Biometric parameters of the temporomandibular joint and association with disc displacement and pain: a magnetic resonance imaging study.

The aim of this study was to evaluate the relationship between biometric parameters of the components of the temporomandibular joint (TMJ), articular disc displacement, and TMJ pain. Magnetic resonance imaging (MRI) examinations of 185 patients were assessed (39 males and 146 females (370 TMJs), mean age 41.3 years, range 18-79 years). The antero-posterior length of the condyle was measured in its medial and lateral regions, as well as the transverse length of the condyle. Possible associations between linear measurements of the condyle, presence of disc displacement, and joint pain were tested. Although pain was more commonly reported among patients with disc displacements, this association was not statistically significant. We found statistically significant associations showing that the antero-posterior length of the condyle at the lateral pole (D1L), the antero-posterior length of the condyle at the medial pole (D1M), and the transverse length of the condyle (D2) were higher among patients without disc displacements when compared to those with unilateral or bilateral displacements. This study showed that disc displacement was associated with smaller condyles in the antero-posterior and transverse dimensions when compared to condyles in subjects with normal disc position.

Evaluation of panoramic radiomorphometric indices related to low bone density in sickle cell disease.

SUMMARY: In sickle cell disease, erythroid hyperplasia causes trabecular destruction leading to low bone density. This condition could be suspected by the radiomorphometric indices and your diagnosis becomes relevant in a multidisciplinary context of health care for sickle cell subjects, providing prognostics and contributing to determine adequate therapeutic and preventive actions. INTRODUCTION: The aim of this study was to assess the risk of low bone density in subjects with sickle cell disease (SCD) through analysis of panoramic radiographic exams by radiomorphometric indices. METHODS: Seventy-eight Brazilian subjects with SCD took part in this study and were subdivided into four groups: (I) 31 SCD subjects aged under 40 years; (II) 13 SCD subjects aged 40 years or more; (III) 12 normal subjects aged under 40 years; and (IV) 22 normal subjects aged 40 years or more. In the panoramic radiographs, the mandibular cortical index (MCI) classification, increased spacing of the trabecular bone, panoramic mandibular index (PMI), and mental index (MI) were evaluated. Exact Fisher's test was used to compare age between the different groups. Descriptive analysis of the data was performed to evaluate the simple visual estimation of low bone density (increased bone trabecular space and MCI), and a one-way analysis of variance (Bonferroni criteria) was used to compare the means of the quantitative indices (PMI and MI). The significance level was p < 0.05. RESULTS: In the MCI classification, C2 was more prevalent, especially in groups I and IV. Increased spacing of the trabecular bone was more frequent in groups I and II. MI did not show a statistically significant difference among the groups. PMI showed a statistically significant difference only between groups III and IV. CONCLUSIONS: The radiomorphometric indices applied in the present study can be used on panoramic radiographs to detect the presence of low bone density in SCD subjects.

Hybrid lesion: central giant cell granuloma and benign fibro-osseous lesion.

Hybrid lesions comprise elements of different pathologies in one lesion. Hybrid lesions comprising central giant cell granulomas (CGCG) with fibro-osseous components are rare, with only six maxillomandibular cases reported in the literature. We report a case of a hybrid lesion in a 38-year-old woman who presented with a swelling in the mandibular parasymphysis, on the left side. Panoramic and occlusal radiographs and CT showed a mixed lesion with expansion of the buccal cortical plate that pointed to the diagnosis of ossifying fibroma (OF). Complete excision of the lesion was performed, and the anatomopathological examination showed features of both CGCG and a fibro-osseous lesion. Clinical, imaging and histopathological features indicate a hybrid lesion of CGCG and OF. The patient remains asymptomatic after 30 months of follow-up.

Surface complexation modeling of uranium(VI) sorbed onto zirconium oxophosphate versus temperature: thermodynamic and structural approaches.

This work presents an investigation of the interaction mechanisms between uranyl ions and a solid phosphate, the zirconium oxophosphate: Zr2O(PO4)2. Both thermodynamic and structural points of view are developed. Indeed, prior to any simulation of the retention data, it is necessary to precisely characterize the system under study in order to gain information at a molecular scale. First, the intrinsic surface properties of this synthetic compound have been investigated for different temperatures ranging from 25 to 90 degrees C. Mass and potentiometric titrations show that the surface site density remains constant between 25 and 90 degrees C, while the experimental point of zero charge slightly decreases from 4.8 to 4.5 with an increasing temperature. The potentiometric titration data are simulated, for each temperature, using the constant capacitance model and taking into account two surface sites ([TRIPLE BOND]ZrO and [TRIPLE BOND]PO) with a total surface site density equal to 7.0 sites nm(-2). For both reactive sites, the intrinsic protonation constants do not change with the temperature, while the deprotonation ones increase. These results led to the determination of the associated enthalpy and entropy changes according to the van't Hoff relation. Second, the speciation of U(VI) at the solid/solution interface has been studied using two complementary spectroscopic techniques probing the sorbed uranyl ions: time-resolved laser-induced fluorescence spectroscopy (TRLFS) and X-ray absorption spectroscopy (EXAFS). The substrate presents two different reactive surface sites against uranium retention, which are constituted by the oxygen atoms of the surface PO4 groups and the oxygen atoms linked to the zirconium atoms. Two inner-sphere complexes are thus present on the substrate, their relative proportion depending on the pH value of the suspension. The effects of the temperature (25-90 degrees C) on the surrounding uranium were checked using the TRLFS technique. The uranyl sorption constants onto the Zr2O(PO4)2 substrate were determined taking into account the structural investigation. The surface complexation modeling was performed using the constant capacitance model included in the FITEQLv4.0 code. The four adsorption edges obtained at 25, 50, 75, and 90 degrees C were simulated. The modeling of these experimental data was realized considering two surface complexes (([TRIPLE BOND]ZrOH)2UO(2+)2, ([TRIPLE BOND]PO)2UO2) according to the structural investigation. The constant value associated with the ZrO site does not change with the temperature, while the one corresponding to the PO site increases. Finally, the enthalpy and entropy changes associated with the uranyl sorption constants have been determined using the van't Hoff relation.

Acute immune and non-immune inflammatory response in spontaneously hypertensive rats and normotensive rats. Role of endogenous nitric oxide.

UNLABELLED: The present study investigated the acute inflammatory response (increase in vascular permeability and leukocytes migration) in the pleura of spontaneously hypertensive rats (SHR) and normotensive rats (NTR), using two different stimulus: carrageenan and active anaphylaxis. In addition, the role of endogenous nitric oxide in these responses was investigated. RESULTS: The inflammatory response induced by intrapleural carrageenan injection in SHR developed similarly to that in NTR. Treatment with L-NAME, reduced the intensity of this response in both groups of rats. The inflammatory response induced by active anaphylaxis in SHR and NTR was different. The increase in vascular permeability occurred later in the SHR compared to NTR. The number of leukocyte present in inflammatory exudates was increased at 4 h in both groups of rats. L-NAME treatment did not inhibit exudation at the intervals under analysis, however, reduced the number of mononuclear cells in the inflammatory exudate of SHR. CONCLUSION: The development of the inflammatory response in SHR differs from that in NTR, depending on the nature of the inflammatory stimulus. Endogenous NO plays a clear role in carrageenan-induced inflamma-tion, but not in immunologically mediated inflammation in the analyzed period.

[Fulminant course of amniotic fluid embolism]. / Embolismo de líquido amniótico con evolución fulminante.

Amniotic fluid embolism is an obstetric complication that can present during pregnancy or labor and is associated with high rates of morbidity and mortality. The incidence is low but the mortality rates for both mother and fetus are high. A 34-year-old woman in the 41st week of gestation was admitted for induction of labor. While still in the labor room, she complained of pruritus around the mouth and tongue. Tonic-clonic convulsions, hypotension, and loss of consciousness followed. Cardiopulmonary resuscitation maneuvers were started and an immediate cesarean section under general anesthesia was performed to deliver a live infant boy. The Apgar score at 5 minutes was 8. The mother was transferred for recovery to the intensive care unit (ICU), where rapid cardiocirculatory and pulmonary decline continued. After 2 episodes of electromechanical dissociation, exitus occurred 2 hours after ICU admission. The autopsy confirmed the diagnosis of amniotic fluid embolism. Keratin squames were found in the capillaries of both lungs and polymorphonuclear cells and proteinaceous material were observed in alveoli. Mechanical obstruction is not the only cause of amniotic fluid embolism. Circulating substances that affect myocardial contractility and coagulation are also implicated and the cause may even be an allergic reaction. The usual signs are acute respiratory failure, cardiovascular collapse, and occasionally convulsions and coagulopathy. Cardiac arrest occurs in 80% of the cases. Treatment is symptomatic to provide life-sustaining measures in response to the clinical picture as it develops.

Embolismo de líquido amniótico con evolución fulminante / Fulminant course of amniotic fluid embolism

El embolismo de líquido amniótico (ELA) es una complicaciónobstétrica con una elevada morbimortalidadque puede presentarse tanto durante el embarazo comoen el parto. Su incidencia es escasa, mientras que tantola mortalidad materna como la fetal permanecen aúnmuy elevadas.Gestante de 34 años y 41 semanas que ingresa parainducción de parto. En la Sala de Dilatación nota pruritoen área peribucal y lengua y seguidamente convulsionestónico-clónicas, hipotensión y pérdida de consciencia.Se realizan maniobras de reanimación cardiopulmonare inmediatamente, bajo anestesia general, sepráctica una cesárea obteniéndose un recién nacido vivocon Apgar de 8 a los 5 minutos. En el postoperatorio setraslada a la paciente a UCI, donde prosigue el deteriorocardiocirculatorio y respiratorio, de manera rápidamenteprogresiva y, tras dos episodios de disociaciónelectromecánica, es éxitus a las 2 horas. La necropsiaconfirmó posteriormente el cuadro como ELA, encontrándoseláminas de queratina en la luz capilar deambos pulmones, con polimorfonucleares y materialproteináceo en la luz alveolar.Se sabe que el ELA no es consecuencia únicamente deuna obstrucción mecánica sino que influyen también unaserie de sustancias humorales liberadas que afectan a lacontractilidad miocárdica, a la coagulación, llegandoincluso a una reacción de hipersensibilidad. La clínicahabitual consiste en una insuficiencia respiratoria aguda,colapso cardiovascular y en ocasiones convulsiones y coagulopatíaque en el 80% de los casos desemboca en unaparada cardiaca. El tratamiento es sintomático y desoporte vital en función de la clínica predominante encada momento

Amniotic fluid embolism is an obstetric complicationthat can present during pregnancy or labor and is associatedwith high rates of morbidity and mortality. Theincidence is low but the mortality rates for both motherand fetus are high.A 34-year-old woman in the 41st week of gestationwas admitted for induction of labor. While still in thelabor room, she complained of pruritus around themouth and tongue. Tonic-clonic convulsions, hypotension,and loss of consciousness followed. Cardiopulmonaryresuscitation maneuvers were started and animmediate cesarean section under general anesthesiawas performed to deliver a live infant boy. The Apgarscore at 5 minutes was 8. The mother was transferredfor recovery to the intensive care unit (ICU), whererapid cardiocirculatory and pulmonary decline continued.After 2 episodes of electromechanical dissociation,exitus occurred 2 hours after ICU admission. Theautopsy confirmed the diagnosis of amniotic fluid embolism.Keratin squames were found in the capillaries ofboth lungs and polymorphonuclear cells and proteinaceousmaterial were observed in alveoli.Mechanical obstruction is not the only cause ofamniotic fluid embolism. Circulating substances thataffect myocardial contractility and coagulation are alsoimplicated and the cause may even be an allergic reaction.The usual signs are acute respiratory failure, cardiovascularcollapse, and occasionally convulsions andcoagulopathy. Cardiac arrest occurs in 80% of the cases.Treatment is symptomatic to provide life-sustainingmeasures in response to the clinical picture as it develops

Atypical P. vivax and P. ovale morphology in two imported cases of malaria in Spain.

The finding of two imported cases of malaria in Spain is reported. Although their origin, their age and their clinical history were different, they both showed parasites of atypical morphology. One was diagnosed as P. vivax and the other as P. ovale, but the morphology observed in both cases does not correspond to what is considered as normal in the two species. In the first case forms similar to those of P. ovale were observed and in the second case P. vivax-like forms. The findings reported confirm the overlapping morphological variability of the two species.