CLEFT RR- New app to Calculate Recurrence Risk in Cleft lip and Palate.

OBJECTIVE: To describe the Cleft Recurrence Risk (Cleft RR) App, designed to be used on genetic counseling for cleft lip and/ or palate. DESIGN: A validation study, single cohort. SETTING: Tertiary care children's Hospital. PATIENTS, PARTICIPANTS: The manual obtained the results of 100 cases undergoing genetic counseling at the cleft lip and palate treatment center. INTERVENTIONS: The application for genetic counseling for cleft lip and/ or palate is designed to calculate quickly the recurrence risk considering the ancestry, cleft type, sex, and family history and thus encourage the implementation of genetic counseling in cleft lip and palate centers around the world. MAIN OUTCOME MEASURE(S): The data were submitted to the Bland-Altman statistics. RESULTS: After defining parameters the application development follows the steps: development, prototyping, and documentation. The validation of the calculated data was performed by comparing the results of 100 cases undergoing genetic counseling at the cleft lip and palate treatment center obtained by the manual method with the results obtained by the mobile app method; the data were submitted to the Bland-Altman statistics and a high concordance was found. CONCLUSIONS: The mobile app for use by healthcare professionals proved to be simple to use, easy to apply, and provided accurate results. Cleft Recurrence Risk is an application for smartphones developed for genetic counseling in cleft lip and palate, supplementary use by health professionals, and should not replace professional performance.

Low Back Pain in Elderly from Belém-Pa, Brazil: Prevalence and Association with Functional Disability.

BACKGROUND: This cross-sectional study aimed to determine the prevalence of low back pain (LBP) in the elderly population living in Belém-Pará and to assess the spectrum of problems related to these diseases including the demographic, socioeconomic, occupational characteristics and disability in this population. METHODS: Three structured questionnaires were applied in a randomly selected representative sample of 512 elderly people aged ≥60 years. RESULTS: LBP prevalence in the elderly population was 55.7%. Among then, 56.1% had pain at the time of the interview (punctual prevalence), 91.7% had LBP in the last 365 days (prevalence in the last year), and 85.3% at some point in life (prevalence at some point in life). Overall, most studies are above average. LBP was positively associated with hypertension and the influence of the physical and mental health on their social activities ranged from slightly to extreme. LBP was negatively associated with characteristics, such as education (over 11 years), class A or B income, physical activity, high satisfaction with previous work, and excellent self-perceived health, corroborating to the literature. CONCLUSIONS: Greater intensity of pain and functional disability were associated with the presence of comorbidities, smoking habits, and low physical activity. LBP prevalence was high, above the national average, mainly affecting the underprivileged classes related to several modifiable factors, highlighting the importance of preventive and interventionist actions for healthy aging.

Multiple Structural Microform Defects Suggest Role of Modifier Genes.

ABSTRACT: One of the biggest challenges in clinical genetics is establishing associations between specific germline mutations and the resulting spectrum of phenotypes. The careful characterization of clinical presentations continues to be a tool for establishing these genotype phenotype correlations. The authors intend, by presenting a case study, proposing that the concomitant occurrence of a combinations of mild structural anomalies in the same individual may be due to changes in genes that can be linked by related pathways. A new born with cleft lip and palate was referred at the Cleft Lip and Palate Center. The anamnese was performed and collected data of familiar history, parental consanguinity, and information about pregnancy period. The careful characterization of clinical presentations and the genetic pathways was studied. It is possible that there is no single mutation that can be clearly identified as the etiology of the combination of the defects displayed in the present case.

COVID-19 in hematology: data from a hematologic and transplant unit

ABSTRACT During the COVID-19 pandemic, special attention has been addressed in cancer care to mitigate the impact on the patient's prognosis. We addressed our preparation to face COVID-19 pandemic in a Hematological and Stem Cell Transplant Unit in Brazil during the first two months of COVID-19 pandemic and described COVID-19 cases in patients and health care workers (HCW). Modifications in daily routines included a separation of area and professionals, SARS-CoV-2 screening protocols, and others. A total of 47 patients and 54 HCW were tested for COVID-19, by PCR-SARS-CoV-2. We report 11 cases of COVID-19 in hematological patients (including 2 post stem cell transplant) and 28 cases in HCW. Hematological cases were most severe or moderate and presented with several poor risk factors. Among HCW, COVID-19 were mostly mild, and all recovered without hospitalization. A cluster was observed among HCW. Despite a decrease in the number of procedures, the Transplant Program performed 8 autologous and 4 allogeneic SCT during the period, and 49 onco-hematological patients were admitted to continuing their treatments. Although we observed a high frequency of COVID-19 among patients and HCW, showing that SARS-CoV-2 is disseminated in Brazil, hematological patients were safely treated during pandemic times.

COVID-19 in hematology: data from a hematologic and transplant unit.

During the COVID-19 pandemic, special attention has been addressed in cancer care to mitigate the impact on the patient's prognosis. We addressed our preparation to face COVID-19 pandemic in a Hematological and Stem Cell Transplant Unit in Brazil during the first two months of COVID-19 pandemic and described COVID-19 cases in patients and health care workers (HCW). Modifications in daily routines included a separation of area and professionals, SARS-CoV-2 screening protocols, and others. A total of 47 patients and 54 HCW were tested for COVID-19, by PCR-SARS-CoV-2. We report 11 cases of COVID-19 in hematological patients (including 2 post stem cell transplant) and 28 cases in HCW. Hematological cases were most severe or moderate and presented with several poor risk factors. Among HCW, COVID-19 were mostly mild, and all recovered without hospitalization. A cluster was observed among HCW. Despite a decrease in the number of procedures, the Transplant Program performed 8 autologous and 4 allogeneic SCT during the period, and 49 onco-hematological patients were admitted to continuing their treatments. Although we observed a high frequency of COVID-19 among patients and HCW, showing that SARS-CoV-2 is disseminated in Brazil, hematological patients were safely treated during pandemic times.

Association between Periodontitis and Hyperglycemia / Associação entre Periodontite e Hiperglicemia

ABSTRACT Objective: The objective of this study was to analyze the prevalence of undiagnosed hyperglycemia in individuals with periodontitis. Methods: The sample was composed of randomly selected individuals that had signed-up for treatment at the Newton Paiva University dental clinic. The volunteers were divided in two groups, the first composed by individuals without periodontitis (n = 30) and the second by individuals with periodontitis (n = 20). All participants answered a questionnaire about habits and overall health condition. Salivary flow was quantified and periodontal examination evaluated bleeding when probed, probing depth and clinical attachment level. Through laboratory tests, the fasting glucose and the glycated hemoglobin levels were quantified. Results: In the sample studied a higher percentage of individuals with hyperglycemia among those with periodontitis than those without periodontitis was identified. Conclusion: It is suggested, therefore, that the request of laboratory tests to check glucose levels becomes a part of the dental treatment protocol of individuals with periodontitis.

RESUMO Objetivo: O objetivo desse estudo foi analisar a prevalência de hiperglicemia não diagnosticada em indivíduos com periodontite. Métodos: A amostra foi composta por indivíduos selecionados aleatoriamente que se inscreveram para tratamento no Curso de Odontologia do Centro Universitário Newton Paiva, Belo Horizonte, Minas Gerais. A amostra foi dividida em dois grupos, o dos indivíduos sem periodontite (n=30) e o dos indivíduos com periodontite (n=20). Todos responderam a um questionário sobre hábitos e condição de saúde geral. Também tiveram o fluxo salivar quantificado e passaram por um exame periodontal para avaliação do sangramento gengival, da profundidade de sondagem e do nível de inserção clínica. Através de exames laboratoriais, quantificou-se a glicemia em jejum e os níveis de hemoglobina glicada. Resultados: Na amostra estudada foi identificado maior percentual de indivíduos com hiperglicemia no grupo com periodontite do que no grupo sem periodontite. Conclusão: Sugere-se, portanto, que a solicitação de exames laboratoriais para avaliação dos níveis glicêmicos faça parte do protocolo odontológico de atendimento dos indivíduos com periodontite.

Facial Growth Changes Induced by Orthodontic Treatment in Patients With Unilateral Cleft Lip and Palate.

The aim of this study was to investigate the effect of orthodontic treatment on the maxillofacial growth of patients with unilateral cleft lip and palate. The Great Ormond Street, London and Oslo (GOSLON) yardstick was used for a longitudinal evaluation of 24 patients with cleft lip and palate treated at the Cleft Center of the Lauro Wanderley University Hospital, Paraiba State, northeastern Brazil. Dental casts were evaluated by 3 orthodontists and classified according to the GOSLON yardstick. The evaluation was performed at 2 different stages: T1 (before orthodontic treatment) and T2 (follow-up evaluation) after a 6-year mean follow-up interval. The Kappa test was used to evaluate intra- and interexaminer agreement, and paired t-test was used to compare the differences between T1 and T2, with a 99% confidence interval. The average intraexaminer Kappa was 0.979, ranging from 0.971 to 0.990. The interexaminer Kappa value was 0.926 at T1, ranging from 0.885 to 0.964, and 0.896 at T2, ranging from 0.696 to 1.0. The mean GOSLON yardstick found at T1 was 2.5 ±â€Š1.18 with 50% in G1 + G2, 29.18% in G3, and 20.82% in G4 + G5. At T2, the GOSLON average was 1.71 ±â€Š1.12, with 79.18% in G1 + G2, 12.5% in G3, and 8.32% in G4 + G5. A statistically significant difference was found between T1 and T2. The results suggest that orthodontic treatment improves facial growth in patients with unilateral cleft lip and palate.

Enfoque bidirecional na relação entre periodontite e diabetes mellitus / Bidirectional approach on the relationship between periodontitis and diabetes mellitus ­ a literature review

O diabetes mellitus (DM) é uma doença crônica caracterizada por deficiência parcial ou total da produção de insulina e/ou resistência à sua ação. A periodontite é a complicação bucal mais prevalente do DM, sendo considerada sua sexta complicação clássica. Tem sido sugerida uma relação bidirecional entre DM e periodontite, na qual o DM favorece o desenvolvimento da periodontite e esta, quando não tratada, piora o controle metabólico do DM. Este trabalho teve como objetivo realizar uma revisão da literatura buscando entender os mecanismos envolvidos nessa relação bidirecional. Os artigos científicos utilizados foram publicados nos últimos dez anos e obtidos nas bases de dados Pubmed, Scielo e Medline. A literatura científica propõe alguns mecanismos para explicar a relação entre DM e periodontite. Eles podem ser agrupados em mecanismos bioquímicos/imunológicos, teciduais, genéticos e ambientais. Alterações do DM, como hiperglicemia e anormalidades da resposta imune, frente às infecções bucais aumentam o risco de periodontite. Em contrapartida, a periodontite pode promover resistência insulínica devido à produção exacerbada de mediadores pró-inflamatórios que dificultam o controle glicêmico. No entanto, ainda não está bem estabelecido como a periodontite pode contribuir para o aparecimento do DM.

Diabetes mellitus (DM) is a chronic disease characterized by partial or complete defi ciency of insulin production and/or resistance to its action. Periodontitis is the most prevalent oral complication of DM, considered its sixth classic complication. It has been suggested a two-way relationship between diabetes and periodontitis in which the DM favors the development of periodontitis and that, left untreated, worsens the metabolic control of diabetes. This paper aims to conduct a literature review in order to understand the mechanisms involved in this bi-directional relationship. The papers used were published in the last 10 years and obtained in Pubmed, Scielo and Medline. The scientifi c literature proposes some mechanisms to explain the relationship between diabetes and periodontitis. They can be grouped into biochemical/immunological, tissue, genetic and environmental mechanisms. DM changes such as hyperglycemia and abnormalities of the immune response, compared to oral infections, increase the risk for periodontitis. By contrast, periodontitis may promote insulin resistance due to the overproduction of proinfl ammatory mediators that hinder glycemic control. However, it is not yet well established how periodontitis may contribute to the onset of DM.

Fitoterápicos na odontologia / Medicines in dentist herbal

A Fitoterapia é conhecida como a ciência que estuda o efeito farmacológico de plantas com finalidade terapêutica. Os medicamentos fitoterápicos têm despertado o interesse de diversos centros de pesquisas e indústrias e o seu uso vem se intensificando. Pesquisas científicas já comprovaram a eficácia de inúmeros extratos vegetais com aplicabilidade na Medicina e na Odontologia. Dentre as principais plantas com ação terapêutica em afecções bucais estão o cravo-da-índia, a camomila, a romã, a malva, a unha-de-gato e a própolis. Essas plantas têm propriedades antimicrobianas, anti-inflamatórias, cicatrizantes e analgésicas. O presente trabalho tem como objetivo realizar uma revisão da literatura sobre a Fitoterapia com ênfase em suas aplicações na Odontologia.

Phytotherapy is known as the science that studies the pharmacological effect of plants for therapeutic purposes. Herbal medicines have attracted the interest of several research centers and industries and their use has intensified. Scientific research has confirmed the efficacy of several plant extracts with applicability in Medicine and Dentistry. Among the main plants with therapeutic action in oral diseases are the clove, chamomile, pomegranate, mauve, the cat's claw and propolis. These plants have antimicrobial properties, anti-inflammatory, analgesic and healing. This paper aims to review the literature on Herbal Medicine with emphasis on their application in Dentistry.

rs1801133C>T polymorphism in MTHFR is a risk factor for nonsyndromic cleft lip with or without cleft palate in the Brazilian population.

BACKGROUND: The MTHFR rs1801131A>C and rs1801133C>T variants have been analyzed as putative genetic risk factors for oral clefts within various populations worldwide. METHODS: To test the role of these polymorphisms in nonsyndromic cleft lip with or without cleft palate (NSCL/P) in the Brazilian population, we conducted a study combining a Family-Based Association Test (transmission disequilibrium test) and a structured association analysis (case-control study) based on the individual ancestry proportions. The rs1801131 and rs1801133 were initially analyzed in 197 case-parent trios by transmission disequilibrium test, and polymorphisms showing significant association with NSCL/P were subsequently studied in independent sample composed of 318 isolated samples of NSCL/P and 598 healthy controls in a case-control approach. Genomic ancestry was characterized by a set of 40 biallelic short insertion/deletion markers. RESULTS: A strong overtransmission of the T allele of rs1801133 was observed in case-parent trios of NSCL/P (p = 0.002), but no preferential parent-of-origin transmission was detected. No association of rs1801131 polymorphism with NSCL/P was observed. The structured case-control analysis supported that the T allele was significantly more frequent in the NSCL/P group (odds ratio: 1.37; 95% CI: 1.12-1.69; p = 0.002) than in the control group. Both polymorphisms were in linkage disequilibrium (D' = 0.94 and r(2) = 0.79), and haplotype-transmission disequilibrium test for allelic combination of rs1801131 and rs1801133 showed a significant overtransmission of haplotype A-T to the affected NSCL/P offspring (p = 0.001). CONCLUSION: Our findings provide evidences for the involvement of rs1801133 in the development of NSCL/P in the Brazilian population.

The influence of positioning in urination: an electromyographic and uroflowmetric evaluation.

PURPOSE: We conducted a cross-sectional study to evaluate whether the different positions during urination influence the electrical activity of the abdominal and perineal musculature, as well as the uroflowmetric parameters of children with lower urinary tract dysfunction (LUTD). MATERIALS AND METHODS: Ninety-four children between the ages of 3 and 14 years with symptoms of LUTD were evaluated. All underwent uroflowmetry and electromyography tests (abdominal and perineal) in two different positions: oriented position (trunk bent slightly forward and feet flat) and atypical position (standing on toes for boys and buttocks not in contact with the lavatory seat and legs flexed in girls). We excluded nine patients due to suspicions of outside interference or elements complicating the analysis of charts. RESULTS: Among patients evaluated 55 (64.7%) were girls and 30 (35.3%) were boys with an average age of 8.5 years. Children urinating in atypical position showed higher levels of perineal electrical activity than when they were in normal position (p=0.018). However, there was no difference in the pattern of the curve if normal or abnormal when comparing the two groups (p=0.824). When evaluated separately, the boys demonstrated no difference between positions, in relation to perineal electrical activity (p=0.412) or abdominal electrical activity (p=0.202). CONCLUSIONS: The electrical activity of the pelvic floor musculature is decreased in the oriented position when compared to atypical positions in female children. Our data suggest that special attention should be given to adopting an adequate posture during urination for girls with LUTD.

Facial growth evaluation of complete unilateral cleft lip and palate operated patients: a cleft reference center in Paraíba, Brazil, using the "GOSLON" yardstick.

OBJECTIVES: To evaluate the surgical outcomes of patients with complete unilateral cleft lip and palate (CUCLP) operated on by a single surgeon of the cleft reference center of the Lauro Wanderley University Hospital at the Federal University of Paraiba. METHODS: Forty-four individuals' dental casts diagnosed with CUCLP, born between 1995 and 2002, mean age of 11 years, were evaluated by three calibrated orthodontic specialists and scored by the Great Ormond Street, London and Oslo (GOSLON) yardstick on two occasions. The scores were compared with those observed in other centers around the world. The Kappa test was applied to evaluate the intra- and inter-examiner agreement. Descriptive statistics was applied for the GOSLON yardsticks core. RESULTS: The mean GOSLON score was 2.75. For the GOSLON yardstick, 43.2 % of the sample presented scores 1 and 2, 31.8 % had score 3, and 25 % were with scores 4 and 5. There was very good intra- and inter-examiner Kappa agreement in the application of the GOSLON yardstick. CONCLUSIONS: The data suggest favorable outcomes, with 75 % of cases with no need of orthognathic surgery. The Kappa values confirmed the high reproducibility of the GOSLON yardstick.

Estudo sobre a acurácia da colonoscopia na detecção do câncer colorretal / A study on the accuracy of colonoscopy in detecting colorectal cancer

Justificativa e objetivos: o câncer colorretal (CCR) é a terceira neoplasia maligna mais comum e a segunda maior causa de morte relacionada ao câncer. A colonoscopia é a técnica de mais acuidade para o diagnóstico de lesões estruturais do cólon. O objetivo deste estudo foi calcular o índice de concordância diagnóstica (Kappa) da colonoscopia na suspeição de câncer colorretal comparando com o exame histopatológico(padrão-ouro) em pacientes sintomáticos examinados entre 2007 e 2010.Pacientes e métodos: foram estudados 233 casos de forma observacional e prospectiva. Resultados: alterações colonoscópicas suspeitas de câncer colorretal estavam presentes em 24 (6,87%) dos pacientes submetidos à colonoscopia e o diagnóstico foi confirmado pela histopatologia em 21 casos. Os locais mais acometidos pelo CCR foram o cólon (62,5%) e o reto (37,5%), não sendo encontradas lesões em ânus e canal anal. O cólon esquerdo foi o mais acometido (75%), com 58,33% das lesões em região sigmoide; e no cólon direito foram encontrados 25% das lesões. Conclusão: o índice Kappa de concordância diagnóstica nesta amostra na detecção do câncer colorretal foi de 0,88 com IC 0,78 e 0,98, considerado substancial.

Justification and objective: colorectal cancer (CRC) is the third most common malignant neoplasm and the second major cause of cancer-related death. Colonoscopy is the most accurate technique for diagnosing structural lesions in the colon. The aim of this study was to calculate the diagnostic agreement rate (Kappa) of colonoscopy in cases of suspected colorectal cancer and histopathological examination (gold standard) in symptomatic patients examined between 2007-2010. Patients and methods: 233 cases were assessed in this observational prospective study. Results: changes upon colonoscopy suggestive of colorectal cancer were present in 24 (6.87%) patients submitted to colonoscopyand diagnosis was confirmed by histopathology in 21 cases. Most affected by CRC were the colon (62.5%) and rectum (37.5%), and no lesions were found in the anus or anal canal. The left colon was the most affected (75%), with 58.33% of the lesions in the sigmoid region; and 25% of lesions were found in the right colon. Conclusion: The Kappa index of diagnostic agreement for this sample in the detection of colorectal cancer was 0.88 with CI 0.78 and 0.98, considered substantial.

Gender dysphoria associated with disorders of sex development.

Disorders of sex development (DSDs) are estimated to be prevalent in 0.1-2% of the global population, although these figures are unlikely to adequately represent non-white patients as they are largely based on studies performed in Europe and the USA. Possible causes of DSDs include disruptions to gene expression and regulation-processes that are considered essential for the development of testes and ovaries in the embryo. Gender dysphoria generally affects between 8.5-20% of individuals with DSDs, depending on the type of DSD. Patients with simple virilizing congenital adrenal hyperplasia (CAH), as well as those with CAH and severe virilization, are less likely to have psychosexual disorders than patients with other types of DSD. Early surgery seems to be a safe option for most of these patients. Male sex assignment is an appropriate alternative in patients with Prader IV or V DSDs. Patients with 5α-reductase 2 (5α-RD2) and 17ß-hydroxysteroid dehydrogenase 3 (17ß-HSD3) deficiencies exhibit the highest rates of gender dysphoria (incidence of up to 63%). Disorders such as ovotesticular DSD and mixed gonadal dysgenesis are relatively rare and it can be difficult to conclusively evaluate patients with these conditions. For all DSDs, it is important that investigators and authors conform to the same nomenclature and definitions to ensure that data can be reliably analysed.

The prevalence of priapism in children and adolescents with sickle cell disease in Brazil.

To evaluate priapism rates in individuals <18 years of age with sickle cell disease (SCD) at a referral center. An evaluation was made of 599 consecutive male patients with SCD, separated according to type of hemoglobinopathy (HbSS, HbSC and HbS-ß-thalassemia). Age at first episode and number of episodes were recorded. Cases of sickle cell trait were excluded. Mean age was similar in all groups. Overall, priapism occurred in 3.6 % of patients (5.6 % of those with HbSS and 1.1 % of those with HbSC; P = 0.01). In HbSS patients, the prevalence rate of priapism was from 3.5 (CI 95 % 0.94-13.4) when compared with patients with HbSC. No patient with ß-thalassemia had priapism. Mean follow-up was 39.7 months (range 1-202 months). Since 91 % of patients with priapism had HbSS, this group was evaluated separately, revealing a rate of priapism of 1.6 % in patients <10 years and 8.3 % in those ≥ 10 years of age (P = 0.002). Regarding priapism in HbSS patients ≥ 10 years (8.3 %) when compared with patients <10 years (1.6 %), the prevalence rate was from 3.3 (CI 95 % 1.1-9.5). Duration of follow-up was not correlated with priapism (P = 0.774). Forty-seven patients were lost to follow-up. Telephone contact was successful with 14/22 patients with priapism, 50 % of whom had required hospital treatment. Most episodes (86 %) occurred at night, always during sleep. Medical interventions were required in 13 cases as follows: intravenous hydration (n = 4), corpora cavernosa puncture and drainage (n = 7) and corpus cavernosum-corpus spongiosum shunts (n = 2). The prevalence of priapism in children <18 years of age with SCD was 3.6 %, lower than previously reported. Prevalence was higher in HbSS patients, increasing in patients >10 years of age. Most episodes occurred at night and half of the patients required some form of urological procedure.

Encefalocele basal esfenoetmoidal associada a fissura labiopalatina mediana: relato de caso / Basal sphenoethmoidal encephalocele in association with midline cleft lip and palate: case report

Associação de encefalocele basal esfenoetmoidal com fissura labiopalatina é extremamente rara. Relatamos um caso de uma criança de nove anos de idade apresentando uma fissura facial mediana com meningocele, que era evidente através da falha do palato como uma massa mediana intranasal pulsátil. Uma análise dos aspectos clínicos e radiológicos deste caso de disrafia craniana foi realizada.

Association of basal sphenoethmoidal encephalocele with midline cleft lip and palate is extremely rare. The authors report the case of a nine-year-old girl presenting a midline facial cleft with meningocele that was noticeable through the palatine defect as a medial intranasal pulsatile mass. An analysis of clinical and radiological findings of the present case of cranial dysraphism is carried out.

Estudo sobre a acuidade diagnóstica da endoscopia digestiva alta na detecção do esôfago de barrett / Study on the diagnostic accuracy of endoscopy in the detection of barrett's esophasus

Introdução: o esôfago de barrett (EB) decorre da substituição do epitélio escamoso do esôfago inferior por epitélio colunar em continuidade com a mucosa gástrica. Sua prevalência é estimada em 1% da população geral. A observação endoscópica cuidadosa e a vigilância através de biópsias permitem um melhor controle da progressão para adenocarcinoma do esôfago. Objetivos: detectar a prevalência da suspeita de EB nos exames endoscópicos, calcular a sensibilidade, especificidade, valor preditivo positivo e negativo da endoscopia digestiva alta (EDA) na detecção do EB e, calcular o índice Kappa de concordância entre o diagnóstico endoscópico e o histopatológico na detecção do EB. Métodos: Foram analisados 3813 laudos dos pacientes submetidos à EDA e 307 laudos de biópsias do esôfago do mesmo grupo de estudo, entre maio de 2007 e fevereiro de 2009. Resultados: A prevalência dos achados endoscópicos suspeitos de EB foi 2,30%(88), sendo que, 80,68%(71) foram confirmados histologicamente; destes, 64,79%(46) apresentaram hérnia de hiato associada, 78,87%(56) apresentaram lesão inferior a 3cm, 81,69%(58) eram do sexo masculino e a média de idade mais acometida foi 53 anos. O índice Kappa de concordância diagnóstica entre o exame endoscópico e o histopatológico foi 0,65. A sensibilidade da EDA no rastreio de EB foi 71% e a especificidade 92%. O valor preditivo positivo do exame endoscópico na mesma população foi 0,61 (61%) e o valor preditivo negativo 0,39 (39%). Conclusão: a EDA é um bom método para detectar EB, porém é melhor para excluí-lo. O índice Kappa foi considerado substancial.

Kidney transplantation in children: a 50-case experience

OBJECTIVES: The aim of this article was to report our experience with kidney transplantation in children. MATERIALS AND METHODS: From June 1980 to December 2003, 690 kidney transplants were performed in our institution, among which 50 were in patients with less than 18 years old. Technical aspects as well as clinical and surgical evolution were reviewed in this study. RESULTS: Patient's mean age was 12 years (2-17 years). Twenty-nine patients were male and 21 female. Live related donors were responsible for 75 percent of the cases (38 patients) and 25 percent (12 patients) came from cadaver donors. The main complications were ureteral fistula in 6 patients (12 percent), arterial stenosis in 2 (4 percent), wall infection and dehiscence in 1 case (2 percent). The overall rate of surgical complication was 20 percent. No case of hyperacute rejection was reported. During the follow-up 20 grafts were lost due to chronic rejection and 2 patients died. No loss of graft due to surgical complications was reported. The graft survival rate was 71 percent in 1 year, 64 percent in 3 years and 57 percent in 5-year follow-up. CONCLUSIONS: Kidney transplantation in children is a viable treatment option for terminal kidney disease presenting success and surgical complication rate similar to kidney transplantation in adults.

Kidney transplantation in children: a 50-case experience.

OBJECTIVES: The aim of this article was to report our experience with kidney transplantation in children. MATERIALS AND METHODS: From June 1980 to December 2003, 690 kidney transplants were performed in our institution, among which 50 were in patients with less than 18 years old. Technical aspects as well as clinical and surgical evolution were reviewed in this study. RESULTS: Patient's mean age was 12 years (2-17 years). Twenty-nine patients were male and 21 female. Live related donors were responsible for 75% of the cases (38 patients) and 25% (12 patients) came from cadaver donors. The main complications were ureteral fistula in 6 patients (12%), arterial stenosis in 2 (4%), wall infection and dehiscence in 1 case (2%). The overall rate of surgical complication was 20%. No case of hyperacute rejection was reported. During the follow-up 20 grafts were lost due to chronic rejection and 2 patients died. No loss of graft due to surgical complications was reported. The graft survival rate was 71% in 1 year, 64% in 3 years and 57% in 5-year follow-up. CONCLUSIONS: Kidney transplantation in children is a viable treatment option for terminal kidney disease presenting success and surgical complication rate similar to kidney transplantation in adults.

Textiloma nine years after nephrectomy.

INTRODUCTION: Foreign bodies after surgical procedures are not very reported in the literature. It is estimated to have 1 case for 1,300 operations, although in practice the frequency might probably be higher. CASE REPORT: A woman, 38 years, submitted to left nephroureterectomy for renal transplantation in 1993. During 9 years, she was asymptomatic, and then she presented intermittent left flank pain. Radiographic workup demonstrated a textiloma. DISCUSSION: In a review of the literature since 1950, solely 8 cases of textiloma in renal surgeries were reported, probably due to legal implications.