Prospective longitudinal comparison study of surgical therapies for peri-implantitis: 3-year follow-up.

BACKGROUND: The aim of this study was to compare different surgical therapies to treat peri-implantitis. METHODS: Twenty-three patients presenting one implant affected by peri-implantitis were divided into three groups: (i) open flap debridement (OFD) and citric acid decontamination (CAD); (ii) OFD, CAD and subepithelial connective tissue graft (SCTG); (iii) OFD, CAD and implantoplasty. Modified plaque index (MPI), gingival bleeding index (GBI), keratinized mucosa (KM) width, probing depth (PD), bleeding or suppuration on probing (B/SOP), and radiographic crestal bone level were registered 1(T1), 2(T2) and 3(T3) years after treatment. RESULTS: In Group 1 there was a significant improvement in MPI from baseline to T1, and a significant reduction in PD over time. In Group 2, none of the assessed clinical parameters showed any statistically significant variation over time. In Group 3, there was a significant decrease in PD and B/SOP over time. When comparing the 3 Groups, KM was significanlty greater in Group 2 vs. Group 1 and Group 3 at T1 and T2, and in Group 2 vs. Group 3 at T3. CONCLUSION: All therapies were successful in the management of peri-implantitis; however, SCTG maintained the greatest KM width. Surgical therapies combined with mechanical and chemical decontamination contributed to peri-implant tissue health.

Manganese exposure and association with hormone imbalance in children living near a ferro-manganese alloy plant.

It has been suggested that manganese (Mn) plays a fundamental role in the reproductive system through interference with the regulation of the secretion of hormones related to puberty. The objective of this study was to evaluate the environmental exposure to Mn and its effects on the endocrine regulation of hormones related to puberty in school-aged children living near a ferro-manganese alloy plant. Toenails, occipital hair, and blood samples were collected from 225 children, between 7 and 12 years of age, in four elementary schools in Simões Filho, Bahia, Brazil, who were exposed to different Mn levels owing to different Mn dust deposition rates. The Mn content was determined in the toenails (MnTn), hair (MnH), and blood (MnB), in addition to blood lead levels (PbB), by using graphite furnace atomic absorption spectrometry. Luteinizing hormone (LH), prolactin (PRL), estradiol (E2), testosterone (T), and thyroid stimulating hormone (TSH) levels were determined by using a chemiluminescence method. Of the total participants, 50.2% were boys, with an average age of 9 years. PRL values were higher in children attending the school with a higher Mn deposition rate (p < 0.004). We observed that MnTn was positively correlated with PRL levels and exhibited a non-linear association with LH levels. None of the tested Mn biomarkers were associated with E2, T, or TSH levels. To date, despite several animal studies that have focused on the correlation between Mn exposure and the endocrine regulation of hormones and pubertal development, very few studies have reported a similar relationship between environmental Mn effects and the human endocrine system. Our findings support the hypothesis that elevated exposure to Mn in children may be associated with hormonal imbalances that might trigger the early onset of puberty.

Space-based observations of crustal deflections for drought characterization in Brazil.

Widespread environmental impacts of frequent drought episodes in Brazil have resulted in several drought-related diagnostics studies. However, the potential of many "opportunistic sensors", such as the Global Positioning System (GPS), has not yet been considered in hydrological hazard monitoring in Brazil. In this study, the response of the Earth's crust to Brazil's 2012-2015 drought event in different structural provinces is analyzed by comparing GPS-observed vertical crustal deformations (VCDs) with the terrestrial water storage (TWS) derived from the Gravity Recovery and Climate Experiment (GRACE). The results indicate that there is no spatial correlation between annual amplitudes of the TWS and VCDs in different structural provinces apart from the purely elastic response of the crust to TWS dynamics, at almost all the 39 GPS stations that were analyzed. However, approximately 15% of the monitoring stations show that VCD leads TWS with a phase lag of 2-4 months. Errors associated with VCD and TWS are within the accepted range for space geodetic techniques (i.e., GPS and GRACE) and despite the need for further investigation, the phase lead seems to be associated with rainfall, which impacts the TWS through the hydrographs. Overall, the GPS-based drought index (DIVCD) reflects the water depletion in many regions of Brazil, which agrees with the GRACE-based DITWS in terms of the Spearman correlation coefficient (ranging from 0.4 to 0.9) in the Amazon, Tocantins, La Plata, and São Francisco river basins. This agreement confirms the drought persistence during the study period and that DIVCD can be used to monitor hydrological droughts. In regions in which DITWS sufficiently agrees with DIVCD (48% of the sites), near real-time drought monitoring is feasible. This could be useful in the optimization of models for the forward prediction of drought events in other regions worldwide, where GPS vertical displacements strongly correlate with hydrological GRACE signals.

Efficacy of a single session protocol for endodontic treatment in primary teeth: in vivo study.

AIMS: To determine the efficacy of a single session protocol (SSP) in the reduction of septic content of primary teeth root canals and identify the persistence of bacterial species associated with unsuccessful treatment. METHODS: Primary teeth root canals (16) with pulp necrosis and peri-radicular lesions were treated. Samples were collected at baseline (T1), and after chemo-mechanical preparation, before filling (T2). Identification of the microorganisms was determined using checkerboard DNA-DNA hybridisation. STATISTICAL ANALYSIS: Wilcoxon test was applied for comparison of mean number of species, proportion and mean count of each species between the evaluation times. RESULTS: Significant reductions were found in the mean number of bacteria species between T1 and T2 (p < 0.05), but not for the reduction in proportion (p > 0.05). There was a reduction (6.0-4.6) of the mean number of species associated with failure, without statistical significance. CONCLUSION: The SSP was capable of significantly reducing the septic content, even though, many of the bacteria associated with failure persisted at the time of root canal filling.

A Bowman-Birk inhibitor induces apoptosis in human breast adenocarcinoma through mitochondrial impairment and oxidative damage following proteasome 20S inhibition.

Proteasome inhibitors are emerging as a new class of chemopreventive agents and have gained huge importance as potential pharmacological tools in breast cancer treatment. Improved understanding of the role played by proteases and their specific inhibitors in humans offers novel and challenging opportunities for preventive and therapeutic intervention. In this study, we demonstrated that the Bowman-Birk protease inhibitor from Vigna unguiculata seeds, named black-eyed pea trypsin/chymotrypsin Inhibitor (BTCI), potently suppresses human breast adenocarcinoma cell viability by inhibiting the activity of proteasome 20S. BTCI induced a negative growth effect against a panel of breast cancer cells, with a concomitant cytostatic effect at the G2/M phase of the cell cycle and an increase in apoptosis, as observed by an augmented number of cells at the sub-G1 phase and annexin V-fluorescin isothiocyanate (FITC)/propidium iodide (PI) staining. In contrast, BTCI exhibited no cytotoxic effect on normal mammary epithelial cells. Moreover, the increased levels of intracellular reactive oxygen species (ROS) and changes in the mitochondrial membrane potential in cells treated with BTCI indicated mitochondrial damage as a crucial cellular event responsible for the apoptotic process. The higher activity of caspase in tumoral cells treated with BTCI in comparison with untreated cells suggests that BTCI induces apoptosis in a caspase-dependent manner. BTCI affected NF-kB target gene expression in both non invasive and invasive breast cancer cell lines, with the effect highly pronounced in the invasive cells. An increased expression of interleukin-8 (IL-8) in both cell lines was also observed. Taken together, these results suggest that BTCI promotes apoptosis through ROS-induced mitochondrial damage following proteasome inhibition. These findings highlight the pharmacological potential and benefit of BTCI in breast cancer treatment.

Increasing leptin level in abstaining alcohol-dependent women.

INTRODUCTION: Leptin, hormone secreted by the fat tissue, changes the signaling of dopamine in the nucleus accumbens, which directly affects the sensitivity of reward and modulation of abstinence. AIMS: To evaluate the level of serum leptin and its relation to nutritional status among alcoholic abstainers and non-abstinent. METHODS: Patients of both sexes, over 18 years old and who used alcohol as their primary drug were included in the study. Abstaining patients were separated according to the time without the use of the drug as A2 (1-3 month-abstainers) and A3 (4 month and over-abstainers). Waist circumference (WC), body fat percentage (%BF) and weight and height were measured to calculate Body Mass Index (BMI). Blood samples were collected for leptin measurement. RESULTS: Mean levels of leptin, leptin/BMI, leptin/%BF were higher in all women categories. Abstaining women (A2) also showed higher leptin, leptin/BMI and leptin/ %BF than non-abstinent (p = 0.039; p = 0.023; p = 0.023). Statistical differences were also shown among abstaining women A2 and A3 as well a significant positive association between leptin levels and BMI and leptin and WC in active female drinkers (leptin × BMI: r = 0.91; p < 0.01; leptin × WC: r = 0.87; p = 0.001). However, a significant association was not shown among these results in abstaining women (leptin × BMI: r = 0.28; p = 0.37/ leptin × WC: r = -0.32, p = 0.92). CONCLUSION: Our results suggest that leptin levels seem to increase only in abstaining women. This result can be related to the length of abstinence.

[Effect of neuromuscular electrical stimulation and isotonic exercises in flexor and extensor muscles of knee of hemiplegic patients]. / Efecto de la estimulación eléctrica neuromuscular y de los ejercicios isotónicos en los músculos flexores y extensores de la rodilla en pacientes hémiplejicos.

AIM: To verify the muscular force and resistance to the movement of the flexor and extensor muscles of the knee of patients with spasticity after treatment with neuromuscular electrical stimulation (NMES) and isotonic exercises. PATIENTS AND METHODS: The patients this study were divided into group 1 (NMES) and group 2 (isotonic exercises). Their muscular torque and resistance to the movement of the flexor and extensor knee muscles were measured by the isokinetic dynamometer and the degree of spasticity by the modified Ashworth scale before and after ten sessions. RESULTS: Alterations in the scores of the modified Ashworth scale were not observed. An increase in the flexor torque in group 1 (p = 0.041) and in group 2 (p = 0.001) was verified. In the passive mode, group 1 presented a reduction of resistance to the flexion movement (p = 0.026), while in group 2, a reduction of resistance to both the flexion (p = 0,029) and extension movements (p = 0.019) was verified. CONCLUSIONS: The two therapeutical resources had their efficiency proven only for the increase of the force of the flexor muscles. The resistance to movement, the isotonic exercises were more effective because they promoted a reduction in the resistance of the flexor and extensor knee muscles.

Purification and characterization of a novel pectinase from Acrophialophora nainiana with emphasis on its physicochemical properties.

An extracellular pectinase (PECI) was purified to apparent homogeneity from liquid state cultures of the thermophilic fungus Acrophialophora nainiana by ultrafiltration and a combination of gel filtration and ion-exchange chromatographic procedures. The molecular masses of PECI were 35,500 and 30,749 Da, as determined by SDS-PAGE and mass spectrometry, respectively. It was more active at 60 degrees C and pH 8.0 and showed high stability at 50 degrees C with half-life of 7 days. However at 60 and 70 degrees C, PECI was much less stable with half lives of approximately 20 and 3 min, respectively. The thermostability of purified PECI was also investigated by fluorescence and circular dichroism spectroscopy. Fluorescence revealed that the unfolding transition region was observed between 45 and 70 degrees C. A major decrease in the stability was found at 70 degrees C. Circular dichroism measurements at pH between 5.0 and 9.0 showed a transition temperature (T(m)) range of 50-55 degrees . The thermodynamic analysis of these results showed that EPGI is thermal stable protein exhibiting maximum stability (DeltaG(25)) of 22.65 and 19.19 kcal/mol at pH 8.0 and 9.0, respectively. The apparent K(m) value on pectin from citrus fruits was 4.22 mgml(-1). PECI exhibited no detectable activity of pectin methylesterase, endo-polygalacturonase, mannanase, xylanase and cellulase. However, it showed exo-polygalacturonase and pectin lyase activities. The presence of carbohydrate was detected in the pure PECI. It was activated by l-tryptophan, DEPC, DTT, DTNB, DTP, l-cystein and beta-mercaptoethanol and inhibited by NBS, Fe(2+), Cu(2+), Zn(2+), Mn(2+), Al(3+) and Ca(2+). The enzyme showed homology with a pectin lyases from Xanthomonas campestris and Bacillus licheniformis.

[Allocation of health care resources in the state of Santa Catarina, Brazil: a contribution to a discussion on health financing]. / Distribuição de recursos de saúde no Estado de Santa Catarina, Brasil: um subsídio para discussões sobre o financiamento em saúde.

OBJECTIVE: To describe the health situation in municipalities in the state of Santa Catarina, Brazil, in 1996, and to investigate how that correlated with federal health spending in 1997. METHODS: Multiple regression analysis was used to investigate the association between federal health care funding and proportional mortality, supply of health services (hospitals and outpatient clinics), and the municipality's population (number of inhabitants). Also investigated was the association between mortality from broad groups of causes and socioeconomic structure, supply of health services, and the municipality's population. RESULTS: The multiple regression analysis showed an association between proportional mortality due to: 1) infectious diseases and: infant mortality, number of non-doctor medical professionals per 10,000 inhabitants, and number of physicians per 10,000 inhabitants (negative association); 2) chronic degenerative diseases and: percentage of individuals 60 years and older, infant mortality (negative association), and number of non-doctor medical professionals per 10,000 inhabitants (negative association); and 3) external causes of death and: the municipality's population, number of hospitals per 10,000 inhabitants (negative association), and percentage of children younger than 1 year. Health spending per inhabitant in 1997 was mainly associated with the municipality's population, number of outpatient clinics per 10,000 inhabitants, Swaroop and Uemura mortality rate, and deaths due to chronic degenerative diseases in 1996. CONCLUSIONS: Municipalities with a better morbidity and mortality profile and a better health services structure received more federal health care resources. To improve this situation, special strategies should be considered in order to ensure additional resources for municipalities that have poorer health indicators.

Lateral esophagostomy: an alternative in the initial management of long gap esophageal atresia without fistula.

The authors report an alternative method of cervical esophagostomy that was used in a child with type A esophageal atresia. This method involved performing a lateral esophagostomy in the proximal pouch, preserving its distal end, allowing the child to swallow normally, without choking, while stimulating the spontaneous growth of the proximal esophagus. As a result, the infant could be discharged home on G-tube feedings while waiting for spontaneous growth of the proximal pouch to occur. There were no episodes of aspiration during this period, and definitive reconstruction through end-to-end esophageal anastomosis was accomplished successfully at the age of 18 months. The authors consider that this alternative might increase the possibility of a definitive correction through delayed primary anastomosis of the infant's own esophagus in children with this type of malformation.

Effects of denaturing and stabilizing agents on the inhibitory activity and conformational stability of Schizolobium parahyba chymotrypsin inhibitor.

The conformational stability of the Schizolobium parahyba chymotrypsin inhibitor (SPCI) was investigated based on conformational changes and inhibitory activity in the presence of chaotropic and stabilizing agents. At 90 degrees C, the half-lifetime of SPCI was 154 min, while in the presence of 1 M KCl and 20% PEG 20,000, it was drastically reduced to 6 and 3 min, respectively. In contrast, at 90 degrees C, the SPCI structure remained unaltered with the addition of 1 mM DTT and 56% glycerol. The reduction of the two disulfide bonds caused conformational changes in the SPCI without altering the inhibitory activity, suggesting that disulfide bonds are irrelevant to the maintenance of SPCI conformation. Unfolded structures were formed in the presence of 6 M GdnHCl, while in the presence of 8 M urea, destabilization was due to peptide bond rupture. These results suggest that the thermal inactivation of SPCI involves conformational changes and that hydrophobic and electrostatic interactions play a significant role, while the disulfide bonds are of secondary importance in maintaining the high thermal stability of SPCI.

[Breast-feeding habits in Ouro Preto, MG, Brazil]. / Práticas de amamentação no município de Ouro Preto, MG, Brasil.

OBJECTIVE: To identify the frequency and median duration of breast-feeding in children aged 0-24 months in the city of Ouro Preto, Brazil. METHODS: A cross-sectional study was carried out to identify the median duration of breastfeeding in children aged 0-24 months. A sample of 229 children from 1800 households was drawn by clusters at three different occasions and stratified according to the area (urban or rural). The frequency and median duration of breast-feeding were calculated using the life table technique. RESULTS: A median duration of 198 days was found for breast-feeding as a whole: 71 days for the group of exclusive plus mainly breastfeeding and 17 days for exclusive breastfeeding. CONCLUSION: The current pattern of breast-feeding is of a short-term practice. This evidence suggests the need for intervention programs to promote breast-feeding for longer periods and delay the introduction of food supplementation, preventing the early weaning.

Avaliaçäo comparativa do efeito dos colírios de apraclonidina e latanoprost na profilaxia da hipertensäo ocular pós capsulotomia com YAG Laser em pacientes näo glaucomatosos / Profilatic use of apraclonidine and latanoprost to prevent intraocular pressure elevation following Nd: YAG laser posterior capsulotomy

Objetivo: Comparar a eficácia do latanoprost 0,005 por cento e da apraclonidina 1 por cento na prevençäo da hipertensäo ocular pós-capsulotomia posterior com YAG laser, em pacientes näo-glaucomatosos. Método: Trinta e seis pacientes (36 olhos) incluídos foram divididos em três grupos que usaram latanoprost 0,005 por cento, apraclonidina 1 por cento ou placebo. Foram realizadas medidas da pressäo ocular antes da instilaçäo de qualquer colírio, 30 minutos após a dilataçäo, 1 hora e 4 horas após o YAG laser. Resultados: Näo houve diferença significativa entre os 3 grupos em relaçä à idade, pressäo ocular inicial e pós-dilataçäo, assim como em quantidade de energia utilizada. Na primeira hora, tanto para a diferença absoluta quanto para o percentual de alteraçäo da pressäo intra-ocular, o grupo da apraclonidina apresentou reduçäo estatisticamente maior em relaçäo ao grupo controle (p<0,05). O grupo do latanoprost näo diferiu estatisticamente dos dois outros grupos (p>0,05). Na 4ª hora näo houve diferença significativa entre os grupos (p>0,05). A quantidade de energia utilizada näo mostrou correlaçäo significativa com o aumento da Po (p>0,05). Conclusäo: A apraclonidina 1 por cento apresentou maior eficácia na profilaxia da hipertensäo após capsulotomia posterior com YAG laser quando comparada com latanoprost 0,005 por cento.

Thermodynamics of the binding of chymotrypsin with the black-eyed pea trypsin and chymotrypsin inhibitor (BTCI).

The binding of alpha-chymotrypsin to black-eyed pea trypsin/chymotrypsin inhibitor (BTCI) has been studied using the inhibitory activity against the enzyme and the formation of the complex enzyme/inhibitor followed by measurements of fluorescence polarization. Apparent equilibrium constants were estimated for several temperatures and the values obtained range from 0.32 x 10(7) to 1.36 x 10(7) M(-1). The following values were found from van't Hoff plots: delta H(0)vh = 10.8 kcal mol(-1) (from inhibitory assays) and 11.1 kcal mol(-1) (from fluorescence polarization); delta S(0) = 67.9 and = 67.8 kcal K(-1) mol(-1), respectively. Calorimetric binding enthalpy was determined (corrected for the ionization heat of the buffer) and the resulting value was delta H(0)cal = 4.9 kcal mol(-1). These results indicate that the binding of chymotrypsin to BTCI is an entropically driven process.

[Role of the obstetric nurse in the Anhanguera community, Campo Grande (MS), in the prevention of cervical cancer]. / Atuação da enfermeira obstetra na comunidade Anhanguera, Campo Grande (MS), na prevenção do câncer cérvico-uterino.

This is a transversal study, developed between women of the Anhanguera community, with the objectives of knowing the demographic, sociocultural, gynecological and obstetric profile and of assessing health preventive behaviors in order to elaborate a plan of obstetric nursing assistance. The research tool was a form applied at home during visits to 104 women. Our results showed that 23.08% did not know about cancer prevention, 50.00% never performed it, 77.88% presented gynecological complaints but, 62.96% of these never looked for health services. Based on nursing diagnoses a plan of nursing care and health education was elaborated for the women from this community.

PIP: In the community of Anhanguera, a poor neighborhood of the state of Mato Grosso do Sul, Brazil, a cross-sectional study was carried out in May 1995 dealing with the prevention of cervical cancer. 104 out of 142 women living in the community were enrolled, and semistructured questionnaires containing questions concerning demographic, sociocultural, obstetrical, gynecological information and diagnosis were administered. Second-year nursing school students made the home visits and collected the data. A 1995 analysis showed that in the previous 10 years there had been a steady increase of deaths due to cervical cancer in this state, especially among women aged 50 years and older owing to difficulty of access to prevention programs or the lack thereof in basic health units and nonutilization of such services by women at risk. Most women studied were in reproductive age, with little or no education, and a steady partner. There was a high percentage of multiparas (38.46%), 79.25% of deliveries were normal, and 20.75% were by cesarean section. 94.66% of newborn infants were breast-fed and 73.39% were breast-fed for 6 months or more. 23.08% of the women did not know about cervical cancer prevention programs and only 50% reported that they had made a visit for preventive examination at least once. 77.88% of the women had gynecological complaints (amount of menstrual flow, vaginal discharge, dysmenorrhea, lower abdominal pain, menstrual irregularity, and vulvar itching), but only 37.04% obtained medical help.

Analysis of the black-eyed pea trypsin and chymotrypsin inhibitor-alpha-chymotrypsin complex.

The black-eyed pea trypsin and chymotrypsin inhibitor (BTCI) is a member of the Bowman-Birk protease inhibitor (BBI) family. The three-dimensional model of the BTCI-chymotrypsin complex was built based on the homology to Bowman-Birk inhibitors with known structures. An extensive theoretical and experimental study of these known structures has been performed. The model confirms the ideas about Bowman-Birk inhibitor structure-function relations and agrees well with our experimental data (circular dichroism, IR and light scattering). The electrostatic potentials at the enzyme-inhibitor contact surface reveal a pattern of complementary electrostatic potentials from which mutations can be inferred that could give these inhibitors an altered specificity.

Influence of finishing and polishing procedures on the decision to replace old amalgam restorations: an in vitro study.

The purpose of this study was to establish the influence that finishing and polishing of existing amalgam restorations might have on the decision to replace them. Forty extracted teeth, in which amalgam restorations had been placed in vivo, were individually examined by 60 practitioners and students prior to and following standard finishing and polishing procedures. Examiners, who had not been informed of the study's methodology or objective, opted either for maintaining or replacing the restoration in question. The main reasons for replacement were also registered. Finishing and polishing significantly reduced the number of decisions to replace restorations in all groups and for all practitioners. "Appearance" (anatomic shape) was the most frequently cited reason for replacing restorations before finishing and polishing, followed by marginal defects and secondary caries.

[Prevalence of normal occlusion and malocclusion in Bauru (Sao Paulo) students. 2. Influence of socioeconomic level]. / Prevalência de oclusão normal e má oclusão em escolares da cidade de Bauru (São Paulo). Parte II: Influência da estratificação sócio-econômica.

We have evaluated 2,416 children of both sexes from Bauru, with mixed dentition, at the age between 7 and 11 years, enrolled in 18 public and private schools. The data regarding their occlusal conditions were written down in index cards previously elaborated to make possible the percentual calculation and the illustrative graphics. In this article we propose to find out the percentage of normal occlusion and distribution of malocclusions, according to the anteroposterior relationship between the dental archs (following the ANGLE3 classification) and their social-economical status. The results show a low percentual of normal occlusion, in total of 11.47% from the studied population. Class I malocclusion was the most prevalent (55%), followed by class II (42%) and, finally, by class III (3%). The social-economical condition had an influence upon the percentual of normal occlusion and class I malocclusion. In a lower social-economical level there was an increase in the percentual of class I malocclusion to the detriment of the reduction of normal occlusion. Class II and III malocclusions were not influenced by the social-economical status.

[Prevalence of normal occlusion and malocclusion in Bauru (Sao Paulo) students. 1. Sagittal relation]. / Prevalência de oclusão normal e má oclusão em escolares da cidade de Bauru (São Paulo). Parte I: Relação sagital.

We have evaluated 2,416 children of both sexes from Bauru, with mixed dentition, at the age between 7 and 11 years, enrolled in 18 public and private schools. In this article we propose to find out the percentage of normal occlusion and the distribution of maloclusions, according to the anteroposterior relationship between the dental archs (following the ANGLE3 classification). The results show a low percentual of normal occlusion, in a total of 11.47% from the studied population. Class I malocclusion was the most prevalent (55%), followed by class II (42%) and, by class III (3%).