Use of diffusion tensor imaging as a prognostic biomarker after decompression surgery for carpal tunnel syndrome.

BACKGROUND: Magnetic resonance diffusion tensor imaging (MR-DTI) has been increasingly applied for carpal tunnel syndrome (CTS) diagnosis, but relatively little is known about the effect of CTS treatment on median nerve (MN) integrity and functional outcome prediction. PURPOSE: To assess how structural changes in MR-DTI of the MN correlates with symptom severity, functional status, and electrophysiological parameters in patients suffering from CTS before and after decompression surgery. MATERIAL AND METHODS: Nine wrists were prospectively enrolled to perform MR-DTI pre- and postoperatively. The apparent diffusion coefficients (ADC) and fractional anisotropy (FA) of the MN were examined in three different regions-distal radioulnar joint, pisiform bone, and hamate bone-and correlated with clinical and electrophysiological parameters. RESULTS: Postoperatively, mean Boston Carpal Tunnel Questionnaire scores decreased 1.55 points (range = 0.08-3; P = 0.0172) and 1.01 points (-0.13 to 1.88; P = 0.0381) in the symptomatic and functional domains, respectively. Postoperative clinical improvement was reflected in proximal FA elevation (P = 0.0078), but not in diffusivity in comparison to baseline examination. Preoperative electrophysiological parameters were correlated with a reduction in the pre- (sensory latencies [rho = -0.6826; P = 0.0312]) and postoperative (motor latencies [rho = -0.7488; P = 0.0325]) distal FA values. Higher sensory amplitudes indicated higher postoperative proximal FA values (rho = 0.7618; P = 0.0280) ​​and lower postoperative proximal ADC values (rho = -0.9047; P = 0.0020). CONCLUSION: Our study demonstrated that pre- and postoperative proximal FA values are useful biomarkers for the structural evaluation of the MN in patients with CTS. Symptomatic improvement can be better predicted by analyzing FA changes.

Comparação de enxerto de tecido conjuntivo e membrana de fibrina rica em plaquetas (PRF) no aumento de espessura de tecido mole peri-implantar: reanálise de dados de ensaios clínicos randomizados / Comparison of conjunctive tissue graft and platelet-rich fibrine membrane (PRF) in the increase in peri-implant soft tissue thickness. Reanalysis of data from randomized controlled trials

O implante dentário é uma importante ferramenta para se obter resultados estéticos e funcionais em pacientes com ausências dentárias, porém é observado que a falta de tecido mole peri-implantar é frequente e pode levar a diversos problemas, como maior reabsorção de crista óssea e maior risco de recessão peri-implantar. Estudos anteriores demonstraram a eficácia de técnica como enxerto de tecido conjuntivo (CTG) que é considerado padrão ouro no aumento de tecido mole peri-implantar em região anterior de maxila. No entanto, a utilização de enxerto de tecido conjuntivo apresenta algumas limitações descrita na literatura, como maior desconforto pósoperatório e quantidade limitada de enxerto. Portanto, outras formas de enxerto de tecido mole para aumento de espessura do tecido periimplantar devem ser investigadas. Bons resultados foram obtidos quando utilizamos fibrina rica em plaquetas (PRF) para o tratamento de diversas condições periodontais e periimplantares. Sendo assim, o objetivo desse estudo é comparar a utilização de PRF com o CTG para aumento da espessura de tecido mole peri-implantar quando colocados simultaneamente a implantes unitários em área estética de maxila. Trinta pacientes advindos de dois estudos clínicos randomizados prévios do presente grupo de pesquisa foram reanalisados. Parâmetros clínicos foram mensurados por um avaliador cego e calibrado em baseline e 4 meses. As seguintes medidas foram avaliadas: espessura do tecido mole periimplantar em vestibular (ETQv) e na oclusal (ETQo) do implante instalado, defeito do rebordo (DR) e altura do tecido queratinizado (ATQ). Além disso, medidas transoperatórias foram reanalisadas. Frente aos resultados observados, o uso do CTG favoreceu melhores resultados em ETQv (3,09mm) e DR (0,27mm) após 4 meses, quando comparado ao PRF, ETQv (2,55mm) e DR (1,26mm). Em adição, avaliações frente à parâmetros centrados no paciente evidenciaram similaridade no desconforto pós-operatório e número de analgésicos utilizados. Conclui-se que os dois grupos apresentaram aumento de espessura do tecido periimplantar, porém o CTG demonstrou maior ganho relativo, até o período de acompanhamento preconizado (AU)

The dental implant is an important tool to obtain aesthetic and functional results in patients with missing teeth, however, it is observed that the lack of peri-implant soft tissue is frequent and can lead to several problems, such as greater bone crest resorption and greater risk peri-implant recession. Previous studies have demonstrated the effectiveness of a technique such as connective tissue grafting (CTG), which is considered the gold standard in the increase of peri-implant soft tissue in the anterior region of the maxilla. However, the use of connective tissue graft has some limitations described in the literature, such as greater postoperative discomfort and limited amount of graft. Therefore, other forms of soft tissue grafting to increase peri-implant tissue thickness should be investigated. Good results were obtained when using platelet-rich fibrin (PRF) for the treatment of various periodontal and peri-implant conditions. Therefore, the aim of this study is to compare the use of PRF with CTG to increase peri-implant soft tissue thickness when placed simultaneously with single implants in the esthetic area of the maxilla. Thirty patients from two previous randomized clinical trials of the present research group were reanalyzed. Clinical parameters were measured by a blinded evaluator and calibrated at baseline and 4 months. The following measurements were evaluated: peri-implant soft tissue thickness in the labial (ETQv) and occlusal (ETQo) of the installed implant, ridge defect (RD) and height of the keratinized tissue (ATQ). In addition, intraoperative measurements were reanalyzed. In view of the observed results, the use of CTG favored better results in ETQv (3.09mm) and RD (0.27mm) after 4 months, when compared to PRF, ETQv (2.55mm) and RD (1.26mm). In addition, evaluations against patient-centered parameters showed similarity in postoperative discomfort and number of analgesics used. It was concluded that both groups showed an increase in periimplant tissue thickness, but the CTG showed a greater relative gain, until the recommended follow-up period (AU)

Bats from the Pedra Branca Forest, Rio de Janeiro, Brazil.

The Pedra Branca Forest is located in a highly-urbanised region of the central portion of Rio de Janeiro City, comprises the largest urban forest on the continent and is isolated from other Atlantic Forest remnants. The local flora and fauna are protected by three conservation units (Pedra Branca State Park, Prainha Municipal Natural Park and Guaratiba State Biological Reserve) and one biological station (Fiocruz Atlantic Forest Biological Station-EFMA). Here, we provide an updated list of the bat fauna for the remnant. The results are based on samplings at EFMA and literature data from Pedra Branca State Park and Prainha Natural Park. The three sampling sites combined resulted in 31 species, 23 genera and four families. Phyllostomidae was the richest family with 24 species, followed by Vespertilionidae with five species (3%) and Molossidae and Noctilionidae with one species. The local bat fauna was predominantly composed of species with a broad geographic distribution.

Isolation and characterization of trypanosomatids, including Crithidia mellificae, in bats from the Atlantic Forest of Rio de Janeiro, Brazil.

We studied infection by Trypanosomatidae in bats captured in two areas with different degradation levels in the Atlantic Forest of Rio de Janeiro state: Reserva Ecológica de Guapiaçu (REGUA) and Estação Fiocruz Mata Atlântica (EFMA). Furthermore, we evaluated whether the diversity of trypanosomatids changes according to bat diversity and the different levels of preservation in the region. The results showed no influence of the level of preservation on bat species richness (15 and 14 species, respectively), with similar chiropterofauna and higher abundance of two common fruit-eating bat species in the tropics: Carollia perspicillata and Artibeus lituratus. Of the 181 bat specimens analyzed by LIT/Schneider hemoculture, we detected 24 infected individuals (13%), including one positive Sturnira lilium individual that was also positive by fresh blood examination. Molecular characterization using nested PCR targeting the 18 SSU rRNA-encoding gene fragment showed similar trypanosomatid infection rates in bats from the two areas: 15% in REGUA and 11% in EFMA (p = 0.46). Trypanosoma dionisii was the most frequently detected parasite (54%), followed by T. cruzi DTUs TcI and TcIV and Trypanosoma sp., in Neotropical phyllostomid bats (RNMO63 and RNMO56); mixed infections by T. dionisii/T. cruzi TcIII and T. dionisii/T. cruzi TcI were also observed. The T. cruzi DTUs TcI and TcIV are the genotypes currently involved in cases of acute Chagas disease in Brazil, and T. dionisii was recently found in the heart tissue of an infected child. Surprisingly, we also describe for the first time Crithidia mellificae, a putative monoxenous parasite from insects, infecting a vertebrate host in the Americas. Bats from the Atlantic Forest of Rio de Janeiro state harbor a great diversity of trypanosomatids, maintaining trypanosomatid diversity in this sylvatic environment.

Karyotype of three Lonchophylla species (Chiroptera, Phyllostomidae) from Southeastern Brazil.

Lonchophylla Thomas, 1903 is a Neotropical bat genus that comprises 12 species, with little cytogenetic information available. Here we present the description of the karyotype of three species collected in Southeastern Brazil. Lonchophylla bokermanni Sazima, Vizotto & Taddei, 1978, Lonchophylla dekeyseri Taddei, Vizotto & Sazima, 1983, and Lonchophylla peracchii Dias, Moratelli & Esberard, 2013 showed the same diploid number 2n = 28 and the same autosomal fundamental number FNa = 50, in both Lonchophylla bokermanni and Lonchophylla peracchii. We observed that the karyotypes were also cytogenetically similar when we compared the studied species with other species within the same genus. It is therefore not possible to differentiate the species using only karyotypes with conventional staining. However, this information increases the knowledge of the genus and can be one more important character for a better phylogenetic comprehension of this taxon.

First evidence of frugivory in Myotis (Chiroptera, Vespertilionidae, Myotinae).

BACKGROUND: Myotis occurs from tropical to temperate regions throughout the globe, and it is the largest bat genus with more than 100 species. Most species are insect-eaters, but a few also feed on other invertebrates and fishes; there is no confirmed evidence of a plant item in their diet. NEW INFORMATION: During fieldwork in the Brazilian Atlantic Forest, small seeds were retrieved from the feces of one adult female of the Black Myotis, Myotis nigricans-one of the most common Neotropical bats. In a germination experiment, 40% of those seeds grew into seedlings. Our findings are the first evidence of fruit consumption for any Myotis species. We reject a possible contamination because the cotton bag was never used before for bats. This study is the first evidence of frugivory in the genus Myotis.