Color Repair of a Composite Resin Restoration.

Fractured teeth with both enamel and dentin involvement might be treated with adhesive composite resin restorations. In cases where a perfect color match between the composite restoration and the remaining tooth structure is not achieved, a repair might be carried out to correct the color of restoration. This procedure avoids the restoration replacement, preserving tooth structure without compromising the esthetic outcome.

Larval settlement and spat recovery rates of the oyster Crassostrea brasiliana (Lamarck, 1819) using different systems to induce metamorphosis.

This study aimed at the assessment, in the laboratory, of the larval settlement and spat recovery rates of oysters of the species Crassostrea brasiliana using plastic collectors, epinephrine (C9H13NO3 C4H6O6) and shell powder in settlement tanks. Polypropylene was used attached to bamboo frames. The material was chosen due to its pliability--that favours the spat detachment. Two experiments were carried out; the first between February and April 2008, and the second between November and December 2008 at the Marine Mussel Laboratory of Santa Catarina Federal University (Laboratório de Moluscos Marinhos da Universidade Federal de Santa Catarina). In the first experiment, the scratched plastic collectors were tested consorting them with shell powder; on the second, the plastic collectors were tested consorted with shell powder, only shell powder and epinephrine as the metamorphosis stimulator. The quantification was carried out of the larvae settled in the plastic collectors, and of the recovery and integrity of the spats after their detachment. The first experiment has shown a recovery rate of 48.83% of the spats in comparison with the D larvae used. From this percentage, 4.9% settled in the plastic collectors and 43.93% in shell powder. The second experiment revealed 55.78% regarding the settled spats in comparison with the total of larvae used (using epinephrine), 78.62% in the treatment with the collector plus shell powder and 58.33% in the treatment only with shell powder. Thus, the use of the collector plus shell powder resulted in a greater spat recovery when compared to the other treatments.

Cerebellar growth in very low birth weight infants.

OBJECTIVE: The aim of this study was to assess cerebellar growth of very low birth weight infants from birth to discharge and compare it with term infants. STUDY DESIGN: Very low birth weight infants were matched by gender, adequacy of weight to gestational age at birth and postmenstrual ages at hospital discharge to term newborns. Exclusion criteria were central nervous system malformation, peri-intraventricular hemorrhage, cerebellar hemorrhage and meningitis. Transverse cerebellar diameter was measured by cranial ultrasound at birth and at hospital discharge in cases, and at birth in matched controls. Very low birth weight infants had magnetic resonance imaging done in the first year. RESULT: Cerebellar growth was similar in very low birth weight infants without periventricular leukomalacia and controls, and smaller in cases with periventricular leukomalacia than in controls. CONCLUSION: We suggest that cerebellar growth is normal in the absence of supratentorial injury.

Detection of Leishmania (L.) chagasi in canine skin.

Canine visceral leishmaniasis (CVL) is caused by a protozoa parasite of the specie Leishmania (L.) chagasi endemic for humans and dogs in many regions of Brazil. The purpose of the present study was the detection of (L.) chagasi in canine skin tissues from three different groups of clinical signs: asymptomatic, oligosymptomatic and polysymptomatic Leishmania-infected dogs. Lesional or non-lesional skin tissue samples from 34 naturally infected dogs were obtained and processed by histochemistry (HE) and immunohistochemistry (IMHC) for direct parasitological examination and the results were compared with a polymerase chain reaction (PCR) method. IMHC and HE methods detected intact Leishmania-amastigote parasites in lesional and no lesional skin, particularly in asymptomatic and oligosymptomatic dogs. 50% of skin samples collected from asymptomatic and 21.4% from oligosymptomatic dogs had parasites in their skins even though with mild inflammatory reaction or without any macroscopic dermatological alterations. On the other hand, 100% of polysymptomatic dogs showed several forms of clinical dermatological alterations and 91.7% had intact amastigotes with parasite load ranging from mild to intense. By PCR, DNA of Leishmania spp. was detected in 97.8% skin samples regardless clinical status of the dogs or IMHC/HE test results. PCR on skin was a sensitive procedure for CVL diagnosis, but direct observation of intact parasite in skin biopsies, particularly by IMHC, may be also considered to support the diagnosis.

Score for Neonatal Acute Physiology and Perinatal Extension II as a predictor of retinopathy of prematurity: study in 304 very-low-birth-weight preterm infants.

AIM: To evaluate the use of the Score for Neonatal Acute Physiology and Perinatal Extension (SNAPPE-II) at admission to predict the development of retinopathy of prematurity (ROP) among very-low-birth-weight preterm babies. METHODS: A prospective cohort study included 304 infants screened for ROP from July 2004 to October 2007. The main outcomes were the development of any stage ROP and severe ROP. The main variable was the SNAPPE-II obtained at admission. Seventeen risk factors for ROP were studied by univariate analysis (chi(2) and Student's t test). A simple descriptive analysis was used for the SNAPPE-II (mean, median, standard deviation and interquartile range: p25-p75). Logistic regression and receiver-operating characteristic (ROC) curve were calculated for SNAPPE-II. Ophthalmological examinations started at the 6th week of life and were repeated until the 45th week of corrected gestational age (GA). RESULTS: The mean GA and mean birth weight of the whole cohort were 30.3 weeks (+/-2.2) and 1,209.2 g (+/-277.7), respectively. The median SNAPPE-II among non-ROP and ROP patients were 6.0 and 15.0, respectively (p = 0.001). When compared with severe ROP patients (25.0) there was also a significant difference (p = 0.003). After logistic regression, the SNAPPE-II adjusted odds ratio for ROP was 1.024. The area under the ROC curve was 0.62 (95% confidence interval: 0.55-0.70, p < 0.001). The best discriminative cutoff value was 8.5 (sensitivity: 68%; specificity: 54%; positive predictive value: 37.3%; negative predictive value: 80.6%). CONCLUSIONS: The SNAPPE-II values at admission were significantly higher among babies with ROP, suggesting a positive association between higher scores with the development of ROP, but after adjusted logistic regression and ROC curve results, the SNAPPE-II scores at admission did not enhance the assessment of risk for ROP.

DNA and heparin chaperone the refolding of purified recombinant replication protein A subunit 1 from Leishmania amazonensis.

Replication protein A (RPA) is a single-stranded DNA-binding protein that has been implicated in DNA metabolism and telomere maintenance. Subunit 1 of RPA from Leishmania amazonensis (LaRPA-1) has previously been affinity-purified on a column containing a G-rich telomeric DNA. LaRPA-1 binds and co-localizes with parasite telomeres in vivo. Here we describe the purification and characterization of native recombinant LaRPA-1 (rLaRPA-1). The protein was initially re-solubilized from inclusion bodies by using urea. After dialysis, rLaRPA-1 was soluble but contaminated with DNA, which was removed by an anion-exchange chromatography of the protein solubilized in urea. However, rLaRPA-1 precipitated after dialysis to remove urea. To investigate whether the contaminating DNA was involved in chaperoning the refolding of rLaRPA-1, salmon sperm DNA or heparin was added to the solution before dialysis. The addition of either of these substances prevented the precipitation of rLaRPA-1. The resulting rLaRPA-1 was soluble, correctly folded, and able to bind telomeric DNA. This is the first report showing the characterization of rLaRPA1 and of the importance of additives in chaperoning the refolding of this protein. The availability of rLaRPA-1 should be helpful in assessing the importance of this protein as a potential drug target.

Organ donation: acceptance and refusal among users of the public health system from Brazil.

The present study sought to identify the perception of a given group of users of the Brazilian Public Health System (Sistema Unico de Saúde) regarding organ donation and to implement an educational policy. Structured interviews were conducted with the aim of describing the profile of donor and nondonor subjects, the importance of organ donation, and the knowledge regarding donation and brain death. One hundred subjects were interviewed: 33% of them considered themselves potential donors; 40% were donors; 13% were nondonors; and 14% were ill-informed potential donors. However, only 40% of users have already officially expressed to their families a willingness to donate. Regarding their knowledge about the propitious moment for organ donation, only 64% of them associated the donation act with brain death. Although the present results revealed that users of the Brazilian Public Health System are prone to organ donation, there actually was a high amount of refusals, which may be due to lack of information and knowledge regarding the donation-transplantation process.

Umbilical cord blood and neonatal endothelin-1 levels in preterm newborns with and without respiratory distress syndrome.

Increased pulmonary vascular resistance in preterm newborn infants with respiratory distress syndrome is suggested, and endothelin-1 plays an important role in pulmonary vascular reactivity in newborns. We determined umbilical cord blood and neonatal (second sample) levels of endothelin-1 in 18 preterm newborns with respiratory distress syndrome who had no clinical or echocardiographic diagnosis of pulmonary hypertension and 22 without respiratory distress syndrome (gestational ages: 31.4 +/- 1.6 and 29.3 +/- 2.3 weeks, respectively). Umbilical cord blood and a second blood sample taken 18 to 40 h after birth were used for endothelin-1 determination by enzyme immunoassay. Median umbilical cord blood endothelin-1 levels were similar in both groups (control: 10.9 and respiratory distress syndrome: 11.4 pg/mL) and were significantly higher than in the second sample (control: 1.7 pg/mL and respiratory distress syndrome: 3.5 pg/mL, P < 0.001 for both groups). Median endothelin-1 levels in the second sample were significantly higher in children with respiratory distress syndrome than in control infants (P < 0.001). There were significant positive correlations between second sample endothelin-1 and Score for Neonatal Acute Physiology and Perinatal Extension II (r = 0.36, P = 0.02), and duration of mechanical ventilation (r = 0.64, P = 0.02). A slower decline of endothelin-1 from birth to 40 h of life was observed in newborns with respiratory distress syndrome when compared to controls. A significant correlation between neonatal endothelin-1 levels and some illness-severity signs suggests that endothelin-1 plays a role in the natural course of respiratory distress syndrome in preterm newborns.

Umbilical cord blood and neonatal endothelin-1 levels in preterm newborns with and without respiratory distress syndrome

Increased pulmonary vascular resistance in preterm newborn infants with respiratory distress syndrome is suggested, and endothelin-1 plays an important role in pulmonary vascular reactivity in newborns. We determined umbilical cord blood and neonatal (second sample) levels of endothelin-1 in 18 preterm newborns with respiratory distress syndrome who had no clinical or echocardiographic diagnosis of pulmonary hypertension and 22 without respiratory distress syndrome (gestational ages: 31.4 ± 1.6 and 29.3 ± 2.3 weeks, respectively). Umbilical cord blood and a second blood sample taken 18 to 40 h after birth were used for endothelin-1 determination by enzyme immunoassay. Median umbilical cord blood endothelin-1 levels were similar in both groups (control: 10.9 and respiratory distress syndrome: 11.4 pg/mL) and were significantly higher than in the second sample (control: 1.7 pg/mL and respiratory distress syndrome: 3.5 pg/mL, P < 0.001 for both groups). Median endothelin-1 levels in the second sample were significantly higher in children with respiratory distress syndrome than in control infants (P < 0.001). There were significant positive correlations between second sample endothelin-1 and Score for Neonatal Acute Physiology and Perinatal Extension II (r = 0.36, P = 0.02), and duration of mechanical ventilation (r = 0.64, P = 0.02). A slower decline of endothelin-1 from birth to 40 h of life was observed in newborns with respiratory distress syndrome when compared to controls. A significant correlation between neonatal endothelin-1 levels and some illness-severity signs suggests that endothelin-1 plays a role in the natural course of respiratory distress syndrome in preterm newborns.

[Hypoxic-ischemic syndrome] / Síndrome hipóxico-isquêmica.

OBJECTIVE: To review the literature on the hypoxic-ischemic syndrome, emphasizing its physiopathology, clinical manifestations, and treatment. SOURCES: Electronic search in the Medline and LILACS databases, with selection of the most relevant articles. SUMMARY OF THE FINDINGS: The hypoxic-ischemic syndrome is a multisystem disease with generalized manifestations. The physiopathology is based on hypoxic-ischemic brain injury and reperfusion with cellular injury caused by failure of ATP production secondary to ischemia, and overproduction of oxidative substances caused by reperfusion. Neurological, cardiovascular, respiratory, metabolic, gastrointestinal, renal, and hematological manifestations are frequent. Multisystem clinical management is complex; the neuroprotective approach is still experimental; and the prognosis is not good for those patients with severe hypoxic-ischemic encephalopathy. CONCLUSIONS: The management of the hypoxic-ischemic syndrome is a great challenge to pediatricians., since treatment requires multisystem intervention.

Evaluation of interleukin-6, tumour necrosis factor-alpha and interleukin-1beta for early diagnosis of neonatal sepsis.

The objective of this study was to assess the contribution of interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) to an early diagnosis of early-onset neonatal sepsis. A cohort of 117 newborn infants delivered during a 1-y period had IL-6, TNF-alpha and IL-1beta, blood and cerebrospinal fluid (CSF) cultures, leucocyte and platelet count collected on the initial evaluation of possible early-onset sepsis. They were divided into four groups: I, positive blood and/or CSF cultures; II, probably infected with clinical sepsis but negative cultures; III, same as group II but mother received antibiotic antepartum; and IV, newborn infants that did not receive any antibiotic therapy. There were no differences among the four groups with respect to mean gestational ages and birthweights, median Apgar scores, type of delivery, or number of newborn infants with leucocyte count <5000 mm(-3) or >25000 mm(-3), platelet count <100000 mm(-3), immature/total neutrophil ratio >0.2, absolute neutrophil count <1000mm(-3) and median IL-1beta levels. Median IL-6 and TNF-alpha levels were significantly higher in groups with patients with a diagnosis of clinical sepsis than in controls. The optimal cut-off point was 32 pg ml(-1) for IL-6 and 12 pg ml(-1) for TNF-alpha. The combination of both provided a sensitivity of 98.5%. In conclusion, the combination of IL-6 and TNF-alpha is a highly sensitive marker of sepsis in the immediate postnatal period.

[Neonatal sepsis: diagnosis and treatment] / Sepse neonatal: diagnóstico e tratamento.

OBJECTIVE: Review the literature on diagnosis and treatment of neonatal sepsis. METHODS: The most important articles on neonatal sepsis were selected through MEDLINE. RESULTS: The present review analyzes the different methods of diagnosis, laboratory and clinical, as well as the different therapeutic managements of neonatal sepsis. CONCLUSION: Neonatal sepsis is a severe disease that must be diagnosed early and properly treated in order to avoid lethal outcome.

[Plasmatic levels of interleukin-1beta and interleukin-6 in newborn infants with fever] / Níveis plasmáticos de interleucina-1ss e interleucina-6 em recém-nascidos com febre.

OBJECTIVE: To study plasma levels of IL-1beta and IL-6 in order to distinguish the presence of bacterial infection in newborn infants with fever. METHODS: A cohort of 117 newborn infants with postnatal age equal to or less than 5 days, with no previous use of antibiotic therapy, and with clinical suspicion of bacterial infection was studied from July 1995 through August 1996. Those with definite criteria for sepsis were considered infected. Fever was defined as axillar temperature > 37.5 degrees C in three independent measurements. The patients were classified in four different groups: Group 1: infected with fever; Group 2: infected without fever; Group 3: not infected with fever; Group 4: not infected without fever. Complete blood count, platelet count, blood or other fluid cultures, and plasmatic levels of IL-1beta and IL-6 were collected before the beginning of antibiotic therapy. RESULTS: Of the 117 newborn infants studied were 66 infected and 51 not infected. Fever was present in 45 (38.46%). The median values of IL-1beta and IL-6 were significantly higher in newborn infants with fever than in those with no fever. There were significant differences between groups 1 and 2, 1 and 4, and 2 and 3 for IL-1beta. There were no significant differences between groups 2 and 4, and 1 and 3 for IL-1beta. Eight (72%) newborn infants with no infection and no fever had environment heating, and 3 had dehydration. There were no differences in median IL-6 levels between groups 1 and 2, and 3 and 4. There were significant differences in the median IL-6 levels between groups 1 and 3, and 1 and 4. CONCLUSIONS: IL- 6 is a marker of early neonatal sepsis. IL-1beta is related to neonatal fever response independently of the presence of bacterial infection.

Fibro-histiocitoma maligno de tecidos moles / Malignant fibrous histiocytoma ofthe soft tissues

O fibro-histiocitoma maligno é um tumor incomum e frequentemente indistinguível de várias outras patologias. Os autores descrevem 2 casos onde a doença ocorre nas partes moles (um do retroperitôneo e outro de membro inferior) e discutem os diagnósticos diferenciais e o papel dos métodos radiológicos na determinaçäo diagnóstica