Prevalência do defeito ósseo de desenvolvimento da mandíbula em exames de tomografi a computadorizada por feixe cônico

The developmental bone defect of the mandible is a bone cavity presenting as a well-defi ned, radiolucent lesion, located in the posterior region of the mandible, just below the inferior dental canal and above the mandibular base. It is asymptomatic, has a greater predilection for males, and a prevalence between 0.1% and 0.48%. The aim of this study was to conduct a review of the literature on the prevalence of this bone defect and compare the literature data to that of an assessment conducted of routine cone-beam computerized tomography (CBCT) scans from a radiological clinic. The use of diagnostic resources such as cone-beam volumetric tomography was also highlighted. CBCT routine scans taken from July 1st, 2012 to September 27, 2012 were retrieved from the digital archives of a private dental radiology clinic and evaluated, for a total of 1,344 CBCT images. Stafne’s cavity was observed In 22 cases (0.16%). Among the 19 male cases, 15 were Type I, 3 were Type II and 1 was Type III, according to Ariji’s classifi cation.5 All of the 3 female cases (the male-to-female ratio was 6.33:1) were Ariji Type I. The fi ndings of this study were consistent with those from the literature consulted, in that the highest prevalence rates were observed for unilateral, Ariji Type I lesions and in the male gender.O defeito ósseo de desenvolvimento da mandíbula (DODM) é uma cavidade óssea que se apresenta como uma lesão radio lúcida de limites definidos e corticalizados. É assintomático, apresenta uma maior predileção pelo gênero masculino, e tem uma prevalência de 0.1% a 0.48%. O objetivo deste estudo foi realizar uma revisão de literatura com o intuito de ampliar o conhecimento a respeito da prevalência desse defeito ósseo e comparar os dados da literatura com os obtidos por meio de uma avaliação de 1344 exames de rotina realizados por meio da tomografia computadorizada de feixe cônico (TCFC) recuperados dos arquivos de uma clínica privada de radiologia odontológica. As imagens foram analisadas no período de 1o de julho de 2012 a 27 de setembro de 2012. Foram observados 22 casos de DODM (0,16%), sendo que 19 casos eram do gênero masculino, totalizando 15 casos do Tipo I, 3 casos do Tipo II e 1 caso do Tipo III de Ariji.5 Foram também encontrados 3 casos do gênero feminino, todos classificados como Tipo I de Ariji, equivalendo a uma proporção entre os gêneros masculino e feminino de 6,33:1. Os resultados encontrados no presente estudo foram compatíveis com os relatados na literatura consultada. Constatou-se uma maior prevalência de lesões unilaterais, Tipo I de Ariji e envolvendo o gênero masculino

Effect of L-glutamine and L-alanyl-L-glutamine supplementation on the response to delayed-type hypersensitivity test (DTH) in rats submitted to intense training

O treinamento intenso e o exercício exaustivo podem ocasionar imunossupressão em atletas por meio da diminuição da concentração plasmática de glutamina. O presente estudo verificou inicialmente o efeito da suplementação com L-glutamina e L-alanilL-glutamina sobre a resposta ao teste de hipersensibilidade do tipo tardio (HTT) em ratos submetidos ao treinamento intenso em natação durante seis semanas. Posteriormente, foi avaliado o efeito dessas intervenções nutricionais sobre a contagem total e porcentual de leucócitos e concentração sérica de anticorpos IgG anti-albumina de soro bovino, em animais submetidos ao teste de exaustão e recuperados durante o período de 3 horas. Não houve efeito do treinamento e da suplementação sobre a resposta ao teste de HTT. Animais suplementados apresentaram maior concentração de glutamina no plasma (PIntense training and exhaustive exercise may cause immunesupression in athletes by reducing plasma glutamine concentration. Initially, this study verified the effect of L-glutamine and L-alanyl-L-glutamine supplementation on the response to delayed-type hypersensitivity test (DTH) in rats submitted to intense swimming training for six weeks. Later on, we assessed the effect of these nutritional interventions on total and differential white blood cell counts and on concentration of anti-bovine serum albumin IgG antibodies, in animals submitted to exhaustion test and a three-hour recovery period. There was no effect of training and supplementation on the response to DTH. Supplemented animals presented greatest plasma glutamine concentration (

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

Evolution of bacterial meningitis diagnosis in Sao Paulo State-Brazil and future challenges

Bacterial meningitis (BM) is a severe disease and still represents a serious public health problem with high rates of morbidity and mortality. The most common cases of BM around the world, mainly in Brazil, have been caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type b. Bacterial culture is the gold-standard technique for BM confirmation, but approximately 50% of suspected cases are not culture-confirmed, due to problems related to improper transportation and seeding or previous antibiotic treatment. Immunological methods present low sensitivity and have possibility of cross-reactions. Real time PCR (qPCR) is a molecular technique and has been successful used for BM diagnosis at Instituto Adolfo Lutz in São Paulo State, Brazil, since 2007. The incorporation of qPCR in the Public Health surveillance routine in our state resulted in diminishing 50% of undetermined BM cases. Our efforts are focused on qPCR implementation in the BM diagnostic routine throughout Brazil

Prevalence of the developmental bone defect of the mandible in cone-beam computed tomography scans

O defeito ósseo de desenvolvimento da mandíbula (DODM) é uma cavidade óssea que se apresenta como uma lesão radio lúcida de limites definidos e corticalizados. É assintomático, apresenta uma maior predileção pelo gênero masculino, e tem uma prevalência de 0.1% a 0.48%. O objetivo deste estudo foi realizar uma revisão de literatura com o intuito de ampliar o conhecimento a respeito da prevalência desse defeito ósseo e comparar os dados da literatura com os obtidos por meio de uma avaliação de 1344 exames de rotina realizados por meio da tomografia computadorizada de feixe cônico (TCFC) recuperados dos arquivos de uma clínica privada de radiologia odontológica. As imagens foram analisadas no período de 1o de julho de 2012 a 27 de setembro de 2012. Foram observados 22 casos de DODM (0,16%), sendo que 19 casos eram do gênero masculino, totalizando 15 casos do Tipo I, 3 casos do Tipo II e 1 caso do Tipo III de Ariji.5 Foram também encontrados 3 casos do gênero feminino, todos classificados como Tipo I de Ariji, equivalendo a uma proporção entre os gêneros masculino e feminino de 6,33:1. Os resultados encontrados no presente estudo foram compatíveis com os relatados na literatura consultada. Constatou-se uma maior prevalência de lesões unilaterais, Tipo I de Ariji e envolvendo o gênero masculino.The developmental bone defect of the mandible is a bone cavity presenting as a well-defi ned, radiolucent lesion, located in the posterior region of the mandible, just below the inferior dental canal and above the mandibular base. It is asymptomatic, has a greater predilection for males, and a prevalence between 0.1% and 0.48%. The aim of this study was to conduct a review of the literature on the prevalence of this bone defect and compare the literature data to that of an assessment conducted of routine cone-beam computerized tomography (CBCT) scans from a radiological clinic. The use of diagnostic resources such as cone-beam volumetric tomography was also highlighted. CBCT routine scans taken from July 1st, 2012 to September 27, 2012 were retrieved from the digital archives of a private dental radiology clinic and evaluated, for a total of 1,344 CBCT images. Stafne’s cavity was observed In 22 cases (0.16%). Among the 19 male cases, 15 were Type I, 3 were Type II and 1 was Type III, according to Ariji’s classifi cation.5 All of the 3 female cases (the male-to-female ratio was 6.33:1) were Ariji Type I. The fi ndings of this study were consistent with those from the literature consulted, in that the highest prevalence rates were observed for unilateral, Ariji Type I lesions and in the male gender