Effect of xylitol varnishes on remineralization of artificial enamel caries lesions in vitro.

OBJECTIVES: Analyse the effect of varnishes containing xylitol alone or combined with fluoride on the remineralization of artificial enamel caries lesions in vitro. METHODS: Bovine enamel specimens were randomly allocated to 7 groups (n=15/group). Artificial caries lesions were produced by immersion in 30 mL of lactic acid buffer containing 3mM CaCl2·2H2O, 3mM KH2PO4, 6 µM tetraetil metil diphosphanate (pH 5.0) for 6 days. The enamel blocks were treated with the following varnishes: 10% xylitol; 20% xylitol; 10% xylitol plus F (5% NaF); 20% xylitol plus F (5% NaF); Duofluorid™ (6% NaF, 2.71% F+6% CaF2), Duraphat™ (5% NaF, positive control) and placebo (no-F/xylitol, negative control). The varnishes were applied in a thin layer and removed after 6h. The blocks were subjected to pH-cycles (demineralization-2h/remineralization-22 h during 8 days) and enamel alterations were quantified by surface hardness and transversal microradiography. The percentage of surface hardness recovery (%SHR), the integrated mineral loss and lesion depth were statistically analysed by ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). RESULTS: Enamel surface remineralization was significantly increased by Duraphat™, 10% xylitol plus F and 20% xylitol plus F formulations, while significant subsurface mineral remineralization could be seen only for enamel treated with Duraphat™, Duofluorid™ and 20% xylitol formulations. CONCLUSIONS: 20% xylitol varnishes seem to be promising alternatives to increase remineralization of artificial caries lesions. CLINICAL SIGNIFICANCE: effective vehicles are desirable for caries control. Xylitol varnishes seem to be promising alternatives to increase enamel remineralization in vitro, which should be confirmed by in situ and clinical studies.

Liver transplantation in bearers of hepatitis B associated or not with delta hepatitis in the age of the new antiviral drugs: is hyperimmune globulin still necessary?

Hepatitis B (HBV) is a public health problem worldwide; one-third of the population has already been in contact with HBV, and 350 million people are chronic carriers of virus. The appearance of hyperimmune gamma globulin and antiviral drugs has allowed that group to undergone hepatic transplantation, achieving satisfactory results to prevent a relapse. But the use of hyperimmune gamma globulin has an extremely high cost, and combined therapies with new antiviral drugs seem to be a therapeutic alternative. We analyzed 21 patients with hepatitis B associated or not with Delta hepatitis over a mean follow-up period of 19.5 months, concluding that use of only nucleotide analogues has sufficient to achieve satisfactory results.

Novel truncating mutations in PKP1 and DSP cause similar skin phenotypes in two Brazilian families.

Inherited mutations in components of desmosomes result in a spectrum of syndromes characterized by variable abnormalities in the skin and its appendages, including blisters and erosions, palmoplantar hyperkeratosis, woolly hair or hypotrichosis and, in some cases, extracutaneous features such as cardiomyopathy. We investigated the molecular basis of two Brazilian patients presenting with clinical features consistent with ectodermal dysplasia-skin fragility syndrome. In patient 1 we identified a homozygous nonsense mutation, p.R672X, in the PKP1 gene (encoding plakophilin 1). This particular mutation has not been reported previously but is similar to the molecular pathology underlying other cases of this syndrome. In patient 2 we found compound heterozygosity for two frameshift mutations, c.2516del4 and c.3971del4, in the DSP gene (encoding desmoplakin). Although there was considerable clinical overlap in the skin and hair abnormalities in these two cases, patient 2 also had early-onset cardiomyopathy. The mutation c.3971del4 occurs in the longer desmoplakin-I isoform (which is the major cardiac transcript) but not in the more ubiquitous desmoplakin-II. In contrast, PKP1 is not expressed in the heart, which accounts for the lack of cardiomyopathy in patient 1. Collectively, these cases represent the first desmosomal genodermatoses to be reported from Brazil and add to genotype-phenotype correlation in this group of inherited disorders. Loss-of-function mutations in the DSP gene can result in a phenotype similar to ectodermal dysplasia-skin fragility syndrome resulting from PKP1 mutations but only DSP pathology is associated with cardiac disease.

Palmar basal cell carcinoma: case report and literature review.

BACKGROUND: Although basal cell carcinoma (BCC) is the most common tumor of the skin, its occurrence on the palm is very rare. Only eight cases not associated with the basal cell nevus syndrome having been reported in the world literature so far. Among these eight cases, one was associated with epidermolysis bullosa dystrophica and another with previous trauma to the site of the appearance of the lesion. OBJECTIVE: The authors report a case of palmar BCC due to its rare occurrence on that site. The case is not associated with any predisposing factors such as basal cell nevus syndrome, trauma, or preexistent dermatosis. METHODS: An incisional biopsy was performed into the border of the palmar ulcer. The histopathologic findings of the fragment, stained by hematoxylin and eosin, were characteristic of BCC. RESULTS: Following surgical removal of the lesion, there was complete healing and the patient has presented no signs of relapse after 3 years of clinical follow-up. CONCLUSION: Palmar BCC not associated with the basal cell nevus syndrome or any other predisposing condition is very rare. Nevertheless, when facing an ulcerated lesion on the palm, BCC should be considered as a diagnostic possibility.

Circumferential fingernail.

We describe a Brazilian girl with a congenital circumferential nail on her left ring finger associated with other bony and soft tissue abnormalities of the affected limb. The tubular nail plate resembling a punch biopsy has been described as a circumferential nail, an extremely rare congenital malformation that can be associated with other congenital anomalies. In our review of the literature, there have only been two previous reports of this unusual condition affecting the fingernails.

Estudo multicêntrico para construçäo de curvas de dilataçäo cervical em funçäo do tempo, em gestantes brasileiras / A multicentric study to create a partograph model in brazilian pregnancy women

Um estudo prospectivo foi realizado em nove hospitais Públicos localizados em distintas regioes brasileiras com o objetivo de construir uma curva de partograma da mulher brasileira. A populaçao incluiu 1382 parturientes de baixo risco que foram internadas em trabalho de parto com dilataçao de colo uterino igual ou inferior a 4cm. Os caracteres epidemiológicos, resultados perinatais e evoluçao do trabalho de parto sao apresentados e discutidos. Foram construídos dois padroes de curvas de partograma nao muito distintos dos já descritos para outros países.