POSTURAL EVALUATION OF PATIENTS WITH TEMPOROMANDIBULAR DISORDERS UNDER USE OF OCCLUSAL SPLINTS

Objectives:

Alterations in the temporomandibular complex can reflect in adaptations of the individual''s entire muscular system, intervening with the head position and scapular waist, developing postural alterations and modifying all corporal biomechanics. The aim of this study was to evaluate the head position (HP) and head postural alterations before and after installation of occlusal splints.

Material and Methods:

Twenty patients with temporomandibular disorders (TMD) underwent clinical and postural examination, before the installation of an occlusal splint, and after 1 week and 1 month of use.

Results:

There were statistically differences for HP, between the initial values and after 1 week of use of the occlusal device (p= 0.048) and also between 1 week and 1 month of evaluation (p= 0.001). Decrease of the painful symptomatology and maintenance of the rectification were also observed.

Conclusions:

The individual''s postural position can suffer biomechanical alterations due to stomatognathic alterations, causing clinically visible changes in dysfunctional individuals and affecting the performance of the involved structures.     

Loss of hepatitis A virus antibodies after bone marrow transplantation

Reimmunization guidelines have recommended the inactivated HAV vaccine for hematopoietic stem cell transplant (HSCT) recipients living in or traveling to areas where hepatitis A is endemic. As a shift from high to medium hepatitis A endemicity has been observed in several countries in Latin America, we conducted a retrospective study to evaluate the prevalence of hepatitis A pre-bone marrow transplant (BMT) and the loss of specific antibodies in consecutive stored serum samples from 77 BMT recipients followed up from 82 to 1530 days. The prevalence of HAV antibodies was 92.2% before BMT. As vaccine was not available in Brazil when the samples were taken, it was assumed that this prevalence reflects natural infection. Survival analysis showed that the probability of becoming seronegative was 4.5% (+/-2.6%), 7.9% (+/-3.4%), 10.1% (+/-4.0%), 23.4% (+/-9.6%) at 1, 2, 3 and 4 years after transplant, respectively. The loss of HAV antibodies was significantly associated with longer follow-up (P=0.0015), younger age (P=0.049) and acute graft-versus-host disease (P=0.035). As most reimmunization protocols start around day +365, in developing countries with similar HAV endemicity, BMT recipients should have serological screening before HAV vaccination and the inactivated vaccine should be advised to those seronegative.     

Effects of gustatory stimulants of salivary secretion on salivary pH and flow: a randomized controlled trial

Objectives:  To compare salivary pH changes and stimulation efficacy of two different gustatory stimulants of salivary secretion (GSSS).
Setting:  Portuguese Dental Faculty Clinic.
Design:  Double blind randomized controlled trial.
Subjects:  One hundred and twenty volunteers were randomized to two intervention groups. Sample sized was calculated using an alpha error of 0.05 and a beta of 0.20.
Materials and methods:  Participants were randomly assigned to receive a new gustatory stimulant of secretory secretion containing a weaker malic acid, fluoride and xylitol or a traditionally citric acid-based one. Saliva collection was obtained by established methods at different times. The salivary pH of the samples was determined with a pH meter and a microelectrode.
Main outcome measures:  Salivary pH variations and counts of subjects with pH below 5.5 for over 1 min and stimulated salivary flow were the main outcome measures.
Results:  Both GSSS significantly stimulated salivary output without significant differences between the two groups. The new gustatory stimulant of salivary secretion presented a risk reduction of 80 ± 10.6% (95% CI) when compared with the traditional one.
Conclusions:  Gustatory stimulants of salivary secretion with fluoride, xylitol and lower acid content maintain similar salivary stimulation capacity while reducing significantly the dental erosion predictive potential.     

Nutritional and vitamin status in patients with neuroendocrine neoplasms

Symptoms of gastroenteropancreatic located neuroendocrine neoplasms(GEPNENs) are often related to food intake and manifest as abdominal pain or diarrhoea which can influence patients nutritional status. Malnutrition is common in cancer patients and influences quality of life, treatment options and survival but is also present in up to 40% of patients with GEP-NENs. As part of malnutrition there are often deficiencies in fat-soluble vitamins, mainly vitamin D. Little knowledge exists on trace elements. Several factors influence the development of malnutrition such as size and localisation of the primary tumour as well as metastases, side effects from treatment but also hormone production of the tumour itself. One of the main influencing factors leading to malnutrition is diarrhoea which leads to dehydration and electrolyte disturbances. Treatment of diarrhoea should be guided by its cause. Screening for malnutrition should be part of routine care in every GEP-NEN patient. Multidisciplinary treatment including dietician support is necessary for all malnourished patients with GEP-NENs.     

Proposal for a hierarchical framework applied to investigation of risk factors for neonatal mortality

Theoretical-conceptual models aim to integrate social, biological, behavioral, and other factors and to explain their interrelations in the determination of health outcomes. In the case of determination of neonatal death in Brazil, few studies have analyzed the mechanisms by which numerous variables and constructs interrelate. This article offers a theoretical discussion of the possible components of a hierarchical framework for studying neonatal mortality. The proposed model sought to include factors that have traditionally been identified as relevant to the occurrence of neonatal death and others that have been studied more recently (like race, social support, and violence during pregnancy). The components were distributed in 11 dimensions allocated to four hierarchical levels (one distal, two intermediary, and one proximal). The proposed framework should be adjusted to the Brazilian reality for neonatal death in large cities and raises various aspects for discussion that have not been explored previously in Brazil.     

Redox-sensitive events in Fas-induced apoptosis in human NK cells include ceramide generation and protein tyrosine dephosphorylation

We previously reported that intracellular oxidation-reduction (redox) regulates NK cell functions and that IL-2-activated NK cells undergo apoptosis upon contact with NK-sensitive target cells. We now report that apoptosis in activated human NK cells is also regulated by redox. Thiol deprivation increased apoptosis in NK cells induced by anti-Fas mAb or Fas ligand-transfected cells, and pretreatment of cells with N- acetyl cysteine, which increased intracellular glutathione, partially inhibited the apoptosis and reversed the effect of thiol-deficient medium, suggesting that Fas-induced apoptosis in NK cells is also redox sensitive. Thiol deprivation did not alter cell surface Fas expression, but did increase ceramide generation following Fas engagement. Although exogenous ceramides induced apoptosis of NK cells, thiol depletion had no effect on this apoptosis. Thiol deprivation increased CPP32 activation induced by Fas engagement, but not by ceramides. These findings suggest that, if ceramide is required for Fas-induced apoptosis, thiol deprivation affects the Fas-mediated signaling pathway at the generation of ceramide and/or upstream thereof. Though tyrosine phosphorylation following Fas engagement was not significantly affected by thiol deprivation, tyrosine dephosphorylation was delayed, suggesting that tyrosine phosphatases may also be redox sensitive. The notion that dephosphorylation is important in the Fas signaling pathway is supported by the finding that tyrosine phosphatase inhibitors significantly enhanced both CPP32 activity and apoptosis following Fas ligation. We conclude that events downstream of tyrosine phosphorylation and upstream of CPP32 activation, including tyrosine dephosphorylation and possibly ceramide generation, are sensitive to regulation by redox in human NK cells, requiring a reducing environment for optimal protection from apoptosis induced by Fas ligation.      

P_(16)蛋白在食管鳞状细胞癌的表达及临床意义

应用免疫络化S－P法检测88例食管浸润世鳞癌P16蛋白的表达，结果P16蛋白阳性率为55．68％（49/88），其阳性颗粒位于细胞浆内；组织学Ⅰ、Ⅱ、Ⅲ级阳性率分予的85．71％（18/21）、55.13％（16/29）、39.47％（15/38）（P＜0．01）；淋巴结转移组和无转移组阳世事分别为36.36％（12／33），67．27％（37／55）（P＜0．01）;3年生存率P16蛋白阳性组和阴性组分别36％和16．67％。结果表明食管鳞癌中P16蛋白的表达可以反映肿瘤的分化程度和转移情况．提示P16蛋白的检测可作为食管鳞癌的重要预后指标之一。     

Anti-spasmogenic effects of bencianol (ZY15051) on human cerebral arteries in vitro

Experiments were performed to assess the ability of bencianol (ZY15051) to reverse contractions of human basilar arteries in vitro that were induced by a wide range of substances implicated in the aetiology of migraine and cerebral arterial spasm. Bencianol caused a dose-related (1-100 micrograms ml-1) reversal of contractions induced by 5-hydroxytryptamine, noradrenaline, angiotensin II, prostaglandin F2 alpha, and U-46619 (a thromboxane-A2 mimetic). Bencianol was more effective against contractions induced by EC50 compared to maximal concentrations of each agent, and was least effective against the thromboxane-A2 mimetic, U-46619. In addition, contractions induced by thromboxane-A2-like substances generated from guinea-pig lungs were also reversed by bencianol but only at the highest concentration used (100 micrograms ml-1). The relevance of this action of bencianol to migraine and cerebral arterial spasm is discussed.