Different air-water spray regulations affect the healing of Er,Cr:YSGG laser incisions

Surgeries performed with high-intensity laser devices may be improved with accurate protocols, including the air-water spray regulation. Thus, this study sought to investigate the healing process of wounds made on the dorsum of rat tongues using an Er,Cr:YSGG laser device with different air-water spray regulations. The incisions were made on the dorsum of Wistar rat tongues using an Er,Cr:YSGG laser with three different air-water spray regulations (100/0%, 50/50%, 11/7%). Scalpel incisions functioned as controls. The sacrifices occurred between 0 and 14 days after surgery. Morphological, histological, and immunohistochemical (fibronectin and type III collagen) analysis of the wounds were performed. The air-water spray regulation influenced wound healing and the inflammatory response, especially in the earlier stages. Incisions performed using the 100/0% air/water spray regulation had the worst results, expressing a greater amount of fibronectin and type III collagen. The 50/50% air/water spray regulation brought in a non-clear surgical field and poor laser interaction with the tissue. The 11/7% air/water spray regulation showed the best clinical results and less pronounced histological events. According to the results encountered, the air-water spray should be regulated to improve surgery.     

Yellow fever disease in a renal transplant recipient: Case report and literature review

Yellow fever (YF) is a viral disease, with clinical presentation among immunosuppressed patients not fully understood. YF vaccination (YFV), a live vaccine, is contraindicated in patients receiving immunosuppressive treatment due to the risk of developing the disease after vaccination. We report a case of a 50‐year‐old male recipient who presented wild‐type YF five years after a deceased donor kidney transplant. He lived in a YF endemic area and inadvertently received YFV. One day after YFV, the patient presented nausea, vomiting, fever, diarrhea, polyarthralgia, thrombocytopenia, and increased levels of liver function enzymes. The serological test was compatible with YF disease, and quantitative viral load confirmed the diagnosis of wild‐type YF. The patient received supportive care for twelve days, with hospital discharge in good clinical condition and stable renal function. One month after discharge, the patient developed de novo donor‐specific anti‐HLA antibodies (DSA) and histological evidence of endothelial lesion, with a diagnosis of acute antibody‐mediated rejection (AMR), treated with plasmapheresis and human IVIg therapy. Six months after therapy, he presented normal renal function with a reduction of DSA MFI. In the reported case, we observed a clinical wild‐type YF diagnosed even after YF vaccine administration, with good clinical outcome. De novo DSA and AMR occurred after the recovering of disease, with an adequate response to therapy and preserved allograft function. We reviewed the published literature on YF and YFV in solid organ transplantation.     

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

IntroductionThe elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps.MethodsThis was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®.ResultsFactors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa = 5.53; 95%CI = 2.23–13.73); chemsex (ORa = 3.97; 95%CI = 1.72–8.92); and, above all, having an HIV-infected partner (ORa = 8.02; 95%CI = 2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa = 0.43; 95%CI = 0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa = 0.43; 95%CI = 0.19–0.95) were associated with decreased chances of having HIV.ConclusionsWe highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services.     

Fibromatosis of the breast in a 52-year-old man (2010: 10b)

Fibromatosis is a proliferation of fibroblastic and miofibroblastic cells that primarily originate from the fascia or aponeuroses of the abdominal wall. This entity has no potential metastatic risk, but can reappear locally. In rare cases it may develop in the breast, and it is extremely uncommon in the male breast. Fibromatosis of the breast presents clinical, mammographic and ultrasound signs of malignancy, and it can only be confirmed through histological analysis. We present the case of a 52-year-old man with a palpable and painless nodule in the right breast of 2 months' evolution with radiological signs of malignancy. The histological analysis determined that this was due to fibromatosis.     

Eighteen‐month clinical and radiographic evaluation of two root canal‐filling materials in primary teeth with pulp necrosis secondary to trauma

Abstract – Aim: This study compared clinically and radiographically the use of zinc oxide and eugenol cement (ZOE) and a commercial calcium hydroxide and polyethylene glycol‐based paste (Calen^®) thickened with zinc oxide as root canal‐filling materials for primary teeth with pulp necrosis secondary to trauma within 18 months of follow up. Material and methods: Eligible patients of both genders aged 2 years and 6 months to 5 years and 10 months who had been referred for dental treatment at a pediatric dental trauma service and presented at least one anterior primary tooth (central and/or lateral incisor) with pulp necrosis secondary to traumatic injury were selected. Twenty‐six children (n = 31 teeth) with mean age of 3.4 years met the inclusion criteria and were enrolled after parental written consent. The root canals were instrumented and filled with either ZOE (group I; n = 15 teeth) or Calen^® paste [composition: 2.5 g calcium hydroxide, 0.5 g zinc oxide, 0.05 g colophony, and 1.75 ml polyethylene glycol 400 (vehicle)] thickened with zinc oxide (Calen^®/ZO; group II; n = 16 teeth). ZO was added to the Calen^® paste for slowing paste resorption, which should ideally occur simultaneously with the physiologic resorption of primary tooth roots. Clinical success after 18 months of follow up was considered as absence of pain, tooth mobility or fistula, and radiographic success as the partial or total remission of apical periodontitis, absence of pathological root resorption or presence of new bone formation. Results: Eighteen months after treatment, the teeth obturated with ZOE and Calen^®/ZO presented statistically similar (Fisher’s exact test; P > 0.05) success rates of 93.3% and 87.5%, respectively. Conclusion: Our results showed the clinical and radiographic outcomes for Calen^®/ZO to be equal to those for ZOE after 18 months, suggesting that both materials can be indicated for obturating primary teeth with pulp necrosis after trauma.