Endo-sinus bone gain following sinus membrane elevation without graft compared with sinus floor augmentation and a composite graft: a one-year single-blind randomized controlled trial.

The objective of this study was to assess endo-sinus bone gain (ESBG) and bone density (BD) following maxillary sinus membrane elevation without graft (test) compared with maxillary sinus floor augmentation and 1:1 ratio of autogenous bone from the buccal antrostomy and deproteinized porcine bone mineral (control) using two- and three-dimensional radiographic methods. Forty healthy patients were randomly allocated to the test and control groups. Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval. Significance was set at ≤ 0.05. ESBG and BD were significantly higher in the control group than test group at T1, T2, and T3 (P < 0.001). A significant decrease in ESBG and increase in BD was observed from T1 to T3 with both treatments (P < 0.001). There was a non-significant positive correlation of ESBG with implant protrusion length and non-significant negative correlation with residual bone height. In conclusion, test was associated with significantly lower ESBG and BD compared with control. However, the lower ESBG and BD did not appear to negatively affect the implant stability quotient or implant treatment outcome after 1 year of functional implant loading.

Endo-sinus bone gain following osteotome-mediated sinus floor elevation with Bio-Oss Collagen compared with no grafting material: a one-year single-blind randomized controlled trial.

The objective of this study was to assess endo-sinus bone gain (ESBG) following osteotome-mediated sinus floor elevation with Bio-Oss Collagen (test) compared with no grafting material (control) using two- and three-dimensional radiographic methods, as part of a randomized controlled trial (ClinicalTrials.gov, NCT04618900). Forty healthy patients who met the necessary eligibility criteria were allocated by block randomization to either the test group (20 patients) or control group (20 patients). Cone beam computed tomography scans were obtained at enrolment (T0), immediately after surgery (T1), at delivery of the prosthetic rehabilitation (T2), and 1 year after functional implant loading (T3). Mean differences were expressed with the 95% confidence interval; significance was set at P < 0.05. ESBG was significantly increased with Bio-Oss Collagen compared with no grafting material at T1, T2, and T3 (P < 0.001). A gradual decrease in ESBG was observed over time with both treatment modalities (P < 0.001), which diminished the difference between the test and control groups at T2 and T3. ESBG was observed to be positively correlated with implant protrusion length and negatively correlated with the residual bone height. In osteotome-mediated sinus floor elevation, the application of Bio-Oss Collagen underneath the elevated Schneiderian membrane improved ESBG significantly when compared with no grafting material. However, the increased ESBG seems not to have positively improved the treatment outcomes in terms of the implant stability quotient or the survival of the implants or suprastructures.

Outcomes following osteotome-mediated sinus floor elevation with Bio-Oss Collagen or no grafting material: a one-year single-blind randomized controlled trial.

The objective of this single-blind randomized controlled trial was to test the hypothesis of no difference in implant treatment outcome and patient-reported outcome measures (PROMs) following osteotome-mediated sinus floor elevation with Bio-Oss Collagen (test) compared with no grafting material (control) after 1 year of implant loading. Forty healthy patients (27 female, 13 male) with a mean age of 49 years (range 24-74 years) were randomly allocated to the test or control group. Outcome measures included survival of the suprastructures and implants, peri-implant marginal bone loss, complications, and PROMs; the latter included the Oral Health Impact Profile-14 and a self-administered questionnaire with visual analogue scales to assess the peri-implant tissue, implant crown, function of the implant, total implant treatment outcome, and oral health-related quality of life. Mean differences were expressed with the standard deviation and 95% confidence interval. The level of significance was 0.05. Survival of the suprastructures and implants was 100% with both treatment modalities. No significant difference in any of the outcome measures was observed between the test and control groups. High patient satisfaction and a significant improvement in quality of life were observed with both treatment modalities. Consequently, no significant difference in implant treatment outcome between the test and control groups was revealed after 1 year of implant loading. Neither of the treatment modalities can therefore be considered better than the other.

Purpureocillium lilacinum an emergent pathogen: antifungal susceptibility of environmental and clinical strains.

Purpureocillium lilacinum is a filamentous and hyaline fungus cosmopolitan, saprophytic, largely used in the biological control of plant-parasitic nematodes and insects, also considered an emerging and opportunistic human pathogen. The standard treatment for hyalohyphomycosis caused by P. lilacinum is not yet defined, since this fungus is resistant to different antifungals, in vitro and in vivo. The aim of this study was to evaluate and compare in vitro antifungal activity against environmental and clinical P. lilacinum isolates and our results demonstrated that these isolates can be resistant to newer generation triazoles, such as voriconazole, and to caspofungin, a drug of the echinocandin class. In summary, we highlight the importance of knowing the different susceptibility profiles of P. lilacinum isolates, and besides that, the emergence of uncommon human and animal opportunistic fungi, such P. lilacinum, especially during COVID-19, highlight the need for antifungal susceptibility testing of isolates since empirical therapy with different treatment schedules failed in great number of patients.

Thrombotic microangiopathy in primary antiphospholipid syndrome is linked to stroke and less deep venous thrombosis.

OBJECTIVE: To compare clinical and laboratory data obtained from patients with primary Antiphospholipid Syndrome (pAPS) with and without Thrombotic Microangiopathy (TMA). PATIENTS AND METHODS: A cross-sectional study with 66 (83.3% female) pAPS patients was performed. Demographic, clinical, drug use, antiphospholipid antibodies data were evaluated. Patients were subdivided into one of two groups: pAPS with TMA and pAPS without TMA and were compared. RESULTS: In this sample, 5/66 (7.6%) of patients had TMA. Primary APS with TMA group exhibited a higher frequency of arterial events (100% vs. 54.1%, p=0.02), stroke (100% vs. 32.8%, p=0.001) and a lower frequency of deep venous thrombosis (0 vs. 68.9%, p=0.0009) compared to the patients without TMA. Analysis of therapy used in these patients showed a higher frequency of current (40% vs. 6.6%, p=0.0006) and previous glucocorticoid use (80% vs. 36%, p=0.0007) and statin use (50% vs. 22.9%, p=0.037) in the first group. The two groups exhibited no differences in the frequency of positive autoantibodies, except for higher IgG anticardiolipin titers (86 ± 52 vs. 34.5 ± 39 GPL, p=0.003). CONCLUSIONS: Patients with pAPS and TMA have distinct clinical and laboratory spectra from those without TMA, that is characterized by an increased frequency of arterial events, stroke, and higher titers of IgG anticardiolipin; they have deep venous thrombosis less frequently.

Expression of VCAN and its receptors in canine mammary carcinomas with or without myoepithelial proliferation.

The proteoglycan versican (VCAN) plays a complex role in cancer. The expression of this molecule has been related to invasion and progression in malignant mixed tumors, such as carcinoma in mixed tumors (CMT) of the canine mammary gland. In addition, its interaction with surface cell receptors EGFR, HER-2 and CD44 in malignant epithelial cells may be responsible for proliferation and cellular motility in early stages of cancer. We comparatively evaluated the expression of this proteoglycan and its receptors in in situ and invasive areas of simple carcinomas (SC) and CMT to investigate similarities and differences between these histological types. Immunohistochemistry was performed with anti-VCAN, anti-CD44, anti-EGFR and anti-HER-2 antibodies in 32 cases of SC or CMT. VCAN was highly expressed in stroma adjacent to invasive areas in SC and CMT. CMTs presented comparatively higher expression of VCAN in stroma adjacent to in situ and in invasive areas than in corresponding areas in SCs. In CMT, EGFR and HER-2 expressions were higher in situ compared to invasive areas. In contrast, increased CD44 and EGFR expression was found in invasive areas in SC compared to CMT. These results indicate that versican expression is similarly associated with invasiveness in SC and CMT, however higher levels were seen in CMT suggesting that the presence of myoepithelial proliferation in this tumor type participates in stromal composition and promoting an increase in the expression of versican.

Cardiac disease in the Spix Macaw (Cyanopsitta spixii): two cases.

Cardiovascular disease in avian species, other than poultry, is being increasingly reported. In psittacine birds, atherosclerosis and congestive heart failure are the leading cardiovascular diseases, often resulting in multiorgan dysfunction and demise. The Spix's macaw (Cyanopsitta spixii) is arguably the most endangered psittacine species worldwide. We aimed to describe the gross and microscopic findings in two adult Spix's macaws wherein severe cardiovascular pathology resulted in sudden death. Bird 1 had pathologic findings consistent with fibrinoheterophilic vegetative pulmonic valvular endocarditis with luminal obliterative thrombosis, myocarditis and epicarditis, myocardial fibrofatty infiltration and cardiomyocyte loss, as well as generalized septicaemia. Microbiological analysis yielded Pantoea septica from the intestines and Acinetobacter baylyi from the cerebrum. Bird 2 had changes suggestive of right brachiocephalic coarctation-like obliterative arteriopathy. The latter is a novel cardiovascular pathology in avian species, and its severity and extent likely led to acute decompensation of pre-existing cardiac disease. These results add to the body of knowledge on avian cardiovascular pathology and may aid in veterinary medical decisions on caged birds, including those part of ex situ conservation efforts.

Association of whole mtDNA, an NADPH G11914A variant, and haplogroups with high physical performance in an elite military troop.

Physical performance is a multifactorial and complex trait influenced by environmental and hereditary factors. Environmental factors alone have been insufficient to characterize all outstanding phenotypes. Recent advances in genomic technologies have enabled the investigation of whole nuclear and mitochondrial genome sequences, increasing our ability to understand interindividual variability in physical performance. Our objective was to evaluate the association of mitochondrial polymorphic loci with physical performance in Brazilian elite military personnel. Eighty-eight male military personnel who participated in the Command Actions Course of the Army were selected. Total DNA was obtained from blood samples and a complete mitochondrial genome (mtDNA) was sequenced using Illumina MiSeq platform. Twenty-nine subjects completed the training program (FINISHED, 'F'), and fifty-nine failed to complete (NOT_FINISHED, 'NF'). The mtDNA from NF was slightly more similar to genomes from African countries frequently related to endurance level. Twenty-two distinct mtDNA haplogroups were identified corroborating the intense genetic admixture of the Brazilian population, but their distribution was similar between the two groups (FST=0.0009). Of 745 polymorphisms detected in the mtDNA, the position G11914A within the NADPH gene component of the electron transport chain, was statistically different between F and NF groups (P=0.011; OR: 4.286; 95%CI: 1.198-16.719), with a higher frequency of the G allele in group F individuals). The high performance of military personnel may be mediated by performance-related genomic traits. Thus, mitochondrial genetic markers such as the ND4 gene may play an important role on physical performance variability.

Association of whole mtDNA, an NADPH G11914A variant, and haplogroups with high physical performance in an elite military troop

Physical performance is a multifactorial and complex trait influenced by environmental and hereditary factors. Environmental factors alone have been insufficient to characterize all outstanding phenotypes. Recent advances in genomic technologies have enabled the investigation of whole nuclear and mitochondrial genome sequences, increasing our ability to understand interindividual variability in physical performance. Our objective was to evaluate the association of mitochondrial polymorphic loci with physical performance in Brazilian elite military personnel. Eighty-eight male military personnel who participated in the Command Actions Course of the Army were selected. Total DNA was obtained from blood samples and a complete mitochondrial genome (mtDNA) was sequenced using Illumina MiSeq platform. Twenty-nine subjects completed the training program (FINISHED, 'F'), and fifty-nine failed to complete (NOT_FINISHED, 'NF'). The mtDNA from NF was slightly more similar to genomes from African countries frequently related to endurance level. Twenty-two distinct mtDNA haplogroups were identified corroborating the intense genetic admixture of the Brazilian population, but their distribution was similar between the two groups (FST=0.0009). Of 745 polymorphisms detected in the mtDNA, the position G11914A within the NADPH gene component of the electron transport chain, was statistically different between F and NF groups (P=0.011; OR: 4.286; 95%CI: 1.198-16.719), with a higher frequency of the G allele in group F individuals). The high performance of military personnel may be mediated by performance-related genomic traits. Thus, mitochondrial genetic markers such as the ND4 gene may play an important role on physical performance variability.

Can severe drought periods increase metal concentrations in mangrove sediments? A case study in eastern Brazil.

Mangrove ecosystems are essential to society, providing ecological and economic services, and play a crucial role in the geochemical land-ocean interface as a sink for potentially toxic metals. This study assessed metals (Al, Ba, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Sr and Zn) and arsenic in sediments from three mangrove zones (Tidal Flat, Rhizophora mangle L. and Avicennia schaueriana Stapf & Leechman ex Moldenke forests) during two seasons: spring of 2015 and autumn of 2016, with the latter being a severe drought year. Overall results suggest that Fe/Mn oxyhydroxides and clay minerals control the distribution of metal and arsenic in the Tidal Flat zone. In the mangrove forest however, sulfur and organic matter dominate complexation, with Fe mainly present as insoluble sulfide, and As, Cd, Cu and Zn as metal sulfides or organometallic complexes. In the autumn of 2016, all elements except Cd and Pb had lower concentrations compared to the spring of 2015. Cd and Pb were probably transferred from sources other than mangrove sediments, due to increased saline water intrusion, a consequence of reduced riverine flow, and precipitated in the Rhizophora mangle and Avicennia schaueriana mangrove forests. This increase of Cd and Pb in the mangrove forest suggests potential storage of metal contaminants in the organic rich areas, a change in availability and potential toxicity to fauna and flora and a need for regulatory responses to sediment quality. These results indicate a change in sediment metal contaminant dynamics with the increasing occurrence of extreme weather events - an increased risk to the ecosystem.

Associations between clinical features and therapy with macrophage subpopulations and T cells in inflammatory lesions in the aorta from patients with Takayasu arteritis.

Takayasu arteritis (TAK) is a large-vessel granulomatous vasculitis; the inflammatory infiltration in arteries comprises macrophages, multi-nucleated giant cells, CD4+ and CD8+ T cells, γδ T cells, natural killer (NK) cells and neutrophils. However, it is unknown which subtype of macrophages predominates. This study aims to evaluate macrophages subpopulations in the aorta in TAK. Immunohistochemistry was performed in the aorta from TAK patients (n = 22), patients with atherosclerotic disease (n = 9) and heart transplant donors (n = 8) using the markers CD68, CD86, CD206, CD3, CD20 and CD56. Active disease was observed in 54·5% of patients and active histological lesions were found in 40·9%. TAK patients presented atherosclerotic lesions in 27·3% of cases. The frequency of macrophages, M1 macrophages, T, B and NK cells was higher in the aorta from TAK and atherosclerotic patients compared to heart transplant donors. In TAK, macrophages and T cells were the most abundant cells in the aorta, and the expression of CD206 was higher than CD86 (P = 0·0007). No associations were found between the expression of cell markers and active disease or with atherosclerotic lesions. In TAK patients, histological disease activity led to higher T cell counts than chronic fibrotic lesions (P = 0.030), whereas prednisone use was associated with lower T cell counts (P = 0·035). In conclusion, M1 macrophages were more frequent in TAK and atherosclerotic patients compared to heart transplant donors, while M2 macrophages dominated M1 macrophages in TAK. T cells were associated with histological disease activity and with prednisone use in TAK.

Extranodal lymphoma in a bush dog (Speothos venaticus) - case report / Linfoma extranodal em um cachorro-do-mato-vinagre (Speothos venaticus) - relato de caso

A captive 7-year-old male bush dog (Speothos venaticus) was diagnosed with lymphoma affecting the kidneys, adrenal glands, liver, and spleen. The animal developed renal failure and was euthanized due to poor prognosis. Grossly, both kidneys were enlarged with multiple nodules. Histologically, the neoplasm was an infiltrative and poorly demarcated round cell tumor. Two morphologically distinct cell populations were observed, smaller cells with a lymphocytic morphology, and another population of larger and pleomorphic cells. Most of the smaller cell population, approximately 40% of the population within the neoplasm, were CD3 positive. Neoplastic cells were CD45, CD11d, and granzime B positive, and negative for CD20, CD79a, PAX5, CD163, and myeloperoxidase. This is the first reported case of lymphoma in a bush dog. This report demonstrated the suitability of several cell surface markers for differential diagnosis of round cell tumors in this species.(AU)

Um cachorro-do-mato-vinagre (Speothos venaticus), de sete anos de idade, mantido em cativeiro, foi diagnosticado com linfoma que havia afetado os rins, as adrenais, o fígado e o baço. O animal desenvolveu insuficiência renal e foi submetido à eutanásia devido ao prognóstico desfavorável. Macroscopicamente, ambos os rins estavam aumentados de tamanho, com múltiplos nódulos. Histologicamente, a neoplasia era infiltrativa, pobremente delimitada e constituída por células redondas. Duas populações distintas foram observadas: células pequenas com morfologia linfocítica e células grandes e pleomórficas. A maior parte da população de células pequenas, correspondendo a aproximadamente 40% da população celular na neoplasia, foi positiva para CD3. As células neoplásicas foram positivas para CD45, CD11d e granzima B e negativas para CD20, CD79a, PAX5, CD163 e mieloperoxidase. Este é o primeiro caso de linfoma em um cachorro-do-mato-vinagre. Tal relado demonstra a utilidade de vários marcadores de superfície celular para o diagnóstico diferencial de tumores de células redondas nessa espécie.(AU)

Engineering the surface of prostate tumor cells and hyaluronan/chitosan multilayer films to modulate cell-substrate adhesion properties.

This paper explores different film assembly conditions of the polyelectrolyte solutions of hyaluronan (HA) and chitosan (CHI), as well as both substrate and cell surface modifications, to investigate PC3 cells adhesion properties. UV-Visible, AFM-IR and Zeta potential techniques indicate that the solution ionic strength is a relevant parameter to modulate the free carboxylic groups of HA on the film surface. In addition, capacitive coupling measurements suggest that assembly conditions that favor surface charge mobility inhibit cell adhesion due to polymer rearrangements that support non-specific electrostatic interactions of positively charged CHI residues and the negatively charged cell moieties, rather than specific CD44-hyaluronan interactions. Moreover, the PC3 cells treatment with hyaluronidase and anti-CD44 antibody also highlighted the importance of CD44 binding site availability on the tumor cell adhesion properties. Finally, the conjugation of wheat germ agglutinin on the film surface proved to be a suitable strategy to boost the PC3 cell adhesion properties. Our results reveal the remarkable capacity of HA/CHI films to modulate cell-substrate properties, which pave the road for the development of surfaces suitable for several applications based on biosensing.

Impact of motion artefacts and motion-artefact correction on diagnostic accuracy of apical periodontitis in CBCT images: an ex vivo study in human cadavers.

AIM: To assess the impact of motion artefacts and motion-artefact correction on diagnostic accuracy of apical periodontitis (AP) in CBCT images. METHODOLOGY: Based on clinical and radiographic inspection of 40 formalin-fixated human jaw specimens, 77 roots in 45 teeth (molars and premolars), with various disease and treatment state, were selected. The specimens were mounted on a robot simulating 3-mm movement types (nodding, lateral rotation and tremor). CBCT images with and without (controls) movements were acquired in four CBCT units: without motion-artefact correction in Cranex 3Dx, Orthophos SL 3D, and Promax 3D Mid, and with motion-artefact correction in Promax 3D Mid and X1. Three observers blindly assessed (i) whether the images were interpretable and (ii) if AP was present (5-step probability index). Histopathology provided the reference standard for presence of AP. Weighted Kappa statistics described inter-observer agreement. Estimates of diagnostic accuracy were assessed by means of receiver operator characteristic (ROC) curve analysis. Area under the curve (AUC) provided a measure of accuracy, and paired-sample AUC difference tests compared differences amongst the CBCT units and movement types. RESULTS: Observer agreement was substantial for control images, moderate for motion-artefact corrected images and fair for images without motion-artefact correction. When movement was present, motion-artefact correction reduced the percentage of images scored as noninterpretable or with uncertain disease state (score 3 in the 5-step probability index). Control images were not perfectly accurate (both false-positive and false-negative results were present; AUC 0.750-0.799). Images acquired with movement and without motion-artefact correction (AUC 0.541-0.709) were associated with significantly lower accuracy than control images (P < 0.05). With motion-artefact correction, accuracy was comparable to that observed in control images (AUC 0.732-0.790). CONCLUSIONS: Diagnostic accuracy of apical periodontitis in CBCT images was dependent on the presence of motion artefacts (i.e. lower accuracy associated with the presence of movement). Motion-artefact correction systems positively influenced image interpretability and diagnostic accuracy.

Expression profiles of growth-related genes in two Nile tilapia strains and their crossbred provide insights into introgressive breeding effects.

The Nile tilapia (Oreochromis niloticus) is a prominent farmed fish in aquaculture worldwide. Crossbreeding has recently been carried out between the Red-Stirling and the wt Chitralada strains of Nile tilapia, producing a heterotic hybrid (7/8 Chitralada and 1/8 Red-Stirling) that combines the superior growth performance of the Chitralada with the reddish coloration of the Red-Stirling strain. While classical selective breeding and crossbreeding strategies are well known, the molecular mechanisms underlying the phenotypic expression of economically advantageous traits in tilapia remain largely unknown. Molecular investigations have shown that variable expression of growth hormone (gh), insulin-like growth factors (igf1 and 2) and somatolactin (smtla) - components of the growth hormone/insulin-like growth factor (GH/IGF) axis - and myostatin (mstn) genes can affect traits of economic relevance in farmed animals. The aim of this study was to assess and compare the gene expression signature among Chitralada, Red-Stirling and their backcross hybrid in order to gain insights into the effects of introgressive breeding in modulation of the GH/IGF axis. Gene expression analyses in distinct tissues showed that most genes of the GH/IGF axis were up-regulated and mstn was down-regulated in backcross animals in comparison with Red-Stirling and Chitralada animals. These gene expression profiles revealed that backcross animals displayed a distinctive expression signature, which attests to the effectiveness of the introgressive breeding technique. Our findings also suggest that the GH/IGF axis and mstn genes might be candidate markers for fish performance and prove useful within genetic improvement programs aimed at the production of superior-quality tilapia strains using introgressive breeding.

Recovery & identification of human Y-STR DNA from immatures of chrysomya albiceps (Diptera: Calliphoridae). Simulation of sexual crime investigation involving victim corpse in state of decay.

The number of sexual crimes in Brazil, as in several other countries, is very high. In many of these crimes the women raped are murdered and their bodies are found days later, in an advanced state of decomposition, with intense cadaverous fauna. Forensic Entomology studies insects and other arthropods that can be used in the expert analysis of various types of crimes. Diptera, the order of insects that comprises the two-winged or true flies, represents one of the largest known groups of insects and is the principal source of cadaveric entomofauna. Members of its Calliphoridae family are observed in cadavers in all phases of decomposition. The retrieval and identification of human Y-STR DNA from the gastrointestinal tract of Calliphoridae species Chrysomya albiceps maggots and pupae can provide a good tool for the gathering of evidence in sexual crime investigations involving rape and death, in which the abandoned victim's body is found in a putrefied state. In this study, the animal model used was a female pig, Sus scrofa, which was sacrificed in a forested area with three shots from a 0.40 calibre Taurus pistol, and inoculated with semen to its anal and vaginal regions, simulating rape and homicide. During decomposition, 20-80 maggots were collected every 24 h and preserved in 70 % alcohol, totalling 289 maggots and 157 pupae (446 immatures) over a period of 14 days (336 h) of decomposition. Each maggot was then dissected for removal of the digestive tract, which was placed in extraction buffer. The molecular phase proceeded with extraction, quantification, amplification and capillary electrophoresis of samples, testing 16 STR loci of the Y chromosome. It was possible to establish a partial Y-STR DNA profile, with the amplification of up to eight sites, by considering a combination of the samples taken at hours 144 h, 168 h, 192 h, 216 h, 240 h, 288 h, 312 h and 336 h.

Brain Tissue Pulmonary Embolism Due to Severe Blunt Force Head Trauma in a Dog.

A 9-week-old male puppy was submitted for necropsy examination after a reported history of developing acute melaena and vomiting blood before death. Grossly, the animal had multiple skull fractures, mostly affecting the occipital region and cranial floor, associated with extensive regions of subcutaneous, periosteal and subdural haemorrhages, as well as petechial haemorrhages within the right middle and caudal lung lobes. Histopathology of the brain revealed multifocal acute meningeal and parenchymal haemorrhage with laceration of the cerebellar folia. In the lung, multiple small- and medium-calibre branches of pulmonary arteries were occluded by aggregates of brain tissue, which exhibited weak immunoreactivity for glial fibrillary acidic protein and strong labelling for neuron specific enolase on immunohistochemistry. These findings were consistent with brain tissue pulmonary embolism, an infrequent phenomenon following severe head trauma. To the best of the authors' knowledge, this is the first reported case of canine brain tissue pulmonary embolism.

Histopathology and immunohistochemistry of peripheral neural sheath tumor and perivascular wall tumor in dog / Histopatologia e imuno-histoquímica de tumor de bainha de nervo periférico e de tumor de parede perivascular em cães

Soft tissue sarcomas (STS) comprise a heterogeneous group of malignancies derived from extra-skeletal mesenchymal tissues that may show similar histopathological changes. Histopathologic patterns suggestive of perivascular wall tumors (PWT) and peripheral nerve sheath tumors (PNST) have been described. This study investigated the histogenesis in a series of 71 cases of canine STS that showed morphological compatibility with what is described for PWT and PNST. Immunohistochemistry analysis were done to CD56, S100, SMA, Desmin, Von Willebrand Factor, NSE and GFAP. Twenty-one cases (29.6%) showed histopathologic features compatible with PWT, 23 cases (32.4%) with PNST and 27 cases (38.0%) shared both histopathological features. By immunohistochemistry, 59 (83.1%) cases showed positivity only for neural markers and 12 (16.9%) had simultaneous positivity for both neural and muscle markers. PNST was the most prevalent neoplasm and none of the cases were positive for muscle markers only. The histopathologic features were not useful to define the diagnosis of PWT, since most tumors were negative for muscle markers but positive for neural markers. Due to this immunoreactivity and the morphologic features, future studies may propose guidelines for the classification of these neoplasms.(AU)

Sarcoma de tecidos moles (STM) compreende um grupo heterogêneo de neoplasias malignas, derivadas de tecidos extraesqueléticos, que podem apresentar alterações histopatológicas similares. Os padrões histopatológicos sugestivos de tumor de parede perivascular (TPP) e de tumor de bainha de nervo periférico (TBNP) têm sido descritos. Este estudo investigou a histogênese de uma série de 71 STM caninos, que apresentavam compatibilidade morfológica com o que é descrito para TPP e TBNP. A análise imuno-histoquímica foi feita para CD56, S100, SMA, Desmina, Fator Von Willebrand, NSE e GFAP. Vinte e um casos (29,6%) apresentaram características histopatológicas compatíveis com TPP, 23 casos (32,4%) com TBNP e 27 casos (38,0%) apresentaram características histopatológicas de ambos. Na imuno-histoquímica, 59 (83,1%) casos apresentaram positividade somente para marcadores neurais e 12 (16,9%) tiveram positividade simultânea tanto para marcadores neurais como para marcadores musculares. TBNP foi a neoplasia mais prevalente e nenhum dos casos foi positivo para somente para marcadores musculares. As características histopatológicas não foram úteis para definir o diagnóstico de TPP, uma vez que a maioria foi negativa para marcadores musculares, mas positiva para marcadores neurais. Devido a essa imunorreatividade e às características morfológicas, pesquisas futuras poderão propor orientações para a classificação dessas neoplasias.(AU)

Diagnostic accuracy of cone beam computed tomography used for assessment of apical periodontitis: an ex vivo histopathological study on human cadavers.

AIM: To assess the diagnostic accuracy of Cone Beam Computed Tomography (CBCT) to diagnose apical periodontitis (AP) using histopathology of ex vivo human jaws as the reference standard. METHODOLOGY: Based on periapical radiographs of jaw specimens from human bodies donated for science, a sample of 223 teeth with 340 roots including all tooth groups, and different disease and treatment statuses was selected. Cone Beam Computed Tomography was performed using Cranex® 3Dx (Soredex Oy, Tuusula, Finland), small field-of-view (5 × 5 cm), and isotropic resolution 0.085 mm. Three observers assessed the presence of AP using a probability index. Histopathological examination of the periapical area was used as a reference standard to calculate estimates of diagnostic accuracy. RESULTS: For non-root filled teeth all estimates of diagnostic accuracy; sensitivity (SENS), specificity (SPEC), positive predictive value (PPV) and negative predictive value (NPV) were high. All estimates were lower for root filled teeth. When mild AP was classified as 'AP', SENS, SPEC and NPV were significantly lower in root filled roots (P < 0.001 in all cases). The same tendency was seen when mild AP was classified as 'No AP' but here only the difference in SPEC was significant (P < 0.001). CONCLUSION: The diagnostic accuracy of CBCT used for diagnosis of AP is dependent on the treatment status of the tooth. For non-root filled teeth the diagnostic accuracy of CBCT is high and almost all cases of AP can be diagnosed correctly with only a very small risk of over-diagnosis. All diagnostic accuracy parameters were lower for root filled roots, hence the diagnosis of AP on root filled roots using CBCT was less accurate.

Does DeMeester score still define GERD?

Gastroesophageal reflux disease (GERD) clinical presentation may encompass a myriad of symptoms that may mimic other esophageal and extra-esophageal diseases. Thus, GERD diagnosis by symptoms only may be inaccurate. Upper digestive endoscopy and barium esophagram may also be misleading. pH monitoring must be added often for a definitive diagnosis. The DeMeester score (DMS) is a composite score of the acid exposure during a prolonged ambulatory pH monitoring that has been used since 1970s to categorize patients as GERD+ or GERD-. We showed in this review that DMS has some limitations and strengths. Although there is not a single instrument to precisely diagnose GERD in all of its variances, pH monitoring analyzed at the light of DMS is still a reliable method for scientific purposes as well as for clinical decision making. There are no data that show that acid exposure time is superior-or for that matter inferior-as compared to DMS.