Enamel development defects and oral symptoms: A hierarchical approach.

OBJECTIVE: This study aimed to determine the relationship between enamel developmental defects (DDEs) and children's oral symptoms in the early and late mixed dentition in a hierarchical approach. METHODS: Population-based cross-sectional study of 772 children. Calibrated dental examiners examined for DDEs, malocclusion, and dental caries. Parents answered questions related to the socioeconomic condition of the family. The Child Perception Questionnaire (CPQ8₋10) was used to identify oral symptoms as the outcome variable. Analysis was adjusted in a backward stepwise hierarchical multiple logistic regression model. RESULTS: Symptoms were predicted by being female, having a father with low education and having DDEs in the upper first molars (ORs = 1.42; 95% CI: 1.06-1.89; 1.46: 1.10-1.96 and 2.02: 0.99-4.05 respectively). CONCLUSION: DDEs are associated with oral symptoms in Brazilian children.

A time-compressed simulated geomagnetic storm influences the nest-exiting flight angles of the stingless bee Tetragonisca angustula.

Insects have been used as models for understanding animal orientation. It is well accepted that social insects such as honeybees and ants use different natural cues in their orientation mechanism. A magnetic sensitivity was suggested for the stingless bee Schwarziana quadripunctata, based on the observation of a surprising effect of a geomagnetic storm on the nest-exiting flight angles. Stimulated by this result, in this paper, the effects of a time-compressed simulated geomagnetic storm (TC-SGS) on the nest-exiting flight angles of another stingless bee, Tetragonisca angustula, are presented. Under an applied SGS, either on the horizontal or vertical component of the geomagnetic field, both nest-exiting flight angles, dip and azimuth, are statistically different from those under geomagnetic conditions. The angular dependence of ferromagnetic resonance (FMR) spectra of whole stingless bees shows the presence of organized magnetic nanoparticles in their bodies, which indicates this material as a possible magnetic detector.

Surgical complications in 100 donor hepatectomies for living donor liver transplantation in a single Brazilian center.

The rising demand for liver transplantation has continued to outspace the availability of deceased donor organs, leading to the need for other treatment options including living donor liver transplantation (LDLT). A precise evaluation of surgical complications is the most important issue in this setting. There are controversies about donor morbidity with reports ranging from 13%-75%. The aim of this study was to retrospectively analyze 100 LDLTs performed in a single Brazilian center from December 2002 to August 2008, stratifying the complications according to Clavien's scoring system. None of the donors experienced life-threatening complications or died. The majority of donors (n = 74) did not suffer any complication. Twenty-eight complications were observed in 26 patients. Fifty-seven hepatectomies were performed for adult and 43 for pediatric transplantations. According to the Brisbane classifications, we performed 49 right and 2 left hepatectomies as well as 49 left lateral segmentectomies. According to Clavien, the complications were as follows: grade I (n = 11; 39.2%); grade II (n = 8; 28.5%); and grade III (n = 9; 32.3%). No patient presented with grade IV or V. The most common problem a biliary tract injury, similar to other series. In this Brazilian series, hepatectomy for LDLT was a safe procedure with low morbidity, regardless of the type of liver resection. This practice will probably continue to grow to alleviate the pressure of growing waiting lists.

Evaluation of the pulse pressure variation index as a predictor of fluid responsiveness during orthotopic liver transplantation.

BACKGROUND: The pulse pressure variation (PPV) index has been shown to be a reliable predictor of fluid responsiveness (FR) in a variety of clinical settings. However, it has not been formally evaluated in the setting of orthotopic liver transplantation (OLT). METHODS: Fifteen (n=15) patients undergoing OLT were enrolled in this study. All patients were monitored with a modified pulmonary artery catheter which measured the cardiac output on a semi-continuous basis. A fluid challenge (FC) with 350 ml of colloid was attempted during the following stages of surgery: hepatectomy (TH), anhepatic phase (TA), early post-reperfusion [(TE)--during the first 30 min], late post-reperfusion [(TL)--after hepatic artery anastomosis], and at the beginning of abdominal closure (TC). PPV and stroke volume index (SVI) were recorded at baseline and 5 min after the FC. Each individual FC which raised the SVI more than 10% from baseline was classified as responsive (R); otherwise, it was considered non-responsive (NR). RESULTS: Forty-one FCs were performed, with 14 (34%) classified as responsive and 27 (66%) as non-responsive. The baseline PPV did not differ significantly between the R and NR groups, showing considerable overlap of its values throughout the procedure [R vs NR; TH: 20% (inter-quartile range 7-32) vs 7% (5-14); TA: 10% (7-14) vs 19% (12-21), and TE+TL: 7% (5-11) vs 9% (7-16)]. CONCLUSIONS: Under the conditions of this study, the PPV index was not shown to be a reliable predictor of FR during OLT. Further studies are warranted to elucidate the role of this and other dynamic indexes in this specific setting.

Evaluation of the right ventricular ejection fraction during orthotopic liver transplantation under propofol anaesthesia.

BACKGROUND: The right ventricular ejection fraction pulmonary artery catheter (RVEF-PAC) has been widely used to monitor the right ventricular (RV) function during orthotopic liver transplantation (OLT). However, the evaluation of the RVEF during this procedure during propofol anaesthesia has not been described. METHODS: Twenty consecutive patients undergoing OLT without veno-venous bypass were studied. Anaesthesia was maintained with propofol, remifentanil and atracurium infusions. All patients were monitored with a modified pulmonary artery catheter (RVEF-PAC), which continuously measures the RVEF. Haemodynamic data were recorded at: baseline (TB), anhepatic stage (TA), and 1, 5, 10, and 30 min post-reperfusion of the graft. RESULTS: The baseline RVEF was decreased [40% (sd 6)] and remained so throughout the OLT. A biphasic pattern was revealed, with the RVEF reaching its lowest values during TA [34% (7)] and gradually returning toward baseline at T30 [39% (8)]. Clinical significant RV dysfunction did not occur. CONCLUSIONS: Although the baseline RVEF was decreased, it showed only minor alterations throughout the procedure, suggesting that the RV function is not significantly compromised during OLT under propofol anaesthesia.