Electromyographic analysis of masseter and temporal muscles, bite force, masticatory efficiency in medicated individuals with schizophrenia and mood disorders compared with healthy controls.

This study aimed to comparatively analyse the electromyographic activity of the masseter and temporal muscles at rest and during mandible postural clinical conditions (right and left laterality, protrusion and maximum voluntary contraction), right and left maximum molar bite forces and the masticatory efficiency of individuals with schizophrenia or mood disorders - all medicated (medicated groups) compared with control group (healthy volunteers) via electromyography. Individuals were distributed into three groups: Group I (Schizophrenia - 20 individuals), Group II (mood disorders - 20 individuals) and Group III (Control - 40 individuals). Basically, the results were only statistically significant for the clinical mandible conditions and bite force. The most unsatisfactory results were observed in the medicated groups in relation to the control group. The group with mood disorders obtained the most unsatisfactory results compared with the group with schizophrenia. It was suggested by these observations that the association of mood disorders and schizophrenia with medication has negatively affected the stomatognathic system in relation to controls when the electromyography and bite force were used for the analysis.

Comparison of pregnancy characteristics and outcomes between HIV-infected and HIV-non-infected women in Brazil.

The aim of this study is to evaluate the characteristics of pregnant women whether they are HIV infected or not and their prenatal care. It is a cross-sectional study. HIV-infected women were derived from a cohort study of all HIV-infected pregnant women followed from 1995 to 2005, at the Instituto de Puericultura e Pediatria Martagão Gesteira - Rio de Janeiro. HIV-non-infected women were derived from a random sample of all pregnant women who gave birth at Rio de Janeiro municipality between 1999 and 2001. All relevant sociodemographic, clinical, and pregnancy outcomes data were retrieved from both studies. To evaluate the prenatal care, we calculated the Kotelchuck Modified Index (KMI). The index is based on the months of initiation of prenatal care and the proportion of visits observed in each trimester, according to gestational age at birth. Comparisons were performed using Student t- and chi-square tests. Variables with p-value < 0.25 were included in an unconditional logistic regression model. There were 713 HIV-infected women and 2145 HIV-non-infected women. Variables independently associated with HIV status were: inadequate KMI (OR=4.08, 95% CI=3.17-5.24); lower educational level (OR=1.32, 95% CI=1.04-1.68); does not live with a partner (OR=3.54, 95% CI=2.66-4.64); lower family income (OR=4.71, 95% CI=3.62-6.14); tobacco use (OR=2.17, 95% CI=1.63-2.88); and hypertension (OR=1.47, 95% CI=1.01-2.17). Prematurity was not independently associated with HIV status. Although in Brazil, the HIV care is free of charge, pregnant women are still having difficulty to reach the specialized care. Better access to care must be offered to this population and studies of prematurity in the HIV-infected women must evaluate their prenatal care.

Molecular frequency and isolation of cyst-forming coccidia from free ranging chickens in Bahia State, Brazil.

The Toxoplasmatinae parasites Toxoplasma gondii, Neospora caninum and Hammondia spp. have carnivores as definitive hosts that shed the parasite oocysts in their feces. Birds that feed directly from the soil, such as chickens, are exposed to infection and may serve as indicators of the presence of the parasite in the environment and as a source of infection for other animals. The aims of this study were to determine the frequency of infection by these parasites in free ranging chickens, to test whether chickens are intermediate hosts of Hammondia spp., and to isolate N. caninum from chickens. One hundred chickens, which were raised in contact to cattle and dogs, were bought in five towns located in Bahia, Brazil. Blood and tissues (brain and heart) were used for serology, molecular tests and bioassay in mice for parasite isolation. T. gondii DNA was detected in 29 chickens, and N. caninum DNA was observed in six animals. Hammondia spp. DNA was not detected in tissues from any chicken. Tissues from eight N. caninum seropositive chickens were bioassayed in interferon-gamma gene knockout mice, but the mice did not become infected; T. gondii was isolated from six of 14 seropositive chickens after bioassay in outbreed Swiss mice. The authors concluded that: chickens seem to be better hosts for T. gondii when compared to N. caninum, based on the molecular and bioassay results; Hammondia spp. probably does not infect chickens or is rarely found in this animal species.

Implant-supported prosthesis following Brånemark protocol on electromyography of masticatory muscles.

This research evaluated the effects of Brånemark protocol on electromyography of the masseter and temporal muscles. The patients were divided into two groups: Group I: patients who wore an implant-supported prosthesis in the mandibular arch following Brånemark protocol, and maxillary removable complete dentures; Group II: dentate individuals (control). Electromyography was carried out at rest, right (RL) and left (LL) laterality, protrusion and maximum voluntary contraction (MVC). Data were compared by t-test. At rest, a higher electromyographic (EMG) activity was observed in Group I, and the values were significant in the right masseter and left temporal muscles. In RL, there were statistically significant differences for right masseter (P < 0·01), left masseter and temporal muscles and for the left temporal muscle in LL (P < 0·05). In protrusion, Group I presented a higher EMG activity, and there was a statistically significant difference for the right masseter muscle (RM) (P < 0·05). In MVC, the EMG values were higher in Group II (control), but significant just for the right temporal muscle (P < 0·05). In conclusion, individuals with mandibular fixed dentures supported according to the Brånemark protocol and maxillary removable complete dentures showed a higher activity of masticatory muscles during the mandibular postural clinical conditions examined; however, in the MVC, Group I presented lower values when compared to dentate group. Despite presenting different EMG values in all of the clinical conditions, both groups showed similar EMG patterns of muscle activation which demonstrates that the proposed treatment can be considered as a good option for oral rehabilitation.

Pregnancy outcome in women infected with HIV-1 receiving combination antiretroviral therapy before versus after conception.

OBJECTIVE: The potential adverse effects of antiretroviral drugs during pregnancy are discrepant and few studies, mostly from Europe, have provided information about pregnancy outcomes of those already on treatment at conception. The aim of this study was to investigate the impact of antiretrovirals (ARVs) on pregnancy outcome according to the timing of treatment initiation in a cohort of pregnant women from Brazil infected with HIV. METHODS: A prospective cohort of 696 pregnant women followed up in one single centre between 1996 and 2006 was studied. Patients who had ARV treatment before pregnancy were compared with those treated after the first trimester. The outcomes evaluated were preterm delivery (PTD) (<37 weeks), severe PTD (<34 weeks), low birth weight (LBW) (<2500 g) and very LBW (<1500 g). RESULTS: Patients who were using ARVs pre-conception had higher rates of LBW (33.3% vs 16.5%; p<0.001) and a similar trend for PTD (26.3% vs 17.7%; p = 0.09). Stratification by type of therapy (dual vs highly active antiretroviral therapy (HAART)) according to timing of initiation of ARVs showed that patients who use HAART pre-conception have a higher rate of PTD (20.2% vs 10.2%; p = 0.03) and LBW (24.2% vs 10.2%; p = 0.002). After adjusting for several factors, HAART used pre-conception was associated with an increased risk for PTD (AOR 5.0; 95% CI 1.5 to 17.0; p = 0.009) and LBW (OR 3.6; 95% CI 1.7 to 7.7; p = 0.001). CONCLUSIONS: We identified an increased risk for LBW and PTD in patients who had HAART prior to pregnancy.

Factors associated with lack of antiretroviral adherence among adolescents in a reference centre in Rio de Janeiro, Brazil.

The objective of this study was to describe the adherence to antiretroviral therapy (ART) among adolescents followed-up in Rio de Janeiro. This cross-sectional study included all adolescents (aged 10-19 years) followed at Instituto de Puericultura e Pediatria Martagão Gesteira and Hospital Universitário Clementino Fraga Filho. Adherence was determined by self-report (number of missed ART doses in three days prior to the interview). Adherence was categorized as taking > or = 95% of the ARTs (adherent), or < 95% (non-adherent). Variables related to demographics and treatment were evaluated and if P value < or = 0.15, they were selected for a logistic regression analysis. One hundred and one adolescents were interviewed. The mean time on ART was 91 months and the mean adherence was 94% of this, 21 were non-adherent, and 80 adherent. The risk factors associated with non-adherence were: if the patient was not concerned about ART, odds ratio (OR) = 3.47 (95% confidence interval [CI] = 1.13-10.68); if they do not carry an extra dose of ART, OR = 6.63 (95% CI = 1.73-25.47); if a health-care worker taught them how to take ART, OR = 0.27 (95% CI = 0.08-0.93). Adherence among adolescents was higher than expected. Factors associated with lack of adherence were: interviewees being unaware of ARTs and lack of commitment to the treatment. Interventions involving these factors must be evaluated.

[Prevalence of caries and its correlation with clinical and immunological classification in HIV-infected children]. / Prevalência de cárie e sua correlação com a classificação clínica e imunológica em crianças infectadas pelo HIV.

This research aims to determine the relationship between the prevalence of caries and clinical and immunological classification in HIV-infected children. Ninety-two outpatients (42 male and 50 female subjects) with definitive diagnosis of HIV infection took part in this research. The patients were examined in order to determine the prevalence of caries (dmf and DMFT indexes), and medical data were collected from their medical records. The mean age of the subjects was 5.77 years. Although no statistical differences were found, young patients (up to 5 years old) had more caries when they were more clinically and immunologically compromised. The same fact was observed regarding older children.

Oral manifestations related to immunosuppression degree in HIV-positive children.

Oral manifestations often found in HIV-infected children are frequently the first clinical sign of the infection. This article aims to report the prevalence of oral manifestations in soft tissues and their relationship with the degree of immunosuppression in 80 HIV-infected patients (average age 6.30 +/- 3.32 years old) at the IPPMG-UFRJ. Thirty children (38%) presented some type of oral lesion and the percentage of CD4 was lower than that found in lesion-free children (p < 0.05); 22.5% presented candidiasis, 17.5% gingivitis, 8.8% enlargement of parotids, 1.3% herpes simplex and 1.3% hairy leukoplakia. Of the 30 children with lesions, 70% showed severe immunosuppression, 23.3% moderate immunosuppression and in only 6.7% was immunosuppression absent. Oral manifestations were directly related to the degree of immunosuppression and such lesions can be considered as indicators of the progression of the HIV infection in children.

Effect of prenatal zidovudine on disease progression in perinatally HIV-1-infected infants.

OBJECTIVE: To determine the influence of prenatal zidovudine (ZDV) prophylaxis on the course of HIV- 1 infection in children by comparing the clinical outcome of infants born to HIV- 1-seropositive mothers who did versus those who did not receive ZDV during pregnancy. METHODS: Medical records of HIV-1-seropositive mothers and their infants were reviewed retrospectively. Participants were divided according to maternal ZDV use: no ZDV (n = 152); ZDV (n = 139). The main outcome measure was rapid disease progression (RPD) in the infant, defined as occurrence of a category C disease or AIDS-related death before 18 months of age. RESULTS: HIV vertical transmission rates were significantly different (no ZDV versus ZDV: 22.3% versus 12.2%; p = .034). Among infected infants, the RPD rate was 29.4% in the no ZDV group compared with 70.6% in the ZDV group (p = .012), and prematurity was significantly associated with a higher risk of RPD (p = .027). CONCLUSIONS: The rate of RPD was significantly higher among perinatally infected infants born to HIV-infected mothers treated with ZDV than among infected infants born to untreated mothers. The decreased proportion of infected infants with nonrapid disease progression in the former group might be related to the ability of ZDV to block intrapartum transmission preferentially and also to nonrapid disease progression resulting from intrapartum transmission.

Bioavailability of once- and twice-daily regimens of didanosine in human immunodeficiency virus-infected children.

The bioavailability of didanosine at 180 mg/m(2) once daily was compared to that at 90 mg/m(2) twice daily in 24 children with advanced human immunodeficiency virus infection. Children were studied at steady state using optimal sampling and prior pharmacokinetic parameter estimates. Relative bioavailability was 0. 95 +/- 0.49, supporting the potential clinical adequacy of once-daily dosing.

Progressive multifocal leukoencephalopathy in a child with acquired immunodeficiency syndrome (AIDS).

Progressive multifocal leukoencephalopathy is a rare viral-induced demyelinating disease associated to immunodeficiency. A 10-year-old boy with AIDS is reported, who developed subacute cerebellar signs and symptoms with multiple cranial nerve involvement and dementia. A computed tomography scan revealed a focal nonenhancing area of low attenuation in the cerebellum. On magnetic resonance imaging high signal lesions in T2 weighted sequences were shown. The biopsy of one of those lesions showed the typical histological findings of progressive multifocal leukoencephalopathy. It seems important to consider this diagnosis in children with AIDS who present with progressive neurological features.