Late Stage Infection in Sleeping Sickness

At the turn of the 19th century, trypanosomes were identified as the causative agent of sleeping sickness and their presence within the cerebrospinal fluid of late stage sleeping sickness patients was described. However, no definitive proof of how the parasites reach the brain has been presented so far. Analyzing electron micrographs prepared from rodent brains more than 20 days after infection, we present here conclusive evidence that the parasites first enter the brain via the choroid plexus from where they penetrate the epithelial cell layer to reach the ventricular system. Adversely, no trypanosomes were observed within the parenchyma outside blood vessels. We also show that brain infection depends on the formation of long slender trypanosomes and that the cerebrospinal fluid as well as the stroma of the choroid plexus is a hostile environment for the survival of trypanosomes, which enter the pial space including the Virchow-Robin space via the subarachnoid space to escape degradation. Our data suggest that trypanosomes do not intend to colonize the brain but reside near or within the glia limitans, from where they can re-populate blood vessels and disrupt the sleep wake cycles

Substitution im Sinne der akzeptierenden Drogenarbeit.

Die Substitution ist eine fest etablierte Behandlungsform von Opioidabhängigkeit. Sie steht in direktem Zusammenhang mit einer akzeptierenden Haltung gegenüber dem Konsumenten. Ziel dieser Arbeit soll die Überprüfung sein, ob Substitution im Sinne jener Haltung erfolgreich ist. Dies sind im Einzelnen die Therapieziele der Substitution wie auch das subjektive Erleben der Akzeptanz seitens der Klienten. Zur Feststellung jener Kriterien wurde eine qualitative Forschung in Form einer Fallstudie mittels Leitfadeninterviews durchgeführt. Das Ergebnis jener ist, dass die Substitution und die akzeptierende Drogenhilfe in diesem Kontext teilweise funktionieren, zum Teil aber auch strukturelle Mängel aufweisen. Durch Substitution können Klienten ihre Therapieziele erreichen, jedoch mit mangelnder Konstanz und nur mit großen Hürden. Die akzeptierende Drogenarbeit wird in der psychosozialen Beratung bereits umgesetzt, in anderen Bereichen der Substitution findet sie jedoch keine Anwendung. Dies bedarf politischen und gesellschaftlichen Anpassungen, um die Hilfeleistung für Opioidabhängige zu verbessern

Tratamento precoce de maloclusão classe III

A maloclusão do tipo Classe III de Angle, caracteriza-se por um prognatismo mandibular e/ou por deficiência maxilar. A etiologia deste tipo de maloclusão pode ser genética ou ambiental. Fatores genéticos podem levar a um crescimento maior da mandíbula ou menor da maxila. Quando há um desvio na erupção dos incisivos superiores para lingual, isto pode provocar uma mordida cruzada, impedindo a maxila de se desenvolver, pois estará bloqueada pela mandíbula.O tratamento precoce é fundamental para se evitar complicações futuras e possíveis cirurgias ortognáticas. Este estudo apresenta um tratamento ortodôntico precoce da maloclusão de Classe III, através do uso de aparelho removível. Paciente L.D.S., 9 anos, melanoderma, apresentou-se à Faculdade de Odontologia de Piracicaba em abril de 2003 para tratamento odontológico e ortodôntico. Ao exame clínico observou-se condição de saúde bucal e higiene deficientes. Optou-se por tratamento restaurador e adequação da saúde bucal para posterior reabilitação ortodôntica. Após a adequação, foi feita nova análise do caso através de modelos, fotografias intra e extrabucais, análise cefalométrica e plano de tratamento. Após esta fase foi adaptado um aparelho removível superior,constituído por um expansor palatino, com molas helicoidais anteriores e arco de Ascher, com ativação semanal de % de volta. Ao final de quatro meses de tratamento, observou-se total descruzamento anterior e harmonização da oclusão com restabelecimento neuromuscular.The Class III malocclusion is characterized by a mandibular prognatism and/or by a maxillary deficiency. Etiology of this type of malocclusion can be genetic or environmental. Genetic factors may lead to a bigger mandibular growth or a smaller maxillary growth. When there is a deviation in the eruptive pattern causing the maxillary permanent incisor to erupt in a lingual position, an anterior cross bite results. This situation hinders maxilla development. Early treatment is fundamental to avoid future complications and possible orthognathic surgery. This paper presents an early orthodontic treatment through the use of removable appliance. The patient L.D.S., 9 years old, melanoderm, locked for dental and orthodontics treatment at Piracicaba Dental School in April 2003. During the clinical exam deficient hygiene and poor oral condition were observed. Therefore restorative treatment and adequacy of the oral cavity were performed before orthodontic treatment. Afterwards, a new exam was done through plaster models, intra and extra oral photographs and cefalometric analysis. Was developed a removable orthodontic expansion appliance with helical springs and Ascher arc was chosen. This appliance was 1/4 turn activated weekly. After four months of treatment, total anterior uncrossing and harmonization of occlusion were observed and neuromuscular balance was achieve