Cariogenic bacteria and dental health status in adolescents: the role of oral health behaviours

AIM: To evaluate the association between dental health status and levels of cariogenic bacteria in teenagers and the influence of behaviours and socio-demographic background on levels of bacteria. MATERIALS AND METHODS: Study design: A cross-sectional population-based sample of 13-year-old adolescents (112 females and 78 males, total 190) was examined. The number of decayed, missing and filled surfaces (DMFS), plaque and hygiene index were recorded according to the WHO criteria. The saliva samples were collected in a sterile container and then analysed by culture on Mitis Salivarius Bacitracin (MSB) agar for mutans Streptococci and on Man Rogosa Sharp (MRS) agar for Lactobacilli. The levels of bacteria were expressed as the number of colonies forming units per millilitre of saliva (CFU/ml). Associations between levels of mutans Streptococci and Lactobacilli and dental health were estimated by odds ratio (OR) and 95% confidence interval (95% CI) using unconditional logistic regression. RESULTS: No mutans Streptococci were detected in 53.2% of the adolescents but 22.6% presented ≥ 10³ CFU/ml. For Lactobacilli, these values were, respectively 43.7% and 34.7%. After adjustment for gender and social class, the OR (95% CI) for DMFS >5 was 8.66 (3.57-21.02) if mutans Streptococci ≥ 10³ CFU and 2.11 (0.96-4.64) if Lactobacilli ≥ 10³ CFU. CONCLUSION: This data allow us to conclude that hygiene habits and dental visits are not associated with high levels of cariogenic bacteria, but high scores of DMFS were found in adolescents with high levels of mutans Streptococci and lower parents' education

Ventricular BNP gene expression in acute cardiac overload

INTRODUCTION:B-type natriuretic peptide (BNP) plasma levels have important diagnostic and prognostic implications in heart failure (HF). Recently, aside from its natriuretic effect, antiproliferative and antifibrotic actions of BNP on the cardiovascular system have been described. Under physiological conditions the atria are the main source of this peptide, while its ventricular expression is still controversial. The aim of this work was to evaluate, in an animal model, the ventricular expression of BNP in normal hearts, at baseline and under acute cardiac overload.METHODS:Anesthetized open chest male Wistar rats (n=18) were instrumented with a micromanometer in the right ventricular cavity for pressure assessment. Randomization for three different protocols was then performed: (i) pressure overload for a period of 6 hours (SPr; n = 6), by pulmonary trunk banding, in order to double basal right ventricular systolic pressure; (ii) volume overload with a six-hour perfusion of Dextran 40 (SVol; n = 6), to raise end-diastolic right ventricular pressure fourfold; (iii) sham operated rats (n = 6). Transmural samples from the right ventricular free wall were then obtained for quantification of BNP mRNA by RT and quantitative real-time PCR. The results are expressed as mean+/-SEM (number molecules of mRNA BNP)/(ng total mRNA); p < 0.05.RESULTS:A basal expression of BNP was identified in the sham group (3.6x10(7) +/- 1.7x10(7)). BNP mRNA levels were elevated in both the SPr and SVol groups (+123.1 +/- 46.3% SPr and +171.6 +/- 87.7% SVol).CONCLUSIONS:Acute cardiac pressure and volume overload are associated with increased ventricular BNP gene expression. Our results suggest that BNP may be involved in early ventricular remodeling

The Dark Side of SAPHO Syndrome

SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) is a relatively rare entity. The therapeutic approach of patients with SAPHO syndrome has included multiple drugs with varying success and incoherence responses. The therapy is still empirical today. SAPHO syndrome is commonly treated with non-steroidal anti-inflammatory drugs, bisphophonates and non-biologic disease modifying antirheumatic drugs. Recent reports showed successful treatment with tumour necrosis factor α (TNF α) antagonists, but there is still a dark side of SAPHO syndrome including a subgroup of patient's refractory to all the treatments that have been empirically experienced. A clinical report of a patient with SAPHO syndrome with 12 years of evolution is described. All the therapeutic approaches, including anti TNF α therapy, have not prevented the clinical and radiographic progression of the disease. Given that the disease affects mostly younger patients, new therapeutic strategies are necessary in order to avoid potentially irreversible joint and bone lesions.info:eu-repo/semantics/publishedVersio

Finite element analysis of pectus carinatum surgical correction via a minimally invasive approach

Pectus carinatum (PC) is a chest deformity caused by a disproportionate growth of the costal cartilages compared to the bony thoracic skeleton, pulling the sternum towards, which leads to its protrusion. There has been a growing interest on using the 'reversed Nuss' technique as a minimally invasive procedure for PC surgical correction. A corrective bar is introduced between the skin and the thoracic cage and positioned on top of the sternum highest protrusion area for continuous pressure. Then, it is fixed to the ribs and kept implanted for about 2-3 years. The purpose of this work was to (a) assess the stresses distribution on the thoracic cage that arise from the procedure, and (b) investigate the impact of different positioning of the corrective bar along the sternum. The higher stresses were generated on the 4th, 5th and 6th ribs backend, supporting the hypothesis of pectus deformities correction-induced scoliosis. The different bar positioning originated different stresses on the ribs' backend. The bar position that led to lower stresses generated on the ribs backend was the one that also led to the smallest sternum displacement. However, this may be preferred, as the risk of induced scoliosis is lowered.This work was financially supported by the Potuguese Foundation for Science and Techrnology (FCT) under the R&D project PTDC/SAU-BEB/103368/2008 and the fellowship SFRH/BPD/46851/2008

Third-generation cholecystectomy by natural orifices: transgastric and transvesical combined approach (with video)

BACKGROUND:An isolated transgastric port has some limitations in performing transluminal endoscopic cholecystectomy. However, transvesical access to the peritoneal cavity has recently been reported to be feasible and safe.OBJECTIVE:To assess the feasibility and the technical benefits of transgastric and transvesical combined approach to overcome the limitations of isolated transgastric ports.DESIGN:We created a transgastric and transvesical combined approach to perform cholecystectomy in 7 consecutive anesthetized female pigs. The transgastric access was achieved after perforation and dilation of the gastric wall with a needle knife and with a balloon, respectively. Under cystoscopic control, an ureteral catheter, a guidewire, and a dilator of the ureteral sheath were used to place a transvesical 5-mm overtube into the peritoneal cavity. By using a gastroscope positioned transgastrically and a ureteroscope positioned transvesically, we carried out cholecystectomy in all animals.RESULTS:Establishment of transvesical and transgastric accesses took place without complications. Under a carbon dioxide pneumoperitoneum controlled by the transvesical port, gallbladder identification, cystic duct, and artery exposure were easily achieved in all cases. Transvesical gallbladder grasping and manipulation proved to be particularly valuable to enhance gastroscope-guided dissection. With the exclusion of 2 cases where mild liver-surface hemorrhage and bile leak secondary to the sliding of cystic clips occurred, all remaining cholecystectomies were carried out without incidents.LIMITATIONS:Once closure of the gastric hole proved to be unreliable when using endoclips, the animals were euthanized; necropsy was performed immediately after the surgical procedure.CONCLUSIONS:A transgastric and transvesical combined approach is feasible, and it was particularly useful to perform a cholecystectomy through exclusive natural orifices

Multiple Arthritis: Three in One

info:eu-repo/semantics/publishedVersio

Long-term monitoring across elevational gradients to assess ecological hypothesis : a description of standardized sampling methods in oceanic islands and first results

We are launching a long-term study to characterize the biodiversity at different elevations in several Azorean Islands. Our aim is to use the Azores as a model archipelago to answer the fundamental question of what generates and maintains the global spatial heterogeneity of diversity in islands and to be able to understand the dynamics of change across time. An extensive, standardized sampling protocol was applied in most of the remnant forest fragments of five Azorean Islands. Fieldwork followed BRYOLAT methodology for the collection of bryophytes, ferns and other vascular plant species. A modified version of the BALA protocol was used for arthropods. A total of 70 plots (10 m x 10 m) are already established in five islands (Flores, Pico, São Jorge, Terceira and São Miguel), all respecting an elevation step of 200 m, resulting in 24 stations examined in Pico, 12 in Terceira, 10 in Flores, 12 in São Miguel and 12 in São Jorge. The first results regarding the vascular plants inventory include 138 vascular species including taxa from Lycopodiophyta (N=2), Pteridophyta (N=27), Pinophyta (N=2) and Magnoliophyta (N=107). In this contribution we also present the main research question for the next six years within the 2020 Horizon

The MOVECLIM – AZORES project: Bryophytes from Pico Island (2012)

ABSTRACT: In September 2012, Pico Island was surveyed along an elevational transept starting on Manhenha, at 10 m a.s.l., and ending on the Pico Mountain caldera, at 2200 m a.s.l. to obtain a systematic inventory of the bryophytes living in natural environments. A total of twelve sites were examined, separated by 200 m elevation steps. At each site, two 10 m x 10 m plots were established within 10-15 m from each other, and within each plot, three 2 m x 2 m quadrats were randomly selected and thoroughly sampled for bryophytes using microplots of 10 cm x 5 cm, collected to paper bags. Six substrates were explored within each quadrat: rock, soil, humus, organic matter, tree bark and leaves/fronds; three replicates were made for each substrate, whenever available and colonized by bryophytes, totalling a maximum of 18 microplots per quadrat, 54 microplots per plot, 108 microplots per site and 1296 microplots on the 12 sites of Pico Island. It was possible to collect two thirds of the maximum expected number of microplots (N=878; 67,75%), resulting in 4896 specimens, the great majority of which (n=4869) were identified to the species/subspecies level. Overall, it was possible to identify 70 moss’ and 71 liverwort’ species and subspecies. The elevation levels both with a greater number of microplots and higher richness of species were those between 600-1000 m a.s.l., coinciding with the native forest plots. The study contributed to improve the knowledge of Azorean bryophyte diversity and distribution at both local and regional scales, including the recording of new taxa for Pico Island and the Azores.info:eu-repo/semantics/publishedVersio

A new methodology for assessment of pectus excavatum correction after bar removal in Nuss procedure: preliminary study

Purpose: The objective is to present a new methodology to assess quantitatively the impact of bar removal on the anterior chest wall, among patients with pectus excavatum who have undergone the Nuss procedure, and present a preliminary study using this methodology. Methods: We propose to acquire, for each patient, the surface of the anterior chest wall using a three-dimensional laser scanner at subsequent time points (short term: before and after surgery; long term: follow-up visit, 6 months, and 12 months after surgery). After surfaces postprocessing, the changes are assessed by overlapping and measuring the distances between surfaces. In this preliminary study, three time points were acquired and two assessments were performed: before vs after bar removal (early) and before vs 2-8 weeks after bar removal (interim). In 21 patients, the signed distances and volumes between surfaces were computed and the data analysis was performed. Results: This methodology revealed useful for monitoring changes in the anterior chest wall. On average, the mean, maximum, and volume variations, in the early assessment, were -0.1 +/- 0.1 cm, -0.6 +/- 0.2 cm, and 47.8 +/- 22.2 cm(3), respectively; and, in the interim assessment, were -0.5 +/- 0.2 cm, -1.3 +/- 0.4 cm, and 122.1 +/- 47.3 cm3, respectively (p < 0.05). Data analysis revealed that the time the bar was in situ was inversely and significantly correlated with postretraction and was a relevant predictor of its decrease following surgery (p < 0.05). Additionally, gender and age suggested influencing the outcome. Conclusions: This methodology is novel, objective and safe, helping on follow-up of pectus excavatum patients. Moreover, the preliminary study suggests that the time the bar was in situ may be the main determinant of the anterior chest wall retraction following bar removal. Further studies should continue to corroborate and reinforce the preliminary findings, by increasing the sample size and performing long-term assessments.FEDER funds, through the Competitiveness Factors Operational Programme (COMPETE), and by National funds, through the Foundation for Science and Technology (FCT), under the scope of the projects PTDC/SAU-BEB/103368/2008 and POCI-01-0145-FEDER-007038; and by the projects NORTE-07-0124-FEDER-000017 and NORTE-01-0145-FEDER-000013, supported by the Northern Portugal Regional Operational Programme (NORTE 2020), under the Portugal 2020 Partnership Agreement, through the European Regional Development Fund (FEDER)info:eu-repo/semantics/publishedVersio