Interaction between poly(A)-binding protein PABPC4 and nuclear receptor corepressor NCoR1 modulates a metabolic stress response.

Mitochondria are organelles known primarily for generating ATP via the oxidative phosphorylation process. Environmental signals are sensed by whole organisms or cells and markedly affect this process, leading to alterations in gene transcription and, consequently, changes in mitochondrial function and biogenesis. The expression of mitochondrial genes is finely regulated by nuclear transcription factors, including nuclear receptors and their coregulators. Among the best-known coregulators is the nuclear receptor corepressor 1 (NCoR1). Muscle-specific knockout of NCoR1 in mice induces an oxidative phenotype, improving glucose and fatty acid metabolism. However, the mechanism by which NCoR1 is regulated remains elusive. In this work, we identified the poly(A)-binding protein 4 (PABPC4) as a new NCoR1 interactor. Unexpectedly, we found that silencing of PABPC4 induced an oxidative phenotype in both C2C12 and MEF cells, as indicated by increased oxygen consumption, mitochondria content, and reduced lactate production. Mechanistically, we demonstrated that PABPC4 silencing increased the ubiquitination and consequent degradation of NCoR1, leading to the derepression of PPAR-regulated genes. As a consequence, cells with PABPC4 silencing had a greater capacity to metabolize lipids, reduced intracellular lipid droplets, and reduced cell death. Interestingly, in conditions known to induce mitochondrial function and biogenesis, both mRNA expression and PABPC4 protein content were markedly reduced. Our study, therefore, suggests that the lowering of PABPC4 expression may represent an adaptive event required to induce mitochondrial activity in response to metabolic stress in skeletal muscle cells. As such, the NCoR1-PABPC4 interface might be a new road to the treatment of metabolic diseases.

Persistent inflammation, immunosuppression and catabolism syndrome (PICS) in critically ill children is associated with clinical outcomes: a prospective longitudinal study.

BACKGROUND: Persistent inflammation, immunosuppression and catabolism syndrome (PICS) has been described in critically ill adults and may contribute to unfavourable outcomes. The present study aimed to describe and characterise PICS in critically ill children (PICS-ped) and to verify its association with clinical outcomes. METHODS: A prospective longitudinal study was conducted in a paediatric intensive care unit (PICU) with children aged between 3 months and 15 years. PICS-ped, based on adult definition, was described. PICS-ped was defined as PICU length of stay >14 days; C-reactive protein > 10.0 mg L-1 ; lymphocytes <25%; and any reduction of mid-upper arm circumference Z-score. Clinical, demographic, nutritional status, nutrition therapy parameters and clinical outcomes were assessed. Statistical analysis comprised Mann-Whitney and Fisher's chi-squared tests, as well as logistic and Cox regression. P < 0.05 was considered statistically significant. RESULTS: In total, 153 children were included, with a median age of 51.7 months (interquartile range 15.6-123.4 months), and 60.8% male. The mortality rate was 10.5%. The prevalence of PICS-ped was 4.6%. Days using vasoactive drugs and days using antibiotics were associated with PICS-ped. PICS-ped was associated with mortality in crude (odds ratio = 6.67; P = 0.013) and adjusted analysis (odds ratio = 7.14; P = 0.017). PICS-ped was also associated with PICU and hospital length of stay, as well as duration of mechanical ventilation. Similar results were found in a subset of critically ill children who required mechanical ventilation for more than 48 h. CONCLUSIONS: Children with PICS-ped required antibiotics or vasoactive drugs for a longer period. PICS-ped was associated with poor clinical outcomes in critically ill children. More studies are needed to properly define PICS-ped for this population.

Biomineralized diamond-like carbon films with incorporated titanium dioxide nanoparticles improved bioactivity properties and reduced biofilm formation.

Recently, the development of coatings to protect biomedical alloys from oxidation, passivation and to reduce the ability for a bacterial biofilm to form after implantation has emerged. Diamond-like carbon films are commonly used for implanted medical due to their physical and chemical characteristics, showing good interactions with the biological environment. However, these properties can be significantly improved when titanium dioxide nanoparticles are included, especially to enhance the bactericidal properties of the films. So far, the deposition of hydroxyapatite on the film surface has been studied in order to improve biocompatibility and bioactive behavior. Herein, we developed a new route to obtain a homogeneous and crystalline apatite coating on diamond-like carbon films grown on 304 biomedical stainless steel and evaluated its antibacterial effect. For this purpose, films containing two different concentrations of titanium dioxide (0.1 and 0.3g/L) were obtained by chemical vapor deposition. To obtain the apatite layer, the samples were soaked in simulated body fluid solution for up to 21days. The antibacterial activity of the films was evaluated by bacterial eradication tests using Staphylococcus aureus biofilm. Scanning electron microscopy, X-ray diffraction, Raman scattering spectroscopy, and goniometry showed that homogeneous, crystalline, and hydrophilic apatite films were formed independently of the titanium dioxide concentration. Interestingly, the diamond-like films containing titanium dioxide and hydroxyapatite reduced the biofilm formation compared to controls. A synergism between hydroxyapatite and titanium dioxide that provided an antimicrobial effect against opportunistic pathogens was clearly observed.

The effect of an inhibitor of gut serotonin (LP533401) during the induction of periodontal disease.

BACKGROUND AND OBJECTIVE: LP533401 is an inhibitor of tryptophan hydroxylase 1, which regulates serotonin production in the gut. Previous work indicates that LP533401 has an anabolic effect in bone. Thus, we hypothesized that inhibition of gut serotonin production may modulate the host response in periodontal disease. In this study, we aimed to analyze the effects of LP533401 in a rat periodontitis model to evaluate the role of gut serotonin in periodontitis pathophysiology. MATERIAL AND METHODS: Twenty-four rats were divided into three groups: treated group (T: ligature-induced periodontal disease and LP533401, 25 mg/kg/d) by gavage; ligature group (L: ligature-induced periodontal disease only); and control group (C: without ligature-induced periodontal disease). After 28 d, radiographic alveolar bone support was measured on digital radiographs, and alveolar bone volume fraction, tissue mineral density and trabeculae characteristics were quantified by microcomputed tomography in the right hemi-mandible. Left hemi-mandibles were decalcified and alveolar bone loss, attachment loss and area of collagen in the gingiva were histologically analyzed. RESULTS: Significant difference between the L and C groups was found, confirming that periodontal disease was induced. We observed no difference between the T and L groups regarding alveolar bone destruction and area of collagen. CONCLUSION: LP533401 (25 mg/kg/d) for 28 d does not prevent bone loss and does not modulate host response in a rat model of induced periodontal disease.

Persea americana Glycolic Extract: In Vitro Study of Antimicrobial Activity against Candida albicans Biofilm and Cytotoxicity Evaluation.

This study evaluated the antifungal activity of Persea americana extract on Candida albicans biofilm and its cytotoxicity in macrophage culture (RAW 264.7). To determine the minimum inhibitory concentration (MIC), microdilution in broth (CLSI M27-S4 protocol) was performed. Thereafter, the concentrations of 12.5, 25, 50, 100, and 200 mg/mL (n = 10) with 5 min exposure were analyzed on mature biofilm in microplate wells for 48 h. Saline was used as control (n = 10). After treatment, biofilm cells were scraped off and dilutions were plated on Sabouraud dextrose agar. After incubation (37°C/48 h), the values of colony forming units per milliliter (CFU/mL) were converted to log10 and analyzed (ANOVA and Tukey test, 5%). The cytotoxicity of the P. americana extract was evaluated on macrophages by MTT assay. The MIC of the extract was 6.25 mg/mL and with 12.5 mg/mL there was elimination of 100% of planktonic cultures. Regarding the biofilms, a significant reduction (P < 0.001) of the biofilm at concentrations of 50 (0.580 ± 0.209 log10), 100 (0.998 ± 0.508 log10), and 200 mg/mL (1.093 ± 0.462 log10) was observed. The concentrations of 200 and 100 mg/mL were cytotoxic for macrophages, while the concentrations of 50, 25, and 12.5 mg/mL showed viability higher than 55%.

Effect of the particle size of maize, rice, and sorghum in extruded diets for dogs on starch gelatinization, digestibility, and the fecal concentration of fermentation products.

The influence of rice, maize, and sorghum raw material particle size in extruded dry dog food on the digestibility of nutrients and energy and the fecal concentration of fermentation products was investigated. Three diets with similar nutrient compositions were formulated, each with 1 starch source. Before incorporation into diets, the cereals were ground into 3 different particle sizes (approximately 300, 450, and 600 µm); therefore, a total of 9 diets were in a 3 × 3 factorial arrangement (3 cereals and 3 particle sizes). Fifty-four beagle dogs (12.0 ± 0.1 kg BW) were randomly assigned to the diets, with 6 dogs per diet. The digestibility was measured with the chromium oxide method. The data were evaluated with ANOVA considering the carbohydrate source, grinding effect, and interactions. The means were compared with the Tukey test and polynomial contrasts (P < 0.05). With the same grinding procedure, rice was reduced to smaller particles than other cereals. The cereal mean geometric diameter (MGD) was directly related to starch gelatinization (SG) during extrusion. For rice diets, the MGD and SG did not change nutrient digestibility (P > 0.05); only GE digestibility was reduced at the largest MGD (P < 0.01). For maize and sorghum diets, the total tract apparent nutrient digestibility was reduced for foods with greater MGD and less SG (P < 0.01). A linear reduction in nutrient digestibility according to cereal particle size was observed for sorghum (r2 < 0.72; P < 0.01). Higher concentrations of fecal total short-chain fatty acids (SCFA) were observed for sorghum diets (P < 0.05) than for other diets. The rice diets led to the production of feces with less lactate (P < 0.05). The increase in raw material MGD did not influence fecal SCFA for rice diets, but for the dogs fed maize and sorghum foods, an increase in propionate and butyrate concentrations were observed as MGD increased (P < 0.05). In conclusion, for dogs fed different particle sizes of the cereal starches in the extruded diets, the digestibility and fecal characteristics were affected, and this effect was ingredient dependent.

Digestibility for dogs and cats of meat and bone meal processed at two different temperature and pressure levels*.

This study evaluated the effect of two rendering processes applied to meat and bone meal (MBM) production, associated or not with extrusion, by measuring diet apparent total tract digestibility of dogs and cats, and true digestibility of amino acids (AA) by cecectomized roosters. Four diets were evaluated, with the main protein source as follows: conventional and extruded MBM; high temperature and pressure (HPT; 135 °C, 3 bar, 20 min) and extruded MBM; conventional non-extruded MBM; HPT non-extruded MBM. Nutrient digestibility and food metabolizable energy content were evaluated with dogs and cats by the method of total collection of faeces. True AA digestibility was evaluated by a precision-fed assay with cecectomized roosters. The evaluated MBM had high-ash content. The HPT process of MBM increased the digestibility of crude protein of the diets by cats, and the true digestibility of several AA by cecectomized roosters. The extrusion process did not modify the apparent total tract nutrient digestibility of MBM by dogs and their amino acid digestibility by roosters, but increased the digestibility of the dietary protein by cats. Dogs fed HPT MBM presented a higher urea post-prandial response, suggesting reductions in bioavailability and protein synthesis from absorbed AA.

Fibre analysis and fibre digestibility in pet foods--a comparison of total dietary fibre, neutral and acid detergent fibre and crude fibre.

Six dry dog foods and six dry cat foods with different carbohydrate sources were investigated in digestion trials. Food and faecal samples were analysed for CF, TDF and starch. In dogs, also neutral detergent fibre (aNDFom) and acid detergent fibre (ADFom) were analysed. N-free extract (NfE) was calculated for CF, and similarly for all other fibre analyses. Linear regressions were calculated between fibre intake and faecal fibre excretion. True digestibility was calculated from the regression coefficients [true digestibility in % = (1 - regression coefficient)*100], with the intercept of the equation representing excretion of material of non-food origin. Crude fibre analyses gave the lowest values, and TDF the highest, while ADFom and aNDFom were in between. Variation between diets was lowest in CF and highest in TDF. Total dietary fibre, aNDFom and ADFom in food were positively correlated. Crude fibre in food did not correlate with any other method. The NfE analogue for TDF was closest to the starch content. Methods of fibre analyses in faeces did not agree very well with each other. Crude fibre had the lowest apparent digestibility, followed by ADFom, TDF and aNDFom. For all fibre analyses, there was a significant correlation between fibre intake and faecal fibre excretion. True digestibility was close to zero for CF, with a high uniformity in both species. In dogs, true digestibility of aNDFom was 53%, of ADFom 26% and of TDF 37%; in cats, true digestibility of TDF was 31%. Except for CF, the intercept of the regression equations suggest that faecal excretion of some material of non-food origin is analysed as fibre. A combination of TDF and CF analyses might give good information on the content of total (TDF), unfermentable (CF) and partially fermentable fibre (TDF-CF) in pet foods.

The role of magnesium sulfate in prevention of seizures induced by pentylenetetrazole in rats / O papel do sulfato de magnésio na prevenção de crises induzidas por pentilenotetrazol em ratos

Magnesium sulfate (MgSO4) has been used to prevent seizures in eclampsia. This study examined the central effects of MgSO4 on different types of pentylenetetrazole (PTZ)-induced seizures. Male Wistar rats were submitted to intracerebroventricular (ICV) administration of MgSO4 at different doses followed by intraperitoneal administration of PTZ. The latency to the onset of the first seizure induced by PTZ was significantly increased by ICV administration of MgSO4 at a dose of 100 µg compared to the control treatment. In addition, the total period during which animals presented with seizures was significantly reduced at this dose of MgSO4. Furthermore, the latency to the onset of the first partial complex seizure was significantly increased by the lowest dose of MgSO4. However, a high dose of MgSO4 had no effect or even potentiated the effect of PTZ. These results suggest that, depending on the dose, MgSO4 may be important in prevention of epileptic seizures.

Sulfato de magnésio (MgSO4) é utilizado para prevenir crises epilépticas na eclampsia. Este estudo examina os efeitos do MgSO4 em diferentes tipos de crise induzidas por pentilenotetrazol (PTZ). Ratos Wistar foram submetidos à administração intracerebroventricular (ICV) de diferentes doses de MgSO4 seguida de administração intraperitoneal de PTZ. A latência para o início da primeira crise induzida por PTZ foi aumentada pela administração ICV de MgSO4 na dose de 100 µg quando comparada ao tratamento controle. Além disso, o período durante o qual os animais apresentaram crises foi reduzido com a mesma dose de MgSO4. A latência para o início da primeira crise parcial complexa também foi aumentada com a dose menor de MgSO4 (32 µg). No entanto, a maior dose (320 µg) de MgSO4 não foi efetiva ou até potencializou os efeitos do PTZ. Esses resultados sugerem que, dependendo da dose, o MgSO4 pode ser útil na prevenção de crises epilépticas.

Nutrient digestibility, but not mineral absorption, is age-dependent in cats.

Availability of nutrients is influenced by extremes of age, and a better characterization of this influence is necessary for appropriate development of foods and nutritional management throughout life stages of cats. This study investigated nutrient digestibility, mineral absorption, faeces and urine production in three groups of six young, mature and old cats fed two diets containing different energy densities. Apparent digestibility and mineral absorption were calculated by total collection method and values were tested with anova and regression analysis. A quadratic relationship was detected between age and digestibility of dry matter, organic matter, crude protein, acid-hydrolysed fat and starch in the low-energy diet. Starch digestibility showed the same response in the high-energy diet. Young adult cats had intermediate digestibility, mature cats the highest and old cats the lowest. Mineral absorption (calcium, phosphorus, magnesium, sodium, potassium and chloride) and urinary pH were not different among groups. These findings confirm previous studies that found low digestibility of nutrients in some old cats, and support evidence that this trend is even more important in less digestible dry foods. On the contrary, data suggest that mineral formulations do not need to be varied in diets for adult cats of different ages.

Effects of six carbohydrate sources on dog diet digestibility and post-prandial glucose and insulin response.

The effects of six extruded diets with different starch sources (cassava flour, brewer's rice, corn, sorghum, peas or lentils) on dog total tract apparent digestibility and glycemic and insulinemic response were investigated. The experiment was carried out on thirty-six dogs with six dogs per diet in a completely randomized design. The diets containing brewer's rice and cassava flour presented the greatest digestibility of dry matter, organic matter and gross energy (p < 0.05), followed by corn and sorghum; pea and lentil diets had the lowest. Starch digestibility was greater than 98% in all diets and was greater for brewer's rice and cassava flour than for lentils and peas diets (p < 0.05). Dogs' immediate post-prandial glucose and insulin responses (AUC < or = 30 min) were greater for brewer's rice, corn, and cassava flour diets (p < 0.05), and later meal responses (AUC > or = 30 min) were greater for sorghum, lentil and pea diets (p < 0.05). Variations in diet digestibility and post-prandial response can be explained by differences in chemical composition of each starch source including fibre content and starch granule structure. The nutritional particularities of each starch ingredient can be explored through diet formulations designed to modulate glycemic response. However, more studies are required to support these.

Protein requirements for Blue-fronted Amazon (Amazona aestiva) growth.

The objective of this study was to evaluate the protein requirements for hand-rearing Blue-fronted Amazon parrots (Amazona aestiva). Forty hatchlings were fed semi-purified diets containing one of four (as-fed basis) protein levels: 13%, 18%, 23% and 28%. The experiment was carried out in a randomized block design with the initial weight of the nestling as the blocking factor and 10 parrots per protein level. Regression analysis was used to determine relationships between protein level and biometric measurements. The data indicated that 13% crude protein supported nestling growth with 18% being the minimum tested level required for maximum development. The optimal protein concentration for maximum weight gain was 24.4% (p = 0.08; r(2) = 0.25), tail length 23.7% (p = 0.09; r(2) = 0.19), wing length 23.0% (p = 0.07; r(2) = 0.17), tarsus length 21.3% (p = 0.06; r(2) = 0.10) and tarsus width 21.4% (p = 0.07; r(2) = 0.09). Tarsus measurements were larger in males (p < 0.05), indicating that sex must be considered when studying developing psittacines. These results were obtained using a highly digestible protein and a diet with moderate metabolizable energy levels.

Effects of six carbohydrate sources on diet digestibility and postprandial glucose and insulin responses in cats.

The effects of diets with different starch sources on the total tract apparent digestibility and glucose and insulin responses in cats were investigated. Six experimental diets consisting of 35% starch were extruded, each containing one of the following ingredients: cassava flour, brewers rice, corn, sorghum, peas, or lentils. The experiment was carried out on 36 cats with 6 replications per diet in a completely randomized block design. The brewers rice diet offered greater DM, OM, and GE digestibility than the sorghum, corn, lentil, and pea diets (P < 0.05). For starch digestibility, the brewers rice diet had greater values (98.6%) than the sorghum (93.9%), lentil (95.2%), and pea (96.3%) diets (P < 0.05); however, starch digestibility was >93% for all the diets, proving that despite the low carbohydrate content of carnivorous diets, cats can efficiently digest this nutrient when it is properly processed into kibble. Mean and maximum glucose concentration and area under the glucose curve were greater for the corn-based diet than the cassava flour, sorghum, lentil, and pea diets (P < 0.05). The corn-based diets led to greater values for the mean glucose incremental concentration (10.2 mg/dL), maximum glucose incremental concentration (24.8 mg/dL), and area under the incremental glucose curve (185.5 mg.dL(-1).h(-1)) than the lentil diet (2.9 mg/dL, 3.1 mg/dL, and -40.4 mg.dL(-1).h(-1), respectively; P < 0.05). When compared with baseline values, only the corn diet stimulated an increase in the glucose response, occurring at 4 and 10 h postmeal (P < 0.05). The corn-based diet resulted in greater values for maximum incremental insulin concentration and area under the incremental insulin curve than the lentil-based diet (P < 0.05). However, plasma insulin concentrations rose in relation to the basal values for cats fed corn, sorghum, pea, and brewers rice diets (P < 0.05). Variations in diet digestibility and postprandial response can be explained by differences in the chemical composition of the starch source, including fiber content and granule structure, and also differences in the chemical compositions of the diets. The data suggest that starch has less of an effect on the cat postprandial glucose and insulin responses than on those of dogs and humans. This can be explained by the metabolic peculiarities of felines, which may slow and prolong starch digestion and absorption, leading to the delayed, less pronounced effects on their blood responses.

Utilização de indicadores para estimar a digestibilidade aparente em gatos / Use of markers to estimate the apparent digestibility in domestic cats

Compararam-se os métodos de coleta total (CT) e dos indicadores óxido crômico (Cr2O3), cinzas insolúveis em ácido (CIA) e lignina na determinação dos coeficientes de digestibilidade aparente (CDA) dos nutrientes para gatos. Os CDA de quatro rações foram determinados pela CT e estimados pelos diferentes indicadores em teste. Foram utilizados 24 gatos adultos castrados, alojados em gaiolas metabólicas individuais, totalizando seis animais por ração. O experimento seguiu um delineamento inteiramente ao acaso, em parcelas subdivididas, sendo as rações as parcelas, os métodos as subparcelas e cada gato uma unidade experimental. Os CDA foram significativamente menores pelo método da lignina em uma das rações estudadas (P<0,05). Os métodos Cr2O3, CIA e CT resultaram em CDA iguais em todas as rações (P>0,05). As taxas de recuperação dos indicadores, médias±erro-padrão da média, foram, respectivamente, de 97,1±2,5 por cento, 97,3±2,9 por cento e 83,9±9,1 por cento para o Cr2O3, CIA e lignina. A CIA e o Cr2O3 mostraram grande potencial para utilização como indicadores, enquanto a ampla variabilidade dos resultados obtidos com a utilização da lignina não justificou seu emprego como substância índice para felinos.

The total collection (TC) method was compared to chromium oxide (Cr2O3), acid-insoluble ash (AIA) and lignin marker methods for determining the coefficients of apparent digestibility (CAD) of nutrients in domestic cats. The CAD of four diets were determined by TC and estimated for the three markers through tests. Twenty-four adult neutered cats were housed in individual metabolic cages, totaling six animals per diet. The experiment was carried out using a completely randomized design in subdivided blocks where diets were blocks, methods were sub-blocks and each cat an experimental unit. CAD for the lignin method was significantly lower than TC method (P<0.05) in one of the studied diets. CAD for the Cr2O3, AIA and TC methods were similar in all diets. Recuperation rates of Cr2O3, AIA and lignin markers were 97.1±2.5 percent, 97.3±2.9 percent and 83.9±9.1 percent respectively. AIA and Cr2O3 methods showed high potential for use as markers while the higher variability in results obtained with the use of lignin did not justify its usage as an indicator substance for felines.

Critical analysis of the international classification of headache disorders diagnostic criteria (ICHD I-1988) and (ICHD II-2004), for migraine in children and adolescents.

The present study analyzed the (ICHD I-1988) and (ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis (Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity (S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria (ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

Structural resistance in immature teeth using root reinforcements in vitro.

The purpose of this study was to evaluate in vitro the efficacy of root reinforcements by light-cured composite resin or zirconium fiber post in simulated immature non-vital teeth. Fifty-six bovine incisors teeth were used for this study. The crown of each tooth was removed in the medium third to obtain a standard length of 30 mm. The specimens were divided into four groups (n = 14): G1) the root canals were instrumented and enlarged to simulate immature non-vital teeth and were reinforced with a light-cured composite resin using a translucent curing post (Luminex system); (G2) the specimens were instrumented, enlarged and they received root reinforcement with zirconium fiber post; G3 (positive control): they received similar treatment to the G1 and G2 groups, but did not receive root reinforcement; G4 (negative control): the roots were not weakened and did not receive reinforcement. Every tooth was submitted to compressive force using an Instron testing machine with an angle of 45 degrees at a speed of 1 mm min(-1) until the fracture. The results showed a markedly increased resistance to fracture in the G1 and G2 (122.38 and 122.08 kg f, respectively). Among the results of G1 and G2 there was not any significant difference (P > 0.05) but they were significantly different from the control groups (P < 0.05). The conclusion is that the use of root reinforcements with zirconium fiber post or composite resin can increase significantly the structural resistance of the weakened teeth, decreasing the risk of the fracture.

In vitro effects of calcium hydroxide and polymyxin B on endotoxins in root canals.

OBJECTIVES: To evaluate the effects of intracanal medicaments on endotoxins in root canals. METHODS: Seventy-five freshly extracted maxillary incisors were used in this study. The crowns of teeth were sectioned near the CEJ in order to standardize the root length to 14 mm. The root canals were instrumented to an apical size #50 file and irrigated with 1% sodium hypochlorite solution and sterilized with 60Co gamma irradiation. Standardized suspension containing Escherichia coli endotoxin was inoculated into the 60 root canals. The specimens were randomly assigned to 5 groups (n=15), according to the intracanal medicament used: (G1) calcium hydroxide; (G2) polymyxin B; (G3) combination neomycin-polymyxin B-hydrocortisone; (G4) positive control (no intracanal medicament); (G5) negative control (no endotoxin and no intracanal medicament). After 7 days, the detoxification of endotoxin was evaluated by Limulus lysate assay and antibody production in B-lymphocytes culture. RESULTS: Groups 1, 2 and 5 presented the best results by Limulus lysate and were significantly different to groups 3 and 4 (p<0.05). Stimulation of antibodies production in cell culture by groups 1 and 6 was smaller and statistically different than groups 2, 3, 4 and 5 (p<0.05). Groups 2 and 5 induced a small increase in the antibodies production in relation to the groups 1 and 6. Groups 3 and 4 induced a significant increase of antibodies production (p<0.05). CONCLUSIONS: The calcium hydroxide and polymyxin B intracanal medicaments detoxified endotoxin in root canals and altered the properties of LPS to stimulate the antibody production by B-lymphocytes. The combination neomycin-polymyxin B-hydrocortisone did not detoxified endotoxin.

Persistent Sydenham's chorea.

BACKGROUND: Sydenham's chorea (SC) occurs in 26% of patients with rheumatic fever (RF). Despite usually being described as a self-limited condition, few reports indicate that SC may persist in rare subjects. OBJECTIVE: To investigate the proportion of subjects with SC lasting more than 2 years and if clinical features differentiate patients with SC with a duration of less than 2 years (Group 1) from those with SC lasting more than 2 years (Group 2). METHODS: Prospective assessment of all patients with SC seen at our service from July 1993 through March 1998 analyzing the following: gender; age at onset; frequency of arthritis, carditis, family history of RF and SC; topographic distribution; and chorea severity on a 0-4 scale. RESULTS: Thirty-two patients (19 female, 13 male) were studied. In Group 1 (16 subjects, 50%) the follow-up period was 36.2 +/- 20.0 months; 50% were female; age at onset was 10.9 +/- 2.6 years; arthritis and carditis were present in 37.5% and 31.2%, respectively; family history of SC was reported by 18.7%; hemichorea was seen in 25.8% of subjects; and the mean intensity of chorea was 2.6 +/- 0.8. In Group 2, with a follow-up period of 34.1 +/- 18.9 months, 68.8% were female; age at onset was 9.3 +/- 3.9 years; arthritis and carditis were diagnosed in 18.7% and 50%, respectively; no patient reported a family history of SC; hemichorea was observed in 6.2% of subjects; and the mean intensity of chorea was 2.8 +/- 0.5. No difference was statistically significant. CONCLUSIONS: SC persists in half of our patients. Female gender, possibly related to endocrine factors, as well as the presence of carditis, indicating a more severe disease, may be risk factors for a longer duration of SC.

Hemifacial spasm and arterial hypertension.

BACKGROUND: Hemifacial spasm (HFS) is a form of segmental myoclonus often associated with vascular compression of the seventh nerve at its exit in the brain stem. Although a few uncontrolled studies describe the association of arterial hypertension (AH) with HFS, their relationship remains to be elucidated. OBJECTIVES: To compare the clinical and radiologic features of patients with HFS and subjects with blepharospasm (BLS) with special emphasis on the presence of AH. MATERIAL AND METHODS: Chart review of all patients with HFS and BLS seen at a hospital-based movement disorders clinic from July 1993 through March 1998, analyzing the following parameters: gender, age at onset, frequency of AH, and abnormalities on computerized tomography (CT) or magnetic resonance imaging (MRI) studies. Neuroimaging studies (52 CT and 14 MRI) were performed in 45 subjects with HFS and in 21 with BFS. All patients were examined by one of the authors (FC). RESULTS: HFS and BLS were diagnosed in 48 (31 women, 17 men) and 34 (28 women, 6 men) patients, respectively. The age at onset was 50.1 +/- 12.6 years in HFS and 50.3 +/- 16.5 years in BLS. AH was diagnosed in 32 (66.7%) subjects with HFS and in 13 (38.2%) patients with BLS (chi-square p = 0.01). Neuroimaging evidence of vascular tortuosity in the cerebello-pontine angle was identified in 16 (25.4%) patients, all of whom had HFS (38.1%). Thirteen of 37 patients with AH who had imaging studies displayed vascular tortuosity in the cerebello-pontine angle (chi-square p = 0.01). CONCLUSIONS: AH is significantly more common in HFS than in BLS. AH is related to vascular tortuosity in the cerebello-pontine angle. Our findings suggest that AH may be an important risk factor for HFS.