Prevalence and severity of clinical consequences of untreated dentine carious lesions in children from a deprived area of Brazil.

Disadvantaged children suffer because tooth cavities are not being treated and their clinical consequences not being surveyed. The present study aimed to assess the prevalence and severity of clinical consequences of untreated dentine carious lesions in schoolchildren from a deprived area of Brazil and to investigate the determinants of the pufa index. A sample of 835 children aged 6-7 years, from six public schools, was examined by 3 calibrated examiners. Clinical consequences of untreated dentine carious lesions in primary teeth were diagnosed using the four codes of the pufa index: 'p' (pulpal involvement), 'u' (ulceration), 'f' (fistulae), 'a' (abscess). Effects of gender, age, school, history of extraction, and toothache on the prevalence of pufa codes were tested. The prevalence of pufa codes was 23.7%. The mean pufa score was 0.4 ± 0.9. Code 'p' was the most prevalent (19.5%), whereas code 'u' was least prevalent (0.1%). Children with a history of extracted primary teeth due to caries had a 2.7 times higher chance to have a pufa code than children with no previous extraction. Children with toothache had a 5.6 times higher chance to have a pufa code than children without toothache. The prevalence of clinical consequences of untreated dentine carious lesions was moderate and the severity was low. The pufa index is an epidemiological tool complementary to existing caries indices aimed to assess dental caries. However, there appears to be no need to include code 'u' nor to score codes 'f' and 'a' separately.

Increase of core temperature induced by corticotropin-releasing factor and urocortin: a comparative study.

This study compared the ability of CRF and UCN1 to induce a thermoregulatory response when centrally injected into rats. The effects of antipyretic drugs and CRF receptor antagonists (CRF1 and CRF2) on the temperature (T) changes induced by these peptides were also investigated. Rectal (rT) and tail skin (T(sk)) temperatures were measured with a thermistor probe while body (bT) temperature was measured with a battery-operated biotelemetry transmitter in male Wistar rats (200 g) every 30 min over a period of 6h, after intracerebroventricular (i.c.v.) injection of 1 nmol of either CRF or UCN1. Rats were pre-treated with indomethacin (2 mg kg⁻¹, i.p.) or celecoxib (5 mg kg⁻¹, p.o.), dexamethasone (0.5 mg kg⁻¹, s.c.), astressin (a CRF1/CRF2 antagonist, 7 nmol, i.c.v.) or antalarmin (a CRF1 antagonist, 20 mg kg⁻¹, i.p.). The increase in body temperature induced by CRF was accompanied by a reduction in T(sk) while the response induced by UCN1 was accompanied by an elevation in T(sk). Indomethacin or celecoxib did not change the increases in rT caused by either CRF or UCN1. Although dexamethasone attenuated the increase in rectal temperature in response to CRF, dexamethasone did not modify the response induced by UCN1. Astressin blocked the UCN1-induced hyperthermia and reduced CRF-induced fever. Antalarmin did not modify the hyperthermia in response to UCN1, but reduced the fever evoked by CRF. This study demonstrated that CRF by acting on the CRF1 receptor induces a prostaglandin-independent fever which seems to depend, at least in part, on the synthesis of other mediators while UCN1 acts on the CRF2 receptor, promoting a hyperthermic response which seems to be independent on synthesis/release of any mediator.

Caries trends in Brazilian non-privileged preschool children in 1996 and 2006.

The aims were to analyse caries trends in Brazilian non- privileged preschool children from 1996 to 2006 and to test the hypothesis that a decline in caries prevalence would manifest itself as a reduction in the rate of caries progression. Subjects were 1- to 5-year-old children born in and life time residents of the Federal District of Brazil (cohort 1996=1,465) and (cohort 2006=2,511). The clinical examination determined whether the tooth surfaces were sound, presented active lesions (non cavitated and cavitated), inactive lesions (non-cavitated and cavitated), fillings, were indicated for extraction or had been extracted. Intra- and inter-examiner reliability of caries scores showed kappa values ranging from 0.71-0.93. A significant increase in the percentage of children who were free from any form of untreated or treated caries was observed (p<0.05; chi(2) test). Caries prevalence decreased by almost a half from 1996 to 2006. Differences in the mean caries scores at surface level, which included non-cavitated lesions, were observed for all age groups (p<0.002; Mann-Whitney test) indicating a reduction in the rate of caries progression. In conclusion, since this population has access to fluoride and presents moderate caries prevalence, other measures to reduce the rate of caries progression are required to further improve oral health in non-privileged children.

Conversion to sirolimus in a population of kidney and kidney-pancreas transplant recipients.

INTRODUCTION: Calcineurin inhibitors (CI) are associated with nephrotoxicity that might reduce long-term graft survival. We report our experience with sirolimus (SRL) conversion among a population of kidney and kidney pancreas transplant recipients. METHODS: Thirty transplant recipients (6 women, 24 men; age 41 +/- 10.5 years old) were converted to SRL therapy at 25.97 +/- 32.5 months after transplantation. Indications for conversion were: intolerance to mycophenolate mofetil (n = 13), diabetes mellitus (n = 3), CI nephrotoxicity (n = 11), CI nephrotoxicity with chronic allograft rejection (n = 2), and side effects of azathioprine (n = 1). Follow-up after conversion is 3 to 45 months. RESULTS: No significant changes were observed in the 3 months postconversion in renal function, hematological profile, and mean arterial blood pressure. In contrast there was a significant increase in cholesterol values (pre: 198.7 +/- 49.4, versus post 221.2 +/- 60.8, P = .018). At a follow-up of 15.2 +/- 9.9 months after conversion two patients (6.7%) died with functioning allograft (one because of infection and one to myocardial infarct) three kidney allografts (10.7%) have been lost: two chronic rejection; one infection. In two patients SRL therapy was discontinued (one infection, one refractory edema). Neither significant change in renal function nor episodes of acute rejection were observed. CONCLUSIONS: Conversion to SRL was safe. There was no deterioration in renal function nor episodes of acute rejection. There was a significant increase in cholesterol values after conversion. The size of the sample and the time of follow-up may have determined our results.

[Practical approximation to the diagnosis of tachyarrhythmias]. / Aproximación práctica al diagnóstico de las taquiarritmias.

Even though the 12-lead electrocardiogram is the most helpful tool in the diagnosis of tachycardia, a careful history and physical examination can be useful in both differentiating between ventricular and supraventricular tachycardia and elucidating the electrophysiological mechanism of supraventricular tachycardia. This article will focus on the most relevant clinical aspects of tachyarrhythmias as well as on the electrocardiographic differential diagnosis of regular broad complex tachycardia.

[Correlation between ventricular arrhythmia and geometric remodeling of the left ventricle in arterial hypertension]. / Correlação entre arritmia ventricular e remodelamento geométrico do ventrículo esquerdo na hipertensão arterial.

PURPOSE: To study the presence and type of ventricular arrhythmias in patients with different geometric patterns of the left ventricle (LV). METHODS: Seventy-two patients with essential hypertension were divided in 4 groups, by the echocardiographic patterns: group I with concentric remodeling of the LV (normal LV mass with increased relative wall thickening); group II with concentric hypertrophy (both LV mass and relative wall thickening increased); group III with normal geometry of the LV (both LV mass and relative wall thickening normal); group IV, with eccentric hypertrophy (increased LV mass with normal relative wall thickening). The groups were compared by the quantity and quality of ventricular arrhythmia, measured by the number of ventricular ectopic beats (VEB) and episodes of ventricular tachycardia (VT) on Holter monitoring, and the presence of late potentials (LP) on signal-averaged electrocardiogram. RESULTS: Group I showed fewer VEB than group II (16.2 +/- 12.85 x 996.4 +/- 518.8, p < 0.05), and a statistic tendency to this result when compared with group IV (16.2 +/- 12.85 x 1634.2 +/- 1001.33, p = 0.063). When compared with group III, no statistical difference was found (16.2 +/- 12.85 x 19.8 +/- 14.81, p = NS). Episodes of VT and the presence of LP were noted only in groups II and IV. CONCLUSION: The group with concentric remodeling of the LV had fewer ventricular arrhythmias than hypertrophic groups, with characteristics closer to the patients with normal LV geometry.

[Myocardial infarction as a consequence of infective endocarditis in valvar bioprosthesis]. / Infarto do miocárdio conseqüente à endocardite infecciosa em bioprótese valvar.

A sixteen year-old male, followed in the Unicamp Cardiology Clinic with a previous record of rheumatic heart disease and a biological mitral prosthesis, presented with infective endocarditis. In spite of a good initial response to antibiotic therapy, the patient died in two weeks. Autopsy disclosed endocarditis of the prosthetic valve and embolic occlusion of the circumflex branch of left coronary artery.

Structure-activity relationships of 110 candidate juvenile hormone analogues for Panstrongylus megistus (Burmeister,1835) a vector of Chagas disease (Hemiptera, Reduviidae, Triatominae).

Procurando novas alternativas para combater triatomineos vetores da doenca de Chagas, estudou-se a atividade de 110 compostos quanto a sua capacidade de juvenilizar P. megistus, quando aplicados topicamente no inicio do quinto estadio. Foram testados compostos pertencentes a varias classes estruturais, estabelecendo-se posteriormente algumas relacoes entre estrutura e atividade. Seis compostos revelaram grande atividade: os eteres aromaticos com cadeia terpenoidal, 3,7-dimetil6,7- epoxi - 1-(3,4-metilenodioxifenoxi) -2noneno e seu analogo 3-etil-7-metil; os derivados da N-geranilanilina, N-(2,5-diclorofenil) -3,7- dimetil -2,6- octadienilamina, seu analogo N-(5-cloro-2-metilfenil), e a N-(5cloro-2-metilfenil)-3,7-dimetil -7-metoxi -2octenilamina, alem do arilterpenoide com esqueleto constituido somente por carbono, 4,8dimetil-7,8-epoxi-1-(3-metoxifenil)-3-noneno.Estes compostos foram capazes de induzir grau medio de juvenilizacao entre 3,9 e 4,0 (sendo 4,0 o grau maximo) e 100% de insetos juvenilizados na dosagem de 1 micro g/ninfa, preservando ainda alguma atividade na dosagem de 0,1 micro g/ninfa. Todos os compostos altamente ativos tinham um substituinte eletronegativo no anel aromatico, com orientacao meta em relacao a cadeia lateral terpenoidal