Factors determining esthetic outcome after breast cancer conservative treatment

The aim of this study was to evaluate the factors that determine esthetic outcome after breast cancer conservative treatment, based on a consensual classification obtained with an international consensus panel. Photographs were taken from 120 women submitted to conservative unilateral breast cancer surgery (with or without axillary surgery) and radiotherapy. The images were sent to a panel of observers from 13 different countries and consensus on the classification of esthetic result (recorded as excellent, good, fair or poor) was obtained in 113 cases by means of a Delphi method. For each patient, data were collected retrospectively regarding patient characteristics, tumor, and treatment factors. Univariate and multivariate analysis were used to evaluate the correlation between these factors and overall cosmetic results. On univariate analysis, younger and thinner patients as well as patients with lower body mass index (BMI) and premenopausal status obtained better cosmetic results. In the group of tumor- and treatment-related factors, larger removed specimens, clearly visible scars, the use of chemotherapy and longer follow-up period were associated with less satisfactory results. On multivariate analysis, only BMI and scar visibility maintained a significant association with cosmesis. BMI and scar visibility are the only factors significantly associated with cosmetic results of breast cancer conservative treatment, as evaluated by an international consensus panel.     

Increased BDNF Levels in Long-term Bipolar Disorder Patients

IntroductionBipolar disorder (BD) is a prevalent, chronic and progressive illness. There is a growing body of evidence indicating that brain-derived neurotrophic factor (BDNF) plays an important role in the pathophysiology of BD.ObjectiveThe aim of this study was to evaluate BDNF plasma levels in BD patients with long term illness in comparison with controls.Methods87 BD type I patients and 58 controls matched by age, gender and education level were enrolled in this study. All subjects were assessed by the Mini-International Neuropsychiatric Interview and the patients by the Young Mania Rating Scale and the Hamilton Depression Rating Scale. The plasma levels of BDNF were measured by ELISA.ResultsOn average, patients had suffered from BD for 23.4 years. In comparison with controls, BD patients with mania presented a 1.90-fold increase in BDNF plasma levels (p = .001), while BD patients in remission presented a 1.64-fold increase in BDNF plasma levels (p = .03). BDNF plasma levels were not influenced by age, length of illness or current medications.ConclusionsThe present study suggests that long-term BD patients exhibit increased circulating levels of BDNF.     

Experimental Zika virus infection induces spinal cord injury and encephalitis in newborn Swiss mice

A widespread epidemic of Zika virus (ZIKV) infection was reported in 2015 in South and Central America, with neurological symptons including meningoencephalitis and Guillain-Barré syndrome in adults, besides an apparent increased incidence of microcephaly in infants born to infected mothers. It is becoming a necessity to have a trustworthy animal model to better understand ZIKV infection. In this study we used newborn white Swiss mice as a model to investigate the ZIKV strain recently isolated in Brazil. ZIKV was inoculated via intracerebral and subcutaneous routes and analysed through gross histopathology and immunohistochemistry. Here we demonstrated first that the intracerebral group (ICG) displayed severe cerebral lesions, with neuronal death, presence of apoptotic bodies, white matter degeneration and neutrophil perivascular cuffing. In the subcutaneous group (SCG), we observed moderate cerebral lesions, morphologically similar to that found in ICG and additional myelopathy, with architectural loss, marked by neuronal death and apoptotic bodies. Interestingly, we found an intense astrogliosis in brain of both groups, with increased immunoexpression of GFAP (glial fibrillary acidic protein) and presence of hypertrophic astrocytes. The spinal cord of subcutaneous group (SCG) exhibited reduction of astrocytes, but those positive for GFAP were hypertrophic and presented prolonged cellular processes. Finally significant lesions in the central nervous system (CNS) were present in newborn mice inoculated by both routes, but SCG method led to an important neurological manifestations (including myelopathy), during a longer period of time and appears for us to be a better model for ZIKV infection.     

Longitudinal evaluation of the impact of dental caries treatment on oral health‐related quality of life among schoolchildren

This study aimed to evaluate the impact of dental caries treatment on oral health‐related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ_8‐10) instrument. Brazilian schoolchildren, 8–10 yr of age, were randomly selected and assigned to two groups – dental caries treatment (DCT) and caries‐free (CF) – according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥0]. The CPQ_8‐10 instrument was administered at baseline and at 4 wk of follow‐up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ_8‐10 scores were observed between the baseline and follow‐up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ_8‐10 scores. Responsiveness of the CPQ_8‐10 instrument (magnitude of change in CPQ_8‐10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ_8‐10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.     

Molar incisor hypomineralization in HIV‐infected children and adolescents

The objective was to determine the prevalence of molar incisor hypomineralization (MIH) among individuals between 7 and 15 years old infected or noninfected with human immunodeficiency virus (HIV). The study was conducted with 33 HIV‐infected individuals (study group; SG) and 66 non‐HIV‐infected schoolchildren (control group; CG), paired by gender and age. Data collection was based on medical records (SG), a questionnaire for caregivers and oral examination for diagnosis of MIH (European Academy of Pediatric Dentistry criteria) and caries (DMFT index and ICDAS). Data were analyzed with Mann‐Whitney, chi‐square, and Fisher's exact tests and logistic regression. In SG, MIH (45.5%) and caries (87.9%) had higher prevalence. MIH was associated with use of protease inhibitors in SG (OR: 2.14; 95% CI: 1.21 to 3.77) and incubator need in CG (OR: 2.80; 95% CI: 1.71 to 9.10). HIV‐infected patients had a higher prevalence of MIH and dental caries in the permanent dentition.     

New poly(ε-caprolactone)/chitosan blend fibers for tissue engineering applications

This study reports for the first time on the production of poly(ε-caprolactone)/chitosan blend fibers for future application as tissue engineering scaffolds. Fibers of chitosan and poly(ε-caprolactone) were prepared by wet spinning from blend solutions, using a formic acid/acetone 70:30 vol.% mixture as common solvent and methanol as coagulant. By this method, blend fibers with a wide compositional range and controllable diameters could be produced. Scanning electron microscopy shows the existence of roughness and porosity at the micron level scale in the blend fiber surface that could be potentially advantageous for cell attachment. Studies were also conducted using both conventional and innovative techniques to evaluate compatibility between the polymers, including FTIR imaging and investigation of the glass transition of chitosan using dynamic mechanical analysis on samples with controlled swelling. The data suggest that a certain degree of interaction exists, although it does not seem to be a result of chemical interaction. The designed fibers could be potentially used for the development of scaffolds for tissue engineering applications.     

Three-dimensional volumetric changes of 5 different bone grafts in human maxillary sinuses reconstruction: a randomized clinical study

Oral and Maxillofacial Surgery - This study aimed to compare the three-dimensional volumetric changes of human maxillary sinuses after reconstruction using 5 different bone grafts. Patients...     

Cerebellar transcranial direct current stimulation in children with ataxic cerebral palsy: A sham-controlled,crossover, pilot study

Objective: The aim of the present study was to analyze the use of anodal tDCS of the cerebellar region combined with treadmill training to improve balance and functional performance in children with ataxic cerebral palsy. Design: Single-blind, sham-controlled, crossover, pilot study. Setting: Rehabilitation center and research motion analysis laboratory. Participants: Children (N = 6) with ataxic cerebral palsy and balance deficit. Main Outcome Measures: Static balance (oscillations of the center of pressure), functional balance (Pediatric Balance Scale) and functional performance (Pediatric Evaluation of Disability Inventory) were evaluated. Results: Significant reductions occurred in oscillations of the center of pressure with eyes closed after active anodal tDCS only. The effects of treadmill training on functional balance and functional performance in mobility were maintained in the active tDCS group only. Conclusion: These preliminary data support the notion that anodal tDCS of the cerebellar region combined with treadmill training improves balance in children with ataxic cerebral palsy.