Torsional stability of interference screws derived from bovine bone - a biomechanical study

Introduction: It has been proposed that individual genetic variation contributes to the course of severe infections and sepsis. Recent studies of single nucleotide polymorphisms (SNPs) within the endotoxin receptor and its signaling system showed an association with the risk of disease development. This study aims to examine the response associated with genetic variations of TLR4, the receptor for bacterial LPS, and a central intracellular signal transducer (TIRAP/Mal) on cytokine release and for susceptibility and course of severe hospital acquired infections in distinct patient populations. Methods: Three intensive care units in tertiary care university hospitals in Greece and Germany participated. 375 and 415 postoperative patients and 159 patients with ventilator associated pneumonia (VAP) were included. TLR4 and TIRAP/Mal polymorphisms in 375 general surgical patients were associated with risk of infection, clinical course and outcome. In two prospective studies, 415 patients following cardiac surgery and 159 patients with newly diagnosed VAP predominantly caused by Gram-negative bacteria were studied for cytokine levels in-vivo and after ex-vivo monocyte stimulation and clinical course. Results: Patients simultaneously carrying polymorphisms in TIRAP/Mal and TLR4 and patients homozygous for the TIRAP/Mal SNP had a significantly higher risk of severe infections after surgery (odds ratio (OR) 5.5; confidence interval (CI): 1.34 - 22.64; P = 0.02 and OR: 7.3; CI: 1.89 - 28.50; P < 0.01 respectively). Additionally we found significantly lower circulating cytokine levels in double-mutant individuals with ventilator associated pneumonia and reduced cytokine production in an ex-vivo monocyte stimulation assay, but this difference was not apparent in TIRAP/Mal-homozygous patients. In cardiac surgery patients without infection, the cytokine release profiles were not changed when comparing different genotypes. Conclusions: Carriers of mutations in sequential components of the TLR signaling system may have an increased risk for severe infections. Patients with this genotype showed a decrease in cytokine release when infected which was not apparent in patients with sterile inflammation following cardiac surgery

Halogen lamp and led activation of resin-modified glass ionomer restorative material. In vitro microhardness after long term storage

AIM: The purpose of this study was to evaluate the activation of resin-modified glass ionomer restorative material (RMGI, Vitremer-3M-ESPE, A3) by halogen lamp (QTH) or light-emitting diode (LED) by Knoop microhardness (KHN) in two storage conditions: 24hrs and 6 months and in two depths (0 and 2 mm). MATERIALS AND METHODS: The specimens were randomly divided into 3 experimental groups (n=10) according to activation form and evaluated in depth after 24h and after 6 months of storage. Activation was performed with QTH for 40s (700 mW/cm2) and for 40 or 20 s with LED (1,200 mW/scm2). After 24 hrs and 6 months of storage at 37°C in relative humidity in lightproof container, the Knoop microhardness test was performed. Statistics Data were analysed by three-way ANOVA and Tukey post-tests (p<0.05). RESULTS: All evaluated factors showed significant differences (p<0.05). After 24 hrs there were no differences within the experimental groups. KHN at 0 mm was significantly higher than 2 mm. After 6 months, there was an increase of microhardness values for all groups, being the ones activated by LED higher than the ones activated by QTH. CONCLUSION: Light-activation with LED positively influenced the KHN for RMGI evaluated after 6 months

Governo Geisel: transição político-econômica? Um ensaio de revisão The Geisel administration: political-economic transition? An essay of revision

Este artigo procura reconstituir os principais traços da política econômica durante o governo Geisel (1974-1978), concentrando-se no exame de dois desdobramentos de especial importância. O primeiro diz respeito à política macroeconômica voltada aos problemas conjunturais (inflação e balanço de pagamentos). Discute-se o grau de importância atribuído a essa faceta da política econômica bem como os resultados alcançados, distinguindo-se dois períodos marcados por ênfases distintas. O segundo desdobramento refere-se ao II PND, marca fundamental da política econômica do período: o artigo procura apresentar uma leitura crítica de alguns pontos controversos suscitados pela literatura dedicada ao tema.<br>This article seeks to trace the main aspects of the Geisel Administration (1974-1978) economic policy, focusing on two main developments. The first concerns the macroeconomic policy related to problems of inflation and balance of payments affecting the economy. A discussion is made of its degree of importance in the conduct of economic policy, as well as the results achieved, distinguishing two periods (1974-1975 and 1976-1978). The second point centers around II PND (National Plan of Development), the focal point of the economic policy of that period: a critical assessment is made of the main issues of controversy surrounding the theme as treated in the literature

Concealed structural heart disease discovered at cardiac magnetic resonance in patients with ventricular extrasystoles from ventricular outflow tract and apparently normal hearts

Background: Outflow tract (OT) premature ventricular contractions (PVCs) are commonly found in clinical practice; in most cases, PVCs are benign and observed in structurally normal hearts, not requiring any therapeutic intervention. In this study, we therefore sought to evaluate with cardiac magnetic resonance (CMR) patients with PVC and apparently normal heart at echocardiographic examination, in order to identify possible substrates linked with higher prevalence of arrhythmias or structural heart disease. Methods: Thirty-three consecutive patients with frequent PVCs originating from the ventricular OT (right and left) were enrolled in the study and assessed by echocardiography and CMR. All patients had normal baseline electrocardiogram. Results: CMR showed structural changes in 5 patients out of 33; in 3 cases, areas of fibrosis limited in one case to the middle basal segments of the interventricular septum and in two patients to the middle basal segments of the inferior-lateral wall were found. In 2 other cases, however, late gadolinium enhancement showed significant anomalies characterized in one patient by extensive areas of subepicardial fibrosis of the left ventricle, suitable with arrhythmogenic left dominant dysplasia; in another patient, a marked trabeculation of left ventricular medium apical segments suitable with non-compaction myocardium was present. Conclusions: CMR may identify cases of structural heart disease in subjects with OT PVCs and apparently normal electrocardiogram and echocardiogram examinations. A preliminary screening with CMR may be considered before any further invasive electrophysiology assessment and therapeutic planning

A política bancária do regime militar: o projeto de conglomerado (1967-1973) The finance policy of military regime: the conglomerate project (1967-1973)

Este artigo examina a política bancária e financeira conduzida por Delfim Netto de 1967 a 1973, a qual se revestiu de características específicas. São examinadas as pronunciadas tendências à concentração no segmento dos bancos comerciais privados e a sua expansão para outras faixas de operação, formando conglomerados financeiros e, assim, alterando profundamente a estrutura projetada originalmente pela reforma de 1964. Ambos os processos estiveram vinculados à orientação particular da política econômica a partir de 1967, cujo sentido maior encontrou expressão na tentativa de implementar, no governo Médici, um projeto de conglomerado integrando banco e indústria, visando a consolidar um segmento de grandes empresas privadas nacionais. O artigo sistematiza evidência disponível acerca desse projeto estratégico - um capítulo importante da política econômica durante uma fase do regime militar.<br>This article discusses the banking policy led by Delfim Netto from 1967 trough 1973, which had special features. It is examined the tendency to banking concentration, very intense in those years, as well as the acute centralization process which led to the constitution of financial conglomerates, thus transforming the financial structure in a way not foreseen by the banking and financial reforms of 1964. Both processes reflected the new course of economic policy since 1967, having as its major objective to induce the formation of a new form of private capitalist organization - the conglomerate, integrating banking and industry -, which would led to the consolidation of a segment of big national private firms. The article seeks to collect the available evidence about that strategic project developed during a phase of the military regime