Marginal bone loss in the second molar related to impacted mandibular third molars : comparison between panoramic images and cone beam computed tomography

Deciding whether or not to extract third molars remains a controversial situation in dental practice. Image exams support this decision by enabling a close view of the third molar, its adjacent bone and its relationship with the second molar. This study aimed to assess and compare second molar bone loss adjacent to impacted mandibular third molar in panoramic radiographs (PAN) and cone beam computed tomography (CBCT) scans. A sample of 70 patients was selected (n=124 teeth). Each patient had a set of a panoramic radiograph and CBCT scans consecutively taken for dental treatment purposes. In PAN and CBCT, mandibular third molars were classified based on their position and bone loss of the adjacent second molar. Agreement between PAN and CBCT scans was assessed and quantified. Outcomes of bone loss assessment were different between PAN and CBCT scans (p<0.05). Bone loss was found in 62.9% of the PAN, while in CBCT scans it was found in 80%. In particular, nearly 29% (n=27) of the teeth that were classified without bone loss in PAN were classified with bone loss in CBCT scans. Mesioangular and horizontal third molars had a statistically significant association with bone loss of the adjacent second molars (p<0.05). In general, PAN underestimated the severity of bone loss compared to CBCT scans (p<0.05). Diagnosing second molar bone loss due to impaction of adjacent third molar in PAN may be challenging because of false negatives. Impacted third molars justify preoperative CBCT scans if second molar bone loss needs to be precisely assessed for a more detailed and reliable treatment plan

Could phylogenetic analysis be used for feline Leukemia Virus (FeLV) classification?

The surface envelope (SU) protein determines the cell tropism and consequently the pathogenesis of the feline leukemia virus (FeLV) in felids. Recombination of exogenous FeLV (exFeLV) with endogenous retroviruses (enFeLV) allows the emergence of more pathogenic variants. Currently, phenotypic testing through interference assays is the only method to distinguish among subgroups—namely, FeLV-A, -B, -C, -E, and -T. This study proposes a new method for FeLV classification based on molecular analysis of the SU gene. A total of 404 publicly available SU sequences were used to reconstruct a maximum likelihood tree. However, only 63 of these sequences had available information about phenotypic tests or subgroup assignments. Two major clusters were observed: (a) clade FeLV-A, which includes FeLV-A, FeLV-C, FeLV-E, and FeLV-T sequences, and (b) clade enFeLV, which includes FeLV-B and enFeLV strains. We found that FeLV-B, FeLV-C, FeLV-E, and FeLV-T SU sequences share similarities to FeLV-A viruses and most likely arose independently through mutation or recombination from this strain. FeLV-B and FeLV-C arose from recombination between FeLV-A and enFeLV viruses, whereas FeLV-T is a monophyletic subgroup that has probably originated from FeLV-A through combined events of deletions and insertions. Unfortunately, this study could not identify polymorphisms that are specifically linked to the FeLV-E subgroup. We propose that phylogenetic and recombination analysis together can explain the current phenotypic classification of FeLV viruses

Level of nitrate in lettuce as a result of fertilization, harvesting time and storage period

O experimento foi conduzido na Fazenda Água Limpa, UnB em Brasília, de janeiro a março de 2004, com o objetivo de avaliar o acúmulo de nitrato em alface, cv. Verônica, sob cultivo protegido, em função da adubação, horário de colheita e tempo de armazenamento (8ºC). O delineamento experimental foi de blocos ao acaso, em esquema fatorial 5 x 4 x 4, em quatro repetições. Os cinco tratamentos de adubação foram: 1,5 kg m-2 de cama-de-frango (T1); 3,0 kg m-2 de esterco bovino (T2); mineral, de acordo com a análise química do solo - M (T3); M acrescida de 1,5 kg m-2 de cama-de-frango (T4) e M acrescida de 3,0 kg m-2 de esterco bovino (T5). Os horários de colheita foram 7; 11; 15 e 18 horas, e os períodos de armazenamento foram 0; 3; 5 e 7 dias. Os tratamentos T1 e T4 resultaram em plantas com os maiores teores de nitrato foliar, 1240,12 e 1303,66 mg NaNO3 kg-1, respectivamente; enquanto T2 resultou no menor acúmulo de nitrato, 547,26 mg NaNO3 kg-1. Porém, quando o esterco bovino foi associado ao adubo mineral (T5), ocorreu um aumento de 2,18 vezes no teor de nitrato foliar (1195,25 mg NaNO3 kg-1). Plantas colhidas às 7 horas apresentaram os menores teores de nitrato, sugerindo ser este o melhor horário para colheita da alface no Distrito Federal. O armazenamento proporcionou uma redução de 29,3% no teor de nitrato ao longo de 7 dias. ________________________________________________________________________________ ABSTRACTThe experiment was carried out in Brasilia, Brazil, from January to March 2004, aiming to evaluate the level of nitrate in lettuce, cv. Veronica, as a result of fertilization, harvesting time and storage period (8ºC). We used the ramdomized blocks experimental design in a factorial 5 x 4 x 4, with four replicates. The five fertilization treatments tested were: 1,5 kg m-2 of chicken manure (T1); 3,0 kg m-2 of cattle manure (T2); mineral, as a result of soil chemical analysis - M (T3); M with 1,5 kg m-2 of chicken manure (T4); and M with 3,0 kg m-2 of cattle manure (T5). The harvesting times were 7 and 11 a.m., and 3 and 6 p.m. The storage periods were 0; 3; 5 and 7 days. The treatments T1 and T4 resulted in plants with the highest levels of nitrate, 1240,12 and 1303,66 mg NaNO3 kg-1, respectivelly, while T2 resulted in the lowest nitrate level, 547,26 mg NaNO3 kg-1. However, when cattle manure was added to M (T5), an increase of 2,18 times was observed in the nitrate level (1195,25 mg NaNO3 kg-1). Plants harvested at 7 a.m. showed the lowest levels of nitrate, suggesting that it is the best moment to harvest lettuce in the Distrito Federal region. During the storage period of seven days, nitrate level was reduced by 29,3%

Contributions of IFN-gamma and granulysin to the clearance of Plasmodium yoelii blood stage

P. vivax-infected Retics (iRetics) express human leukocyte antigen class I (HLA-I), are recognized by CD8+ T cells and killed by granulysin (GNLY) and granzymes. However, how Plasmodium infection induces MHC-I expression on Retics is unknown. In addition, whether GNLY helps control Plasmodium infection in vivo has not been studied. Here, we examine these questions using rodent infection with the P. yoelii 17XNL strain, which has tropism for Retics. Infection with P. yoelii caused extramedullary erythropoiesis, reticulocytosis and expansion of CD8+CD44+CD62L- IFN-gamma-producing T cells that form immune synapses with iRetics. We now provide evidence that MHC-I expression by iRetic is dependent on IFN-gamma-induced transcription of IRF-1, MHC-I and beta2-microglobulin (beta2-m) in erythroblasts. Consistently, CTLs from infected wild type (WT) mice formed immune synapses with iRetics in an IFN-gamma- and MHC-I-dependent manner. When challenged with P. yoelii 17XNL, WT mice cleared parasitemia and survived, while IFN-gamma KO mice remained parasitemic and all died. beta2-m KO mice that do not express MHC-I and have virtually no CD8+ T cells had prolonged parasitemia, and 80% survived. Because mice do not express GNLY, GNLY-transgenic mice can be used to assess the in vivo importance of GNLY. Parasite clearance was accelerated in GNLY-transgenic mice and depletion of CD8+ T cells ablated the GNLY-mediated resistance to P. yoelii. Altogether, our results indicate that in addition to previously described mechanisms, IFN-gamma promotes host resistance to the Retic-tropic P. yoelii 17XNL strain by promoting MHC-I expression on iRetics that become targets for CD8+ cytotoxic T lymphocytes and GNLY

New Vaccine Formulations Containing a Modified Version of the Amastigote 2 Antigen and the Non-Virulent Trypanosoma cruzi CL-14 Strain Are Highly Antigenic and Protective against Leishmania infantum Challenge

Visceral leishmaniasis (VL) is a major public health issue reported as the second illness in mortality among all tropical diseases. Clinical trials have shown that protection against VL is associated with robust T cell responses, especially those producing IFN-gamma. The Leishmania amastigote 2 (A2) protein has been repeatedly described as immunogenic and protective against VL in different animal models; it is recognized by human T cells, and it is also commercially available in a vaccine formulation containing saponin against canine VL. Moving toward a more appropriate formulation for human vaccination, here, we tested a new optimized version of the recombinant protein (rA2), designed for Escherichia coli expression, in combination with adjuvants that have been approved for human use. Moreover, aiming at improving the cellular immune response triggered by rA2, we generated a recombinant live vaccine vector using Trypanosoma cruzi CL-14 non-virulent strain, named CL-14 A2. Mice immunized with respective rA2, adsorbed in Alum/CpG B297, a TLR9 agonist recognized by mice and human homologs, or with the recombinant CL-14 A2 parasites through homologous prime-boost protocol, were evaluated for antigen-specific immune responses and protection against Leishmania infantum promastigote challenge. Immunization with the new rA2/Alum/CpG formulations and CL-14 A2 transgenic vectors elicited stronger cellular immune responses than control groups, as shown by increased levels of IFN-gamma, conferring protection against L. infantum challenge. Interestingly, the use of the wild-type CL-14 alone was enough to boost immunity and confer protection, confirming the previously reported immunogenic potential of this strain. Together, these results support the success of both the newly designed rA2 antigen and the ability of T. cruzi CL-14 to induce strong T cell-mediated immune responses against VL in animal models when used as a live vaccine vector. In conclusion, the vaccination strategies explored here reveal promising alternatives for the development of new rA2 vaccine formulations to be translated human clinical trials

Association between perineal trauma and pain in primiparous women

Objective To identify the association between perineal trauma and pain in 473 primiparous women. Method Cross-sectional study in which pain was measured by the numerical pain scale (0 to 10 - 0 being no pain and 10 maximal pain). Results The prevalence and mean intensity of pain were 33.0% and 4.7 points (standard deviation = 2.0) in the numeric scale, respectively. Episiotomy represented the most frequent trauma (46.7%). The occurrence and intensity of the pain were associated with perineal trauma and postpartum time. Having perineal trauma tripled the chance of pain. Each hour elapsed following the birth reduced the chance of pain by 4.8%. Conclusion Primiparous women are subject to a high frequency of perineal trauma, with episiotomy being the most prominent. Perineal pain affects approximately one-third of primiparous women and is associated with the postpartum time and perineal traumas.Objetivo Identificar la asociación entre el trauma y el dolor perineal en 473 primíparas. Método Estudio transversal, en el que el dolor se midió por medio de la escala numérica del dolor (0 a 10; 0 = ningún dolor y 10 = dolor máximo). Resultados La prevalencia y el promedio de intensidad del dolor fueron 33,0% y 4,7 (Desviación Estándar = 2,0) puntos en la escala, respectivamente. La episiotomía fue el trauma más frecuente (46,7%). La ocurrencia y la intensidad del dolor se asociaron con el trauma y el tiempo del postparto. Tener trauma perineal triplica la probabilidad de tener dolor. Cada hora transcurrida después del nacimiento reduce la posibilidad de dolor en 4,8%. Conclusión Las primíparas están sujetas a altas tasas de trauma perineal, especialmente episiotomía. El dolor perineal afecta aproximadamente a un tercio de las primíparas y se asocia con el tiempo de postparto y el traumatismo perineal.

Objetivo Identificar a associação entre trauma perineal e dor em 473 primíparas. Método Estudo transversal, no qual dor foi mensurada por meio da escala numérica de dor (0 a 10 – sendo 0 ausência de dor e 10 dor máxima). A prevalência e a média de intensidade de dor foram 33,0% e 4,7 (Desvio Padrão = 2,0) pontos na escala numérica, respectivamente. Resultados A episiotomia foi o trauma mais frequente (46,7%). A ocorrência e a intensidade da dor foram associadas ao trauma perineal e ao tempo de pós-parto. Ter trauma perineal triplicou a chance de dor. Cada hora decorrida depois do parto reduziu a chance de dor em 4,8%. Conclusão As primíparas estão sujeitas a elevada frequência de trauma perineal, sobretudo episiotomia. A dor perineal afeta, aproximadamente, um terço das primíparas e está associada ao tempo de pós-parto e aos traumas locais

Cone-beam computed tomography in Endodontics:an exploratory research of the main clinical applications

This study revisited three oral radiology centers (ORC) and screened the main clinical indications that justified the request for cone-beam computed tomography (CBCT) examination in Endodontics. The databases of three ORCs were searched for requests of CBCT exams taken for Endodontic purposes over the last two years. The extracted data consisted of the total number of CBCT exams, the clinical indication in the endodontic field that justified the CBCT exam, the outcome of each exam (from the report of Oral Radiologists), and demographic data of the patients. From the total CBCT exams (n = 4,583), nearly 13% (n = 611) were taken for Endodontic purposes. Most of the clinical indications were related to root fractures (65%) and periapical lesions/disease (24.1%). Radiologists’ reports hypothesized more often toward periapical lesion/disease (70.5%), root fracture (51.4%) and accidents/complications (25.2%). Some clinical indications significantly varied based on age. In particular, post-traumatic imaging and the investigation of root resorption were more common in young patients, while the prevalence of exams for the investigation of pulpal calcifications and root fractures increased with age. More interestingly, there was a significant disagreement between the clinical indication that justified the CBCT examinations and the outcomes retrieved from radiologists’ reports (p &lt; 0.005). This study illustrates the broad spectrum of CBCT applications for the diagnosis, treatment planning and follow-up in Endodontics. Attention is necessary to the disagreements between clinical indications and imaging outcomes, especially because certain conditions in the routine Endodontics are only visible with the aid of advanced tools.Este estudio revisitó tres centros de radiología oral (CRO) y cribo las principales indicaciones clínicas que justificaron la solicitud de examen por tomografía computarizada de haz cónico (CBCT) en endodoncia. Se realizaron búsquedas en las bases de datos de tres CRO en busca de solicitudes de exámenes CBCT realizados con fines endodónticos durante los últimos dos años. Los datos extraídos consistieron en el número total de exámenes CBCT, la indicación clínica en el campo endodóntico que justificó el examen CBCT, el resultado de cada examen (del informe de los radiólogos orales) y los datos demográficos de los pacientes. Del total de exámenes CBCT (n = 4583), casi el 13% (n = 611) se tomaron con fines de endodoncia. La mayoría de las indicaciones clínicas se relacionaron con fracturas radiculares (65%) y lesiones / enfermedades periapicales (24,1%). Los informes de los radiólogos plantearon con mayor frecuencia la hipótesis de lesión / enfermedad periapical (70,5%), fractura de raíz (51,4%) y accidentes / complicaciones (25,2%). Algunas indicaciones clínicas variaron significativamente según la edad. En particular, las imágenes postraumáticas y la investigación de la reabsorción radicular fueron más comunes en pacientes jóvenes, mientras que la prevalencia de exámenes para la investigación de calcificaciones pulpares y fracturas radiculares aumentó con la edad. Más interesante aún, hubo un desacuerdo significativo entre la indicación clínica que justificaba los exámenes CBCT y los resultados obtenidos de los informes de los radiólogos (p &lt;0,005). Este estudio ilustra el amplio espectro de CBCT para el diagnóstico, la planificación del tratamiento y el seguimiento en endodoncia. Es necesario prestar atención a los desacuerdos entre las indicaciones clínicas y los resultados de las imágenes, especialmente porque ciertas condiciones en la endodoncia de rutina solo son visibles con la ayuda de herramientas avanzadas.O presente estudo revisitou três centros de radiologia odontológica (ORC) e rastreou as principais indicações clínicas que justificaram a solicitação do exame de tomografia computadorizada de feixe cônico (TCFC) em Endodontia. Os bancos de dados de três ORCs foram pesquisados em busca de solicitações de exames CBCT realizados para fins endodônticos nos últimos dois anos. Os dados extraídos consistiram no número total de exames de TCFC, a indicação clínica na área endodôntica que justificou o exame de TCFC, o resultado de cada exame (a partir do laudo do Radiologista Oral) e os dados demográficos dos pacientes. Do total de exames de TCFC (n = 4.583), quase 13% (n = 611) foram feitos para fins endodônticos. A maioria das indicações clínicas foi relacionada a fraturas radiculares (65%) e lesões / doenças periapicais (24,1%). Os laudos dos radiologistas levantaram a hipótese mais frequentemente de lesão / doença periapical (70,5%), fratura radicular (51,4%) e acidentes / complicações (25,2%). Algumas indicações clínicas variaram significativamente com base na idade. Em particular, a imagem pós-traumática e a investigação de reabsorção radicular foram mais comuns em pacientes jovens, enquanto a prevalência de exames para investigação de calcificações pulpares e fraturas radiculares aumentou com a idade. Mais curiosamente, houve uma discordância significativa entre a indicação clínica que justificou os exames de TCFC e os resultados obtidos dos relatórios dos radiologistas (p &lt;0,005). Este estudo ilustra o amplo espectro de aplicações da TCFC para o diagnóstico, planejamento de tratamento e acompanhamento em Endodontia. É preciso atentar para as divergências entre as indicações clínicas e os desfechos de imagem, principalmente porque certas condições da rotina da Endodontia só são visíveis com o auxílio de ferramentas avançadas

Relationship between clinical-epidemiological parameters and outcomes of patients with COVID-19 admitted to the intensive care unit: a report from a Brazilian hospital

BackgroundPeople in low-income countries, especially those with low socio-economic conditions, are likelier to test positive for SARS-CoV-2. The unequal conditions of public health systems also increase the infection rate and make early identification and treatment of at-risk patients difficult. Here, we aimed to characterize the epidemiological profile of COVID-19 patients in intensive care and identify laboratory and clinical markers associated with death.Materials and methodsWe conducted an observational, descriptive, and cross-sectional study in a reference hospital for COVID-19 treatment in the Southern Region of Bahia State, in Brazil, to evaluate the epidemiological, clinical, and laboratory characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Additionally, we used the area under the curve (AUC) to classify survivors and non-survivors and a multivariate logistic regression analysis to assess factors associated with death. Data was collected from the hospital databases between April 2020 and July 2021.ResultsThe use of bladder catheters (OR 79.30; p &lt; 0.0001) and central venous catheters (OR, 45.12; p &lt; 0.0001) were the main factors associated with death in ICU COVID-19 patients. Additionally, the number of non-survivors increased with age (p &lt; 0.0001) and prolonged ICU stay (p &lt; 0.0001). Besides, SAPS3 presents a higher sensibility (77.9%) and specificity (63.1%) to discriminate between survivors and non-survivor with an AUC of 0.79 (p &lt; 0.0001).ConclusionWe suggest that multi-laboratory parameters can predict patient prognosis and guide healthcare teams toward more assertive clinical management, better resource allocation, and improved survival of COVID-19 patients admitted to the ICU