Conservative approach for esthetic treatment of enamel hypoplasia.

This article describes a minimally invasive technique for removal of intrinsic enamel stains and discoloration. The technique is based on enamel microabrasion with application of an acid-abrasive gel. Treatment may be complemented with composite resin to compensate for the effects of acid or to finish the masking effect.

Occurrence of pneumocystis pneumonia in hiv-infected patients and the interference of the highly active antiretroviral therapy

From the beginning of the AIDS epidemic, pneumocystis pneumonia (PCP) has been distinguished as one of the most frequent opportunistic diseases with high morbid-mortality. As from 1996, the advent of the highly active antiretroviral therapy (HAART) has changed the characteristics of such epidemic by reducing its related diseases and, as a result, AIDS-related mortality. With the purpose to estimate PCP occurrence and HAART interference, 376 HIV-infected or AIDS patients were studied from January 1992 to December 2002. Among them, 58 (15.5 percent) PCP cases were found. There was a higher occurrence of PCP in the group of patients in which HAART was not used, with 40 (69.0 percent) of the episodes. As regards the studied period, a tendency to a linear reduction in annual PCP incidence was observed. The mean of T CD4+ lymphocytes in the patients with PCP (117 cells/mm³) was significantly lower when compared to that of the other individuals (325 cells/mm³). Therefore, this study suggests a temporal reduction in PCP occurrence related to HAART use with higher T CD4+ lymphocyte counts. Nevertheless, this opportunistic infection still shows significant incidence in AIDS patients. (NCT00516581).

Assessment of cytokine values in serum by RT-PCR in HIV-1 infected individuals with and without highly active anti-retroviral therapy (HAART)

A cross-sectional study was performed on HIV-1 infected individuals with or without antiretroviral treatment (ARV) in the AIDS Day Hospital, Botucatu Medical School, UNESP. Between August 2004 and October 2005, 73 HIV-1 infected individuals were divided into three groups: infected individuals with or without AIDS who had never received ARV (G1 = 15); patients on HAART that had had plasma HIV-1 RNA viral load (VL) equal to or greater than 50 copies/mL (G2 = 27); and patients on HAART with undetectable VL for at least the past six months (G3 = 31). There was also an additional group that comprised blood donors without any sign of the disease and with negative HIV serum tests (G4 = 20), which was the control group. Serum cytokine levels (values in pg/mL) were measured by enzyme-linked immunosorbent assay (ELISA) and specific mRNA expression by reverse transcription polymerase chain reaction (RT-PCR). Both techniques were performed on the four groups for TNF-á, IL-2, INF-ã, IL-4 and IL-10. All patients were submitted to VL determination and CD4+ and CD8+T lymphocyte counts. The analysis of the results revealed a significant comparison among groups for both methods and an association between the latter (> 80% r² > 0.80). There was only one exception, in control individuals for IL-2 by ELISA. The cytokine profiles, in both methods, for the three patient groups, were mature Th-0. The behaviors of IL-2 and INF-ã required emphasis due to consequent expression of dominant Th profile. Both methods showed low IL-2 and high mean values of INF-ã in the three groups. Several authors have recently drawn attention to the substantial apoptosis of infected and non-infected CD4+T cells, mainly during primary infection, persisting only in those with INF-ã phenotype producer and not IL-2. HIV infected individuals submitted to HAART are expected to produce IL-2 in an attempt to present Th-1 profile, but in most cases this did not occur.(AU)

Biological restorations using tooth fragments.

A "biological" restoration technique using dental fragments and adhesive materials is described. These fragments were obtained from extracted human teeth which had been previously sterilized and stored in a tooth bank. The advantages are: the use of extracted teeth as restorative material, esthetics, and treatment cost. The positive sensation of having back the missing tooth was the most mentioned comment among patients. The disadvantages are: the difficulty of obtaining teeth with the needed characteristics, problems of making an indirect restoration, matching the original color, and the non-acceptance by some patients who consider it strange to have other people's teeth placed in their mouths.

Dinamismos grupais na equipe psiquiatrica. / Group dynamics in a psychiatric team

Os autores descrevem uma situacao ocorrida em um grupo de estudo da equipe tecnica de um hospital psiquiatrico. Assinalam os dinamismos grupais que surgiram na situacao estudada e mostram a necessidade de identifica-los, compreende-los e maneja-los quando se pretende manter a eficacia do trabalho