The Portuguese version of “The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty”: validation and clinical application

Introduction

The evaluation of surgical outcomes measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery.

Risk factors for dental caries in children with cerebral palsy

This study was conducted to examine the oral condition and the salivary and microbiological parameters associated with dental caries in 62 children with cerebral palsy, who came from households of low socioeconomic status (Study Group). This group had mixed (6 to 11 years old) and permanent (11 to 16 years old) dentition. Dental examinations were performed to measure dental caries, plaque index, salivary levels of mutans streptococci and lactobacilli, salivary flow rate, pH of stimulated saliva, and buffer capacity of saliva. A group of 67 non-handicapped children from similar socioeconomic backgrounds also were examined using these parameters (Control Group). Data were analyzed statistically by non-parametric tests and by correlation. The results showed that children with cerebral palsy who had permanent dentitions had a higher mean decayed, missing and filled surfaces index, as well as a higher plaque index for both sexes. Microbiological examination revealed higher levels of mutans streptococci among Study Group subjects with mixed dentition than in the Control Group. Also, lactobacillus counts were higher in the Study Group, regardless of sex or dentition. With respect to salivary flow rate, pH and buffering capacity, lower mean values were obtained for the Study Group.     

Study and value of high amplification atrial signal in arterial hypertension]

The aim is the analysis of the P wave on the signal averaged ECG in 31 pts: 12 control pts (6 M, 6 W, 40 +/- 10 y) 12 HTA (9 M, 3 W, 60 +/- 7 y), 7 pts (5 M, 2W, 48 +/- 7 y) with sustained paroxystic atrial fibrillation (AF) without organic heart disease, without antiarrhythmic drugs. We measured the filtered P wave duration (Ad), the integral of Ad, the root mean square voltage of Ad for the last 10, 20, 30, 40, 60 msec and the duration of P wave on the ECG in lead II (P II) and the echocardiographic dimensions of the atria (LAd). HTA Ad (132 +/- 12 msec)* et > control Ad (116 +/- 10 msec) HTA LAd (38 +/- 3 mm) et > control LAd (31 +/- 0.7 mm) HTA PII (120 +/- 1.5 mm)* et > control PII (88 +/- 10 mm). The difference between HTA Ad (132 +/- 12 msec) and AF Ad (129 +/- 7 msec) is not significant. The linear regression tests don't show correlation between P II and Ad and between LAd and Ad in HTA group. There is a correlation between Ad and LAF in AF group (r = 0.83, p 0.02). HTA RMS 2o (2.2 + 0.6 microV), control RMS 2o (3.9 + 1.8 V) but HTA RMS 2o and AF RMS 2o (2.4 +/- 0.6 microV) are not significantly different and are not correlated with LAd and PII. A long duration of P filtered P wave and a low RMS 2o observed in HTA group and AF group would be a criteria of atrial vulnerability. p < 0.05.     

Spatiotemporal Effects of Syncytial Heterogeneities on Cardiac Far-Field Excitations During Monophasic and Biphasic Shocks

Far-Field Excitation Via Syncytial Heterogeneities. Introduction: It has recently been postulated that syncytial (anatomic) heterogeneities inherent within cardiac tissue might represent a significant mechanism underlying field-induced polarization of the bulk myocardium. This simulation study examines and characterizes the spatiotemporal excitatory dynamics associated with this newly hypothesized mechanism. Methods and Results: Two-dimensional regions of syncytially heterogeneous cardiac tissue were simulated with active membrane kinetics. Heterogeneities were manifested via random spatial variations of intracellular volume fractions over multiple length scales. Excitation thresholds were determined for uniform rectangular monophasic (M) and symmetric biphasic (B) far-field stimuli, from which strength-duration and strength-interval relationships were constructed. For regions measuring 5.4 × 5.4 mm, baseline diastolic thresholds for longitudinal (L) and transverse (T) shocks of 5-msec total duration averaged (in V/cm, n = 10) M-L = 2.87 ± 0.26. M-T = 6.71 ± 0.83, B-L = 3.22 ± 0.25, and B-T = 7.93 ± 0.51. These thresholds decreased by 15% to 25% when the region sizes were increased to 10.8 × 10.8 mm. Strength-duration relationships correlated strongly with the Weiss-Lapicque hyperbolic relationship, with rheobases and chronaxies of 2.33 V/cm and 1.15 msec for M-L stimuli, and 2.28 V/cm and 2.04 msec for B-L stimuli. Strength-interval relationships for M-I. and B-L stimuli decreased monotonically with increasing coupling intervals, with similar minimum coupling intervals at absolute refractoriness. However, the B-L thresholds were substantially less sensitive to changes in coupling intervals than their M-L counterparts. Conclusion: This study provides strong additional support for and understanding of the syncytial heterogeneity hypothesis and its manifested properties. Furthermore, these results predict that syncytial heterogeneities of even modest proportions could represent a significant mechanism contributing to the far-field excitation process.     

Somatomedin-C and growth hormone levels in anorexia nervosa in relation to the puberal or post puberal stages

1. 1. Plasma concentrations of somatomedin-C and GH were determined in 21 patients diagnosed as anorexia nervosa (AN) and in 44 controls.

2. 2. Somatomedin-C concentrations were significantly lower in pubertal AN patients than in controls, but not in post pubertal patients.

3. 3. GH was increased in both pubertal and post pubertal AN patients, although more in pubertal AN patients.

4. 4. Our results suggest that the hormonal alterations that appear in AN constitute a mechanism of defense against starvation. The activation of these defense mechanisms and the degree of modification produced in normal hormonal patterns depend not only on caloric intake but also on metabolic requirements.

Cyclosporine-induced cell-mediated injury of the thymic medullary epithelium

Cyclosporine (CsA) can induce prolonged tolerance to alloantigens, but it requires an intact thymus. In normal rats, CsA causes a rapid but reversible ablation of the thymic medulla with an associated loss of the Hassall's corpuscles and apparent maturation arrest of the thymocytes. We have tested the hypothesis that CsA induces a cell-mediated lysis of the medullary epithelium. Normal rats were treated with CsA (15 mg/kg) or vehicle. The thymocytes were then adoptively transferred into syngeneic target rats, purged of thymocytes by recent total-body irradiation. After 4-48 hr, the target animals were sacrificed. The target thymi showed increased lymphocytic exocytosis of the Hassall's corpuscles with OX-8+ (CD8+) T lymphocytes (OX-19+, OX-44+) and associated epithelial cell injury. Compared to recipients of control thymocytes, ultrastructural evaluation showed broad-based and point contact between lymphocytes and adjacent medullary epithelium with increased epithelial cell injury. The results support a cell-mediated injury to the Hassall's corpuscles in CsA-treated animals.     

Modulation of Healthy Pig Coronary Arteries by Self-Expanding Stents

Objectives: To evaluate the expansion ratio of a self-expanding stem over time, and the chronic effect of stent pressure on the vessel wall . Methods: Self-expanding stents, developed by Medtronic Inc. (Minneapolis, MN, USA) and the Rouen group (Letac, Cribier, France), were implanted in 21 normal pig coronary arteries. Animals were sacrificed after recatheterization at 1 day (group I, n = 4), I week (group 2, n = 3), 3 weeks (group 3, n = 5), or 8 weeks (group 4, n = 4). Histological morphometry of the vessel medial and neointimal layers was performed. Changes were related to the, stent diameter and. its force on the vessel wall . Results: The stent expansion ratio gradually increased from 73% to 93% after 8 weeks, which implicates that radial force decreased concomitantly from 0.10 N to 0.03 N. Media compression under the rods ranged from 4l%-66% immediately after stent implantation. The mean compression was unrelated to stent expansion and remained nearly the same (40%-50%) during follow-up. Individual media rod compression ranged from 5%-95%. The neointimal layer on top of the rods increased until the third week after stent implant (neointimal thickness 211 ± 108 μm). The layer significantly decreased at 8 weeks (neointimal thickness 65 ± 9 μm). The cross-sectional neointimal area increased gradually only at the end of the stent during the 8-week follow-up . Conclusions: The self-expanding stent implanted in normal pig coronary arteries reached a gradual relaxation state 8 weeks after implantation due to the persistent radial force. This radial force induces medial wall compression, which was only positively related to the thickness of the neointimal layer at 3 weeks after implant . (J Interven Cardiol 1996;9:45–52)     

V{beta}6-bearing T cells are involved in resistance to Trypanosoma cruzi infection in XID mice

BALB.xid mice, carrying an X-linked mutation leading to theabsence of CD5⁺ B cells, are highly resistant to Trypanosomacruzi Infection. These mice clear blood parasites In the acutephase of infection and do not develop the inflammatory Infiltrationcharacteristically observed in the chronic phase of susceptiblestrains of mice. We have shown that the resistance of BALB.xldIs dependent on the production of high levels of IFN-y. Natural(adoptive foster) or artificial (In vivo Injection of blockingantibodies) treatments of BALB.xld induced deletion of CD4⁺and CD8⁺ cells bearing V_ß6 TCR. The absence of V_ß6lymphocytes considerably reduced resistance to infection. Furthermore,in BALB.xld lacking this minor fraction of the T cell repertoire,almost 50% of the IFN-y production is lost. This indicates thatV_ß6-bearing T cells are either directly or Indirectlyinvolved in the production of IFN-y and, thus, important foran effective immune response during the acute phase of experimentalChagas' disease.     

Multiplane Transthoracic Echocardiography: Image Orientation, Anatomic Correlation, and Clinical Experience with a Prototype Phased Array Multiplane Surface Probe

Multiplane transthoracic echocardiography provides numerous sequential images by rotation of the transducer imaging array through 180° with the surface probe at a fixed site. We explored the potential of this new technique with a 3.7/5-MHz prototype multiplane transthoracic probe. Echoanatomic correlations were first examined in ten explanted hearts. The transducer was then applied in 30 normal humans at transthoracic acoustic windows to determine the imaging planes available. Use of this probe in 76 patients with various cardiac disorders indicated that this probe eases the procedure of transthoracic echocardiographic examination, provides incremental information for improved delineation and understanding of cardiac pathology, and yields many novel insights to echocardiographic interpretation. Multiplane transthoracic echocardiography appears to expand the versatility of transthoracic two-dimensional echocardiography.     

Myocardial revascularization surgery during a developing infarction

Our results with surgical revascularization for evolving myocardial infarction in 30 patients are analyzed. There were 25 men and 5 women (mean age 55 +/- 10 years), most with unstable angina (80%), which sustained an acute myocardial infarction secondary to either a severe stenosis (23%) or a complete obstruction (77%) of a mayor coronary artery during a diagnostic coronarography (27%) or a percutaneous transluminal coronary angioplasty (73%). The most frequently involved vessels were the left anterior descending and right coronary arteries (11 cases), followed by the left main stem (5 cases) and the circumflex artery (3 cases). Nineteen patients (group I) developed electrocardiographic and/or enzymatic evidence of established myocardial necrosis despite early reperfusion, whereas 11 patients did not (group II). These groups were compared according to different clinical, angiographic, hemodynamic, and operative variables. Group I patients had a more recent disease and a better segmentary contraction. The same variables were compared between the 5 patients with early cardiac death (group III) and the remainder 25 (group IV). Refractory cardiac arrest, jeopardized myocardial mass and coronary perfusion indexes after the infarction-related complication, all were more desfavorable in group III. The ischemic interval between infarction onset and reperfusion was not different between the groups. The potential of surgery for myocardial salvage in the setting of evolving necrosis is emphasized as well as the influence of the magnitude of involved myocardium and its clinical repercussion on early mortality.