Useful radiological techniques in orthodontics

Specialists in dento-facial orthopedics have a large range of dental radiological techniques at their disposal to help them in their diagnostic and therapeutic procedures. Peri-apical, occlusal, panoramic, and cephalometric X-Rays are two-dimensional techniques that orthodontists can complement, if necessary, with Multi slices CT scan or Cone Beam Computed Tomography. Orthodontists must apply and respect quality criteria for each type of film in order to derive the best information from every image and to avoid producing artifacts or false images that will reduce their diagnostic value and, accordingly, the service that they render to patients. Practitioners must be willing to spend the few moments it takes to position patients correctly in the radiological apparatus instead of taking multiple views to compensate for failing to scrupulously follow protocols of radiology.     

Evaluation of antigens from various Leishmania species in a Western blot for diagnosis of American tegumentary leishmaniasis

A Western blot method that uses antigens from culture promastigote forms of Leishmania (Viannia) braziliensis, L. (Leishmania) amazonensis, L. (Leishmania) tropica, and a trypanosomatid (strain 268T) isolated from naturally infected tomatoes was evaluated for laboratory diagnosis of American tegumentary leishmaniasis (ATL). Serum samples were obtained from 108 patients with ATL (group I), 23 chagasic patients (group II), 32 patients with other diseases (group III), and 78 healthy individuals (group IV). The overall analysis showed a sensitivity of 76.90%, 90.40%, 78.50%, and 87.90%, a specificity of 100%, 93.80%, 87.80%, and 77.10%, a positive predictive value of 100%, 94.00%, 89.50%, and 72.50%, a negative predictive value of 75.70%, 90.00%, 75.40%, and 90.20%, and a concordance coefficient kappa of 0.7358, 0.8400, 0.6491, and 0.6287 for L. (V.) braziliensis, L. (L.) amazonensis, L. (L.) tropica, and strain 268T antigens, respectively. The antigenic profile recognized by serum samples from patients with ATL and with Chagas' disease permits serologic distinction between these infections.     

Enhanced detection of reversible myocardial hypoperfusion by technetium 99m-tetrofosmin imaging and first-pass radionuclide angiography after nitroglycerin administration

Background  Reversal of ischemia after myocardial infarction by revascularization is worth-while only if viability exists in a sufficiently large portion of the left ventricle. Methods and Results  To determine myocardial hypoperfusion reversibility and its influence on segmental and global function, we studied 50 patients after myocardial infarction. Three technetium 99m-tetrofosmin scintigraphies were performed: 1 at rest, 1 after 0.6 mg sublingual nitroglycerin (NTG), and 1 after injection at peak stress. First-pass multigated radionuclide angiography was obtained at rest and after NTG. Each patient also underwent a stress redistribution-reinjection thallium-201 scintigraphy. During stress ^99mTc-tetrofosmin, 104 segments had normal uptake, 51 showed moderately reduced uptake, and 186 had severely reduced uptake. Of these 186 segments, 33 (18%) improved at rest, and 41 (22%) improved only after NTG. Fifty-nine (79%) of these segments with improved uptake were also found to have reversible defects on ²⁰¹Tl imaging. In the 26 patients with ventricular dysfunction, a 73% agreement was found between the functional and ^99mTc-tetrofosmin uptake post-NTG improvement, whereas a 69% agreement was found with thallium reinjection. No significant differences were seen between ^99mTc-tetrofosmin and ²⁰¹Tl imaging. Conclusion  Nitroglycerin administration during ^99mTc-tetrofosmin scintigraphy improves the detection of myocardium with reversible hypoperfusion in patients with a previous myocardial infarction.     

Bond strength of HEMA-containing versus HEMA-free self-etch adhesive systems to dentin

This study analyzed the bond strength (BS) of HEMA versus HEMA-free self-etch adhesive systems to dentin. The occlusal surface of 20 third molars was removed and the dentin was abraded with 600-grit silicon carbide paper. The teeth were randomly assigned to 4 groups (n = 5) and restored with GO, Adper SE Plus, OptiBond All-In-One, and Clearfil 3S Bond adhesive systems and Filtek Z350 composite. After light curing (600 mW/cm2), the teeth were stored in distilled water at 37 oC for 24 h and were sectioned in the mesiodistal and buccolingual directions to obtain sticks (0.8 mm2). The sticks were subjected to tensile force using a universal testing machine (0.5 mm/min), and the modes of failure were analyzed by scanning electron microscopy and classified as adhesive, cohesive, or mixed. The BS data (in MPa) were treated using one-way ANOVA and Tukey's tests at 5% significance. GO presented the lowest mean bond strength value (10.57 ± 3.72) and differed significantly from the other materials (p = 0.001), which, in turn, presented statistically similar results (p>0.05) among themselves: Adper SE Plus (29.08 ± 8.93), OptiBond All-In-One (28.36 ± 6.49), and Clearfil 3S Bond (28.62 ± 6.97). Mixed fractures were the most prevalent. It was concluded that the influence of HEMA on BS to dentin was material dependent.     

Anxiolytic-like effects of acute and chronic treatment with Achillea millefolium L. extract

Ethnopharmacological relevance

Achillea millefolium L. (Asteraceae), known as yarrow (“mil folhas”), has been used as folk medicine for gastrointestinal disorders, inflammation, anxiety, and insomnia.

Aim

To evaluate the potential anxiolytic-like effect of hydroalcoholic extract of Achillea millefolium L. in animal models.

Methods

The present study evaluated the effects of the hydroalcoholic extract from the aerial parts of Achillea millefolium L. in mice subjected to the elevated plus-maze, marble-burying, and open-field tests. Additionally, the GABA_A/benzodiazepine (BDZ) mediation of the effects of Achillea millefolium was evaluated by pretreatment with the noncompetitive GABA_A receptor antagonist picrotoxin and the BDZ antagonist flumazenil and by [³H]-flunitrazepam binding to the BDZ site on the GABA_A receptor.

Results

Achillea millefolium exerted anxiolytic-like effects in the elevated plus-maze and marble-burying test after acute and chronic (25 days) administration at doses that did not alter locomotor activity. This behavioral profile was similar to diazepam. The effects of Achillea millefolium in the elevated plus-maze were not altered by picrotoxin pretreatment but were partially blocked by flumazenil. Furthermore, Achillea millefolium did not induce any changes in [³H]-flunitrazepam binding.

Conclusion

The results indicate that the orally administered hydroalcoholic extract of Achillea millefolium L. exerted anxiolytic-like effects that likely were not mediated by GABA_A/BDZ neurotransmission and did not present tolerance after short-term, repeated administration.     

Using focus groups to revise an educational booklet for people living with methicillin-resistant Staphylococcus aureus (MRSA)

The incidence of methicillin-resistant staphylococcus aureus (MRSA) has grown in epidemic proportions; in many individuals, MRSA causes recurrent infections. MRSA infections can be transmitted from person to person through direct contact or contact with contaminated objects. Once confined to hospitalized individuals, MRSA is now seen in otherwise healthy individuals and congregate community settings. There is a demand for educational materials to guide MRSA patients in self-care, preventing recurrences, and reducing transmission. In 2004, Tacoma-Pierce County Health Department in Washington State led the effort to create an educational booklet for people with MRSA. Due to resource constraints, it was created without audience testing. In 2005, the revision of Living With MRSA involved audience testing using two focus groups comprising people living with MRSA and their families. This report describes the work of an interdisciplinary professional work group using focus groups to revise an educational booklet for people living with MRSA as patients, family members, and caregivers.     

Obesity in kidney disease: A heavyweight opponent

Obesity is an important worldwide challenge that must be faced in most developed and developing countries because of unhealthy nutritional habits. The consequences of obesity and being overweight are observed in different organs, but the kidney is one of the most affected. Excess adipose tissue causes hemodynamic alterations in the kidney that can result in renal disease. However, obesity is also commonly associated with other comorbidities such as chronic inflammation, hypertension and diabetes. This association of several aggravating factors is still a matter of concern in clinical and basic research because the pathophysiologic mechanisms surrounding chronic kidney disease development in obese patients remain unclear. This review will discuss the consequences of obesity in the context of renal injury.     

Tinea faciei in an infant caused by Microsporum gypseum simulating a dry impetigo

We report a 14-month-old White boy who was referred to our dermatology unit for evaluation of a skin eruption on his nose. The initial examination led us to the clinical diagnosis of impetigo. The mycologic studies found an uncommon dermatophyte agent, Microsporum gypseum. The main differential diagnosis of tinea faciei is discussed.     

Myocardial architecture, texture and left ventricular heterogeneity in the pulsed Doppler tissue imaging pattern.

The regional contribution for the global ventricular functional performance is complex and heterogeneous, the myocardial texture could reflect this particular aspect, during the phases of myocardial contraction and relaxation. The objective of our clinical study was to evaluate the relationship between the segmental myocardial velocity pattern by Doppler tissue imaging and the ultrasound characteristics of the left ventricular myocardium analysed by computerized ultrasound densitometry with the calculation of its intensity (dB), in a population of 22 subjects without clinical history of cardiovascular pathology, 50% female gender, mean age 43 +/- 11 years (19-66 years). In the methodology of study, the left ventricular myocardium was divided in 16 segments, according with the transthoracic echocardiographic recommendations of the American Society of Echocardiography (A.S.E.). During one cardiac cycle interval, the ultrasound characteristics of the left ventricular myocardium were evaluated continuously and in a quantitative manner, applying the computerized ultrasound densitometry method on the gray scale images of the ventricular myocardium, with the sample size identical to the myocardial wall thickness. The peak (Vmax-cm/sec) and mean (Vm-cm/sec) pulsed Doppler tissue imaging velocities, individuals, segmental and a total velocities, contraction and relaxation velocities of the left ventricular myocardium were obtained immediately after the computerized ultrasound densitometry analysis. Ultrasound densitometry and Doppler tissue imaging data were obtained in a total number of 352 left ventricular myocardial segments. Using the multiple linear correlation matrix analysis, the ultrasound intensity registered inverse significant correlation's with the Doppler tissue imaging Vmax and Vm for the systolic "s" wave in the total segments and each one of them (r = -0.66; p = 0.001; interval 2-18 cm/sec; r = -0.52 to -0.70) and with the early diastolic "e" wave (r = -0.42; p = 0.01; interval 2-19 cm/sec; r = -0.35 to -0.55). Direct correlation's were obtained for the computerized ultrasound densitometry intensity and Doppler tissue imaging Vmax and Vm of the late diastolic "a" wave in the total number of the left ventricular myocardial wall segments and in each one of them (r = 0.51; p = 0.01; interval 1-17 cm/sec; r = 0.42 a 0.66). We conclude that in our study and under physiological conditions of myocardial performance, a direct correlation was obtained between the ultrasound characteristics of the ventricular myocardial imaging and its velocities of contraction and relaxation. These facts reflect the close relationship between left ventricular myocardial structure and function, analyzed by the new ultrasound Doppler technologies.