Cartilage Tissue Engineering and Regeneration

Cartilaginous tissue is mainly present in the joints, and it consists predominantly of type II collagen and glycoproteins, which promote functions of supporting biomechanical forces generated during the ambulation. The cartilage has a very limited regenerating capacity, causing traumas or degenerative diseases in this region difficult to solve. The current treatments for regeneration of the articular cartilages may be conservative or surgical, but they are not very successful, since the damaged tissue is replaced by fibrous tissue or fibrocartilage, with predominantly type I collagen, which present inferior functions. Cellular therapies, biomaterials, and tissue engineering to assist the healing process have been showing great potential. For example, the in vitro chondrogenesis of mesenchymal stem cells (MSCs) is a technique that stimulates undifferentiated cells to transform into chondrocytes, creating a dense mass of aggregated MSCs and an environment with strong cell-cell interactions

Incidence, persistence and risk factors of fear of falling in older adults: cohort study (2008–2013) in Rio de Janeiro, Brazil

OBJECTIVE: To evaluate the incidence and persistence of fear of falling in older adults and the clinical/functional, psychosocial and lifestyle-related risk factors. METHODS: A longitudinal study with 393 community-dwelling older adults aged 65 years and over (110 men/ 283 women) resident in the North Zone of the city of Rio de Janeiro, Brazil. The fear of falling was assessed by the Falls Efficacy Scale-I-BR. The explanatory variables assessed were: number of comorbidities and medicines, history of falls, fracture from falling, use of walking aids, functional dependence in basic and instrumental activities of daily living, hearing and visual impairment, hand grip strength, walking speed, self-rated health, body mass index, depressive symptoms, cognitive impairment, living alone and activity level. Incidence, persistence and risk factors were estimated. Multivariate analysis was performed using Poisson Regression, obtaining relative risks (RR) and corresponding to 95% confidence intervals. RESULTS: Among the 393 participants, fear of falling occurred in 33.5% and was persistent in 71.3%. Incidence was found to associate with using seven or more medicines and reporting worse activity level than the prior year. Risk factors for persistent fear were: using seven or more medicines, a history of one or two falls, reduced walking speed, hearing impairment, cognitive impairment, depressive symptoms and poor or very poor self-rated health. CONCLUSION: Fear of falling is a frequent and persistent condition. Many factors related to persistent fear showed no association with the incidence of fear, emphasizing the need for focused strategies to reduce risk factors that may be associated with the chronification of fear of falling

Correlation between clinical performance and degree of conversion of resin cements: a literature review

AbstractResin-based cements have been frequently employed in clinical practice to lute indirect restorations. However, there are numerous factors that may compromise the clinical performance of those cements. The aim of this literature review is to present and discuss some of the clinical factors that may affect the performance of current resin-based luting systems. Resin cements may have three different curing mechanisms: chemical curing, photo curing or a combination of both. Chemically cured systems are recommended to be used under opaque or thick restorations, due to the reduced access of the light. Photo-cured cements are mainly indicated for translucent veneers, due to the possibility of light transmission through the restoration. Dual-cured are more versatile systems and, theoretically, can be used in either situation, since the presence of both curing mechanisms might guarantee a high degree of conversion (DC) under every condition. However, it has been demonstrated that clinical procedures and characteristics of the materials may have many different implications in the DC of currently available resin cements, affecting their mechanical properties, bond strength to the substrate and the esthetic results of the restoration. Factors such as curing mechanism, choice of adhesive system, indirect restorative material and light-curing device may affect the degree of conversion of the cement and, therefore, have an effect on the clinical performance of resin-based cements. Specific measures are to be taken to ensure a higher DC of the luting system to be used

AUDITORIAS INTERNAS COMO FONTE DE INFORMAÇÃO PARA O CONHECIMENTO ORGANIZACIONAL: ESTUDO DE CASO EM UMA IFES

Este artigo se destina a analisar como os processos de auditoria interna vêm se transformando em fonte de informação para o conhecimento organizacional em uma IFES. Para isso, foi abordado o conhecimento organizacional, a teoria de sua criação, o controle da administração pública no Brasil e a auditoria interna governamental. Quanto à caracterização da pesquisa, apresentou-se como multidisciplinar, descritiva, indutiva, qualitativa e, como instrumento, os documentos existentes. O contexto do estudo de caso foi o da Universidade Federal da Paraíba, onde foram consideradas as recomendações contidas nos relatórios das auditorias internas, entre 2008 e 2010. Para a análise dos dados, utilizou-se o procedimento de análise de conteúdo de Bardin (2011), havendo a identificação e classificação das recomendações em nota de auditoria, falha operacional e ressarcimento ao erário, as quais foram avaliadas quanto as suas incidências e reincidências. Os resultados mostraram que: as recomendações do tipo falha operacional são em maior incidência e reincidência, as incidência e reincidência variam de acordo com as áreas auditadas e que grande parte das recomendações consignadas foram implementadas até a auditoria subseqüente, refletindo que a maioria dos processos de auditoria vêm se transformando em fonte de informação para o conhecimento organizacional

Neoadjuvant Chemoradiotherapy And Surgery Compared With Surgery Alone In Squamous Cell Carcinoma Of The Esophagus.

Despite progress in recent years in methods of diagnosis and surgical treatment of esophageal cancer, there is still controversy about the benefits from neoadjuvant chemoradiotherapy. To analise the survival of patients submitted to esophagectomy for squamous cell carcinoma of the esophagus with or without neoadjuvant chemoradiotherapy. A retrospective, non-randomized study conducted using the medical charts of patients operated for squamous cell carcinoma of the esophagus at the School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil between 1979 and 2006. The Kaplan-Meier analysis was used to calculate survival curves and the log-rank test to compare data in each group. The significance level was settled as 5%. A total of 123 patients were evaluated in this study, divided into three groups: I-26 (21.2%) patients submitted to esophagectomy alone; II-81 (65.8%) patients submitted to neoadjuvant radiotherapy plus esophagectomy and III-16 (13%) patients submitted to neoadjuvant chemoradiotherapy plus esophagectomy. A statistically significant survival was recorded between the groups (log rank=6.007; P=0.05), survival being greatest in the group submitted to neoadjuvant chemoradiotherapy, followed by the group submitted to neoadjuvant radiotherapy compared to the group submitted to esophagectomy alone as the initial treatment of choice. Radiotherapy and chemotherapy neoadjuvants in patients with squamous cell carcinoma of the esophagus offers benefits and increases survival.50101-

Gingival peeling and periodontal aesthetics: a case report.

Melanic pigmentations (MP) are dark stains located on the masticatory mucosa. These pigmentations are consequence of the excess of melanin  production by  the  melanocytes  located  in  the  basal  layer  of  the epithelium, between epithelial cells and connective tissue cells. The MP of the periodontium are the results of the melanin granules transfer from the melanocytes to the keratinocytes, in a process called epidermal melanin.  This study aims to report a clinical case of dermabrasion for treatment of gingival melanin hyper pigmentation of a female patient, 21 years of age, non smoker, under orthodontic treatment and without systemic alterations. This patient attended the Clinic of Specialization in Periodontics of the Brazilian Association of Dentistry (ABO) with the aesthetic of her smile as the chief complain, due to the excess of melanin on the gingival tissues, in the anterior superior region.  The  epithelial  dermabrasion technique, with hand tools, promoted aesthetic results on the melanic depigmentation.Melanic pigmentations (MP) are dark stains located on the masticatory mucosa. These pigmentations are consequence of the excess of melanin  production by  the  melanocytes  located  in  the  basal  layer  of  the epithelium, between epithelial cells and connective tissue cells. The MP of the periodontium are the results of the melanin granules transfer from the melanocytes to the keratinocytes, in a process called epidermal melanin.  This study aims to report a clinical case of dermabrasion for treatment of gingival melanin hyper pigmentation of a female patient, 21 years of age, non smoker, under orthodontic treatment and without systemic alterations. This patient attended the Clinic of Specialization in Periodontics of the Brazilian Association of Dentistry (ABO) with the aesthetic of her smile as the chief complain, due to the excess of melanin on the gingival tissues, in the anterior superior region.  The  epithelial  dermabrasion technique, with hand tools, promoted aesthetic results on the melanic depigmentation

Translation, cross-cultural adaptation, and reproducibility of the Brazilian portuguese-language version of the Wisconsin Smoking Withdrawal Scale

OBJECTIVE: To cross-culturally adapt the Wisconsin Smoking Withdrawal Scale (WSWS) for use in Brazil and evaluate the reproducibility of the new (Brazilian Portuguese-language) version. METHODS: The original English version of the WSWS was translated into Brazilian Portuguese. For cross-cultural adaptation, the Brazilian Portuguese-language version of the WSWS was administered to eight volunteers, all of whom were smokers. After adjustments had been made, the WSWS version was back-translated into English. The Brazilian Portuguese-language version was thereby found to be accurate. The final Brazilian Portuguese-language version of the WSWS was applied to 75 smokers at three distinct times. For the assessment of interobserver reproducibility, it was applied twice within a 30-min interval by two different interviewers. For the assessment of intraobserver reproducibility, it was applied again 15 days later by one of the interviewers. Intraclass correlation coefficients (ICCs) were used in order to test the concordance of the answers. The significance level was set at p < 0.05. RESULTS: Of the 75 volunteers, 43 (57.3%) were female. The overall mean age was 46.3 years. Interobserver and intraobserver reproducibility was determined for each of the WSWS seven domains, the ICCs for which ranged from 0.87 to 0.94 and from 0.76 to 0.92, respectively. The mean time to completion of the WSWS was 6 min and 44 s, and the response time per question ranged from 4.2 to 12.6 s. CONCLUSIONS: The Brazilian Portuguese-language version of the WSWS is reproducible, fast, and simple. It can therefore be used as a tool for assessing the severity of the symptoms of nicotine withdrawal syndrome.OBJETIVO: Adaptar culturalmente e avaliar a reprodutibilidade da Wisconsin Smoking Withdrawal Scale (WSWS) para o português do Brasil. MÉTODOS: Foi realizada a tradução da versão original em língua inglesa para o português. A versão traduzida foi aplicada em 8 voluntários fumantes para a adaptação cultural. Após ajustes, a versão da WSWS foi submetida à tradução retrógrada do português para o inglês. A versão em português do Brasil foi considerada adequada. Para a avaliação da reprodutibilidade, a escala foi aplicada em 75 fumantes em dois momentos, com intervalo de 30 minutos (reprodutibilidade interobservador) e, num terceiro momento, após 15 dias (reprodutibilidade intraobservador). Utilizou-se o coeficiente de correlação intraclasse (CCI) para testar a concordância entre as respostas. O nível de significância adotado foi p < 0,05. RESULTADOS: Dos 75 voluntários, 43 (57,3%) eram do gênero feminino. A média geral de idade foi 46,3 anos. A reprodutibilidade interobservador e intraobservador foi determinada para cada um dos sete domínios da WSWS, com CCI variando de, respectivamente, 0,87 a 0,94 e de 0,76 a 0,92. O tempo médio de resposta da WSWS foi 6 min e 44 s, e o tempo de resposta para cada questão variou de 4,2 a 12,6 s. CONCLUSÕES: A versão da WSWS para o português do Brasil é reprodutível, de aplicação rápida e simples, podendo ser utilizada como um instrumento de avaliação da gravidade dos sintomas da síndrome da abstinência à nicotina.Universidade Estadual de Ciências da Saúde de AlagoasUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversity of Wisconsin Center for Tobacco Research and InterventionUNIFESP, EPMSciEL

Gastric Adenocarcinoma After Gastric Bypass For Morbid Obesity: A Case Report And Review Of The Literature.

Gastric adenocarcinoma after gastric bypass for morbid obesity is rare but has been described. The diet restriction, weight loss, and difficult assessment of the bypassed stomach, after this procedure, hinder and delay its diagnosis. We present a 52-year-old man who underwent Roux-en-Y gastric bypass 2 years ago and whose previous upper digestive endoscopy was considered normal. He presented with weight loss, attributed to the procedure, and progressive dysphagia. Upper digestive endoscopy revealed stenosing tumor in gastric pouch whose biopsy showed diffuse-type gastric adenocarcinoma. He underwent total gastrectomy, left lobectomy, distal pancreatectomy and splenectomy, segmental colectomy, and bowel resection with esophagojejunal anastomosis. The histopathological analysis confirmed the presence of gastric cancer. The pathogenesis of gastric pouch adenocarcinoma is discussed with a literature review.201360972

Diferenças em colonização do hospedeiro por isolados de Xylella fastidiosa de citros e cafeeiro em inoculações recíprocas

Clorose variegada dos citros (CVC) e atrofia dos ramos do cafeeiro (ARC) são doenças importantes no Brasil, associadas a estirpes de Xylella fastidiosa que são geneticamente próximas. Entretanto, pouco se sabe a respeito de plantas hospedeiras em comum e da importância de citros e cafeeiro como fontes de inóculo dessas estirpes. Neste estudo, realizaram-se experimentos de inoculação recíproca para determinar se isolados de X. fastidiosa de CVC e de ARC são biologicamente semelhantes em plantas de citros e café. Estes dois hospedeiros foram mecanicamente inoculados com um isolado de CVC e um isolado de ARC, em quatro concentrações que variaram de 10³ a 10(9) unidades formadoras de colônias UFC mL-1. Aos dois, quatro e oito meses após a inoculação, a eficiência de infecção e a população bacteriana dos isolados em cada hospedeiro foram determinadas por cultura. O isolado de CVC infectou tanto plantas de citros quanto de café, mas desenvolveu populações mais baixas em cafeeiro. O isolado de ARC não colonizou citros. A inoculação de plantas de café com o isolado de CVC resultou em baixas taxas de infecção e exigiu uma concentração de inóculo dez vezes mais alta que a necessária para obter uma taxa de infecção semelhante (25%) em citros. A reduzida taxa de infecção e a baixa população bacteriana do isolado de CVC em cafeeiro em relação a citros sugerem que cafeeiro não é um hospedeiro adequado para atuar como fonte de inóculo da estirpe de CVC para disseminação deste patógeno para pomares de laranja ou dentro de cafezais.Citrus variegated chlorosis (CVC) and coffee stem atrophy (CSA) are important diseases in Brazil associated with closely-related strains of Xylella fastidiosa, but little is know about host aoverlappingnd importance of citrus and coffee as inoculum sources of these strains. In this study, reciprocal-inoculation experiments were performed to determine if CVC and CSA isolates are biologically similar within citrus and coffee plants. These two hosts were mechanically inoculated with a CVC and a CSA isolate of X. fastidiosa at four concentrations ranging between10³ and 10(9) colony forming units CFU mL-1. At two, four and eight months after inoculation, the infection efficiency and bacterial populations of the isolates in each host were determined by culturing. The CVC isolate infected both citrus and coffee plants, but developed lower populations in coffee. The CSA isolate did not colonize citrus. Inoculation of coffee plants with the CVC isolate resulted in low rates of infection and required an inoculum concentration ten-fold higher than that necessary to obtain a similar (25%) rate of infection in citrus. The relatively low infection rates and bacterial numbers of the CVC isolate in coffee plants compared with those observed in citrus suggest that coffee is not a suitable host to serve as a source of inoculum of the CVC strain for primary spread to citrus or within coffee plantations