Chloroquine-induced hyperpigmentation of the hard palate

This article reports a rare case of extensive palatal pigmentation secondary to long-term chloroquine treatment. Chloroquine was originally used as an antimalarial agent, but it is now widely used as an adjunct in the treatment of autoimmune diseases. Adverse effects of chloroquine usually include skin changes such as bullous pemphigoid, exacerbation of psoriasis, and pigmentation of the skin and mucous membranes as well as retinopathy, gastrointestinal alterations, and neuromuscular disorders. Extensive oral pigmentation is an uncommon feature of an adverse drug effect, and diagnosis should be based on clinicopathological findings.     

The influence of composite resin restorations and lining on radiographic diagnosis and decision-making: an in vitro investigation

The objective of this study was to evaluate the influence of resin-based restorations on the interpretation of digital and conventional radiographic images and to correlate the proposed diagnosis with decision-making. Class II cavities were prepared in one of the proximal surfaces of extracted human molars. Teeth were divided into five groups (n = 10) according to the restoratives used: Natural Flow (NF) and Filtek Supreme (FS); Filtek Flow (FF) and FS; Tetric Flow (TF) and FS; Protect Liner F (PLF) and FS; and FS alone. Bitewing radiographs were taken using conventional and digital systems. Subjective analysis was performed for each surface: no restoration; restored teeth; or restored teeth with gap. Based on the given diagnosis, clinical conduct was then indicated. Material radiopacity was determined according to ISO 4049. A Fisher exact test evaluated the influence of the restoratives on the diagnosis. Means were compared using ANOVA and the Games-Howell test. A Friedman test was used to analyze the influence of the systems on the diagnosis, and a binomial test was used to analyze the association between the presence of gaps and the decision to replace the restoration (P = 0.05). For each system, TF+FS was significantly associated with a high percentage of correct diagnoses. The opposite was the case for PLF+FS, which differed from all other groups. Radiographic systems presented similar behaviors, except for NF+FS. Apart from PLF, adequate radiopacity was observed. Diagnosis was influenced by restorative materials, regardless of the radiographic system used. The low radiopacity of PLF led to a greater number of erroneous diagnoses. Moreover, the decision-making process was influenced strongly by the given diagnosis.     

Simultaneous or sequential gastrectomy in pediatric liver transplant recipients

The association between LT and gastrectomy is not common. Only two studies reported the gastrectomy/LT association in children. Here, we report three children who underwent LT who required a concomitant or sequential gastrectomy for different reasons. Patient 1, a 16‐yr‐old boy, during the LT, underwent a partial gastrectomy due to extensive injury to the duodenum. He had a previous and unusual portoenterostomy performed in the duodenum. Bowel reconstruction was performed using an intestinal loop that was first used for the bilio‐enteric anastomosis and then connected to the gastric stump. Patient 2, a 22‐month‐old female child, underwent a partial gastrectomy with a Roux‐en‐Y reconstruction during a retransplantation. She had a large perforated gastric ulcer blocked by the allograft liver. Patient 3, a 26‐month‐old male child, five yr after living donor LT, was submitted to a partial gastrectomy because of gastric outlet obstruction. The histopathology was compatible with eosinophilic gastritis. The association between LT and gastrectomy in the pediatric population is extremely rare. Appropriate knowledge of the previous transplantation technique is very important. Further studies are required to assess the outcomes of the different types of gastric reconstruction in pediatric recipients.     

EMG study of the pectoralis major (sternal portion), teres major, latissimus dorsi and deltoid medial muscles in volleyball players

The pectoralis major (sternal portion), teres major, latissimus dorsi and deltoid medial muscles has been studied through in the electromyography in 8 male individuals, who practice volleyball, youth category, (age between 15 and 17 (average 16.25), right-handed, involved in volleyball for about one year. The objective was to analyze the potential of action of these muscles engaged in the volleyball movements: service, spike, pass, set and blocking with and without ball. The work was developed in the laboratory of Electromyography and Biomechanics of Posture (Physical Education Faculty - State University of Campinas - UNICAMP). To caption the muscles action potential, surface electrodes were set with conductive gel and fixed on the skin, in the center of the muscles. It was used an electromyography Lynx with 6 channels. The apparatus calibration was 3000 microV; 1199.760 Hz. The sequential experiments without ball were performed for 10 seconds, and the sequential experiments with ball in 12 seconds. RESULTS: None of the muscles presented significative difference (p > 0,05) when compared to the sequential movements executed with and without ball. When compared to the sequential movements executed without ball, the only muscles that presented significative differences (p < 0,05) were: pectoralis major / deltoid and latissimus dorsi / deltoid, for another hand when in the comparative of the movements with ball, all muscles when compared to the latissimus dorsi, presented a significance difference (p < 0,05). It is interesting to observe, that the general average and the standard deviation of the deltoid muscle (medial portion), teres major, and latis-simus dorsi were higher in the sequential movements executed without ball.