Choleperitoneum secondary to isolated subserosal gallbladder injury due to blunt abdominal trauma - A case report.

When dealing with rare traumatic injuries, surgeons might have difficulty diagnosing them and choosing the most appropriate management when no consensus exist on the best course of action. In such circumstances, drawing on the experience of colleagues can be of great value. Traumatic injuries of the gallbladder are unusual and might not be readily identifiable neither in imaging studies nor during surgery. Retrograde cholangiography plays an important role in correctly diagnosing these injuries and guiding decision-making. We report a case of a subserosal perforation due to blunt trauma to the abdomen, which was identified intraoperatively after a transcystic retrograde cholangiogram was performed and managed successfully with formal cholecystectomy.

Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study.

Background: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1-3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (eBC). Due to limited access to genomic assays in Brazil, treatment decisions remain largely driven by traditional clinicopathologic risk factors. ODX has been reported to be cost-effective in different health system, but limited data are available considering the reality of middle-income countries such as Brazil. We aim to evaluate the cost-effectiveness of ODX across strata of clinical risk groups using data from a dataset of patients from Brazilian institutions. Methods: Clinicopathologic and ODX information were analyzed for patients with T1-T3, N0-N1, HR+/HER2- eBC who had an ODX performed between 2005 and 2020. Projections of CT indication by clinicopathologic criteria were based on binary clinical risk categorization based on the Adjuvant! Algorithm. The ODX score was correlated with the indication of CT according to TAILORx and RxPONDER data. Two decision-tree models were developed. In the first model, low and high clinical risk patients were included while in the second, only high clinical risk patients were included. The cost for ODX and CT was based on the Brazilian private medicine perspective. Results: In all, 645 patients were analyzed; 411 patients (63.7%) had low clinical risk and 234 patients (36.3%) had high clinical risk disease. The ODX indicated low (<11), intermediate (11-25), and high (>25) risk in 119 (18.4%), 415 (64.3%), and 111 (17.2%) patients, respectively. Among 645 patients analyzed in the first model, ODX was effective (5.6% reduction in CT indication) though with an incremental cost of United States Dollar (US$) 2288.87 per patient. Among 234 patients analyzed in the second model (high clinical risk only), ODX led to a 57.7% reduction in CT indication and reduced costs by US$ 4350.66 per patient. Conclusions: Our study suggests that ODX is cost-saving for patients with high clinical risk HR+/HER2- eBC and cost-attractive for the overall population in the Brazilian private medicine perspective. Its incorporation into routine practice should be strongly considered by healthcare providers.

Effects of core strengthening on balance in university judo athletes.

BACKGROUND: Core strengthening prepares the body in an integral, safe and efficient way, favoring balance and postural control; physical abilities constantly demanded in sports, especially in body contact modalities, such as Judo. OBJECTIVE: This study investigated the effects of core strengthening on balance in university judo athletes. METHODS: Eighteen athletes from the University of Southern Santa Catarina (UNISUL) were randomly allocated into two groups: experimental (n = 9) and control (n = 9). Experimental group athletes were submitted to a core strengthening protocol (30-min sessions, twice a week for 5 consecutive weeks). Evaluations consisted of Stabilometic (center of pressure behavior parameters: total area in mm2, laterolateral and anteroposterior width in mm) and baropodometric analysis [peak pressure: obtained during a 30-s acquisition period and expressed by foot area, i.e., (a) forefoot (metatarsal heads and toes); and (b) hindfoot (calcaneus region, distal third of the foot)]. Right/left foot ratios were calculated as relative percentages and used for the analysis. The analyzes were performed at baseline and after 5 weeks of core strengthening. The athletes were evaluated in two situations: eyes-open and eyes-closed. RESULTS: Total right/left foot ratio pressure, right/left fore and hindfoot ratio pressure, as well as anteroposterior width measurements were statistically smaller in the experimental group. CONCLUSION: Although the results obtained showed that core strengthening presents certain benefits, these data alone are not enough to confirm its effects upon postural oscillation in university judo athletes.

Mercury Contamination in Riverine Sediments and Fish Associated with Artisanal and Small-Scale Gold Mining in Madre de Dios, Peru.

Artisanal and small-scale gold mining (ASGM) in Madre de Dios, Peru, continues to expand rapidly, raising concerns about increases in loading of mercury (Hg) to the environment. We measured physicochemical parameters in water and sampled and analyzed sediments and fish from multiple sites along one ASGM-impacted river and two unimpacted rivers in the region to examine whether Hg concentrations were elevated and possibly related to ASGM activity. We also analyzed the 308 fish samples, representing 36 species, for stable isotopes (δ15N and δ13C) to estimate their trophic position. Trophic position was positively correlated with the log-transformed Hg concentrations in fish among all sites. There was a lack of relationship between Hg concentrations in fish and either Hg concentrations in sediments or ASGM activity among sites, suggesting that fish Hg concentrations alone is not an ideal bioindicator of site-specific Hg contamination in the region. Fish Hg concentrations were not elevated in the ASGM-impacted river relative to the other two rivers; however, sediment Hg concentrations were highest in the ASGM-impacted river. Degraded habitat conditions and commensurate shifts in fish species and ecological processes may influence Hg bioaccumulation in the ASGM-impacted river. More research is needed on food web dynamics in the region to elucidate any effects caused by ASGM, especially through feeding relationships and food sources.

Th17 cells and CD4(+) multifunctional T cells in patients with systemic lupus erythematosus.

INTRODUCTION/OBJECTIVE: Recent evidence suggests that abnormalities involving Th17 lymphocytes are associated with the pathophysiology of systemic lupus erythematosus (SLE). In addition, multifunctional T cells (MFT), i.e., those producing multiple cytokines simultaneously, are present in the inflammatory milieu and may be implicated in the autoimmune process observed in SLE. In the present study, we aimed to characterize the functional status of CD4(+) T cells in SLE by simultaneously determining the concentration of IL-2, IFN-γ and IL-17 in lymphocyte cultures under exogenous and self-antigenic stimuli. PATIENTS AND METHODS: Eighteen patients with active disease, 18 with inactive disease, and 14 healthy controls had functional status of CD4(+) T cells analyzed. RESULTS: We found that SLE patients presented a decreased number of total CD4(+) cells, an increased number of activated T cells, and an increased frequency of Th17 cells compared to healthy controls (HC). MFT cells had increased frequency in SLE patients and there was an increased frequency of tri-functional MFT in patients with active SLE compared with those with inactive SLE. Interestingly, MTF cells produced larger amounts of IFNγ than mono-functional T cells in patients and controls. CONCLUSION: Taken together these data indicate the participation of recently activated Th17 cells and MTF cells in the SLE pathophysiology.

Linfócitos Th17 e linfócitos T CD4+ multifuncionais em pacientes com lúpus eritematoso sistêmico / Th17 cells and CD4+ multifunctional T cells in patients with systemic lupus erythematosus

Resumo Introdução/Objetivo: Evidências recentes sugerem que anormalidades que envolvem os linfócitos Th17 estão associadas à fisiopatologia do lúpus eritematoso sistêmico (LES). Além disso, os linfócitos T multifuncionais (LTM), ou seja, aqueles que produzem múltiplas citocinas simultaneamente, estão presentes no meio inflamatório e podem estar implicados no processo autoimune observado no LES. No presente estudo, objetiva-se caracterizar o estado funcional dos linfócitos T CD4+ no LES e determinar simultaneamente a concentração de IL-2, IFN-γ e IL-17 em culturas de linfócitos sob estímulos exógenos e autoantigênicos. Pacientes e métodos: Dezoito pacientes com doença ativa, 18 com doença inativa e 14 controles saudáveis foram submetidos à análise do estado funcional dos linfócitos T CD4+. Resultados: Encontrou-se que os pacientes com LES apresentaram uma diminuição na quantidade total de células CD4+, um aumento na quantidade de linfócitos T ativados e um aumento na frequência de linfócitos Th17 em comparação com controles saudáveis (HC). As células LTM tinha frequência aumentada em pacientes com LES e houve um aumento na frequência de LTM trifuncionais em pacientes com LES ativo em comparação com aqueles com LES inativo. Curiosamente, as células MTF produziram quantidades maiores de IFN-γ do que os linfócitos T monofuncionais em pacientes e controles. Conclusão: Analisados em conjunto, esses dados indicam a participação dos linfócitos Th17 recentemente ativados e células MTF na fisiopatologia do LES.

Abstract Introduction/Objective: Recent evidence suggests that abnormalities involving Th17 lymphocytes are associated with the pathophysiology of systemic lupus erythematosus (SLE). In addition, multifunctional T cells (MFT), i. e., those producing multiple cytokines simultaneously, are present in the inflammatory milieu and may be implicated in the autoimmune process observed in SLE. In the present study, we aimed to characterize the functional status of CD4+ T cells in SLE by simultaneously determining the concentration of IL-2, IFN-γ and IL-17 in lymphocyte cultures under exogenous and self-antigenic stimuli. Patients and methods: Eighteen patients with active disease, 18 with inactive disease, and 14 healthy controls had functional status of CD4+ T cells analyzed. Results: We found that SLE patients presented a decreased number of total CD4+ cells, an increased number of activated T cells, and an increased frequency of Th17 cells compared to healthy controls (HC). MFT cells had increased frequency in SLE patients and there was an increased frequency of tri-functional MFT in patients with active SLE compared with those with inactive SLE. Interestingly, MTF cells produced larger amounts of IFNγ than mono-functional T cells in patients and controls. Conclusion: Taken together these data indicate the participation of recently activated Th17 cells and MTF cells in the SLE pathophysiology.

Plataforma Switching: considerações atuais / Platform Switching: an update

A utilização de implantes na reabilitação dentária em associação a próteses torna-se um tratamento cada vez mais gradativo e eficiente para aqueles dispostos a recuperar a função mastigatória, fonética e estética de seus elementos dentários, conferindo-lhes naturalidade. O implante consiste num parafuso de titânio instalado através de cirurgia e submetido à osseointegração em maxila ou mandíbula. Sobre a plataforma do implante acopla-se um componente protético de mesmo diâmetro. Todavia, o conceito de Plataforma Switching referese ao uso do componente protético de diâmetro menor quando comparado ao diâmetro da plataforma do implante. Essa técnica faz com que a junção implante-pilar se direcione para a porção mais central distanciandoa da crista óssea alveolar. Esse aspecto tem gerado aceitação por parte dos tecidos duros e moles, evitando a formação de micro-espaços na crista do osso e reduzindo o estresse sobre ele. Estudos comprovam que o uso da plataforma switching em Implantodontia atua na manutenção dos níveis de osso minimizando sua perda e favorecendo a estabilidade primária, embora alguns autores afirmem que essa redução é insignificante. Esperase que esta revisão aflore o interesse de mais pesquisadores, de forma a ampliar o campo de estudo teórico, prático e clínico, a fim de garantir maiores evidências a respeito dos benefícios da plataforma switching e delimitar suas restrições para cada caso

The use of implants in dental rehabilitation in combination with prosthesis is becoming a more gradual and efficient treatment for those willing to recover the masticatory, phonetic and aesthetic functions of their teeth, providing them with naturalness. The implant consists of a titanium screw installed by means of surgery being submitted to osseointegration in the maxilla or mandible. Above the implant platform a prosthetic component of the same diameter is coupled. However, the concept of platform switching refers to the use of the prosthetic component with smaller diameter compared to the diameter of the implant platform. This technique allows the implant-abutment junction to orientate itself towards the more central portion, distancing itself from the bone alveolar crest. This process has generated adaptation by the hard and soft tissues, preventing the formation of micro-spaces in bone crest and reducing the stress on it. Some studies show that the use of platform switching in Implantology actuates in the maintenance of bone levels, minimizing the loss and favoring primary stability, although some authors state that this reduction is insignificant. It is expected that this review flourishes the interest of more researchers in order to increase the theoretical, practical and clinical of study, to ensure more evidence concerning the benefits of choosing platform switching and define the restrictions for each case

Abnormal phenotypic distribution of regulatory and effector T cells in octogenarian and nonagenarian women.

INTRODUCTION: aging is associated with several immunologic changes. Regulatory (Treg) and effector T cells are involved in the pathogenesis of infectious, neoplastic, and autoimmune diseases. Little is known about the effects of aging on the frequency and function of these T cell subpopulations. METHODS: peripheral blood mononuclear cells (PBMC) were obtained from 26 young (under 44 years old) and 18 elderly (above 80 years old) healthy women. T cell subpopulations were analyzed by flow cytometry. RESULTS: elderly individuals had lower frequency of several activated effector T cell phenotypes as compared with young individuals: CD3+CD4+CD25+ (3.82±1.93 versus 9.53±4.49; p<0.0001); CD3+CD4+CD25+CD127+(2.39±1.19 versus 7.26±3.84; p<0.0001); CD3+CD4+CD25+ (0.41±0.22 versus 1.86±0.85, p<0.0001); and CD3+CD4+CD25highCD127+(0.06±0.038 versus 0.94±0.64, p<0.0001). Treg (CD3+CD4+CD25+CD127øFoxp3+) presented lower frequency in elderly individuals as compared to young adults (0.34±0.18 versus 0.76±0.48; p=0.0004) and its frequency was inversely correlated with age in the whole group (r=-0.439; p=0.013). The elderly group showed higher frequency of two undefined CD25øFoxp3+ phenotypes: CD3+CD4+CD25øFoxp3+(15.05±7.34 versus 1.65±1.71; p<0.0001) and CD3+CD4+CD25øCD127øFoxp3+(13.0±5.52 versus 3.51±2.87; p<0.0001). CONCLUSIONS: the altered proportion of different T cell subsets herein documented in healthy elderly women may be relevant to the understanding of the immunologic behavior and disease susceptibility patterns observed in geriatric patients.

Abnormal phenotypic distribution of regulatory and effector T cells in octogenarian and nonagenarian women / Distribuição fenotípica anormal das células T reguladoras e efetoras em mulheres octogenárias e nonagenárias

SummaryIntroduction:aging is associated with several immunologic changes. Regulatory (Treg) and effector T cells are involved in the pathogenesis of infectious, neoplastic, and autoimmune diseases. Little is known about the effects of aging on the frequency and function of these T cell subpopulations.Methods:peripheral blood mononuclear cells (PBMC) were obtained from 26 young (under 44 years old) and 18 elderly (above 80 years old) healthy women. T cell subpopulations were analyzed by flow cytometry.Results:elderly individuals had lower frequency of several activated effector T cell phenotypes as compared with young individuals: CD3+CD4+CD25+ (3.82±1.93 versus 9.53±4.49; p<0.0001); CD3+CD4+CD25+CD127+(2.39±1.19 versus 7.26±3.84; p<0.0001); CD3+CD4+CD25+ (0.41±0.22 versus 1.86±0.85, p<0.0001); and CD3+CD4+CD25highCD127+(0.06±0.038 versus 0.94±0.64, p<0.0001). Treg (CD3+CD4+CD25+CD127øFoxp3+) presented lower frequency in elderly individuals as compared to young adults (0.34±0.18 versus 0.76±0.48; p=0.0004) and its frequency was inversely correlated with age in the whole group (r=-0.439; p=0.013). The elderly group showed higher frequency of two undefined CD25øFoxp3+ phenotypes: CD3+CD4+CD25øFoxp3+(15.05±7.34 versus 1.65±1.71; p<0.0001) and CD3+CD4+CD25øCD127øFoxp3+(13.0±5.52 versus 3.51±2.87; p<0.0001).Conclusions:the altered proportion of different T cell subsets herein documented in healthy elderly women may be relevant to the understanding of the immunologic behavior and disease susceptibility patterns observed in geriatric patients.

ResumoIntrodução:o envelhecimento está associado a diversas alterações imunológicas. Células T reguladoras e efetoras estão envolvidas na patogênese de enfermidades infecciosas, neoplásicas e autoimunes. Pouco se sabe acerca dos efeitos da idade sobre a frequência e a função dessas populações celulares.Métodos:células mononucleares do sangue periférico foram obtidas de participantes saudáveis (26 com idade inferior a 44 anos e 18 acima de 80 anos). As subpopulações celulares foram analisadas por citometria de fluxo.Resultados:o grupo constituído por idosas apresentou menor frequência de vários fenótipos de células T efetoras ativadas em comparação com jovens: CD3+CD4+CD25+ (3,82±1,93 versus 9,53±4,49, p<0,0001); CD3+CD4+ CD25+CD127+ (2,39±1,19 versus7,26±3,84, p<0,0001); CD3+CD4+CD25high(0,41±0,22 versus 1,86±0,85, p<0,0001); CD3+CD4+CD25highCD127+(0,06±0,038 versus 0,94±0,64, p<0,0001). As células T reguladoras CD3+CD4+CD25highCD127øFoxP3+ apresentaram menor frequência em indivíduos idosos em comparação com adultos jovens (0,34±0,18 versus0,76±0,48, p=0,0004) e sua frequência foi inversamente correlacionada com a idade em todo o grupo (r=-0,439; p=0,013). O grupo de idosas apresentou maior frequência de dois fenótipos indefinidos (CD25øFoxP3+), células CD3+CD4+CD25øFoxP3+ (15,05±7,34 versus 1,65±1,71, p<0,0001) e células CD3+CD4+CD25øCD127øFoxP3+(13,0±5,52 versus 3,51±2,87, p<0,0001).Conclusão:as proporções alteradas de diferentes subpopulações de células T em idosas saudáveis contribuem para a compreensão dos padrões de comportamento e suscetibilidade a doenças imunológicas evidenciadas em pacientes geriátricos.

Avaliação comparativa do processo de incorporação de bloco sintético bifásico, e do osso autógeno: estudo histológico, histométrico e imunoistoquímico em coelhos / Comparative evaluation of the block synthetic biphasic incorporation, and autogenous bone: histological, histometric and immunohistochemical study in rabbits

Proposição: O objetivo desse trabalho foi avaliar a interface enxerto/leito receptor de um bloco sintético bifásico, composto de 60% de hidroxiapatita e 40% de beta tricálcio fosfato (β-TCP) por meio de análise histológica, histométrica e imunoistoquímica. Materiais e métodos: Foram utilizados 12 coelhos albinus que foram submetidos à cirurgia de enxerto ósseo aposicional em bloco para ganho em espessura. O enxerto autógeno foi removido da tíbia com o auxílio de uma broca trefina de 8 mm e parafusado na mandíbula esquerda, enquanto o bloco teste bifásico, composto de 60% de HA e 40% de β-TCP, foi parafusado na mandíbula direita. Os animais sofreram eutanásia após 2 e 8 semanas do procedimento cirúrgico e a peça foi removida para processamento e análises. Os resultados obtidos tiveram sua normalidade testada para definir o teste estatístico indicado. Resultados: Na análise histométrica, podemos observar que o grupo autógeno demonstrou maiores taxas de neoformação óssea nos dois tempos estudados quando comparados ao grupo do biomaterial, demonstrando uma diferença estatisticamente significativa. Quando comparamos os tempos estudados em cada material, o grupo autógeno teve um aumento considerável da segunda para a oitava semana, porem não foi encontrada diferenças estatisticamente significativas. O grupo biomaterial não teve um aumento significativa de neoformação óssea durante o período de reparo. Na imunoistoquímica, com relação ao tempo, podemos observar que a enzima TRAP mostrou maior manifestação no período de 2 semanas do que no período de 8 semanas considerando os dois materiais estudados. No quesito material, a proteína OC mostrou mais evidente no grupo autógeno de uma forma geral. Quando se avaliou material e tempo em cada proteína isoladamente não foram encontradas diferenças estatisticamente significativas. Conclusão: O bloco testado manteve valores de neoformação óssea inferiores ao bloco controle, demonstrando menor potencial de integração. A sua...

Proposition: The purpose of this study was to evaluate the interface graft / recipient bed of a two-phase synthetic block, consisting of 60 % hydroxyapatite and 40 % beta tricalcium phosphate (β -TCP) by histological analysis, histometric and immunohistochemistry. Methods: We used 12 albinus rabbits that underwent appositional bone graft surgery block to gain in thickness. The autogenous graft was removed from the tibia with the aid of a trephine drill 8 mm and screwed into the left jaw, while the biphasic pattern block, composed of 60 % HA and 40% β -TCP, was screwed in the right jaw. The animals were euthanized after 2 and 8 weeks of surgery and the piece was removed for processing and analysis. The results were tested for normality define the statistical test indicated. Results: In histometric analysis, we can see that the autogenous group showed higher rates of bone formation in both times studied compared to the biomaterial group, demonstrating a statistically significant difference. When we compare the times studied in each material, the autogenous group had a significant increase from the second to the eighth week, however, there was no statistically significant differences. The biomaterial group remained during the repair period. In immunohistochemistry, with respect to time, we can see that the TRAP enzyme showed greater expression in the two weeks period than 8 weeks considering the two materials studied. In the item material, OC protein was more evident in the group of autogenic general. When assessing the material and time each protein alone were no statistically significant differences. Conclusion: The block kept tested values of bone formation below the control block, showing less potential for integration. Its composition has proven reliable for alveolar reconstruction in thickness to fill order. Further studies with different study models and methods to be analyzed, preferably associated with cellular components in order to we find an ideal...

Avaliação comparativa do processo de incorporação de bloco sintético bifásico, e do osso autógeno: estudo histológico, histométrico e imunoistoquímico em coelhos / Comparative evaluation of the block synthetic biphasic incorporation, and autogenous bone: histological, histometric and immunohistochemical study in rabbits

Proposição: O objetivo desse trabalho foi avaliar a interface enxerto/leito receptor de um bloco sintético bifásico, composto de 60% de hidroxiapatita e 40% de beta tricálcio fosfato (β-TCP) por meio de análise histológica, histométrica e imunoistoquímica. Materiais e métodos: Foram utilizados 12 coelhos albinus que foram submetidos à cirurgia de enxerto ósseo aposicional em bloco para ganho em espessura. O enxerto autógeno foi removido da tíbia com o auxílio de uma broca trefina de 8 mm e parafusado na mandíbula esquerda, enquanto o bloco teste bifásico, composto de 60% de HA e 40% de β-TCP, foi parafusado na mandíbula direita. Os animais sofreram eutanásia após 2 e 8 semanas do procedimento cirúrgico e a peça foi removida para processamento e análises. Os resultados obtidos tiveram sua normalidade testada para definir o teste estatístico indicado. Resultados: Na análise histométrica, podemos observar que o grupo autógeno demonstrou maiores taxas de neoformação óssea nos dois tempos estudados quando comparados ao grupo do biomaterial, demonstrando uma diferença estatisticamente significativa. Quando comparamos os tempos estudados em cada material, o grupo autógeno teve um aumento considerável da segunda para a oitava semana, porem não foi encontrada diferenças estatisticamente significativas. O grupo biomaterial não teve um aumento significativa de neoformação óssea durante o período de reparo. Na imunoistoquímica, com relação ao tempo, podemos observar que a enzima TRAP mostrou maior manifestação no período de 2 semanas do que no período de 8 semanas considerando os dois materiais estudados. No quesito material, a proteína OC mostrou mais evidente no grupo autógeno de uma forma geral. Quando se avaliou material e tempo em cada proteína isoladamente não foram encontradas diferenças estatisticamente significativas. Conclusão: O bloco testado manteve valores de neoformação óssea inferiores ao bloco controle, demonstrando menor potencial de integração. A sua...

Proposition: The purpose of this study was to evaluate the interface graft / recipient bed of a two-phase synthetic block, consisting of 60 % hydroxyapatite and 40 % beta tricalcium phosphate (β -TCP) by histological analysis, histometric and immunohistochemistry. Methods: We used 12 albinus rabbits that underwent appositional bone graft surgery block to gain in thickness. The autogenous graft was removed from the tibia with the aid of a trephine drill 8 mm and screwed into the left jaw, while the biphasic pattern block, composed of 60 % HA and 40% β -TCP, was screwed in the right jaw. The animals were euthanized after 2 and 8 weeks of surgery and the piece was removed for processing and analysis. The results were tested for normality define the statistical test indicated. Results: In histometric analysis, we can see that the autogenous group showed higher rates of bone formation in both times studied compared to the biomaterial group, demonstrating a statistically significant difference. When we compare the times studied in each material, the autogenous group had a significant increase from the second to the eighth week, however, there was no statistically significant differences. The biomaterial group remained during the repair period. In immunohistochemistry, with respect to time, we can see that the TRAP enzyme showed greater expression in the two weeks period than 8 weeks considering the two materials studied. In the item material, OC protein was more evident in the group of autogenic general. When assessing the material and time each protein alone were no statistically significant differences. Conclusion: The block kept tested values of bone formation below the control block, showing less potential for integration. Its composition has proven reliable for alveolar reconstruction in thickness to fill order. Further studies with different study models and methods to be analyzed, preferably associated with cellular components in order to we find an ideal...

O uso de ansiolítico no pré-atendimento em Odontologia: revisão de literatura / The use of anxiolytic in dentistry pre-attendant: a literature review

A ansiedade produzida perante o procedimento odontológico é um fator que deve ser sempre levado em consideração, principalmente antes de procedimentos cirúrgicos. O profissional deve estar preparado para controlar essa tensão e, dentre as opções existentes, está a utilização de ansiolíticos que promovem sedação consciente, como o Midazolam ou Diazepam. Com relação ao primeiro, um benzodiazepínico, apresenta rápida absorção quando administrado por via oral e extensa margem de segurança. Já o segundo, Diazepam, gera uma sedação de longa duração. Assim sendo, o presente trabalho tem a finalidade de fazer uma revisão da literatura acerca do uso prévio de ansiolítico em Odontologia

The anxiety produced during dental procedure is a factor that should be taken into consideration, especially before surgical procedures. With the aim of controlling it, in dentistry we have several alternatives, including a choice of using anxiolytic drugs: how Midazolam or Diazepam, which promote conscious sedation. With respect to the first, benzodiazepine, has rapid absorption when administered orally and extensive safety margin. The second, Diazepam, generates a long lasting sedation. Therefore, this study aims to do a review of the literature on previous use of oral anxiolytic in surgery, especially concerning the use of midazolam

Immune system - part I. Fundamentals of innate immunity with emphasis on molecular and cellular mechanisms of inflammatory response.

The immune system consists of an intricate network of organs, cells, and molecules responsible for maintaining the body's homeostasis and responding to aggression in general. Innate immunity operates in conjunction with adaptive immunity and is characterized by rapid response to aggression, regardless of previous stimulus, being the organism first line of defense. Its mechanisms include physical, chemical and biological barriers, cellular components, as well as soluble molecules. The organism first line of defense against tissue damage involves several steps closely integrated and constituted by different components of this system. The aim of this review is to restore the foundations of this response, which has high complexity and consists of several components that converge to articulate the development of adaptive immune response. We selected some of the following steps to review: perception and molecular recognition of aggressive agents; activation of intracellular pathways, which result in vascular and tissue changes; production of a myriad of mediators with local and systemic effects on cell activation and proliferation, synthesis of new products involved in the chemoattraction and migration of cells specialized in destruction and removal of offending agent; and finally, tissue recovery with restoration of functional tissue or organ.

Immune system - part II: basis of the immunological response mediated by T and B lymphocytes.

The immune system consists of an intricate network of organs, cells, and molecules responsible for maintaining the body's homeostasis and responding to aggression in general. Innate immunity operates in conjunction with adaptive immunity and is characterized by rapid response to aggression, regardless of previous stimulus, being the organism first line of defense. Its mechanisms include physical, chemical and biological barriers, cellular components, as well as soluble molecules. The organism first line of defense against tissue damage involves several steps closely integrated and constituted by different components of this system. The aim of this review is to restore the foundations of this response, which has high complexity and consists of several components that converge to articulate the development of adaptive immune response. We selected some of the following steps to review: perception and molecular recognition of aggressive agents; activation of intracellular pathways, which result in vascular and tissue changes; production of a myriad of mediators with local and systemic effects on cell activation and proliferation, synthesis of new products involved in the chemoattraction and migration of cells specialized in destruction and removal of offending agent; and finally, tissue recovery with restoration of functional tissue or organ.

A equoterapia no desenvolvimento motor e autopercepção de escolares com dificuldade de aprendizagem / Influence of equine therapy on motor development and self-perception of schoolchildren with learning disability

O objetivo do estudo descritivo de duplo-caso, com crianças da quarta série do ensino fundamental, foi investigar os benefícios da equoterapia no desenvolvimento motor e autopercepção de escolares com dificuldade de aprendizagem. Para avaliação foram utilizadas a Escala de Desenvolvimento Motor e Escala do Perfil de Auto-Percepção para Crianças. Os atendimentos ocorreram duas vezes por semana durante três meses. Na primeira avaliação, os participantes apresentaram atraso em todas as áreas do desenvolvimento motor e em diferentes domínios da autoestima. Após intervenção, o sujeito A progrediu em todas as áreas motoras. A motricidade fina e esquema corporal atingiram os 132 meses, resultado superior ao esperado para a idade. O sujeito B evoluiu em cinco áreas, sendo que a mais deficitária antes da intervenção, organização espacial, avançou 48 meses. O quociente motor geral do sujeito A aumentou de “Muito Inferior” para “Normal Médio” e o do sujeito B de “Inferior” para “Normal Baixo”. Na autopercepção, o sujeito A evoluiu nos domínios do Comportamento e Mais Valia Global e o sujeito B, na Competência Escolar e Comportamento. Acredita-se que tal efeito se deva ao ambiente equoterápico. Sugerem-se mais estudos na área para o avanço escolar e desenvolvimento das crianças.

Interação virtual e a autoria de artigos científicos: nos bastidores da produção acadêmica / Virtual interaction and scientific article authorship: the backstage of academic production

Este artigo trata de uma experiência com o gênero digital fórum educacional na disciplina Leitura e Produção do Texto Acadêmico (LPTA), do curso de Letras da UFC, cujo propósito foi desenvolver habilidades de compreensão e produção de textos acadêmicos, em especial o artigo científico. Para isso, os estudantes, em aulas presenciais, aprenderam sobre o gênero artigo científico e seus movimentos retóricos mais comuns. A partir dessas aulas, começaram a produzir seu próprio texto e, nesse momento, o fórum serviu como ferramenta didática para a apropriação de saberes em torno do artigo. Como resultado, a aprendizagem sobre o artigo foi bastante significativa e colaborativa, pois os alunos usaram, satisfatoriamente, os recursos multimodais disponibilizados pelo fórum, bem como analisaram os textos dos outros estudantes da turma, com um olhar mais crítico, afirmando perceber falhas e acertos e, desse modo, estar mais atentos às suas próprias produções.

This article concerns the use of the digital genre of electronic forum in the Literacy and Production of Academic Texts Course at the Federal University of Ceará - Brazil, in which the objective was to develop skills in the comprehension and production of academic texts, specifically scientific articles. To this aim, students learned, in classes where they were physically present, about the genre of scientific article and its most widely used rhetorical devices. From these classes, students began to produce their own texts, at which point the forum served as a didactic tool for the appropriation of knowledge regarding the article. Results demonstrated that the learning about article production was very significant and collaborative, as the students satisfactorily used the multimodal resources available through the forum, and critically analyzed the texts of other students in the group, confirming that they perceived the successes and failures, and therefore, became more attentive to their own production.

Sistema imunitário: parte III. O delicado equilíbrio do sistema imunológico entre os pólos de tolerância e autoimunidade / Immune system: part III. The delicate balance of the immune system between tolerance and autoimmunity

O sistema imunológico é constituído por uma intrincada rede de órgãos, células e moléculas e tem por finalidade manter a homeostase do organismo, combatendo as agressões em geral. A imunidade inata atua em conjunto com a imunidade adaptativa e caracteriza-se pela rápida resposta à agressão, independentemente de estímulo prévio, sendo a primeira linha de defesa do organismo. Seus mecanismos compreendem barreiras físicas, químicas e biológicas, componentes celulares e moléculas solúveis. A primeira defesa do organismo frente a um dano tecidual envolve diversas etapas intimamente integradas e constituídas pelos diferentes componentes desse sistema. A presente revisão tem como objetivo resgatar os fundamentos dessa resposta, que apresenta elevada complexidade e é constituída por diversos componentes articulados que convergem para a elaboração da resposta imune adaptativa. Destacamos algumas etapas: reconhecimento molecular dos agentes agressores; ativação de vias bioquímicas intracelulares que resultam em modificações vasculares e teciduais; produção de uma miríade de mediadores com efeitos locais e sistêmicos no âmbito da ativação e proliferação celulares; síntese de novos produtos envolvidos na quimioatração e migração de células especializadas na destruição e remoção do agente agressor; e finalmente a recuperação tecidual com o restabelecimento funcional do tecido ou órgão.

The immune system consists of an intricate network of organs, cells, and molecules responsible for maintaining the body's homeostasis and responding to aggression in general. Innate immunity operates in conjunction with adaptive immunity and is characterized by rapid response to aggression, regardless of previous stimulus, being the organism first line of defense. Its mechanisms include physical, chemical and biological barriers, cellular components, as well as soluble molecules. The organism first line of defense against tissue damage involves several steps closely integrated and constituted by different components of this system. The aim of this review is to restore the foundations of this response, which has high complexity and consists of several components that converge to articulate the development of adaptive immune response. We selected some of the following steps to review: perception and molecular recognition of aggressive agents; activation of intracellular pathways, which result in vascular and tissue changes; production of a myriad of mediators with local and systemic effects on cell activation and proliferation, synthesis of new products involved in the chemoattraction and migration of cells specialized in destruction and removal of offending agent; and finally, tissue recovery with restoration of functional tissue or organ.

Sistema imunitário - parte II: fundamentos da resposta imunológica mediada por linfócitos T e B / Immune system - part II: basis of the immunological response mediated by T and B lymphocytes

O sistema imunológico é constituído por uma intrincada rede de órgãos, células e moléculas, e tem por finalidade manter a homeostase do organismo, combatendo as agressões em geral. A imunidade inata atua em conjunto com a imunidade adaptativa e caracteriza-se pela rápida resposta à agressão, independentemente de estímulo prévio, sendo a primeira linha de defesa do organismo. Seus mecanismos compreendem barreiras físicas, químicas e biológicas, componentes celulares e moléculas solúveis. A primeira defesa do organismo frente a um dano tecidual envolve diversas etapas intimamente integradas e constituídas pelos diferentes componentes desse sistema. A presente revisão tem como objetivo resgatar os fundamentos dessa resposta, que apresenta elevada complexidade e é constituída por diversos componentes articulados que convergem para a elaboração da resposta imune adaptativa. Destacamos algumas etapas: reconhecimento molecular dos agentes agressores; ativação de vias bioquímicas intracelulares que resultam em modificações vasculares e teciduais; produção de uma miríade de mediadores com efeitos locais e sistêmicos no âmbito da ativação e proliferação celulares, síntese de novos produtos envolvidos na quimioatração e migração de células especializadas na destruição e remoção do agente agressor, e finalmente a recuperação tecidual com o restabelecimento funcional do tecido ou órgão.

The immune system consists of an intricate network of organs, cells, and molecules responsible for maintaining the body's homeostasis and responding to aggression in general. Innate immunity operates in conjunction with adaptive immunity and is characterized by rapid response to aggression, regardless of previous stimulus, being the organism first line of defense. Its mechanisms include physical, chemical and biological barriers, cellular components, as well as soluble molecules. The organism first line of defense against tissue damage involves several steps closely integrated and constituted by different components of this system. The aim of this review is to restore the foundations of this response, which has high complexity and consists of several components that converge to articulate the development of adaptive immune response. We selected some of the following steps to review: perception and molecular recognition of aggressive agents; activation of intracellular pathways, which result in vascular and tissue changes; production of a myriad of mediators with local and systemic effects on cell activation and proliferation, synthesis of new products involved in the chemoattraction and migration of cells specialized in destruction and removal of offending agent; and finally, tissue recovery with restoration of functional tissue or organ.

Sistema imunitário: Parte I. Fundamentos da imunidade inata com ênfase nos mecanismos moleculares e celulares da resposta inflamatória / Immune system: Part I. Fundamentals of innate immunity with emphasis on molecular and cellular mechanisms of inflammatory response

O sistema imunológico é constituído por uma intrincada rede de órgãos, células e moléculas, e tem por finalidade manter a homeostase do organismo, combatendo as agressões em geral. A imunidade inata atua em conjunto com a imunidade adaptativa e caracteriza-se pela rápida resposta à agressão, independentemente de estímulo prévio, sendo a primeira linha de defesa do organismo. Seus mecanismos compreendem barreiras físicas, químicas e biológicas, componentes celulares e moléculas solúveis. A primeira defesa do organismo frente a um dano tecidual envolve diversas etapas intimamente integradas e constituídas pelos diferentes componentes desse sistema. A presente revisão tem como objetivo resgatar os fundamentos dessa resposta, que apresenta elevada complexidade e é constituída por diversos componentes articulados que convergem para a elaboração da resposta imune adaptativa. Destacamos algumas etapas: reconhecimento molecular dos agentes agressores; ativação de vias bioquímicas intracelulares que resultam em modificações vasculares e teciduais; produção de uma miríade de mediadores com efeitos locais e sistêmicos no âmbito da ativação e proliferação celulares, síntese de novos produtos envolvidos na quimioatração e migração de células especializadas na destruição e remoção do agente agressor, e finalmente a recuperação tecidual com o restabelecimento funcional do tecido ou órgão.

The immune system consists of an intricate network of organs, cells, and molecules responsible for maintaining the body's homeostasis and responding to aggression in general. Innate immunity operates in conjunction with adaptive immunity and is characterized by rapid response to aggression, regardless of previous stimulus, being the organism first line of defense. Its mechanisms include physical, chemical and biological barriers, cellular components, as well as soluble molecules. The organism first line of defense against tissue damage involves several steps closely integrated and constituted by different components of this system. The aim of this review is to restore the foundations of this response, which has high complexity and consists of several components that converge to articulate the development of adaptive immune response. We selected some of the following steps to review: perception and molecular recognition of aggressive agents; activation of intracellular pathways, which result in vascular and tissue changes; production of a myriad of mediators with local and systemic effects on cell activation and proliferation, synthesis of new products involved in the chemoattraction and migration of cells specialized in destruction and removal of offending agent; and finally, tissue recovery with restoration of functional tissue or organ.

Immune system: part III. The delicate balance of the immune system between tolerance and autoimmunity.

The immune system consists of an intricate network of organs, cells, and molecules responsible for maintaining the body's homeostasis and responding to aggression in general. Innate immunity operates in conjunction with adaptive immunity and is characterized by rapid response to aggression, regardless of previous stimulus, being the organism first line of defense. Its mechanisms include physical, chemical and biological barriers, cellular components, as well as soluble molecules. The organism first line of defense against tissue damage involves several steps closely integrated and constituted by different components of this system. The aim of this review is to restore the foundations of this response, which has high complexity and consists of several components that converge to articulate the development of adaptive immune response. We selected some of the following steps to review: perception and molecular recognition of aggressive agents; activation of intracellular pathways, which result in vascular and tissue changes; production of a myriad of mediators with local and systemic effects on cell activation and proliferation, synthesis of new products involved in the chemoattraction and migration of cells specialized in destruction and removal of offending agent; and finally, tissue recovery with restoration of functional tissue or organ.