AZOOR with unilateral disc edema: An atypical case report

Acute zonal occult outer retinopathy (AZOOR) diagnosis is challenging and frequently delayed. Atypical findings were described, nevertheless optic disc edema has not been consistently reported. In this study we pretend to describe a challenging diagnosis of AZOOR. In our case, a 19-year-old female presented painless vision loss in her right eye for 2 weeks. Fundus examination revealed optic disc hyperaemic edema and the visual field (VF) an enlarged blind spot. Non-infectious optic neuritis was assumed and intravenous corticotherapy administered. Four months later, VA had improved, but a VF defect persisted. Funduscopic examination showed mild peripapillary atrophy and autofluorescence zonal hyperautofluorescence around optic disc. Optical coherence tomography demonstrated diffuse loss of outer retinal layers and electroretinogram weakened signal at the corresponding region. In conclusion, unilateral optic disc edema, generally not associated with AZOOR typical presentation, hamper an early diagnosis and expresses this case relevance.

Insights into the antiviral activity of phospholipases A2 (PLA2s) from snake venoms

Viruses are associated with several human diseases that infect a large number of individuals, hence directly affecting global health and economy. Owing to the lack of efficient vaccines, antiviral therapy and emerging resistance strains, many viruses are considered as a potential threat to public health. Therefore, researches have been developed to identify new drug candidates for future treatments. Among them, antiviral research based on natural molecules is a promising approach. Phospholipases A₂ (PLA₂s) isolated from snake venom have shown significant antiviral activity against some viruses such as Dengue virus, Human Immunodeficiency virus, Hepatitis C virus and Yellow fever virus, and have emerged as an attractive alternative strategy for the development of novel antiviral therapy. Thus, this review provides an overview of remarkable findings involving PLA₂s from snake venom that possess antiviral activity, and discusses the mechanisms of action mediated by PLA₂s against different stages of virus replication cycle. Additionally, molecular docking simulations were performed by interacting between phospholipids from Dengue virus envelope and PLA₂s from Bothrops asper snake venom. Studies on snake venom PLA₂s highlight the potential use of these proteins for the development of broad-spectrum antiviral drugs.

PET/CT with 18F-FDG predicts short-term outcome in stage II/III breast cancer patients upstaged to N2/3 nodal disease

INTRODUCTION

¹⁸F-FDG PET/CT has high positive predictive value for the detection of avid lymph node metastases in breast cancer patients. We analysed the effect of upstaging lymph nodes by PET/CT on short-term outcome in stage II/III breast cancer patients.

PATIENTS AND METHODS

A total of 278 stage II/III primary breast cancer patients (mean age 48.9 years, range 19-75 years) were re-staged with ¹⁸F-FDG PET/CT before start of pre-operative systemic treatment (PST). Patients were divided in three groups based on risk for local recurrence: a low - (T2N0), intermediate - (T0-2N1 and T3N0) and a high-risk group (T0-3N2-3, T3N1 and T4). Within these groups we looked at local recurrence-free survival (LRFS), recurrence-free survival (RFS) and overall survival (OS) within the first 3 years of follow-up.

RESULTS

With a median follow-up (FU) of 50 months the RFS, LRFS and OS were 87%, 88% and 92% respectively for the whole group. PET/CT upstaged 43 patients from the low- and intermediate risk group to the high-risk group, based on detection of ≥4 avid axillary nodes or occult N2/3-disease. Patients upstaged with PET/CT had more events for all three analyses compared to the original risk groups, which resulted in a significantly worse RFS (69.8%; p = 0.03) a nearly significantly worse LRFS (p = 0.052) and no effect in OS (p = 0.433).

DISCUSSION

Additional PET/CT staging allows breast cancer patients to be treated according to the true stage, still stage II/III breast cancer patients upstaged to N2/3 by PET/CT have worse short-term outcome, despite adjustment of treatment, than patients staged high-risk with conventional imaging.

Microhardness change of enamel due to bleaching with in-office bleaching gels of different acidity

OBJECTIVE

The aim of this study was to assess the enamel microhardness treated with three in-office bleaching agents, containing 35% hydrogen peroxide with different acidity.

MATERIALS AND METHODS

Bovine incisors were divided into three groups that received the following bleaching agents: Whiteness HP, Total Bleach and Opalescence Xtra. Three gel applications/10-min each, totaling 30-min of bleaching treatment, were made on the teeth and activated with a blue LED (1000 mW/470 nm) combined to a LASER (120 mW/795 nm) device (Easy Bleach-Clean Line). Vickers hardness (VH) was evaluated at baseline and after the bleaching procedure. The values of Hardness loss [HNL] (% reduction) were calculated. The two-sample t-test was used for comparison of the HNL of the three bleaching products (5% level of significance).

RESULTS

The Opalescence Xtra, which had the lowest pH value (pH = 4.30), showed a significant increase of HNL when compared with Total Bleach bleaching agent, which had the highest pH value (pH = 6.62).

CONCLUSIONS

The 35% hydrogen peroxide bleaching agents resulted in a reduction in surface enamel microhardness and bleaching with the most acid agent resulted in a significant enamel hardness loss compared to the less acid agent (4.30 vs 6.62). Strategies proposed to reduce the enamel loss after bleaching treatment may include the use of daily fluoride therapy, mouth rinsing (fluoride, milk and sodium bicarbonate solution), fluoride/bicarbonate dentifrices without abrasives, do not toothbrush immediately after bleaching, fluorides and calcium add to bleaching agents.

Comunidade Beira-rio: primeiro relato sobre condição bucal, hábitos de higiene e dieta alimentar

A Comunidade Beira-rio, composta de 114 indivíduos, em função da sua localização geográfica no município de São José dos Campos – SP permaneceu praticamente isolada por 42 anos. O intuito desse trabalho foi um estudo exploratório sobre experiência de cárie, condição gengival, ocorrência de fluorose e comportamento em saúde bucal da Comunidade Beira-rio. Participaram do estudo 49 indivíduos de 1 a 50 anos de idade. Entre 1 e 2 anos, 50% já apresentavam experiência de cárie, aumentando para 89%na faixa etária de 3 a 6 anos. Dos 7 aos 12 anos, somente 52,6% eram livres de cárie na dentição permanente. Entre 21 e 50 anos, verificou-se 100% de experiência de cárie. Não foram observados casos de fluorose nos indivíduos examinados. Embora tenha sido relatado que a maioria higienizava-se 2 vezes ao dia com escova e dentifrício, 100% apresentavam placa bacteriana nos dentes examinados. O açúcar refinado faz parte da alimentação dessa população, e todos os pais entrevistados relataram colocá-lo nos alimentos dados aos filhos. Ao final dos procedimentos foram ministradas palestras aos participantes em função da faixa etária. A comunidade necessita de ações adequadas à realidade da população, tanto coletivamente quanto nas alterações de hábitos individuais. Verificou-se a necessidade de educação para a prevenção dos problemas bucais mais freqüentes e de atendimento precoce para a melhoria da condição bucal da população.

Substrate specificity and subsite mobility in T. aurantiacus xylanase 10A

The substrate specificity of Thermoascus aurantiacus xylanase 10A (TAX) has been investigated both biochemically and structurally. High resolution crystallographic analyses at 291 K and 100 K of TAX complexes with xylobiose show that the ligand is in its alpha anomeric conformation and provide a rationale for specificity on p-nitrophenyl glycosides at the -1 and -2 subsites. Trp 275, which is disordered in uncomplexed structures, is stabilised by its interaction with xylobiose. Two structural subsets in family 10 are identified, which differ by the presence or absence of a short helical stretch in the eighth betaalpha-loop of the TIM barrel, the loop bearing Trp 275. This structural difference is discussed in the context of Trp 275 mobility and xylanase function.

[Botulinum toxin the treatment of spasmodic torticollis: a meta-analysis]

The authors made a meta-analysis of the results of botulinum toxin injection for the treatment of spasmodic torticollis. They concluded that botulinum toxin is effective for the treatment of cervical dystonia.