Influence of enhancement filters in apical bone loss measurement : a cone-beam computed tomography study

The use of cone-beam computed tomography images (CBCT) providing a better assessment of bone injuries, although the sensibility of lesions measurement might be improved by the use of enhancement filters. Objective: This study aimed to analyze the influence of enhancement filters in apical bone loss measurement. Eighteen CBCT cases randomly selected of apical bone loss were evaluated. The analyses were carried out following the evaluation in axial, coronal and sagittal protocols, using enhancement filters as Hard, Normal, and Very Sharp. The variables were statistically analyzed by Friedman and Wilcoxon test, Spearman?s rho, and intraclass correlation coefficient. The differences between filters in axial and sagittal protocols were significant (p<0.05); however, this was not observed in the coronal slice. The use of Hard filter demonstrates better results than Very Sharp and Normal filter, improving significantly the bone loss measurement. A strong, significant and positive correlation was noted for all filters (with p< 0.001), such as a strong agreement between the variables, when the Normal filter was used as a reference. The use of enhancement filters increases the sensitivity of alveolar bone loss measurement, with relative advantage for Hard filter

Fatores de risco para hipotermia pós-operatória em sala de recuperação pós-anestésica : estudo piloto prospectivo de prognóstico

Justificativa: A hipotermia ocorre em até 20% dos pacientes no perioperatório. A monitoração sistemática pós-operatória da temperatura não é um padrão de atendimento no Brasil e há poucas publicações sobre recuperação da temperatura na sala de recuperação pós-anestésica. Desenho e cenário: Estudo multicêntrico, observacional, transversal, conduzido no Hospital de Base do Distrito Federal e no Hospital Materno Infantil de Brasília. Métodos: Na admissão e alta da sala de recuperação pós-anestesia, os pacientes submetidos a procedimentos cirúrgicos eletivos ou de urgência foram avaliados de acordo com a temperatura timpânica, sinais vitais, eventos adversos perioperatórios, tempo de permanência na sala de recuperação pós-anestesia e tempo de internação hospitalar. Resultados: Setenta e oito pacientes com idades entre 18 e 85 anos foram avaliados. A incidência de temperatura <36 ºC na admissão à sala de recuperação pós-anestesia foi de 69,2%. Raquianestesia (p < 0,0001), cesariana (p = 0,03) e os pacientes que receberam morfina (p = 0,005) e sufentanil (p = 0,003) apresentaram temperaturas significativamente menores ao longo do tempo. Durante a permanência na sala de recuperação pós-anestesia, os pacientes idosos apresentaram uma tendência maior a apresentarem hipotermia e menor capacidade de recuperação dessa condição, em comparação com os pacientes jovens (p < 0,001). Anestesia combinada também foi associada a taxas mais altas de hipotermia, seguida pelas anestesias regional e geral isoladas (p < 0,001). Conclusão: Em conclusão, este estudo piloto mostrou que a hipotermia perioperatória ainda é um problema prevalente em nossa prática anestésica. Mais de metade dos pacientes analisados apresentaram hipotermia durante a admissão à sala de recuperação pós-anestésica. Demonstramos a viabilidade de um grande estudo multicêntrico, transversal, de hipotermia pós-operatória em sala de recuperação pós-anestésica.Background: Hypothermia occurs in up to 20% of perioperative patients. Systematic postoperative temperature monitoring is not a standard of care in Brazil and there are few publications about temperature recovery in the postoperative care unit. Design and setting: Multicenter, observational, cross-sectional study, at Hospital de Base do Distrito Federal and Hospital Materno Infantil de Brasília. Methods: At admission and discharge from postoperative care unit, patients undergoing elective or urgent surgical procedures were evaluated according to tympanic temperature, vital signs, perioperative adverse events, and length of stay in postoperative care unit and length of hospital stay. Results: 78 patients, from 18 to 85 years old, were assessed. The incidence of temperatures <36 ºC at postoperative care unit admission was 69.2%. Spinal anesthesia (p < 0.0001), cesarean section (p = 0.03), and patients who received morphine (p = 0.005) and sufentanil (p = 0.003) had significantly lower temperatures through time. During postoperative care unit stay, the elderly presented a greater tendency to hypothermia and lower recovery ability from this condition when compared to young patients (p < 0.001). Combined anesthesia was also associated to higher rates of hypothermia, followed by regional and general anesthesia alone (p < 0.001). Conclusion: In conclusion, this pilot study showed that perioperative hypothermia is still a prevalent problem in our anesthetic practice. More than half of the analyzed patients presented hypothermia through postoperative care unit admission. We have demonstrated the feasibility of a large, multicenter, cross-sectional study of postoperative hypothermia in the post-anesthetic care unit

Fatores de risco associados ao comportamento alimentar inadequado em futebolistas

The inappropriate eating behavior (IEB) appears to be associated with numerous factors. However, the population of athletes, especially males, is lacking in such investigations. The purpose of this study was to identify risk factors for IEB in young footballers. 271 footballers of Juiz de Fora/MG were evaluated. IEB was assessed by applying the Eating Attitudes Test (EAT-26). The body dissatisfaction was verified through the Body Shape Questionnaire. We measured from this weight and height to calculate the body mass index (BMI), and skinfold thickness in order to estimate the adiposity. We carried out binary logistic regression to assess risks on the IEB, instilling a significance level of 5%. It was observed that only body dissatisfaction remained associated with IEB, both the simple model, as adjusted for all the variables (p < 0.05). It was concluded that body dissatisfaction presented risks to the manifestation of IEB.El comportamiento inadecuado de alimentos (CIA), parece estar relacionado con varios factores. Sin embargo, la población de atletas, sobre todo varones, está en la necesidad de tales investigaciones. El objetivo de este estudio fue identificar los factores de riesgo para la CIA en los jóvenes futbolistas. Se evaluaron 271 futbolistas de Juiz de Fora/MG. Se evaluó la CIA aplicando el Eating Attitudes Test (EAT-26). La insatisfacción corporal se evaluó a través del Body Shape Questionnaire. Se ha medido el peso y la altura para calcular el índice de masa corporal y grosor del pliegue cutáneo con el fin de estimar la grasa corporal. Hemos llevado a cabo una regresión logística binaria para evaluar los riesgos en el CIA, infundiendo un nivel de significación del 5%. Se observó que la insatisfacción corporal sólo se mantuvo asociada con el CIA, tanto en el modelo simple, como el conjunto de todas las variables (p < 0,05). Se concluyó que los riesgos de insatisfacción del cuerpo presentes en la manifestación de la CIA.O comportamento alimentar inadequado (CAI) parece estar associado a diversos fatores. No entanto, a população de atletas, principalmente do sexo masculino, é carente de investigações deste tipo. O objetivo do presente estudo foi identificar fatores de risco para o CAI em jovens futebolistas. Foram avaliados 271 futebolistas de Juiz de Fora/MG. Avaliou-se o CAI mediante aplicação do Eating Attitudes Test (EAT-26). A insatisfação corporal foi verificada por intermédio do Body Shape Questionnaire. Aferiu-se massa corporal e estatura para calcular-se o índice de massa corporal, além de dobras cutâneas com o propósito de estimar a adiposidade corporal. Conduziu-se regressão logística binária para avaliar riscos sobre o CAI, incutindo nível de significância de 5%. Observou-se que somente a insatisfação corporal manteve-se associada ao CAI, tanto no modelo simples, quanto no ajustado para todas as variáveis (p < 0,05). Concluiu-se que a insatisfação corporal apresentou riscos para a manifestação do CAI

Dried blood spot technique-based liquid chromatography-tandem mass spectrometry method as a simple alternative for benznidazole pharmacokinetic assessment

Chagas disease (CD) is recognized as one of the major neglected global tropical diseases. Benznidazole (BNZ) is the drug of choice for the treatment of adults, young infants, and newborns with CD. However, the pharmacokinetics (PK) of BNZ have been poorly evaluated in all age groups, with consequent gaps in knowledge about PK-pharmacodynamic relationships in CD. The purpose of this study was to develop and validate a bioanalytical method to quantify BNZ levels in small-volume whole-blood samples collected as dried blood spots (DBS). The analysis was performed using high-performance liquid chromatography-positive electrospray tandem mass spectrometry. PK evaluation in healthy male volunteers was conducted to verify the correlation between DBS and plasma BNZ concentrations. The calibration curve was linear from 50 to 20,000 ng · ml1. Intra- and interday precision and bias values were less than 14.87% (n 9) and 9.81% (n 27), respectively. The recovery rates ranged from 94 to 100% with no matrix effect. There was no hematocrit level effect in a range of 20 to 70%. The PK results obtained from DBS and plasma were comparable (r2 0.8295) and equivalent to previously published information on BNZ. BNZ in DBS was stable at room temperature for more than one year. This article describes the first microsampling method for measuring BNZ levels in DBS that has the potential to facilitate broad implementation of PK in clinical trials involving adult and pediatric patients in remote areas and helps to address existing knowledge gaps in the treatment of CD.Fil: Galindo Bedor, Danilo César. Universidade Federal de Pernambuco; BrasilFil: Tavares Cavalcanti Bedor, Noely Camila. No especifíca;Fil: Wellithom Viturino da Silva, José. Universidade Federal de Pernambuco; BrasilFil: Damasceno Sousa, Giovana. Universidade Federal de Pernambuco; BrasilFil: Pereira de Santana, Davi. Universidade Federal de Pernambuco; BrasilFil: Garcia Bournissen, Facundo. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; Argentina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Altcheh, Jaime Marcelo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Blum, Bethania. No especifíca;Fil: Alves, Fabiana. No especifíca;Fil: Ribeiro, Isabela. No especifíca

Cell Culture and Maintenance of the Evolutionary Forms of <em>Trypanosoma cruzi</em> for Studies of Parasitic Biology

This chapter aims to present and discuss the main cell culture techniques used for the growth and maintenance of the different evolutionary forms of the protozoan Trypanosoma cruzi, the etiologic agent of the Chagas disease. Chagas disease is a neglected tropical disease endemic in several Latin American countries. Here, we intend to present the main difficulties, advantages, and disadvantages of using Trypanosoma cruzi cell culture in parasitic biology. Finally, we present the main research opportunities in the context of Trypanosoma cruzi parasitic biology using cell culture techniques, such as drug development, characterization of pharmacological targets, molecular markers for diagnosis, structural biology, and many other biomedical applications

Parasite load in the blood and skin of dogs naturally infected by Leishmania infantum is correlated with their capacity to infect sand fly vectors

AbstractThe sand fly Lutzomyia longipalpis is primarily responsible for the transmission of visceral leishmaniasis (VL) in the New World, and dogs are considered to be the main urban reservoir of this disease. In order to improve the efficacy of control measures, it is essential to assess the transmission capacity of Leishmania infantum to the sand fly vector by naturally infected dogs. The present study investigated the existence of correlations between canine clinical presentation and the intensity of parasite load in the blood, skin and spleen of naturally infected dogs. In addition, we also attempted to establish correlations between the intensity of parasite load in canine tissue and the parasite load detected in sandflies five days after feeding on naturally infected dogs. A total of 23 dogs were examined and classified according to clinical manifestation of canine VL. Blood samples, splenic aspirate and skin biopsies were collected and parasite DNA was quantified by qPCR. Canine capacity to infect Lu. longipalpis with parasites was evaluated by xenodiagnosis and parasite loads were measured five days after feeding. No significant differences were observed with respect to canine clinical manifestation and the parasite loads detected in the blood, skin and spleen samples obtained from naturally infected dogs. Regardless of clinical canine visceral leishmaniasis (CVL) presentation and the degree of parasite burden, almost half of the dogs successfully infected sandflies with parasites, albeit to a low number of sandflies with correspondingly low parasite loads. Parasite loads in both canine blood and skin were shown to be positively correlated with the canine infectiousness to the sand fly vector, and positive correlations were also observed with respect to these tissues and the sand fly infection rate, as well as the parasite load detected in sandflies following xenodiagnosis. In conclusion, this indicates that parasite loads in both blood and skin can function as potentially reliable markers of canine capacity to infect sand fly vector

Development of a risk score for earlier diagnosis of chronic kidney disease in children

Objective To develop a clinical score for the early identification of chronic kidney disease (CKD) in children and adolescents. The early diagnosis of CKD in childhood allows the adoption of measures to slow the progression of the disease, thereby reducing morbidity and mortality. Nevertheless, the diagnosis is often made too late for proper patient management. Study design We preformed a case-control study of a multicenter Brazilian sample of 752 pediatric patients; the study cases (n = 376) were CKD patients with a median estimated GFR of 37 (IQR = 22 to 57) ml/min/1.73 m(2). The control group (n = 376) comprised age-, gender-and center-matched children who were followed for nonrenal diseases. Potential risk factors were investigated through a standard questionnaire that included symptoms, medical history, and a clinical examination. Two multivariable models (A and B) were fitted to assess predictors of the diagnosis of CKD. Results In model A, 9 variables were associated with CKD diagnosis: antenatal ultrasound with urinary malformation, recurrent urinary tract infection, polyuria, abnormal urine stream, nocturia, growth curve flattening, history of hypertension, foamy urine and edema (c-statistic = 0.938). Model B had the same variables as model A, except for the addition of the history of admission during the neonatal period and the exclusion of antenatal ultrasound variables (c-statistic = 0.927). Conclusions The present scores may serve as a warning sign for CKD diagnosis in children among professionals working in the primary care setting where the symptoms associated with a risk of CKD may be overlooked14

PCRRT Expert Committee ICONIC Position Paper on Prescribing Kidney Replacement Therapy in Critically Sick Children With Acute Liver Failure

Management of acute liver failure (ALF) and acute on chronic liver failure (ACLF) in the pediatric population can be challenging. Kidney manifestations of liver failure, such as hepatorenal syndrome (HRS) and acute kidney injury (AKI), are increasingly prevalent and may portend a poor prognosis. The overall incidence of AKI in children with ALF has not been well-established, partially due to the difficulty of precisely estimating kidney function in these patients. The true incidence of AKI in pediatric patients may still be underestimated due to decreased creatinine production in patients with advanced liver dysfunction and those with critical conditions including shock and cardiovascular compromise with poor kidney perfusion. Current treatment for kidney dysfunction secondary to liver failure include conservative management, intravenous fluids, and kidney replacement therapy (KRT). Despite the paucity of evidence-based recommendations concerning the application of KRT in children with kidney dysfunction in the setting of ALF, expert clinical opinions have been evaluated regarding the optimal modalities and timing of KRT, dialysis/replacement solutions, blood and dialysate flow rates and dialysis dose, and anticoagulation methods