Tratamento integrado para correção do sorriso gengival: relato de caso / Integrated treatment for correction of gingival smile: case report

O sorriso gengival possui inúmeras causas, podendo acontecer por motivos esqueléticos, musculares ou por alteração no desenvolvimento dos tecidos de suporte. No entanto, na atualidade, a estética vermelha e a branca têm se apresentado completamente passíveis de transformações e com uma gama de procedimentos cirúrgicos ou não cirúrgicos para sanar as queixas dos pacientes. O objetivo geral deste trabalho é mostrar o poder que a odontologia tem frente às questões estéticas, como, por exemplo, a vergonha de sorrir por não se sentir confortável com os dentes curtos e com uma grande faixa de gengiva sendo exposta. O método utilizado foi um relato de caso. Que descreve todos os passos clínicos do tratamento de um paciente de 40 anos, que estava insatisfeita com o seu sorriso por apresentar erupção passiva alterada juntamente com hiperatividade do lábio superior. O plano de tratamento escolhido foi de realizar a cirurgia de aumento de coroa clínica estético, seguido de clareamento dentário e posteriormente um reposicionamento labial, com ajuda da toxina botulínica. Finalizando, para ajudar na cicatrização, o uso de laserterapia. O resultado de todo o processo cirúrgico envolvido neste trabalho, é satisfação do paciente, materializando o sonho deste, devolvendo segurança e espontaneidade ao sorrir. Pôde-se observar que através da combinação de técnicas cirúrgicas periodontais para tratar o sorriso gengival, obtém-se êxito tanto no sentido científico quanto no biológico, alcançando um sorriso esteticamente mais atrativo(AU)

Gummy smile has numerous causes, which can occur for skeletal or muscular reasons or due to changes in the development of supporting tissues. However, nowadays, the red and white aesthetics have been completely capable of transformation and with a range of surgical or non-surgical procedures to resolve patients' complaints. The general objective of this work is to show the power that dentistry has in the face of aesthetic issues, such as, for example, the shame of smiling due to not feeling comfortable with short teeth and a large strip of gum being exposed. The method used was a case report. Which describes all the clinical steps of the treatment of a 40-year-old patient, who was dissatisfied with her smile due to an altered passive eruption together with hyperactivity of the upper lip. The chosen treatment plan was to perform aesthetic clinical crown augmentation surgery, followed by tooth whitening and later lip repositioning, with the help of botulinum toxin. Finally, to help with healing, the use of laser therapy. The result of the entire surgical process involved in this work is patient satisfaction, materializing the patient's dream, restoring security and spontaneity when smiling. It was observed that through the combination of periodontal surgical techniques to treat gummy smile, success is achieved both in the scientific and biological sense, achieving a more aesthetically attractive smile(AU)

Effect of Salivary Flow on Bleached Enamel Roughness and Mineral Content: an In Situ and In Vitro Study.

This study aimed to evaluate the effect of human saliva in vitro and salivary flow in situ on the roughness and mineral content of bleached enamel. Dental specimens were divided into five groups (n=15): not bleached (NB); bleached (35% hydrogen peroxide) and exposed to distilled water (DW); human saliva in vitro (IV); normal salivary flow in situ (NSF); and low salivary flow (LSF) in situ. Enamel roughness (Ra, Rz) and calcium/phosphorus contents were evaluated with laser profilometry and energy-dispersive spectroscopy, respectively, at baseline (T1), after bleaching (T2), and after seven days (T3). Salivary pH and buffer capacity were evaluated with colorimetric strips and salivary calcium and phosphorus with absorbance spectrophotometry. Data were analyzed with non-parametric tests and linear regression (α=0.05). After contact with saliva, Ra and Rz of LSF=DW>IV=NSF=NB was found. For DW and LSF, the roughness of T1

Motivation and anxiety during the second COVID-19 lockdown in gym exercisers: The mediating role of affects and satisfaction with life.

The present study aimed to analyze the association between motivation (self-determined and non-self-determined motivation), positive and negative affect, life satisfaction and state-anxiety in a sample of gym exercisers, during the 2nd COVID-19 lockdown in Portugal. Also, we aimed to analyze the possible mediating role of positive and negative affect and life satisfaction in the relationship between motivation and levels of state-anxiety. A total of 201 gym participants (30.42 ± 11.22) were enrolled in the present study, of which 116 (57.7%) were women and 85 (42.3%) were men. The survey included sociodemographic data as well as the subsequently validated instruments: the State-Trait Anxiety Inventory, the Positive and Negative Affect Schedule, and the Satisfaction with Life Scale. The results revealed a positive association between state-anxiety and negative affect (r = .69), controlled motivation (r = .33), and autonomous motivation (r = .25). Still, state-anxiety was negatively associated with positive affect (r = -.40) and with satisfaction with life (r = -.43),. In addition, the results of mediation analysis, revealed inconsistent mediation of positive affect and life satisfaction in the relationship between autonomous motivation and state-anxiety. However, a total mediation was observed through negative affect and life satisfaction in the relationship between controlled motivation and anxiety since the indirect effect (ß = .27) is higher than the direct effect (ß = .06). Overall, the results reinforce that positive affect and satisfaction with life could act as a possible buffer against state-anxiety in gym exercisers and, thus, should be considered in future interventions and studies.

The relationship between past exercise behavior and future exercise adherence: A sequential mediation analysis.

The present study explored the mediation role of past exercise adherence, self-reported frequency and intentions in the association between past experience and future exercise adherence. In total, 431 exercisers (female = 216; male = 215) aged 18 and 64 years, engaged in fitness activities such as group fitness classes and resistance training, were included in the analysis. Serial mediation procedures were employed to examine the direct, indirect, and total indirect effects among variables. The predictor variable and all mediators displayed a positive and significant association with future six-month adherence. Past six-month exercise adherence displayed the most significant association with future six-month adherence. The sequential indirect path from exercise experience → past six-months adherence → self-reported frequency → intentions future six-months adherence displayed a positive and significant effect (ß = .19 [CI95% = .09, .31]), presenting a partial mediation effect. Past behaviour is the most significant predictor of future adherence, and thus interventions should be based on promoting consistent exercise frequency. Professionals working in the fitness centre context can identify possible dropouts based on their past behaviour and intentions to be physically active in the future.

Validação da Passion Scale para a população portuguesa praticante de exercício físico / Validación de la Escala de Pasión para la población portuguesa que practica ejercicio físico / Validation of the Passion Scale for the Portuguese population practicing exercise

El concepto de pasión se refiere a una fuerte inclinación a realizar una actividad que las personas disfrutan, que encuentran importante y en la que invierten tiempo y energía. El Modelo Dualístico de la Pasión explora este concepto en las dimensiones armoniosa y obsesiva y sus implicaciones en la motivación y parámetros asociados a la realización de conductas. Para apoyar la modificación conductual orientada a la práctica del ejercicio, son cruciales instrumentos adecuados y de calidad para evaluar la pasión. El objetivo principal del presente estudio fue analizar la validez y confiabilidad de la Escala de la Pasión en practicantes de ejercicio físico en el contexto del gimnasio y clubes de salud. La muestra estuvo compuesta por 203 participantes (sexo femenino = 109; sexo masculino = 94), con edades comprendidas entre 18 y 68 (M = 29.24; DT = 9.76) años. Los resultados de este estudio indican que el modelo de medición original de la Escala de Pasión de 16 ítems presentó un ajuste aceptable a los datos. Con la excepción de la pasión obsesiva por el hábito, todos los factores de la escala mostraron asociaciones positivas con la intención y el hábito. Los datos de este estudio sugieren que el modelo de medición Passion Scale (16 ítems/tres factores) adaptado al contexto del ejercicio se ajusta a los datos de la muestra del estudio y es una herramienta viable para el estudio de los factores involucrados en la adherencia continua en la práctica. (AU)

The concept of passion refers to a strong inclination to carry out an activity that people enjoy, that they find important and in which they invest time and energy. The Dualistic Model of Passion explores this concept in the harmonious and obsessive dimensions and its implications for motivation and parameters associated with the performance of behaviors. To support behavioral modification oriented towards the practice of exercise, adequateand quality instruments to assess passion are crucial.The main objective of the present study was to analyze the validity and reliability of the Passion Scale in practitioners of physical exercise in the context of the gym and health clubs. The sample consisted of 203 participants (female sex = 109; male sex = 94), aged between 18 and 68 (M = 29.24; SD = 9.76) years.The results of this study indicate that the original 16-item Passion Scale measurement model presented an acceptable fit to the data. Exceptfor the association between obsessive passion on habit, all factors on the scale showed positive associations with intention and habit. The data from this study suggest that the Passion Scale measurement model (16 items/three factors) adapted to the exercise context fits the data in the study sample and is a viable tool for the study of factors involved in continued adherence in practice. (AU)

O conceito de paixão refere-se a uma forte inclinação para a realização de uma atividade que as pessoas gostam, que acham importante e na qual investem tempo e energia. O Modelo Dualístico da Paixão explora esse conceito nas dimensões harmoniosa e obsessiva e suas implicações na motivação e parâmetros associados à realização de comportamentos. Visando o apoio à modificação comportamental orientada para a prática de exercício, instrumentos adequados e com qualidade para avaliar a paixão são determinantes. O objetivo do presente estudo foi analisar a validade e a fiabilidade da Passion Scale em praticantes de exercício físico no contexto do ginásio e health clubs. A amostra foi constituída por 203 participantes (sexo feminino = 109; sexo masculino = 94), com idades compreendidas entre 18 e 68 (M = 29.24; DP = 9.76) anos. Os resultados deste estudo indicam que o modelo de medida original de 16 itens da Passion Scale apresentou um ajustamento aceitável aos dados. Há exceção da paixão obsessiva com o hábito, todos os fatores da escala apresentaram associações positivas com a intenção e hábito. Os dados deste estudo sugerem que o modelo de medida da Passion Scale (16 itens/três fatores) adaptado ao contexto do exercício se ajusta aos dados na amostra em estudo e é uma ferramenta viável para o estudo de fatores envolvidos à adesão continuada na prática. (AU)

Relação entre os estados de humor e a síndrome de overtraining em jovens atletas / Relación entre estados de ánimo y síndrome de overtraining en jóvenes deportistas / Relationship between mood states and overtraining syndrome in young athletes

O presente estudo analisou a associação entre estados humor e Síndrome de Overtraining (SOT) em jovens atletas e as possíveis diferenças nos estados de humor e na SOT em função do nível competitivo e em função das idades. Métodos: No total, 219 jovens atletas, com idades compreendidas entre os 13 e os 17 anos (M = 14.81; DP = 1.35), foram considerados para análise deste estudo. Resultados: Os resultados demonstraram que existe uma relação positiva e significativa entre a depressão, o desajuste ao treino, a confusão (negativo) e a tensão com a SOT. Foram, também, encontradas diferenças significativas nos estados de humor hostilidade e depressão em função do nível competitivo e nos estados de humor confusão (positivo) e hostilidade em função da idade. Conclusão Estes dados indicam, não só, que existe uma associação positiva entre estados de humor negativos e a SOT, como a existência de diferenças entre níveis competitivos e entre idades, sendo, por isso, necessário ter em conta essas variáveis. (AU)

Este estudio analizó la asociación entre los estados de ánimo y el Síndrome de Overtraining (SOT) en deportistas jóvenes y las posibles diferencias en los estados de ánimo y en SOT considerando el nivel competitivo y los grupos de edad. Métodos: En total, 219 atletas jóvenes, con edades entre 13 y 17 años (M = 14.81; DT = 1.35), fueron considerados para el análisis en este estudio. Resultados: Los resultados demuestran que existe una relación positiva y significativa entre depresión, inadaptación al entrenamiento, confusión (negativa) y tensión con SOT. También se encontraron diferencias significativas en los estados de ánimo, ira y depresión a nivel competitivo, y en confusión (positiva) e ira según la edad. Conclusiones: Estos datos indican, no solo, que existe una asociación positiva entre estados de ánimo negativos y SOT, así como la existencia de diferencias entre niveles competitivos y entre grupos de edad, por lo que es necesario tener en cuenta estas variables. (AU)

This study analyzed the association between mood states and Overtraining Syndrome (OTS) in young athletes and the possible differences in mood states and in OTS considering the competitive level and age groups. Methods: In total, 219 young athletes, aged between 13 and 17 years old (M = 14.81; SD = 1.35), were considered for analysis in this study. Results: The results demonstrate that there is a positive and significant relationship between depression, maladjustment to training, confusion (negative) and tension with OTS. Significant differences were also found in the mood states, anger and depression at the competitive level, and in confusion (positive) and anger according to age. Conclusions: These data indicate, not only, that there is a positive association between negative mood states and OTS, as well as the existence of differences between competitive levels and between age groups, therefore, it is necessary to take these variables into account. (AU)

Examining the Coach Motivation Questionnaire in Fitness Professionals (CMQ-FP): Factor Structure, Invariance, and Predictive Analysis.

Purpose: To date, most research on the assessment of motivation has been exerciser-focused and has not considered how fitness professionals' motivations impact their behaviors toward exercisers during training sessions. The purpose of this study was to examine the factor structure of the Coach Motivation Questionnaire in a sample of fitness professionals (CMQ-FP) to ascertain its usefulness for this vocational grouping. Measurement invariance analysis was conducted between female and male fitness professionals, and predictive validity was tested considering need-supportive and need-thwarting behaviors as outcomes. Methods: Participants were 799 fitness professionals (female = 412) aged between 20 and 56 years (M = 28.71, SD = 3.24), who completed a multi-section survey assessing their motivation toward work and their interpersonal behaviors when engaging with exercisers. Results: The results of this research supported all three hypotheses. First, the hypothesized 6-factor measurement model showed acceptable fit to the data. Second, the factor structure of the CMQ-FP was invariant across gender (male and female fitness professionals). Third, fitness professionals' (autonomous or controlled) motivation was a valid predictor of need-supportive or need-thwarting behaviors. Conclusion: This study supported the factor structure of the CMQ-FP, presenting as a valid measure of motivation in fitness professionals. Understanding fitness professionals' perceptions of their coaching motivation can inform professional development activities to assist fitness professionals to increase understanding of what motivates these professionals and how they might be more need-supportive and less need-thwarting in their pedagogical behaviors.

Use of fluoridated dentifrices by children in Araçatuba, Brazil: factors affecting brushing habits and amount applied on the brush.

PURPOSE: To evaluate the type and the amount of fluoridated dentifrice applied on children's toothbrushes by parents/guardians according to descriptions typically recommended by scientific societies, as well as to assess the influence of demographic and socioeconomic variables on dentifrice use. METHODS: Parents/guardians of children (0-7 years old; n = 306; convenience sample) attending vaccination centres from Araçatuba (Brazil), answered to a structured questionnaire comprising items related to interviewees' education, child's age, gender, brushing habits and use of fluoridated dentifrice. The amount of toothpaste used by children during toothbrushing was estimated using a portable scale. Similarly, the interviewees were requested to apply dentifrices on toothbrushes according to eight descriptions, ranging from "smear" to "all bristles", following a random sequence. Data were submitted to Mann-Whitney's, Kruskal-Wallis' and Friedman's tests, and Spearman's correlation coefficient (p < 0.05). RESULTS: The type of toothpaste and the amount of product used at home were not affected by the respondents' educational level or family income. However, child's age was significantly correlated with the amount of toothpaste placed on the toothbrush (r = 0.324, p < 0.001). Also, the amount of toothpaste placed on the toothbrush increased according to what would be expected from the descriptions, although wide variations were observed within each description, with large interquartile and overall ranges. CONCLUSION: The amount and the type of dentifrice used by children were influenced by their age, while parents/caregivers' interpretation on verbal instructions regarding appropriate dentifrice quantities varied widely. This reinforces the need for educative measures on the appropriate use by dentifrices by children.

Adaptation and Validation of a Portuguese Version of the Sports Motivation Scale-II (SMS-II-P) Showing Invariance for Gender and Sport Type.

In the present cross-sectional study, we adapted and examined the validity of a Portuguese version of the Sport Motivation Scale II (SMS-II-P) within a sample of 1148 Portuguese athletes (women = 546, men = 602) with a mean age of 18.45 years (SD = 5.36), participating in a variety of sports (i.e., football, basketball, swimming, and athletics). We conducted confirmatory factor analysis, convergent and discriminant validity analysis, and multigroup analysis across participants' sport type (team and individual) and gender. We also examined the correlations between the SMS-II-P behavioral regulations and basic psychological needs satisfaction. The results supported that the SMS-II-P had good psychometric properties and was invariant across gender and sport type. The scale demonstrated good convergent and discriminant validity, and the subscales achieved adequate internal consistency. Correlations between the six types of regulation measured in the SMS-II supported the distinction between autonomous and controlled behavioral regulations, and the correlations between these subscales and other measures of autonomy, competence, and relatedness satisfaction provided evidence of the self-determination continuum. Implications of this research for assessing Portuguese athletes and conducting future research are discussed.

Information-seeking behaviors and barriers to the incorporation of scientific evidence into clinical practice: A survey with Brazilian dentists.

The aim of this online cross-sectional study is to identify the sources of scientific information used by Brazilian dentists in clinical decision-making and the barriers that they perceive as important to the incorporation of scientific evidence into clinical practice. A pretested questionnaire created in Google Forms which was made available to participants through links sent by e-mail or shared on Facebook® and Instagram® was used to collect the data between October 2018 and May 2019. Only dentists who were involved in direct or indirect care of patients (i.e. clinicians who performed dental procedures or dental educators who participated in the clinical training of graduate or postgraduate dental students) were asked to complete the questionnaire. The sample was comprised of 528 dentists (the response rate from the alumni database was 6.9%); their mean age was 45.2 years (±12.5) and 30.9% had an academic position. The majority were women (68.0%) and lived in Southern or Southeastern Brazil (96.0%). The sources of scientific information more frequently used by them in clinical decision-making were clinical guidelines (65.1%; 95% CI: 60.9, 69.2), scientific articles (56.8%; 95%CI: 52.5, 61.1) and bibliographic databases (48.3%; 95% CI: 43.9, 52.6). The information resource less frequently used was social media. The most important barriers to the clinical use of scientific evidence were: difficulty in determining whether scientific contents found on the Internet were reliable or not (41.8%; 95% CI: 37.6, 46.2), high cost of access to scientific papers (37.7%; 95% CI: 33.5, 41.9), and lack of time for reading scientific articles (32.4%; 95% CI: 28.4, 36.6). Although Brazilian dentists show a positive attitude towards obtaining scientific evidence from reliable sources, there still remain important barriers to the translation of evidence into practice. This can have significant implications for quality of care and should be further investigated.

Sex Differences in Relationships Between Perceived Coach-Induced Motivational Climates, Basic Psychological Needs, and Behavior Regulation Among Young Swimmers.

This study analyzed independent and codependent effects of task- and ego-involving motivational climates on basic psychological need satisfaction and behavioral regulation (i.e., autonomous and controlled motivation) among young athletes. Participants were young Portuguese female (n = 114) and male (n = 324) swimmers, nested within four different clubs. Participants completed a multisection survey, assessing motivational climates, basic psychological needs satisfaction, and behavioral regulation. We used polynomial regression analysis with surface response methodology to analyze the interactions between these constructs. We found that perceived task- and ego-involving motivational climates were not mutually exclusive; rather, their relationship depended on how athletes perceived coaches' behaviors and how coaches emphasized one or both climates. Coaches who fostered both motivational climates promoted positive outcomes among male (but not female) athletes.

On-board study of gas embolism in marine turtles caught in bottom trawl fisheries in the Atlantic Ocean.

Decompression sickness (DCS) was first diagnosed in marine turtles in 2014. After capture in net fisheries, animals typically start showing clinical evidence of DCS hours after being hauled on-board, often dying if untreated. These turtles are normally immediately released without any understanding of subsequent clinical problems or outcome. The objectives of this study were to describe early occurrence and severity of gaseous embolism (GE) and DCS in marine turtles after incidental capture in trawl gear, and to provide estimates of on-board and post-release mortality. Twenty-eight marine turtles were examined on-board fishing vessels. All 20 turtles assessed by ultrasound and/or post-mortem examination developed GE, independent of season, depth and duration of trawl and ascent speed. Gas emboli were obvious by ultrasound within 15 minutes after surfacing and worsened over the course of 2 hours. Blood data were consistent with extreme lactic acidosis, reduced glomerular filtration, and stress. Twelve of 28 (43%) animals died on-board, and 3 of 15 (20%) active turtles released with satellite tags died within 6 days. This is the first empirically-based estimate of on-board and post-release mortality of bycaught marine turtles that has until now been unaccounted for in trawl fisheries not equipped with turtle excluder devices.

Motivational patterns in persistent swimmers: A serial mediation analysis.

Objective: The main objective of the present study was to examine the associations between coach-created task-involving climate and athletes' intentions to continue practicing sport, through a serial mediation analysis that included basic psychological needs satisfaction (BPN), self-determined motivation (SDM) and enjoyment. Methods: Seven-hundred and ninety-nine elite swimmers (450 males, 349 females; aged 12-22 years, M = 16.65, SD = 2.83) participated in the present study. Groups were created according to age, years of experience, and gender. Results: Serial mediation analysis provided support for the proposed model where BPN's and enjoyment represent the most important mediators between task-involving climate and athletes' intentions to continue sport practice. Conclusion: Enjoyment stands out as the most relevant predictor of intention to persist and as a significant mediator in the relation between task-involvement climate, BPN, SDM, and long-term sports practice. The task-involving climate created by coaches appears to set in motion a sequence where the satisfaction of basic needs and SDM lead to more enjoyment and increased persistence among young athletes.

Cardioprotective effects of alternagin-C (ALT-C), a disintegrin-like protein from Rhinocerophis alternatus snake venom, on hypoxia-reoxygenation-induced injury in fish.

Alternagin-C (ALT-C) is a disintegrin-like peptide purified from Rhinocerophis alternatus snake venom with the property of inducing vascular endothelial growth factor (VEGF) expression, endothelial cell proliferation and migration, and angiogenesis. Therefore, this protein could be interesting as a new approach for ischemic heart diseases, an imbalance between myocardial oxygen supply and demand, leading to cardiac dysfunction. We investigated the effects of a single dose of alternagin-C (0.5 mg kg-1, via intra-arterial), after 7 days, on hypoxia/reoxygenation challenge in isolated ventricle strips and on morphological changes and density of blood vessels of the heart, using fish as an alternative experimental model. ALT-C treatment provided protection of cardiomyocytes against hypoxia/reoxygenation-induced negative inotropism. ALT-C also stimulated angiogenesis and improved excitation-contraction coupling during hypoxic conditions. Our results provide a new insight into a functional role of ALT-C against hypoxia/reoxygenation-induced cardiomyocyte injury pointing out to a potential therapeutic strategy for ischemia-related diseases.

Remoção cirúrgica de grande tórus mandíbular ­ relato de caso / Surgical removal of a large mandibular torus ­ case report

O tórus mandibular é um tipo de alteração anatômica que acomete a tábua óssea lingual localizada normalmente na região dos pré-molares e molares inferiores, geralmente assintomático. Clinicamente é observado através da protuberância na face lingual da mandíbula e confirmado com exames complementares de imagens. O presente trabalho teve como objetivo descrever o tratamento do tórus mandibular volumoso com indicação cirúrgica desde o diagnóstico ao pós-operatório. Paciente do gênero feminino, 40 anos, leucoderma, foi encaminhada para o serviço de cirurgia bucomaxilofacial como queixa principal de dor ao falar, dificuldade de deglutição e interposição lingual. Clinicamente, havia presença de aumento de volume multilobular nos dois lados da mandíbula. Nos exames imaginológicos, foram observadas imagens radiopacas circunscritas, com forma arredondada e sobrepostas ao terço médio das raízes dos dentes indicando diagnóstico clínico e imaginológico de tórus mandibular. Diante da indicação, foi realizada a remoção cirúrgica. A remoção cirúrgica de tórus mandibular restabeleceu as funções do sistema estomatognático, melhorando a mastigação, fonação e deglutição (AU).

Mandibular torus is a type of anatomical alteration that affects the lingual bone plate usually located in the region of the premolars and mandibular molars, generally asymptomatic. Clinically it is observed through the protuberance on the lingual aspect of the mandible and confirmed with complementary imaging tests. This study aimed to describe the treatment of large mandibular torus with surgical indication from diagnosis to postoperative. Female patient, 40 years old, leucoderma, was referred to the department of Oral and Maxillofacial Surgery as the main complaint of pain when speaking, difficulty in swallowing, and lingual interposition. Clinically, there was presence of multilobular volume increase on both sides of the mandible. Imaging examinations revealed circumscribed rounded shape radiopaque images overlapping the middle third of the teeth roots indicating clinical and imaging diagnosis of mandibular torus. Due to clinical indication, the surgical removal was performed. The surgical removal of the mandibular torus reestablished the functions of the stomatognatic system, improving mastication, phonation, and deglutition (AU).

Effects of animal type (wild vs. domestic) and diet alfalfa level on intake and digestibility of European adult rabbits (Oryctolagus cuniculus).

The aim of this study was to evaluate the effect of the level of alfalfa in the diet on feed intake and digestibility of two types of rabbits, wild (Oryctolagus cuniculus algirus) vs. domestic (O. cuniculus cuniculus). Ten wild (W; mean LW = 927 g) and 10 domestic (D; mean LW = 4,645 g) adult rabbit does were fed ad libitum two pelleted diets: a control diet (C) with 15% of dehydrated alfalfa hay (as feed basis) and a test diet (A) with 36% of dehydrated alfalfa hay (as feed basis), according to a change-over design. Wild does dry matter (DM) intake per kg live weight (BW) was 55% higher (p < .001) than the intake of the D ones (58 g vs. 37 g DM per kg BW respectively). However, no difference (p > .05) was found when intake was expressed per kg0.75 BW (ca. 56 g DM) and tended to be higher (p = .07) in D does when expressed per kg0.67 BW (62 g vs. 55 g DM). Domestic does showed a higher (p < .05) DM, organic matter, crude energy and neutral detergent fibre digestibility (3; 2; 3; 3 percentage points respectively) than W does. The amount of nutrients and energy digested by D does was lower per kg BW (p < .001), similar per kg0.75 BW (p > .05) and tended to be higher per kg0.67 BW (p < .1) than in W does. The diet content of alfalfa did not affect (p > .05) the feed intake nor the diet digestibility. This study suggests that W rabbits exhibit a higher intake per kg BW and a lower digestibility than their D counterparts, which results in similar digestible nutrient and energy intake per kg BW powered to 0.75. The nutritive value of dehydrated alfalfa for rabbits, evaluated through intake and digestibility, seems to be equivalent to their base diets (forage plus concentrate).

Twelve years of Lyell's Syndrome in the burn unit of São João Hospital Centre.

Stevens-Johnson syndrome (SSJ) and toxic epidermal necrolysis (TEN) correspond to an acute and rare life-threatening mucocutaneous reaction. We describe the etiology, length of stay, comorbidities and mortality of TEN in our hospital in a retrospective study of 12 years. Twenty-one patients were included in the study. The mean age was 66 years: 57.1% were females. One third had mucosal surface involvement. Median TBSA of epidermal detachment was 66% on day 1. Forty-two per cent had a SCORTEN at admission of 3 and 28.6% had a SCORTEN of 4, which performs 70.6% with SCORTEN ≥5. The most common causes of SJS/TEN in this study were antibiotics. There were a total of 15 deaths (71.4%). All the patients in the antibiotic group died. Patients who needed invasive ventilation had higher mortality (91%) than the non-invasive ventilation group (50%) and the group on spontaneous ventilation (42.8%). The most common complications were sepsis (53%) and renal failure (23%). Highest mortality due to sepsis was in the antibiotic group. When SCORTEN score was calculated for each patient, statistical evaluation showed an increase in mortality with increasing final score. The most crucial interventions are discontinuation of the causative drug and immediate referral to a burn unit, which helps in early diagnosis and decreases mortality. Our study provides insights into the confirmation of the risk of SJS/TEN as well as its treatment. When SSJ/TEN is caused by antibiotics, the suspicion of developing fatal sepsis should be high regardless of the patient's medical condition.

Le syndrome de Stevens-Johnson et la nécrolyse épidermique toxique (NET) consistent en une réaction cutanéo-muqueuse grave rare. Nous décrivons de manière rétrospective l'étiologie, la durée de séjour, les complications et la mortalité des 21 patients hospitalisés dans notre service pour TEN pendant 12 ans. L'âge moyen des patients était de 66 ans, 57,1% étaient des femmes. Le tiers des patients avaient des atteintes muqueuses. La surface décollée moyenne à J1 était de 66%. Le SCORTEN à l'admission était à 3 chez 42% des patients, 4 chez 28,6% soit 70,6% avec SCORTEN ≤ 5. Les médicaments les plus souvent en cause étaient les antibiotiques. Quinze patients (71,4%) sont décédés, parmi lesques tous ceux dont le TEN était lié à un antibiotique. Les patients nécessitant une ventilation invasive sont morts dans 91% des cas, ceux sous VNI dans 50% des cas, ceux qui n'ont pas été ventilés dans 42,8% des cas. Les complications les plus fréquentes étaient le sepsis (53%) et l'insuffisance rénale (23%). La mortalité reliée au sepsis était plus fréquente dans le groupe des NET déclenchés par un antibiotique. Elle était reliée au SCORTEN. L'arrêt du médicament en cause et l'hospitalisation immédiate en CTB permettent un diagnostic plus précoce et une réduction de la mortalité. Cette étude donne des éclairages sur les risques de SJS/NET et leur traitement. Quand ils sont dus à un antibiotique, le danger de décéder par sepsis est élevé, quel que soit l'état initial du patient..

Inhalation injury in a burn unit: a retrospective review of prognostic factors.

Inhalation injury (InI) is known to seriously affect the prognosis of burn patients, as it is strongly associated with high morbidity and mortality. Despite major advances in the treatment of burn patients in the past years, advances in the treatment of smoke InI have been somewhat limited; mortality reduction mostly results from improvements in critical care. It is difficult to separate the contribution of InI from other mechanisms that also affect respiratory tract and lungs. The aim of this study was to compare patients with and without InI and to identify prognostic factors among patients with smoke InI. Patients with InI displayed higher total body surface area (TBSA) burned, higher incidence of pneumonia and acute respiratory distress syndrome (ARDS), a higher rate of positive blood cultures and a significantly higher death rate. We could conclude that older age, higher TBSA, ARDS and pneumonia were independent predictive factors for mortality in our global study population. Older age and higher TBSA were the only independent factors found to be predictive of mortality in patients with InI.

L'inhalation de fumées (IF) est reconnue comme aggravant le pronostic des patients brûlés, étant fortement corrélée avec une morbidité et une mortalité élevées. Alors que des progrès majeurs ont été réalisés, ces dernières années, dans le traitement des brûlés, ils ont été plus limités dans celui de l'IF, les avancées étant surtout le fait des mesures générales de réanimation. Il est difficile de faire la part de l'IF et d'autres mécanismes touchant le système respiratoire. Le but de cette étude était de comparer les patients avec et sans IF pour identifier les facteurs pronostiques concernant les patients avec IF. Ceux ­ ci étant brûlés sur une plus grande surface, avaient plus fréquemment des pneumonies et des SDRA, plus d'hémocultures positives et mouraient plus souvent. Nous avons observé que l'âge plus élevé, la surface brûlée plus importante, le SDRA et la pneumonie étaient des facteurs pronostics de mortalité de la population globale, l'âge avancé et la surface brûlés étant les seuls critères pronostiques indépendants de mortalité des patients avec IF.

Antifungal activity of tyrosol and farnesol used in combination against Candida species in the planktonic state or forming biofilms.

AIM: This study examined the antifungal activity of the combination of tyrosol and farnesol against Candida albicans and Candida glabrata in the planktonic state or forming biofilms. METHODS AND RESULTS: The effect of drug association against Candida planktonic cells was assessed by the fractional inhibitory concentration index. Mono- and dual-species biofilms were developed during 24 h and then treated with the compounds for 3 days, with two daily treatments of 1 min each. After, the total biomass, metabolic activity and the number of cultivable cells were quantified. Planktonic cells of the two species showed a similar susceptibility to the drug combination, however, a synergistic effect was only verified for C. glabrata. Regarding biofilm susceptibility, significant reductions in C. glabrata biomass, metabolism of C. albicans and mixed biofilms, and cultivable cells of single biofilms were verified for the drug combination, indicating an additive effect. For all other experiments, the effects were classified as indifferent. CONCLUSION: The combined use of tyrosol and farnesol was advantageous for some of the analysed parameters against Candida species. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings may contribute to the development of oral care products containing tyrosol and farnesol to combat oral infections caused by Candida species.

Peeling gengival / Gingival peeling ­ case report

O objetivo desse trabalho foi relatar um caso clínico de despigmentação melânica utilizando a técnica de peeling gengival com lâmina de bisturi 15C no arco superior. A paciente em questão procurou a clínica queixando-se da cor da sua gengiva. Foi oferecida a ela a despigmentação melânica através da técnica de microabrasão. O resultado cirúrgico alcançado foi extremamente satisfatório quando a gengiva, após 30 dias, se apresentou rósea e seus aspectos de arco côncavo regulares. O pós-operatório vem sendo acompanhado há três meses, não havendo retorno da pigmentação melânica.

The aim of article was to report a case of melanin depigmentation trough the gingival peeling technique using a scalpel blade 15c in the anterior maxillary arch. The patient sought the clinics complaining about the color of its gingiva. After patient authorization, the microabrasion technique was proposed for depigmentation. The surgical result observed 30 days later was extremely satisfactory with a pink color and a regular scalloped margin. The postoperative results have been followed-up for 3 months and the previous tissue color condition did not demonstrate any signs of recurrency..