Computerized Baropodometry In Obese Patients

Background: Few studies have investigated the influence of obesity on the structural and functional performance of the feet, and its potential implications for the musculoskeletal system. Computerized baropodometric analysis (CPA) is a new investigation for the center of pressure, plantar surface area and plantar pressure while standing on the platform of a specialized apparatus. CPA is relevant to gait and posture, and may be important as well for postoperative musculoskeletal disorders. We investigated the biomechanical dysfunctions of foot pressure by means of CPA in bariatric and non-bariatric subjects. Methods: Subjects (n=67, 71.6% females, age 40.8 ± 13.8 years, BMI 31.4 ± 11.0 kg/m²) included obese (BMI 30.0-60.0 kg/m², n=27), overweight (BMI 25.0-29.9 kg/m², n=12) and normal-weight controls (BMI 20.0-24.9 kg/m², n=28) of equivalent age and gender. Variables included center of pressure location, plantar ground contact area and pressure, and pressure patterns (maximum and average) in different regions of the foot, during quiet standing on the platform of the baropodometer. Results: A significant increase was detected for peak pressure on forefoot and plantar ground contact area in the obese group, compared to control and overweight cases, during quiet standing. Conclusion: Excessive forefoot pressure and enlarged support area were a consequence of obesity, mirroring the efforts of the obese subject to acquire a wider and stronger support base. Although this is originally a physiological change, it may result in maladaptative and degenerative musculoskeletal consequences. Re-education exercises may be advised, in combination with bariatric surgery in the morbidly obese, aiming at restoration of normal gait and posture, as well as at minimization of stress damage to bones and joints in the axial skeleton.     

Neorickettsia helminthoeca associated lymphoid,enteric, and pulmonary lesions in dogs from Southern Brazil: An immunohistochemical study

Neorickettsia helminthoeca (NH), the agent of salmon poisoning disease or canine neorickettiosis (CN), is a bacterial endosymbiont of the nematode Nanophyetus salmincola, and infections are spreading among specific fish‐eating mammalians. This article describes the pathologic and immunohistochemical findings associated with spontaneous NH‐induced infections in dogs from Southern Brazil. The principal pathologic findings were hypertrophy of Peyer patches and lymphadenopathy with lymphocytic proliferation, chronic interstitial pneumonia, and chronic enteritis associated with positive intralesional immunoreactivity to antigens of NH within macrophages and histiocytes. Positive immunoreactivity against canine parvovirus‐2 (CPV‐2) or/and canine distemper virus was not detected in the evaluated intestinal segments or in the samples from the cerebellum and lungs, respectively, from the dogs evaluated. These findings demonstrated that NH was involved in the enteric, pulmonary, and lymphoid lesions herein described, and provide additional information to confirm the occurrence of this bacterial endosymbiont within this geographical location. It is proposed that chronic pneumonia should be considered as a pathologic manifestation of NH‐induced infections. Additionally, our results show that the occurrences of CN seem to be underdiagnosed in Southern Brazil due to the confusion with the incidence of CPV‐2.     

Decreased TNF-α gene expression in periodontal ligature in MSG-obese rats: A possible protective effect of hypothalamic obesity against periodontal disease?

The prevalence of obesity is increasing globally. There is evidence that the uncontrolled energetic metabolism in obese patients can accelerate periodontal disease. Therefore, the aim of this study was evaluate the possible relationship between hypothalamic obesity induced by neonatal treatment with MSG and experimental periodontal disease. Newborn male Wistar rats received subcutaneous injections in the cervical region, of 4g/Kg/day of body weight (BW) of MSG (MSG group) or hypertonic saline solution, 1.25/kg/day BW (control group, CTL). At 70 days of life periodontal disease was induced in these animals. After they were sacrificed, radiographic analyses of alveolar bone resorption and Tumor Necrosis Factor α (TNFα) gene expression in gingival tissue were performed. The neonatal treatment with MSG did not affect the concentration of plasma glucose and cholesterol (CHOL). However, plasma insulin, non-esterified fatty acids (NEFA) and triglycerides (TG) leves were higher in MSG compared with CTL group. The alveolar bone resorption was 44% lower in MSG-obese rats compared with CTL rats. In the presence of periodontal ligature, there was an increase in this parameter in all groups. The TNFα gene expression, an inflammatory marker, in periodontal tissue was similar in obese and CTL rats. The presence of ligature increased TNFα gene expression in both groups, but in a lower extension in MSG-obese rats. In conclusion these results suggested that hypothalamic obesity may produce a protective effect against periodontal disease, however further research is needed to understand the mechanisms involved in this process.     

Age of first dental visit and predictors for oral healthcare utilisation in preschool children

Purpose: To assess the age the of the first dental visit and the association of self-perceived oral health, socioeconomic and clinical indicators with healthcare utilisation in Brazilian preschool children. Materials and Methods: An epidemiological survey with 455 5- to 59-month-old children was conducted on National Children's Vaccination Day in Santa Maria, RS, Brazil. Data about age and reasons for the first dental visit, healthcare utilisation, socioeconomic status and self-perceived oral health were collected by means of a parental semi-structured questionnaire. Calibrated examiners evaluated the prevalence of dental caries (WHO) and dental trauma. The assessment of the association used Poisson regression models (prevalence ratio; 95% confidence interval [CI]). Results: A total of 24.2% (95% CI: 20.3% to 28.4%) of the study sample had already had a first dental visit. Older children, those with dental caries and dental trauma and whose mothers had a higher level of education were more likely to have gone to the dentist. Children of low socioeconomic status were more likely to have visited public than private healthcare services. The reasons for the first dental visit were associated with clinical indicators of the sample. The distribution of utilisation of the types of oral healthcare services (public or private) varied across the socioeconomic groups. Non-white children with dental caries and dental trauma tended to visit a dentist only for treatment reasons. Conclusion: Socioeconomic and clinical indicators are associated with the use of dental services, indicating the need for strategies to promote public health and reorientation of services that facilitate dental access for preschool children.     

Use of the connective tissue graft for the coverage of composite resin-restored root surfaces in maxillary central incisors

The purpose of this article is to report the use of the subepithelial connective tissue graft technique combined with the coronally positioned flap on a composite resin-restored root surface to treat Miller Class I gingival recessions associated with deep cervical abrasions in maxillary central incisors. Clinical measurements, including gingival recession height, probing depth, and bleeding on probing (BoP), were recorded during the preoperative clinical examination and at 2, 6, 12, and 24 months postoperatively. During the follow-up periods, no periodontal pockets or BoP were observed. The periodontal tissue of the teeth presented normal color, texture, and contouring. In addition, it was observed that creeping attachment had occurred on the restoration. This case report shows that this form of treatment can be highly effective and predictable in resolving gingival recession associated with a deep cervical abrasion.     

Correlates of change in self-perceived oral health among older adults in Brazil: findings from the Health, Well-Being and Aging Study

BackgroundIdentifying changes in the oral health status of older populations, and their predictors and explanations, is necessary for public health planning. The authors assessed patterns of change in oral health–related quality of life in a large cohort of older adults in Brazil during a five-year period and evaluated associations between baseline characteristics and those changes.MethodsThe sample consisted of 747 older people enrolled in a Brazilian cohort study called the Health, Well-Being and Aging (Saúde, Bem-estar e Envelhecimento [SABE]) Study. Trained examiners measured participants' self-perceived oral health by using the General Oral Health Assessment Index (GOHAI). The authors calculated changes in the overall GOHAI score and in the scores for each of the GOHAI's three dimensions individually by subtracting the baseline score from the score at follow-up. A positive difference indicated improvement in oral health, a negative difference indicated a decline and a difference of zero indicated no change.ResultsThe authors found that 48.56 percent of the participants experienced a decline in oral health and 33.48 percent experienced an improvement. Participants with 16 or more missing teeth and eight or more years of education were more likely to have an improvement in total GOHAI score. Deterioration was more likely to occur among those with two or more diseases. Improvement and decline in GOHAI functional scores were related to the number of missing teeth. The authors found no significant model for the change in the psychosocial score, and self-rated general health was the only variable related to both improvement and decline in pain or discomfort scores.ConclusionsThe authors observed a bidirectional change in self-perceived oral health, with deterioration predominating. The strongest predictor of improvement in the total GOHAI score was the number of missing teeth, whereas the number of diseases was the strongest predictor of deterioration.Clinical ImplicationsDental professionals and policymakers need to know the directions of change in older adults' oral health to establish treatment priorities and evaluate the impact of services directed at this population.     

Ultrastructural evaluation of the hybrid layer after cementation of fiber posts using adhesive systems with different curing modes

This in vitro study evaluated the adhesive interface of intraradicular fiber glass posts and root dentin using scanning electron microscopy (SEM). Forty-eight single-rooted premolars were randomly divided into 6 groups consisting of chemical, dual, or light cured adhesive systems combined with either chemical or dual cure resin cements. Scanning electron microscopic analysis showed the best results for continuity, density and morphology of the hybrid layer and resin tags for the combination of a self-cure adhesive with self-cure cement resin, followed by a dual-cure adhesive with self-cure cement resin, and finally a light-cure adhesive with self-cure cement. For the dual-cure resin cement, the same relation may be observed. The apical third was the most critical region for evaluated the criteria for all combinations of materials (Kruskal-Wallis and Friedman tests; p<0.001). Generally, the simplification of steps in the adhesive system and the polymerization reaction of resin adhesives and cements produced a direct effect on the quality of the adhesive post/dentin substrate interface.     

Vestibular rehabilitation therapy in children.

OBJECTIVES: Vestibular disturbances are underdiagnosed in children. However, balance impairment may compromise the normal development of affected children. The appropriate therapeutic approach has not been agreed on for this age group. Vestibular rehabilitation therapy has excellent results in adults, but very few data exist regarding its results in children. We evaluated through clinical assessment and computerized dynamic posturography the outcome of children with peripheral vestibular disturbances undergoing vestibular rehabilitation therapy and observed the influence of learning and of central nervous system maturation on posturography retest results. METHODS: Sixteen children (10 boys and 6 girls) with peripheral vestibular disorders (mean age, 8 yr 7 mo) constituted the cohort and were consecutively treated with vestibular rehabilitation therapy. Symptomatic children underwent pre- and posttreatment computerized dynamic posturography. Their outcome was clinically assessed. Another 16 asymptomatic children, paired by sex and age, underwent two computerized dynamic posturography procedures with the same time interval as that of the symptomatic group. RESULTS: All children completed the treatment. Total recovery of symptoms occurred in nine (56.3%) patients, whereas a dramatic partial recovery was observed in the remaining seven (43.7%) children. Posturography Conditions 5 and 6, the vestibular ratio of the sensory analysis, and the composite equilibrium score had a significant quantitative improvement after vestibular rehabilitation therapy. No adverse reactions occurred to the exercises. No statistically significant posturography changes were observed in the asymptomatic children. CONCLUSION: Vestibular rehabilitation therapy seems to be a safe and efficacious therapeutic option in children with peripheral vestibular disturbances.     

Longer Times of Receipt of Adjuvant Endocrine Therapy Correspond to Improved Functional Capacity and Lower Adiposity in Women Receiving Adjuvant Therapy

Purpose

To study the use of functional capacity (FC) level and duration of aromatase inhibitor (AI) therapy with adiposity parameters in women with breast cancer.

Seasonal variation of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in endemic area of visceral leishmaniasis, Campo Grande, state of Mato Grosso do Sul, Brazil

The seasonal distribution of Lutzomyia longipalpis was studied in two forested and five domiciliary areas of the urban area of Campo Grande; MS, from December 2003 to November 2005. Weekly captures were carried out with CDC light traps positioned on ground and in the canopy inside a residual forest and on the edge (ground) of a woodland and in at least one of the following ecotopes in peridomiciles-a cultivated area, a chicken coop, a pigsty, a kennel, a goat and sheep shelter and an intradomicile. A total of 9519 sand flies were collected, 2666 during the first year and 6853 during the second. L. longipalpis was found throughout the 2-year period, presenting smaller peaks at intervals of 2-3 months and two greater peaks, the first in February and the second in April 2005, soon after periods of heavy rain. Only In one of the woodlands was a significant negative correlation (p<0.05) between the number of insects and temperature during the first year and the climatic factors (temperature, RHA and rain) was observed. In the domiciliary areas in four domiciles some positive correlations (p< or =0.05) occurred in relation to one or more climatic factors; however, the species shows a clear tendency to greater frequency (72%) in the rainy season than in the dry (28%). Thus, we recommend an intensification of the VL control measures applied in Campo Grande, MS, during the rainy season with a view to reducing the risk of the transmission of the disease.