Abdominal and pelvic ultrasonography in healthy golden retriever dogs, carriers and affected by gradual muscular dystrophy

A distrofia muscular de Duchenne (DMD) é um tipo de distrofia muscular em humanos caracterizada por uma doença genética ligada ao cromossomo X. O cão golden retriever portador da distrofia muscular (GRMD) tem sido intensamente estudado e considerado o modelo mais representativo para a doença observada em humanos. Assim, como forma de verificar anormalidades em órgãos internos nesses animais, foi realizado o exame ultra-sonográfico de 24 cães golden retriever saudáveis, portadores e afetados pela distrofia muscular. O exame ultra-sonográfico do GRMD diagnosticou aumento hepático de moderado a severo, incluindo os vasos hepáticos e seus ramos e aumento de ecogenicidade da vesícula biliar e vesícula urinária. Entretanto, não foram observadas imagens claras de alterações no baço e nos vasos ramos da aorta. A partir disso, acreditamos que o exame ultra-sonográfico constitui-se em um procedimento útil no acesso de órgãos abdominais em cães afetados pela distrofia muscular.Duchenne muscular dystrophy (DMD) is one type of human’s muscular dystrophy characterized by a genetic disorder linked to the X chromosome. The Golden Retriever muscular dystrophic (GRMD) has been extensively studied and considered the best resembling model to the human disease. Therefore, for identifying internal organs abnormality in GRMD, abdominal and pelvic ultrasonography was performed in 24 golden retriever dogs, either healthy or muscular dystrophic in different levels of disease. The GRMD ultrasonographic exams diagnosed moderate to severe liver enlargement, including hepatic vessels and their branches and increase of echogenicity in gallbladder and urinary bladder. However was not-clearly recognized pathologic images from spleen and aortic vessels were accessed. Therefore, we believe, the ultrasonographic exam was an useful procedure to the assessment of abdominal organs in dogs affected by muscular dystrophy

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Cell proliferation rate in clinically healthy oral mucosa of crack cocaine users

Objetivo: Avaliar a taxa proliferativa de células esfoliadas da mucosa bucal clinicamente saudável de usuários de crack. Material e Métodos: esfregaços orais foram coletados de língua e assoalho bucal de 87 indivíduos, divididos em três grupos: os usuários de crack (CRCO), n = 26; fumantes / etilistas (SA), n = 26 e controles (C ), n = 35. Lâminas histológicas foram submetidas à técnica de impregnação pela prata para quantificação do número de AgNORs/núcleo. As imagens foram obtidas por um sistema de captura de imagem adaptado a um microscópio de luz em x1000 ampliação. A média AgNOR por núcleo (mAgnor) e a percentagem de células com mais de 1,2,3 e 4 AgNORs por núcleo (pAgNOR> 1,> 2> 3 um> 4) foram calculados. Resultados: As células esfoliadas de mucosa da língua SA (3,34 ± 0,51 AgNOR / núcleo) exibiram maior taxa de proliferação celular (p 1,>2,>3 e > 4. Conclusão: usuários de crack não apresentaram alterações na taxa proliferativa celular da mucosa bucal. Diante dos dados apresentados, o consumo de cigarro, em combinação com o consumo de álcool, continua sendo o maior fator prejudicial à mucosa bucal.Objective: The aim of this study was to evaluate cell proliferation rate of cells exfoliated from clinically healthy mucosa of crack cocaine users. Material and Methods: Oral smears were collected from tongue and floor of the mouth mucosa of 87 individuals divided into three groups: crack cocaine users (CrCo), n=26; smokers/alcohol drinkers (SA), n=26 and controls (C), n=35. Histological slides were silver-stained using AgNOR technique to evaluate cell proliferation rate. Images were obtained by an image capturing system adapted to a light microscope at x1000 magnification. Quantification considered 50 cells by smear in which the number of AgNOR dots was visually counted. Mean AgNOR numbers per nucleus (mAgNOR) and the percentage of cells with more than 1,2,3 and 4 AgNORs per nucleus (pAgNOR>1,>2>3 an>4) were calculated. Results: Cells exfoliated from tongue mucosa of SA (3.34±0.51 AgNOR/nucleus) exhibit higher cell proliferation rate (p1,>2,>3 e >4. Conclusion: Crack cocaine users did not present changes in cell proliferation rate of oral mucosa. Between the expositions studied here, cigarette smoking in combination with alcohol consumption remain as the most harmful factors to oral mucosa

Cell proliferation rate in clinically healthy oral mucosa of crack cocaine users

Objetivo: Avaliar a taxa proliferativa de células esfoliadas da mucosa bucal clinicamente saudável de usuários de crack. Material e Métodos: esfregaços orais foram coletados de língua e assoalho bucal de 87 indivíduos, divididos em três grupos: os usuários de crack (CRCO), n = 26; fumantes / etilistas (SA), n = 26 e controles (C ), n = 35. Lâminas histológicas foram submetidas à técnica de impregnação pela prata para quantificação do número de AgNORs/núcleo. As imagens foram obtidas por um sistema de captura de imagem adaptado a um microscópio de luz em x1000 ampliação. A média AgNOR por núcleo (mAgnor) e a percentagem de células com mais de 1,2,3 e 4 AgNORs por núcleo (pAgNOR> 1,> 2> 3 um> 4) foram calculados. Resultados: As células esfoliadas de mucosa da língua SA (3,34 ± 0,51 AgNOR / núcleo) exibiram maior taxa de proliferação celular (p 1,>2,>3 e > 4. Conclusão: usuários de crack não apresentaram alterações na taxa proliferativa celular da mucosa bucal. Diante dos dados apresentados, o consumo de cigarro, em combinação com o consumo de álcool, continua sendo o maior fator prejudicial à mucosa bucal.Objective: The aim of this study was to evaluate cell proliferation rate of cells exfoliated from clinically healthy mucosa of crack cocaine users. Material and Methods: Oral smears were collected from tongue and floor of the mouth mucosa of 87 individuals divided into three groups: crack cocaine users (CrCo), n=26; smokers/alcohol drinkers (SA), n=26 and controls (C), n=35. Histological slides were silver-stained using AgNOR technique to evaluate cell proliferation rate. Images were obtained by an image capturing system adapted to a light microscope at x1000 magnification. Quantification considered 50 cells by smear in which the number of AgNOR dots was visually counted. Mean AgNOR numbers per nucleus (mAgNOR) and the percentage of cells with more than 1,2,3 and 4 AgNORs per nucleus (pAgNOR>1,>2>3 an>4) were calculated. Results: Cells exfoliated from tongue mucosa of SA (3.34±0.51 AgNOR/nucleus) exhibit higher cell proliferation rate (p1,>2,>3 e >4. Conclusion: Crack cocaine users did not present changes in cell proliferation rate of oral mucosa. Between the expositions studied here, cigarette smoking in combination with alcohol consumption remain as the most harmful factors to oral mucosa

Correlation among mandibular, femoral, lumbar and cervical bone density

INTRODUÇÃO: diante da maior frequência de pacientes adultos que se submetem atualmente ao tratamento ortodôntico, as condições gerais de saúde dessa faixa etária têm sido motivo de investigações correlacionadas aos eventos ligados ao metabolismo ósseo, haja vista que os movimentos dentários são dependentes do processo de remodelação óssea, ainda que num nível local. Diferentes padrões de densidade óssea podem acarretar diferentes respostas ao movimento ortodôntico. OBJETIVOS: o presente estudo avaliou a correlação da densidade mineral óssea (DMO) geral com aquela da região mandibular. MÉTODOS: para tanto, 22 mulheres saudáveis, com idades entre 30 e 45 anos, foram selecionadas para os exames de densitometria óssea das regiões lombar, cervical e femural, bem como da região mandibular. Foram testadas as correlações entre essas leituras e, também, estabelecidos valores de referência para as áreas cervical e mandibular. RESULTADOS: os resultados não demonstraram correlação significativa entre a densidade mandibular e as demais áreas estudadas. Houve correlação significativa apenas entre a região cervical e a femural. O valor médio DMO normal para a região mandibular foi de 0,983g/cm² (d.p. = 0,334), enquanto para a região cervical foi de 0,768g/cm² (d.p. = 0,102), e os valores médios para a região lombar e femural foram de, respectivamente, 1,127g/cm² (d.p. = 0,067) e 0,925g/cm² (d.p. = 0,078), esses últimos semelhantes aos valores de referência da Organização Mundial de Saúde. CONCLUSÕES: sugere-se que o exame da área femural possa abranger o valor esperado para a área cervical, entretanto há necessidade do exame densitométrico particular para a área mandibular, não sendo adequada a extrapolação dos valores tradicionais (lombar e femural) para estimativa dessa área. Estudos adicionais são necessários para avaliar as variações densitométricas locais e eventual influência sobre a movimentação ortodôntica.INTRODUCTION: Due to the rise in frequency of adult patients who currently are submitted to orthodontic treatment, general health conditions of this age have been a reason of inquiries correlated to events related to bone metabolism, as dental movements are dependent on the process of bone remodeling, even though in a local level. Different standards of bone density can give different answers to the orthodontic movement. AIM: The present study evaluated the correlation of the general bone mineral density (BMD) to the mandibular region. METHODS: Therefore, 22 healthy women aged between 30 and 45 years old were selected for bone densitometry examinations of lumbar, cervical, femoral, as well as mandibular alveolar region. The correlations to these readings were tested as well as values of reference were established for cervical and mandibular areas. RESULTS: The results did not demonstrate significant correlation among the mandibular density to the others studied areas. There was only significant correlation between cervical and femural region. Normal BMD average value for mandibular region was 0.983g/cm² (SD = 0.334), whereas for cervical region was 0.768g/cm² (SD = 0.102), and the average values for lumbar and femoral regions were respectively 1.127g/cm² (SD = 0.067) and 0.925g/cm² (SD = 0.078), these last ones were similar to the reference values of World Health Organization (WHO). CONCLUSIONS: It is suggested that the examination of the femoral area can comprehend the expected value to cervical area, however particular densitometry examination for the mandibular area is needed, and the exploration of the traditional values (lumbar and femoral) is not appropriate to the estimative of this area. Additional studies are necessary to evaluate local density variations and its influence on orthodontic movement

Aspectos clinicopatológicos, histoquímicos e imunoistoquímicos de angioleiomioma de mucosa jugal : relato de caso

Introduction: Leiomyomas are benign smooth muscle neoplasms that preferably affect the genitals, skin, and gastrointestinal tract, being rarely seen in the oral cavity. They are commonly classified into three microscopic patterns: solid leiomyoma, angioleiomyoma (ALM), and epithelioid leiomyoma. The most frequently reported sites of occurrence of oral ALM are the lip (48.6%), palate (21.1%), buccal mucosa and tongue (9.2%), and intraosseous lesions (8.3%). Case report: A 62 years old male presented a painless swelling in the left cheek. In this report histopathological and immunohistochemical analysis were made to confirm the diagnosis, since several lesions were possible. The treatment was local surgical excision of the tumor.Introdução: Leiomiomas são tumores benignos de músculo liso que afetam preferencialmente os genitais, pele e do trato gastrointestinal, sendo raramente visto na cavidade bucal. Esses tumores são comumente classificados em três padrões microscópicos: leiomioma sólido, angioleiomioma (ALM), e leiomioma epitelióide. Os locais mais freqüentemente afetados por ALM na boca são: lábio (48,6%), palato (21,1%), mucosa jugal e língua (9,2%) e intra-óssea (8,3%). Relato de caso: Paciente de 62 anos, masculino apresentou um inchaço indolor na bochecha esquerda. Neste relato de caso foram realizadas análises histopatológicas e imuno-histoquímico para confirmar o diagnóstico, uma vez que várias lesões podem fazer diagnóstico diferencial. O tratamento foi excisão cirúrgica local do tumor

Aspectos clinicopatológicos, histoquímicos e imunoistoquímicos de angioleiomioma de mucosa jugal : relato de caso

Introduction: Leiomyomas are benign smooth muscle neoplasms that preferably affect the genitals, skin, and gastrointestinal tract, being rarely seen in the oral cavity. They are commonly classified into three microscopic patterns: solid leiomyoma, angioleiomyoma (ALM), and epithelioid leiomyoma. The most frequently reported sites of occurrence of oral ALM are the lip (48.6%), palate (21.1%), buccal mucosa and tongue (9.2%), and intraosseous lesions (8.3%). Case report: A 62 years old male presented a painless swelling in the left cheek. In this report histopathological and immunohistochemical analysis were made to confirm the diagnosis, since several lesions were possible. The treatment was local surgical excision of the tumor.Introdução: Leiomiomas são tumores benignos de músculo liso que afetam preferencialmente os genitais, pele e do trato gastrointestinal, sendo raramente visto na cavidade bucal. Esses tumores são comumente classificados em três padrões microscópicos: leiomioma sólido, angioleiomioma (ALM), e leiomioma epitelióide. Os locais mais freqüentemente afetados por ALM na boca são: lábio (48,6%), palato (21,1%), mucosa jugal e língua (9,2%) e intra-óssea (8,3%). Relato de caso: Paciente de 62 anos, masculino apresentou um inchaço indolor na bochecha esquerda. Neste relato de caso foram realizadas análises histopatológicas e imuno-histoquímico para confirmar o diagnóstico, uma vez que várias lesões podem fazer diagnóstico diferencial. O tratamento foi excisão cirúrgica local do tumor