Surgical planning for resection of an ameloblastoma and reconstruction of the mandible using a selective laser sintering 3D biomodel

Ameloblastoma is a benign locally aggressive infiltrative odontogenic lesion. It is characterized by slow growth and painless swelling. The treatment for ameloblastoma varies from curettage to en bloc resection, and the reported recurrence rates after treatment are high; the safety margin of resection is important to avoid recurrence. Advances in technology brought about great benefits in dentistry; a new generation of computed tomography scanners and 3-dimensional images enhance the surgical planning and management of maxillofacial tumors. The development of new prototyping systems provides accurate 3D biomodels on which surgery can be simulated, especially in cases of ameloblastoma, in which the safety margin is important for treatment success. A case of mandibular follicular ameloblastoma is reported where a 3D biomodel was used before and during surgery.     

Treatment of New World cutaneous leishmaniasis--a systematic review with a meta-analysis

Background New World leishmaniasis is an important endemic disease and public health problem in developing countries. The increase in ecologic tourism has extended this problem to developed countries. Few drugs have emerged over the past 50 years, and drug resistance has increased, such that the cure rate is no better than 80% in large studies. Despite these data, there has been no systematic review with a meta‐analysis of the therapy used in this important tropical disease. The aim of this study was to determine the best drug management in the treatment of cutaneous leishmaniasis (CL) in Latin America based on the best studies published in the medical literature. Methods MEDLINE, LILACS, EMBASE, Web of Science, and Cochrane Library databases were searched to identify articles related to CL and therapy. Articles with adequate data on cure and treatment failure, internal and external validity information, and more than four patients in each treatment arm were included. Results Fifty‐four articles met our inclusion criteria and 12 were included in the meta‐analysis. Pentavalent antimonials were the most studied drugs, with a total of 1150 patients, achieving a cure rate of 76.5%. The cure rate of pentamidine was similar to that of pentavalent antimonials. Other drugs showed variable results, and all demonstrated an inferior response. Conclusion Although pentavalent antimonials are the drugs of choice in the treatment of CL, pentamidine showed similar results. Nevertheless, several aspects, such as cost, adverse effects, local experience, and availability of drugs to treat CL, must be considered when determining the best management of this disease, especially in developing countries where resources are scarce.     

Substance P and NK1 receptor expression in the enteric nervous system is related to the development of chagasic megacolon

Chagasic megacolon is one of the most important forms of Chagas disease. This form is characterized by inflammation, neuronal destruction and organ dilatation. The aim of this study is to characterize the expression of substance P and its main receptor, NK1 receptor, in dilated and non-dilated samples of colon from chagasic patients with megacolon. Our results demonstrate that dilated portions of colon present high levels of substance P and low levels of NK1 receptor, whereas non-dilated portions and samples from non-infected individuals present low levels of substance P and high levels of NK1 receptor. We believe that this may indicate a neuro-immune relationship that occurs in Chagas disease.     

Prevalence of hemoglobin S in the State of Paraná, Brazil, based on neonatal screening

The Brazilian Ministry of Health created the National Neonatal Screening Program under ruling no. 822/2001, including neonatal screening for hemoglobinopathies. In the State of Paraná, neonatal screening is conducted by the Ecumenical Foundation for the Protection of the Handicapped. The prevalence rates were determined for homozygous and heterozygous hemoglobin S and Sbeta-thalassemia. Blood samples drawn on filter paper were examined by isoelectric focusing (IEF) and high-performance liquid chromatography (HPLC). From January 2002 to December 2004, 548,810 newborns were screened, with the detection of 21 with FS, two FSA/FS, and four FSA. After confirmatory tests at six months of age, 12 were defined as sickle-cell anemia, or a prevalence of 2.2:100,000 newborns; Sbeta-thalassemia was confirmed in 15 (2.7:100,000 newborns); and 8,321 newborns were diagnosed as heterozygous HbS (1,500:100,000 newborns). HbS prevalence in Paraná (in southern Brazil) is lower than in the Central-West, North, and Northeast of the country. Ethnic origin of the population, fetal deaths, and non-random procreation may contribute to the relatively low number of homozygous individuals in the State. Sbeta-thalassemia interaction suggests the presence of Euro-Mediterranean peoples in this population's miscegenation.     

Effectiveness of weekly iron supplementation on hemoglobin concentration, nutritional status and development of infants of public daycare centers in Recife, Pernambuco State, Brazil

This study analyzed the effectiveness of weekly iron supplementation on hemoglobin concentration, nutritional status, and mental and motor development of infants at four public daycare centers in Recife, Pernambuco State, Brazil. This was a before-after intervention study conducted with weekly iron supplementation for six months in a sample of 76 infants in the 4 to 24 month age group, from February to December 2005. Mental and motor development was assessed through the Bayley Scale of Infant Development II. After supplementation, a significant increase was observed in hemoglobin concentration in the group of infants with initial hemoglobin level < or = 9.5g/dL (p = 0.001). There was also a significant increase in the mean weight-for-length z-score, but the opposite was found for length-for-age. No difference was observed in the developmental indices. We conclude that weekly iron supplementation was effective for increasing hemoglobin concentration in infants with lower initial levels, but no impact on infant development was observed.     

Tuberculosis contact control in Brazil: a literature review (1984-2004)

This study aims to review plans for tuberculosis control through the analysis of measures for tuberculosis contact tracing in Brazil from 1984 to 2004. This article presents a literature review on tuberculosis control published in manuals of the Ministry of Health and the State Department of Health of Sao Paulo, and in Medline and Lilacs databases. There was a gap in the standardization of control measures in the decade from 1984 to 1994. It was concluded that health professionals need to incorporate TB control and prevention actions from the perspective of health surveillance and systematic monitoring.     

On the functional integration between postural and supra-postural tasks on the basis of contextual cues and task constraint

In order to evaluate the effects of uncertainty about direction of mechanical perturbation and supra-postural task constraint on postural control, young adults had their upright stance perturbed while holding a tray in a horizontal position. Stance was perturbed by moving forward or backward a supporting platform, contrasting situations of certainty versus uncertainty of direction of displacement. Increased constraint on postural stability was imposed by a supra-postural task of equilibrating a cylinder on the tray. Performance was assessed through EMG of anterior leg muscles, angular displacement of the main joints involved in the postural reactions and displacement of the tray. Results showed that both certainty on the direction of perturbation and increased supra-postural task constraint led to decreased angular displacement of the knee and the hip. Furthermore, combination of certainty and high supra-postural task constraint produced shorter latency of muscular activation. Such postural responses were paralleled by decreased displacement of the tray. These results suggest a functional integration between the tasks, with central set priming reactive postural responses from contextual cues and increased stability demand.     

Violence exposures by school children in Brazil: results from the National Adolescent School-based Health Survey (PeNSE)

This article presents the main results of the National Adolescent School-based Health Survey (PeNSE). A questionnaire was applied to a sample of 60,973 students of the 9th year of Junior high school in public and private schools of the Brazilian state capitals and the Federal District, between March and June 2009. The prevalence and confidence interval of 95% (CI 95%) of the violence situations involving adolescents were analyzed. The following situations were identified: lack of safety on the way home-school (6.4%; CI95%: 6.1%-6.8%) and at school (5.5%; CI95%: 5.2%-5.8%); involving fights with physical aggression (12.9%; CI95%: 12.4%-13.4%), with knife (6.1%; CI95%: 5.7%-6.4%) or fire arm (4.0%; CI95%: 3.7%-4.3%); physical aggression by family member (9.5%; CI95%: 9.1%-9.9%). Violence situations were more prevalent among male students. There were great variations among the cities studied. Adolescents are exposed to different violence manifestations in the institutions that supposedly must assure their protection and healthy development: school and the home. These results aim to support health promotion measures and prevention of these risk factors.     

Effects of abdominoplasty on female sexuality: a pilot study

IntroductionChanges in the pubic region resulting from abdominoplasty may have a psychosexual impact. Thus, it is important to study the influence of physical changes on the sexuality of patients after abdominoplasty.AimTo evaluate the effects of the elevation of the mons pubis and consequent exposure of the clitoris in the vulvar commissure on the sexual functioning and sexual satisfaction of women who underwent abdominoplasty.MethodsData were presented as mean ± standard deviation. Nineteen women with a mean age of 35 ± 7 years, mean body mass index of 23 ± 2 kg/m² and who expressed a desire to undergo abdominoplasty were selected from consecutive patients attending the abdominal plastic surgery outpatient unit of a university hospital.Main Outcome MeasuresPhysical change (measured by the distance between the xiphoid process and vulvar commissure [xipho‐vc]), sexual functioning, and sexual satisfaction (assessed with the Sexuality Assessment Scale), and body image (measured using the Body Shape Questionnaire [BSQ]) were evaluated preoperatively and 6 months after abdominoplasty.ResultsThere was a significant reduction (P = 0.0004; z = ?3.53) in the xipho‐vc distance 6 months after abdominoplasty compared with baseline (mean difference 3.63 ± 2.79 cm), corresponding to an elevation of the mons pubis and consequent exposure of the clitoris. All patients reported a significant improvement in sexual functioning and sexual satisfaction 6 months after abdominoplasty when compared with baseline (P = 0.0001; z = ?3.83). BSQ scores indicated an improvement in the patients' concerns about body shape (P = 0.0003; z = ?3.58).ConclusionOur results suggest that physical change and the new position of the clitoris may have a positive impact on sexuality. de Brito MJA, Nahas FX, Bussolaro RA, Shinmyo LM, Barbosa MVJ, and Ferreira LM. Effects of abdominoplasty on female sexuality: A pilot study. J Sex Med 2012;9:918–926.     

Is maintenance of the ileocecal valve important to the intestinal adaptation mechanisms in a weaning rat model of short bowel?

Purpose

To evaluate the role of maintenance of the ileocecal valve (ICV) in intestinal adaptation mechanisms, in a weaning rat experimental model of short bowel.

Methods

Forty animals were operated on to produce short bowel syndrome. They were divided into five groups: maintenance (MV) or resection of ICV (RV), kill after 4 days (MV4 and RV4) or 21 days (MV21 and RV21), and a control group (21-day-old rats). Body weights, small bowel and colon lengths and diameters, villus heights, crypt depths, lamina propria and muscle layer thickness, as well as the apoptosis index of villi and crypts and expression of pro- and anti-apoptotic genes, were studied.

Results

Preservation of the ICV promoted increased weight gain (p?=?0.0001) and intestinal villus height after 21 days; crypt depth was higher in comparison to controls. It was verified a higher expression of Ki-67 in bowel villi and crypts (p?=?0.018 and p?=?0.015, respectively) in RV4 group and a higher expression in bowel villi of MV4 group animals (p?=?0.03). The maintenance of ICV promoted late increased expression of the anti-apoptotic gene Bcl-XL in the colon (p?=?0.043, p?=?0.002, p?=?0.01).

Conclusion

The maintenance of the ICV led to positive changes in this model.