Resumo: O objetivo deste estudo foi avaliar o efeito de diferentes protocolos de polimento sobre a rugosidade e morfologia superficial de uma cerâmica à base de dissilicato de lítio (IPS e.max CAD). Foram confeccionadas 50 barras cerâmicas (2,0x3,0x2,5 mm), separadas aleatoriamente em cinco grupos (n=10), conforme os tratamentos de superfície: C: Controle; BC: Borracha Ceramaster (60 s); RP: Roda de pano impregnado granulação grossa (30 s) + Roda de pano impregnado granulação fina (30 s); BE: Borracha Exa-Cerapol cinza (20 s) + Borracha Exa-Cerapol rosa (20 s) + Borracha Cerapol Super (20 s); RF: Roda de feltro com pasta diamantada grossa (30 s) + roda de feltro com pasta diamantada fina (30 s). As amostras foram avaliadas quantitativamente quanto à rugosidade superficial (Ra) e qualitativamente em MEV, em diferentes momentos: inicialmente (antes da asperização), após asperização e após os polimentos. As médias de Ra foram submetidas aos testes estatísticos ANOVA (two-way) e Tukey (p<0,05). Após os diferentes protocolos de polimento, não foi possível observar diferenças significativas entre os grupos BC e BE (p=0,6347), entre BE e RP (p=0,1366) e RP e RF (p=0,5433). Comparando as diferentes etapas de um mesmo grupo foi possível observar que os grupos RP (p<0,0001) e RF (p<0,0001) apresentaram diferenças significativas. Em MEV, os grupos BC e BE apresentam um padrão morfológico superficial semelhante ao grupo controle. Todos os sistemas de polimento foram efetivos na redução da rugosidade de superfície para o mesmo padrão de cerâmica.

Abstract: The aim of this study was to evaluate the effect of different polishing protocols on surface roughness and morphology of lithium disilicate ceramics (IPS e.max CAD). Fifty ceramic bars (2.0x3.0x2.5 mm) were produced and randomly divided into five groups (n=10), according to surface treatments: C: Control; Cer: Ceramaster (60 s); CW: cloth wheel with large-grit diamond (30 s) + cloth wheel with fine-grit diamond paste (30 s); E: grey Exa-Cerapol (20 s) + pink Exa-Cerapol (20 s) + Cerapol Super (20 s); F: Felt wheel with large-grit diamond paste (30 s) + Felt wheel with fine-grit diamond paste (30 s). The samples were evaluated quantitatively for surface roughness (Ra) and qualitatively by SEM, at different moments: initial (prior to roughening), after roughening and after polishing procedures. Ra means were submitted to two-way ANOVA and Tukey test (p<0.05). After the different polishing protocols, no statistically significant differences were observed between the Cer and E groups (p=0.6347), E and CW groups (p=0.1366), and CW and FW groups (p=0.5433). Comparing different stages in the same group, it was possible to observe that CW (p<0.0001) and FW groups (p<0.0001) showed significant differences. SEM analysis revealed that both Cer and E groups exhibited a surface morphological pattern similar to that of control group. All polishing systems were effective in reducing the surface roughness of the studied ceramic type.

Holoprosencephaly (HPE) is a spectrum of brain and facial malformations primarily reflecting genetic factors, such as chromosomal abnormalities and gene mutations. Here, we present a clinical and molecular analysis of 195 probands with HPE or microforms; approximately 72% of the patients were derived from the Latin American Collaborative Study of Congenital Malformations (ECLAMC), and 82% of the patients were newborns. Alobar HPE was the predominant brain defect in almost all facial defect categories, except for patients without oral cleft and median or lateral oral clefts. Ethmocephaly, cebocephaly, and premaxillary agenesis were primarily observed among female patients. Premaxillary agenesis occurred in six of the nine diabetic mothers. Recurrence of HPE or microform was approximately 19%. The frequency of microdeletions, detected using Multiplex Ligation-dependant Probe Amplification (MLPA) was 17% in patients with a normal karyotype. Cytogenetics or QF-PCR analyses revealed chromosomal anomalies in 27% of the probands. Mutational analyses in genes SHH, ZIC2, SIX3 and TGIF were performed in 119 patients, revealing eight mutations in SHH, two mutations in SIX3 and two mutations in ZIC2. Thus, a detailed clinical description of new HPE cases with identified genetic anomalies might establish genotypic and phenotypic correlations and contribute to the development of additional strategies for the analysis of new cases.

Background Patients with atrial fibrillation represent a group of risk for thromboembolic complications, with catastrophic consequences when affecting the central nervous system. The performance of risks scores to predict clinical events has been evaluated by several publications; yet, its correlation with the presence of thrombi in the left atrium or left atrial appendage has been poorly investigated. The use of the CHA2DS2-VASc score has been recently proposed for stratification of throm-boembolic risk. Objective To evaluate the prevalence of left atrial thrombus and its correlation with the components of the CHA2DS2-VASc score and with left ventricular systolic function in patients scheduled for electrical cardioversion. Methods A prospective registry of the medical history of patients with atrial fibrillation of unknown duration or lasting >48 hours, undergoing transesophageal echocardiography before scheduled electrical cardioversion was conducted. The correlation of the components of the CHA2DS2-VASc scores and of the total score with the presence of thrombi in transesophageal echocardiography was analyzed. The result of the sum of the CHA2DS2-VASc score plus a score of left ventricular systolic function (normal = 0, mild dysfunction = 1, moderate dysfunction = 2, severe dysfunction = 3) was also evaluated. Results A total of 129 patients (mean age 70±12 years) were included; 21 (16%) had thrombus. This finding was more prevalent in patients with risk factors, but was only statistically significant for heart failure and diabetes. The risk of thrombus in the LA/LAA progressively increased at higher CHA2DS2-VASc (3.6±1.6 with thrombus vs. 2.7±1 without thrombus; p = 0.024, area under the ROC curve = 0.65). This association was greater when left ventricular systolic function was included (p = 0.006, area under the ROC curve = 0.69). A CHA2DS2-VASc < 2 did not warrant the absence of thrombi.

Introducción Los pacientes con fibrilación auricular representan un grupo de riesgo para el desarrollo de complicaciones tromboembólicas, con consecuencias devastadoras cuando afectan el sistema nervioso central. El rendimiento de los índices de riesgo para predecir eventos clínicos se ha evaluado en numerosas publicaciones, mientras que su relación con la presencia de trombo en la aurícula izquierda o su orejuela se ha explorado menos. Recientemente se ha propuesto la utilización del índice conocido con el acrónimo CHA2DS2-VASc para la estratificación de riesgo cardioembólico. Objetivo Evaluar la prevalencia de trombo en la aurícula izquierda y su relación con las variables del índice CHA2DS2-VASc y la función sistólica del ventrículo izquierdo en pacientes con fibrilación auricular que serán sometidos a cardioversión eléctrica. Material y métodos Se efectuó un registro prospectivo de los antecedentes clínicos de pacientes con fibrilación auricular de tiempo indeterminado o > 48 horas, a los que se les realizó un eco transesofágico previo a una cardioversión eléctrica. Se analizó la relación de las variables que conforman el índice CHA2DS2-VASc y del puntaje total para predecir trombo en el eco transesofágico. Se evaluó además un modelo que resultó de sumar al CHA2DS2-VASc un puntaje según la función sistólica del ventrículo izquierdo: normal = 0, deterioro leve = 1, moderado = 2, grave = 3. Resultados Se incluyeron 129 pacientes con edad media de 70 ± 12 años, de los cuales 21 (16%) presentaron trombo. Este hallazgo fue más prevalente en pacientes con factores de riesgo, pero alcanzó nivel de significación solo para insuficiencia cardíaca y diabetes. Se observó un incremento progresivo del riesgo de trombo en relación con el CHA2DS2-VASc (3,6 ± 1,6 con trombo vs. 2,7 ± 1 sin trombo; p = 0,024, área bajo la curva ROC = 0,65). La asociación se ve reforzada cuando se incluye la función sistólica del ventrículo izquierdo (p = 0,006, área bajo la curva ROC = 0,69). Un puntaje de CHA2DS2-VASc < 2 no garantizó la ausencia de trombos. Conclusiones El puntaje CHA2DS2-VASc desarrollado para predecir riesgo clínico de fenómenos embólicos también se asocia con la presencia de trombo en pacientes con fibrilación auricular de tiempo indeterminado. El agregado de la función sistólica del ventrículo izquierdo al puntaje total podría mejorar la capacidad predictiva.

OBJECTIVES: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the São José dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. MATERIAL AND METHODS: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. RESULTS: The fracture test presented the following averages and standard deviation: G1 (45.63±8.77), G2 (49.98±7.08), G3 (43.84±5.52), G4 (47.61±7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. CONCLUSIONS: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008-PA/CEP).

OBJETIVOS: Este estudo prospectivo, randomizado, aberto e controlado por comparador ativo teve o objetivo de avaliar a eficácia analgésica e tolerabilidade da heparina não-fracionada administrada topicamente no tratamento de queimaduras. MÉTODOS: Cinquenta e oito pacientes do sexo masculino ou feminino foram randomizados para tratamento convencional (C) ou tratamento com heparina tópica (HT). Foram incluídos pacientes com: idade entre 18 e 55 anos, queimaduras de 2º e 3º graus por fogo ou escaldo em 10% a 30% da superfície corpórea (SC), sem história de diáteses hemorrágicas ou hipersensibilidade à heparina e com área queimada em 3º grau menor de 10% da SC. O grupo C realizou periodicamente balneoterapia terapêutica para desbridamento das lesões seguida de curativos com sulfadiazina de prata. O grupo HT realizou o primeiro desbridamento e teve suas áreas queimadas deixadas expostas para receber três vezes ao dia heparina não fracionada em spray na dose de 4200 UI para cada 1% de SC queimada. A eficácia analgésica foi avaliada nos 38 pacientes que completaram o estudo pela demanda de medicamentos analgésicos e pela Escala Analógico Visual de Dor (EAV). A tolerabilidade foi avaliada nos 58 pacientes randomizados pela incidência comparativa de reações adversas nos dois grupos. RESULTADOS: O grupo HT solicitou menos analgésicos (11,83 ± 9,38 por paciente no grupo HT contra 33,35 ± 20,63 no grupo C, p<0,01), referiu menos dor pela EAV, apresentou menos febre e mais sangramento que o grupo C. Não houve diferença na incidência de infecção local, septicemia e nos exames de segurança. CONCLUSÃO: O esquema HT apresentou eficácia analgésica superior ao esquema C sem problemas importantes de tolerabilidade.

OBJECTIVE: This was a prospective, randomized, open-label study controlled by active comparator. The aim was to assess analgesic efficacy and overall tolerability of a burn treatment based on topic administration of unfractionated heparin. METHODS: Fifty eight male or female patients were randomized for conventional treatment (group C) or topical heparin treatment (group TH). Ages of patients enrolled ranged from 18 to 55 years. They had 2nd and 3rd degree burns on 10% to 30% of the body surface (BS) caused by fire or scald, no hemorrhagic diseases, no hypersensitivity to heparin and less than 10% of the BS burned to 3rd degree. The group C had frequent debridement under anesthesia or analgesia and received silver sulfadiazine dressings. The group TH had the first debridement and their wounds left open to receive 4200 IU of unfractionated heparin topically for each 1% of burned BS, three times daily. Efficacy was evaluated from files of the 38 patients who completed the study according to demand of analgesic medications and response to the pain Visual Analog Scale (VAS). Tolerability was evaluated from the files of all 58 randomized patients by the comparative incidence of adverse reactions. RESULTS: The group TH demanded less analgesic medications (11.83 ± 9.38 per patient against 33.35 ± 20.63 for the C group, p<0.01), reported less pain in the VAS, had less fever and more bleeding than group C. There was no difference in the incidence of local infection, septicemia and safety exams. CONCLUSION: The group TH presented less pain without important tolerability problems.

Sheep overgrazing in grasslands of Tierra del Fuego has determined a decrease of grass cover but an increase in a prostrate shrub of low forage value (murtilla, Empetrum rubrum). We selected soils with different modality of grazing, which determined particular characteristics in soil and vegetation. Abundance and diversity of spores of arbuscular mycorrhizal fungi were studied on the four soils and on three of the most frequent grasses (Festuca gracillima, Deschampsia flexuosa y Poa rigidifolia). Spore counts were measured in rizospheric soil, along with nutrient content (P and N) in plants, and percentage of root length colonised and the morphology of colonisation. The most frequent species was Glomus fasciculatum. The soil, the host plant, and the interaction between both variables influenced total spore counts and percentage of root length colonised. Poa rigidifolia showed the highest number of rizospheric spores and the highest percentage of root length colonised. Neither relationship between spore counts and root colonisation nor relationship between root colonisation and P or N plant contents were observed using the whole data (soils and plants). Total spore counts were correlated positively with measures of N, P, Ca, K and pH in soil. Nevertheless, when soils and plants were studied separately, both the relationship between spore counts and percent of root colonised and its direction depended on the soil-host combination.

El sobrepastoreo ovino en pastizales de suelos ácidos de Tierra del Fuego ha determinado una disminución de la cobertura de gramíneas de interés forrajero y un aumento de la cobertura de un arbusto postrado poco apetecible (murtilla, Empetrum rubrum). Se seleccionaron suelos sometidos a distinta modalidad de pastoreo que tenían características y vegetación particulares. Se midió la cantidad total y la diversidad de esporas de hongos micorrízicos arbusculares en los cuatro suelos y en la rizósfera de tres de las gramíneas más frecuentes (Festuca gracillima, Deschampsia flexuosa y Poa rigidifolia) en los pastizales de la estepa fueguina. En el suelo rizosférico se determinó la cantidad y la diversidad de esporas de hongos micorrízicos arbusculares, y en las plantas el contenido de P, N y el porcentaje y morfología de la colonización micorrízica en raíces. Se identificaron las esporas de las tres especies de hongos micorrízicos arbusculares más abundantes. Glomus fasciculatum fue la especie de mayor frecuencia. La cantidad total de esporas y la colonización en raíz dependieron del suelo, de la especie hospedante y de la interacción entre ambas variables. Poa rigidifolia presentó el mayor número total de esporas en su rizósfera y la mayor colonización en raíz. Para todos los suelos y plantas estudiadas no hubo relación entre la cantidad total de esporas y el porcentaje colonizado de la raíz, ni tampoco entre este porcentaje y las concentraciones de N y P en planta. La cantidad total de esporas se correlacionó positivamente con las medidas de N, P, Ca, K y pH del suelo. Sin embargo, al analizar el suelo y las planta de manera separada, tanto la existencia de relación entre la cantidad de esporas y el porcentaje colonizado como la dirección y el sentido de la misma dependieron de la combinación suelohospedante.