensive health care. PATIENTS: Eighty-two consecutively hospitalized patients with AIDS (Centers for Disease Control and Prevention class C). MAIN OUTCOME MEASUREMENT: Specimens for HSV culture were obtained with premoistened swabs of the perianal region at approximately 7-day intervals during the hospitalization of each patient. After the specimens were inoculated into cultures of human foreskin and Vero cells, supernatants of cultures showing the cytopathic effect characteristic of HSV infection were tested for virus in a confirmatory immunoenzymatic assay. Typing of HSV was performed by polymerase chain reaction amplification of HSV-1- and HSV-2-specific DNA polymerase sequences. RESULTS: On early into the study, 12 (15%) of 82 patients had perianal ulceration and 70 did not. None of the patients in the latter group developed perianal ulcers during the study period, but HSV was isolated at least once from 17 (24%) of them. Nine of the 17 asymptomatic perianal shedders had a mean of 3 perianal swabs collected before the first HSV isolation, and 11 (65%) of 17 had a total of 18 perianal swabs collected 8 to 62 days after the HSV isolation. All postpositive samples were negative for HSV except 1 obtained from a patient 13 days after the first positive sample. Twelve of the 17 asymptomatic perianal shedders of HSV were followed up clinically for 8 to 62 days after the first episode of shedding and none developed perianal ulceration. CONCLUSIONS: We conclude that asymptomatic perianal shedding of HSV is common in patients with AIDS, even among those without a history of perianal HSV lesions. This shedding appears to be short-lived, intermittent, and not associated with early subsequent development of perianal ulcers. These findings present a new perspective on the natural course of perianal HSV infection in patients with AIDS.

Regulacao renal da excrecao de sodio na insuficiencia cardiaca experimental: estudo da hemodinamica e da funcao tubular renal / Renal regulation of sodium excretion in experimental heart failure: study of hemodynamics and renal tubular function

O objetivo do presente trabalho foi estudar o papel desempenhado pelo rim na retencao de sodio e agua na insuficiencia cardiaca em caes com fistulas arterio-venosas femorais atraves de medidas de clearance e hemodinamica. Vinte e sete caes foram estudados em hidropenia e em diurese aquosa, 96 horas apos a realizacao de fistulas arterio-venosas femorais bilaterais, em 3 periodos: 1) fistulas abertas; 2) fistulas fechadas e 3) fistulas reabertas. Os animais retinham sal e agua e desenvolveram edema no periodo em que as fistulas estavam abertas. Quando as mesmas foram fechadas ocorreu uma maior diurese, natriurese, com aumento da excrecao urinaria de fosfato e do aporte distal de solutos, sugerindo uma diminuicao da reabsorcao proximal de sodio e agua. Apos a reabertura das fistulas, observou-se um aumento da reabsorcao de sodio pelos segmentos distais do nefron, sugerido pela elevacao da excrecao de agua livre por unidade de aporte de solutos. Estes achados nao foram acompanhados por alteracoes da distribuicao do fluxo sanguineo renal cortical. Em conclusao, a retencao de sodio e agua na insuficiencia cardiaca congestiva produzida por fistulas arterio-venosas se deve a um aumento da reabsorcao de sodio pelos segmentos distais do nefron e nao e devida a uma redistribuicao do fluxo sanguineo renal cortical.

[Renal regulation of sodium excretion in experimental heart failure: study of hemodynamics and renal tubular function]. / Regulação renal da excreção de sódio na insuficiência cardíaca experimental: estudo da hemodinâmica e da função tubular renal.

This study was designed to evaluate the role of the kidney on sodium retention in congestive heart failure by clearance and hemodynamic studies. Twenty seven dogs were studied during hydropenia and aqueous diuresis 96 hours after the construction of a bilateral femoral A-V fistula, in 3 periods: 1) with open fistulae; 2) with closed fistulae and 3) with reopened fistulae. The animals retained sodium and water and developed edema during the first period when the fistulae were opened. Closure of the AV fistulae produced an enhanced diuresis and natriuresis associated with an increase in phosphaturia and distal sodium delivery, suggesting a diminished proximal sodium reabsorption. However, when the fistulae were reopened, sodium retention was observed in the presence of an increase in free-water clearance corrected by distal sodium delivery, indicating an increase in sodium reabsorption by distal segments. These findings were not associated with alterations in cortical distribution of renal blood flow. In conclusion, the sodium and water retention in congestive heart failure produced by A-V fistula is due to an increase in sodium reabsorption by the distal nephron segments, and it is not associated to a redistribution of the cortical renal blood flow.

Ma absorcao e ma digestao: fisiopatologia, diagnostico, tratamento. / Malabsorption and maldigestion: physiopathology, diagnosis and treatment

Sao revistos o conceito, fisiopatologia, classificacao, diagnostico e tratamento da sindrome de ma absorcao, apresentados de forma a interessar o clinico geral e procurando, em diversos aspectos, traduzir a experiencia dos autores