Evaluation of the efficacy of a commercially available regimen vs brushing alone on established plaque and gingivitis on adolescents: Study protocol for a randomized, controlled, blind clinical trial

BACKGROUND

Dental biofilm accumulation and poor personal oral hygiene are known major risk factors for gingivitis and halitosis. However, it is not clear how studies compare the effectiveness of hygiene regimens, associated with outcomes centered on patients.

METHODS

A randomized, blind, controlled clinical trial involving 58 participants aged from 12 to 17 years, who search the Department of Pediatric Dentistry of Universidade Metropolitana de Santos, will be conducted. Immediately, the volunteers will be inserted into Group 1 (commercially available hygiene regimen) or Group 2 (tooth brushing alone). In Group 1, participants will receive Colgate Total 12 toothpastes, Plax mouthwashes and Colgate Ultrasoft toothbrushes, while Group 2 will use Colgate Cavity Protection toothpastes and Colgate Ultrasoft toothbrushes. The interventions will be conducted in the periods of 1, 3, and 6 months after the baseline, when the evaluations will also be performed. Biofilm and halitosis indexes will be evaluated. Data regarding discomfort, satisfaction and the socioeconomic/individual characteristics will also be computed.

DISCUSSION

Although toothbrushing has shown positive effects in decreasing biofilm and in gingival health, there is no comparison in the literature of different brushing regimens with halitosis measurement in adolescents. In addition, the effectiveness of these protocols would be confirmed from the acceptability of the volunteers.

Temporomandibular disorder and headache in university professors

[Purpose] Temporomandibular disorder is a condition with a multifactor etiology that involves the temporomandibular joint, bones, surrounding muscles and facial pain is the most common symptom. This study evaluated the possible association between headache and temporomandibular disorder in university professors. [Participants and Methods] Twenty-seven professors were recruited and answered the Axis II of the Research Diagnostic Criteria for Temporomandibular Disorders for the evaluation and diagnosis of temporomandibular disorder and filled out a “Headache Diary” proposed by the American Headache Society. [Results] The university professors showed headache and temporomandibular disorder, but no association was found between the two conditions. Comparing the gender, the males were most frequently affected, but females had more intensity of signs and symptoms. There is a lack of data on the population addressed in the present study. [Conclusion] Indeed, this was the first such study developed with university professors. It is of considerable importance to develop further studies to investigate the possible association between headache and temporomandibular disorder.

Evaluation of primary headache associated with temporomandibular dysfunction in adolescents from Santos, SP, Brazil: an observational study

[Purpose] Evaluate the association of primary headache and Temporomandibular Dysfunction in healthy adolescents from the Santos, SP, Brazil. [Participants and Methods] A total of 208 adolescents, aged 11 to 16 years old were randomly selected at the dentistry clinic at Universidade Metropolitana de Santos. For that, the Fonseca Anamnestic Index was applied, including information such as: limitation when opening the mouth and moving the jaw, headaches, pain in the temporomandibular joint, noises in the temporomandibular joint, and the habit of tightening or grinding the teeth. The data were submitted to descriptive statistical analysis and the χ² test and Fisher’s exact test were used to evaluate the association of categorical variables. [Results] The results were 63% of male participants, and 61% of female participants had Temporomandibular Dysfunction. In both genders headache was associated with the presence of Temporomandibular Dysfunction, with 93 participants with light headache and 39 with moderate headache. [Conclusion] There was an association between headache and the presence of Temporomandibular Dysfunction, and the percentage of affected males was slightly higher among this association. In the sample of adolescents who presented Temporomandibular Dysfunction, moderate headache was the main reported symptom of both genders.

Effect of nandrolone decanoate on skeletal muscle repair

This study analyzed the effect of nandrolone decanoate (ND) on muscle repair and the expression of myogenic regulatory factors following cryoinjury in rat skeletal muscle. Adult male Wistar rats were randomly divided into 4 groups: control group, sham group, cryoinjured group treated with ND and non-injured group treated with ND. Treatment consisted of subcutaneous injections of ND (5 mg/kg) twice a week. After sacrifice, the tibialis anterior muscle was removed for the isolation of total RNA and analysis of myogenic regulatory factors using real-time PCR as well as morphological analysis using the hematoxylin-eosin assay. There was a significant increase in MyoD mRNA after 7 days and in myogenin mRNA after 21 days in the cryoinjured ND group in comparison to other groups in the same period. The morphological analysis revealed no edema or myonecrosis after 7 days as well as no edema or inflammatory infiltrate after 14 days in the cryoinjured ND group. In conclusion the anabolic steroid nandrolone decanoate can modulate the muscle repair process in rats following cryoinjury by influencing the expression of regulatory myogenic factors and phases of muscle repair.

PP090. The contribution of podocyturia to the evaluation of ongoing glomerular disorder in pregnant women with kidney graft (preliminary results)

INTRODUCTION

Progressive proteinuria and glomerulosclerosis characterize chronic allograft nephropathy. However, the causes are not fully elucidated. Injury of parietal epithelial cells in glomeruli, the podocytes, is the initiating cause of many renal diseases, leading to proteinuria with possible progression to glomerulosclerosis. Podocytes are highly specialized cells, with an important role in maintaining the glomerular filtration barrier and producing growth factor for mesangial cells and endothelial cells. With their foot processes they cover the glomerular basement membrane, and form slit diaphragms with neighboring podocytes. The potential role of podocytes in the failing transplanted kidney is unknown.

OBJECTIVES

To evaluate podocyturia as a functional marker in pregnant women with kidney grafts.

METHODS

Twenty pregnant women with kidney grafts had their urine samples cytocentrifugated and evaluated by indirect immunofluorescence. The slide was incubated for 45' at room temperature with fluorescein (FITC) anti-rabbit IgG secondary antibody (Sigma-Aldrich, EUA). Then Vectashield (mounting medium for fluorescence) with DAPI (4'6-diamino-2-fenilindol dihidrocloreto) were applied H-1200 (Vector laboratories, inc, USA). The podocytes and the total number of cells were counted in 15 fields photographed under 400x magnification with a digital camera coupled to an epifluorescence microscope DM1000 (Leica, Germany) connected to a computer. The results were expressed as podocyte/total cells (%) per area of higher cell concentration (hot spots) in the field of 400x detected by staining of nuclei and cytoplasm. (Grant FAPESP 08/56338-1).

RESULTS

The mean age of the women was 26years. The urinalysis was performed at the third trimester of gestation; 11 did not exhibit urinary podocytes and 9 had podocyturia. There was also a relationship between blood pressure levels, proteinuria and the excretion of podocytes.

CONCLUSION

Urinary podocyte number, blood pressure and proteinuria were associated. We observed that urinary podocyte excretion occurs in pregnant women with kidney transplant almost synchronously with higher systolic and diastolic blood pressure and higher mean levels of proteinuria. The detection of podocyturia in these women could be useful for early diagnosis and follow-up of glomerular injury, eventually preeclampsia. It may be also associated to its severity or activity, although additional studies are necessary to confirm these aspects.

Síndrome de Cushing como complicação do tratamento de líquen plano oral erosivo

O líquen plano oral (LPO) é uma doença mucocutânea inflamatória crônica relacionada com alterações na imunidade mediada por células T. Diversos medicamentos têm sido utilizados no tratamento desta doença, especialmente nas formas erosivas e ulcerativas, com resultados variados. O objetivo deste trabalho é descrever e discutir um caso clínico de líquen plano oral erosivo tratado com corticóide sistêmico que resultou em Síndrome de Cushing, que se manteve com o uso de corticóide tópico.

Altering glomerular epithelial function in vitro using transient and stable transfection

Damage of the glomerular filtration barrier leads to proteinuria and progressive renal failure. Several independent lines of research have implicated the glomerular epithelial cell (GEC) as a key player in initiation and propagation of pathways leading to glomerulosclerosis. A growing number of molecules activated in this process have been identified. To further define their cellular function, manipulation of these molecules using pharmacological or genetic approaches in tissue culture systems are required. In this study, strategies for altering GEC gene expression by transient and stable transfection of fluorescence labeled proteins will be presented and discussed. The insight gained through these and comparable systems should allow a detailed dissection of the molecular pathways active in GEC function and failure.

Widespread hematogenous metastases and Trousseau's syndrome in gastric adenocarcinoma

A case of widespread hematogenous metastases and Trousseau's syndrome is reported in a 40 year-old white housewife with gastric cancer, presenting subdural hematoma, ecchymoses, epistaxis, stomach and uterine bleeding. After undergoing hematoma drainage, she was unsuccessfully treated with platelets, red blood cells, plasma cryoprecipitate transfusions, and antibiotics. Necropsy disclosed gastric ring-signet adenocarcinoma invading the serous layer, with massive disseminated intravascular coagulation and systemic neoplastic embolism. Multiple old and recent hyaline (rich in fibrin and platelets) microthrombi, and tumor emboli were observed in the bone marrow, meninges, liver, lungs, kidneys, lymph nodes, adrenals, thyroid, heart, pancreas, and ovaries (Krukenberg tumor).

Neuron count reevaluation in the myenteric plexus of chagasic megacolon after morphometric neuron analysis

This study was made with the objective of reevaluating the colon denervation in chronic Chagas' disease. The diameters of neuron perikaryons of the myenteric plexus were measured on paraffin sections in a ring from the sigmoid in Chagas' disease patients, 17 with and 10 without megacolon and in 10 non-chagasic controls. All neurons were counted in ten en-echelon sections. Neuron hypertrophy only occurred in the group with megacolon, and the average increase in diameter was 69.3%. This could generate an error factor in the neuron count by increasing the probability of neurons being seen in a greater number of histological sections. The original result of the neuron count gave medians of 1264, 1961, and 2665 in the groups of chagasic patients with megacolon, without megacolon, and in the control, respectively. The denervation was greater than 55% in only seven megacolon cases (41.2%). After applying a correction factor, the median in the group with megacolon was 746, and the denervation was greater than 55% in 13 cases (76.5%). This occurrence demonstrates the need to apply a correction factor when the neuron count in chagasic megacolon is being evaluated and in the other pathologies where neuron hypertrophy may be found.

Effects of ionizing radiation on progressive experimental renal disease: a hemodynamic approach

In order to evaluate the progression of renal disease, Munich-Wistar rats were submitted to 5/6 nephrectomy and given whole-body x- or gamma-irradiation with or without remnant kidney protection or were submitted only to remnant kidney irradiation. All groups received a single 6-Gy dose immediately after surgery. Whole-kidney function, glomerular hemodynamics, 24-hour proteinuria and histopathology were assessed 60 days after surgery and irradiation. The irradiated nephrectomized animals presented whole-kidney function parameters comparable to those of normal rats. In addition, they were less hypertensive and had higher hematocrit. They showed glomerular hyperfiltration and hypertension even greater than their respective nephrectomized controls. However, the interrelations among the glomerular filtration determinants were somewhat different in irradiated animals. Their 24-hour proteinuria was significantly lower and the sclerosis index and tubulointerstitial injury score were markedly smaller. Among irradiated animals, the worst sclerosis index was observed in those with a shielded remnant kidney and the best in those without protection of the remnant kidney. This led us to speculate about a possible influence of resident mesangial cells on the early events following renal mass ablation and on the maintenance of subsequent physiopathologic changes. Therefore, radiation undoubtedly provoked a beneficial change in the course of renal disease when the renal mass ablation model was employed. Many factors could have contributed to this favorable feature including lower levels of systemic arterial pressure, less increment in DeltaP, diminished proteinuria, and maintenance of tubulointerstitial space integrity. Our data also suggest that development of glomerulosclerosis seems to be determined by events occurring immediately after injury.

[Contribution to the morphologic diagnosis of lung adiaspiromycosis]

The diagnosis of adiaspiromycosis is usually based on lung sections stained by hematoxylin-eosin, periodic acid Schiff and methenamine silver. Authors describe the fungus aspect examined by mucicarmin, picro-sirius and Congo red methods, including polarized light microscopy. In doubtful cases, these methods could contribute to histopathological diagnosis of Emmonsia parva var crescens.

Pressure sores among malnourished necropsied adults--preliminary data

Pressure sores are common among bedridden, elderly, or malnourished patients, and may occur in terminal ill patients because of impaired mobility, fecal or urinary incontinence, and decreased healing capacity. The aim of this study was to compare frequency of pressure sores between malnourished and non-malnourished necropsied adults.

METHOD

All (n = 201) adults (age >/= 18 years) autopsied between 1986 and 1996 at the Teaching Hospital of Triangulo Mineiro Medical School (Uberaba) were eligible for the study. Gender, race, weight, height and main diagnoses were recorded. Ninety-six cases were excluded because of probable body water retention (congestive heart failure, hepatic insufficiency, nephrotic syndrome) or pressure sores secondary to peripheral vascular ischemia. Body mass index (BMI) was used to define malnourished (BMI < 18.5 kg/m2) and non-malnourished (BMI > 18.5kg/m2) groups.

RESULTS

Except for weight (42.5kg; range: 28-57 vs. 60; 36-134.5kg) and BMI (16.9; range: 12.4-18.5 vs. 22.7; range: 18.5-54.6kg/m2), respectively, there were no statistical differences among 43 malnourished and 62 non-malnourished cases in relation to age (54.9 +/- 20.4 vs. 52.9 +/- 17.9 years), percentage of white persons (74.4 vs. 64.5%), male gender (76.7 vs. 69.3%) and main diagnoses. Five malnourished (11. 6%) and 7 (11.5%) non-malnourished cases had pressure sores (p=0.89).

CONCLUSION

Pressure sores were equally common findings in necropsied persons with protein-energy malnutrition, as assessed by body mass index.

[Occurrence of encephalic and cardiac cysticercosis (Cysticercus cellulosae) in necropsy]

OBJECTIVE

To review the incidence and pathologic findings of cysticercosis diagnosed at autopsies, with emphasis on the most common organs affected.

METHODS

Reports of 1.596 autopsies performed between 1974 and 1997 at a school hospital in Uberaba, MG, Brazil were studied. The following data were obtained: age, sex, ethnic group, body mass index, and the site of the cysticercosis.

RESULTS

The study found diagnosis of cysticercosis in 53 autopsies (3.3%). The average age of patients with cysticercosis was 50 (range: 15 to 86 years); 62.3% were male, and 64.1% Caucasian. The most affected organs were: brain (79.2%), heart (22.6%), skeletal muscle (11.3%), and other organs (5.7%). No statistical differences were found comparing age, gender, ethnic group, and body mass index of the affected and the non-affected patients. In two cases of neurocysticercosis the lesions were located in the ventromedial nucleus of the hypothalamus.

CONCLUSION

Both the overall incidence of cysticercosis and the incidence of cardiac cysticercosis were greater in the study than in other autopsy series from the same geographic areas. In two cases there was an association between hypothalamic cysticercosis and obesity

Ocular linguatuliasis in Ecuador: case report and morphometric study of the larva of Linguatula serrata

Linguatula serrata is a pentastomid, a cosmopolitan parasite belonging to the Phylum Pentastomida. Humans may act as an intermediate or accidental definitive host of this parasite, manifesting the nasopharyngeal or visceral form, with the latter having been described more frequently. The occurrence of ocular linguatuliasis is extremely rare, but it has been reported in the United States and Israel. The objective of the present paper was to report the first case of ocular linguatuliasis in Ecuador and to extend the morphologic study of L. serrata by morphometric analysis. The patient studied was a 34-year old woman from Guayaquil, Ecuador who complained of ocular pain with conjunctivitis and visual difficulties of two-months duration. Biomicroscopic examination revealed a mobile body in the anterior chamber of the eye. The mobile body was surgically removed. The specimen was fixed in alcohol, cleared using the technique of Loos, stained with acetic carmine, and mounted on balsam between a slide and a coverslip. It was observed with stereoscopic and common light microscopes in combination with an automatic system for image analysis and processing. The morphologic and morphometric characteristics corresponded to the third-instar larval form of L. serrata. To our knowledge, ocular linguatuliasis has not been previously described in South America, with this being the first report for Ecuador and South America. The present study shows that computer morphometry can adequately contribute both to the morphologic study and to the systematic classification of Pentastomids, and L. serrata in particular.

Acute renal failure in experimental envenomation with Africanized bee venom

Human victims of multiple bee or wasp stings have been reported and develop severe clinical signs and symptoms. Acute renal failure (ARF), usually due to acute tubular necrosis (ATN) was a frequent complication. The pathogenetic mechanisms of ATN occurring in these accidents are still unclear. In the present study, female Wistar rats weighing 150-200 g were injected intravenously with Africanized bee venom at a dose of 0.4 microL/100 g body weight, and the kidney was observed under light and transmission electron microscopy and in immunohistochemical studies. The animals were divided into two groups: an Early group studied 3 to 8 hours after inoculation, and a Late group studied 24 to 30 hours after inoculation. The animals showed ATN mainly in the cortex and outer medulla with cast formation. After 24 hours, frequent mitotic figures were found in the tubular epithelium. Immunohistochemical studies revealed the presence of myoglobin and muscle actin in the tubular casts. Under electron microscopy, proximal tubule segments showed increasing intracytoplasmic vacuoles and attenuation of the brush border and of the basolateral infolding. This segment and the thick ascending limb of Henle's loop showed hydropic degeneration. Dead cells with apoptosis or necrosis due to cellular disintegration resulted in tubular basement membrane denudation. In the Late group, figures of intracytoplasmic myelin could be observed, some of them containing mitochondrial fragments. These changes are likely to be due to interactive effects of venom components, mainly mellitin and enzymes such as phospholipases, both acting on biological membranes. The ATN found was probably due to multiple causes, mainly a direct action of the venom on tubular cells, myoglobinuria, and perhaps ischemic mechanisms.

Enkephalin- and serotonin-like immunoreactivity in the aortico-pulmonary paraganglia of the white-belly opossum Didelphis albiventris (Marsupialia)

Serial histological sections of the interatrial septum and basal heart vessels of the weaned and juvenile white-belly opossum (Didelphis albiventris) were obtained in order to study the presence of paraganglia and their content of regulatory peptides and serotonin. Paraganglion groups were mapped between the aorta and pulmonary arteries and close to the bifurcation of the pulmonary trunk and were found to contain cells with immunoreactivity to serotonin and to the neuroendocrine markers PGP 9.5 and NSE. When these paraganglia were tested for immunoreactivity to a battery of regulatory peptides, all were found to be positive for methionine-enkephalin, leucine-enkephalin and galanin. The hypothesis is raised that these peptides and serotonin, besides catecholamines, produced by these paraganglia may play a physiological role in the functions of the cardiovascular system of the white-belly opossum.

Immunocytochemical identification of neuroendocrine markers in human cardiac paraganglion-like structures

Paraganglion-like structures (PLS) containing chromaffin-positive cells have been reported to be present in the adult human heart. The present work was initiated in order to evaluate the density of these structures in the interatrial septum and to study the presence of immunoreactivity of their cells to NSE and PGP 9,5 antibodies, two neuroendocrine markers. Six hundred 6-microns paraffin serial sections were obtained from the upper third of the interatrial septum from six adult human hearts. From 2 to 12 paraganglia were found in each case, and their principal cells stained positively with NSE and PGP 9,5 antibodies. Depending on how these PLS related to other cardiac structures, four different types were identified: Type I - "True paraganglia" (located adjacent to ganglia or nerve fibers); Type II - "Free paraganglia" (immersed in the interatrial adipose tissue, without evident connection to other structures); Type III - "Intraganglionic paraganglia" (located within the nervous ganglia); Type IV - "Intramyocardic paraganglia" (small nests of immunoreactive cells closely related to myocardiocyte bundles). These cardiac paraganglia, which probably belong to the visceral-autonomic group, may have a role in the regulation of the cardiac function and in the adaptive mechanisms of the heart. Its is also possible that they originate functioning and non-functioning tumours.

[Comparative study of the conventional method and the peroxidase-antiperoxidase method in the search for tissue parasitism in chronic Chagas' cardiopathy]

Na maioria dos chagásicos crônicos o Trypanosoma cruzi não é detectado no tecido ou apresenta se com extrema raridade, mesmo quando é pesquisado exaustivamente. Sendo os métodos utilizados, até então, inespecíficos para a demonstração do T. cruzi, propôs-se no presente trabalho proceder ao estudo comparativo entre o método convencional (HE) e o método imunocitoquímico pela peroxidase anti-peroxidase (PAP), na avaliação quantitativa do parasitismo. Selecionaram-se 3 casos de cardiopatia chagásica crônica e, de um mesmo fragmento de cada caso, obtiveram se cortes que foram corados pelo H.E. (média de 100 cortes por caso) e, consecutivamente, outros que foram corados pelo PAP (média de 70 cortes por caso). O caso n.° 1 foi autopsiado em 1952 e apresentava parasitismo freqüente. Nos demais, o exame rotineiro foi negativo. Obtiveram-se os seguintes resultados expressos em n.° de ninhos/100 cortes, respectivamente, corados pelo H.E. e pelo P.A.P. (HE/PAP). Caso n.° 1 - 80/171; caso n.° 2 = 5/116 e caso n.° 3 = 1/2. Os resultados mostram que o método imunocitoquímico empregado, além de facilitar o diagnóstico do parasitismo, demonstra também pequenos ninhos de amastigotas que dificilmente seriam diagnosticados pelos métodos convencionais; além disso mostrou-se útil mesmo em tecido incluídos em parafina há longo tempo.