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au:MOREIRA, MARIA STELLA

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Gingival cyst of the adult
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Mota, Maria Emília

; Oliveira, Dandara Menezes de Araujo

; Medeiros, Yuri de Lima

; Moreira, Maria Stella

; Lopes, Rodrigo Nascimento

; Alves, Fábio Abreu

; Louredo, Brendo Vinícius Rodrigues

; Vargas, Pablo Agustin

; Prado, José Divaldo

Autopsy and Case Reports

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2023, Volume 13 elocation e2023454

Abstract: En | Text: En | PDF: En

ABSTRACT The gingival cyst of the adult (GCA) is a rare odontogenic cyst, consisting of 0.3% of all odontogenic cysts. This case report, based on CARE guidelines for case reports, aims to present a case of a 52-year-old female patient with a symptomatic translucent nodule in the upper left anterior gingiva, measuring approximately 6mm. Excisional biopsy was performed, and the histological examination revealed multiple cystic cavities lined by the squamous epithelium of varying thickness with focal areas of nodular thickenings. The presence of clusters of cells with clear cytoplasm within epithelial thickenings was observed. PAS staining was negative in clear cells. The diagnosis of the GCA was established. Despite its rarity, GCA should be considered in the differential diagnosis of gingival lesions. Conservative surgical treatment proved to be effective, with no signs of recurrence.

https://doi.org/10.4322/acr.2023.454

Biological Properties of Experimental Methacrylate-Based Sealers Containing Calcium Phosphates
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Mestieri, Leticia Boldrin

; Collares, Fabrício Mezzomo

; Zaccara, Ivana Maria

; Moreira, Maria Stella Nunes Araujo

; Kopper, Patrícia Maria Polli

; Leitune, Vicente Castello Branco

; Grecca, Fabiana Soares

Brazilian Dental Journal

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feb 2021, Volume 32 N. 1 Pages 59 - 66

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo O objetivo deste estudo foi avaliar a biocompatibilidade de cimentos endodônticos experimentais à base de metacrilato contendo fosfato α-tricálcico ou hidroxiapatita nanoestruturada in vitro e in vivo. Cimentos experimentais de cura dual à base de metacrilato com a adição de fosfato de α-tricálcico (α-TCP) ou hidroxiapatita (HAp), a 10% em peso, foram formulados e comparados com AH Plus (AHP). Viabilidade celular foi avaliada por brometo de 3- (4,5-dimetil-tiazoil) -2,5-difenil-tetrazólio (MTT) e sulforodamina B (SRB). Cimentos foram implantados no tecido subcutâneo dos ratos e avaliados histologicamente. Bioatividade foi avaliada pela atividade da enzima fosfatase alcalina (ALP) e Alizarin Red (AR) utilizando células da papila apical (SCAPs) e pela deposição óssea, medida em cavidades cirúrgicas no fêmur de ratos preenchidos com AH Plus e α-TCP. Nos dois ensaios de viabilidade, HAp e AHP não apresentaram diferenças estatísticas, α-TCP apresentou menores resultados de viabilidade para o ensaio MTT (p <0,05). Resultados histológicos mostraram que houve uma diminuição do conteúdo inflamatório de acordo com os períodos, e o AHP foi o único grupo que apresentou células gigantes (período de 7 dias). A condensação das fibras colágenas aumentou conforme os períodos, sem diferenças entre os grupos. Houve aumento da atividade da ALP e deposição de nódulos mineralizados de acordo com os períodos. HAp e α-TCP apresentaram maiores valores para a atividade de ALP em 5 dias e em 5, 10 e 15 dias para AR, com diferença para o AHP (p <0,05). O α-TCP apresentou valores superiores aos 10 e 15 dias quando comparado ao HAp e AHP para AR (p <0,05). Aos 90 dias, α-TCP e controle (cavidade vazia) apresentaram maior deposição de tecido ósseo quando comparado ao AHP (p <0,05). α-TCP e HAp, presentes nos cimentos à base de metacrilato, apresentaram biocompatibilidade e potencial para serem utilizados como seladores endodônticos na prática clínica. Investigações adicionais são necessárias para obter informações sobre as propriedades físico-químicas dessas formulações de cimentos antes de sua implementação clínica.

Abstract This study aimed to evaluate, in vitro and in vivo, the biocompatibility of experimental methacrylate-based endodontic sealers containing α-tricalcium phosphate (α-TCP) or nanostructured hydroxyapatite (HAp). Experimental methacrylate-based dual-cure sealers with the addition of α-TCP or HAp, at 10%wt were formulated and compared to AH Plus (AHP). Cell viability was assessed by 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide (MTT), and sulforhodamine B (SRB). Sealers were implanted in rats’ subcutaneous tissue and histologically evaluated. Bioactivity was assessed by alkaline phosphatase enzyme activity (ALP) and Alizarin Red (AR), using apical papillary cells (SCAPs), and by the bone deposition measured in surgical cavities on rats’ femur filled with AH Plus or α-TCP. In both viability assays, HAp and AHP sealers were similar, and α-TCP presented lower viability compared to the others at MTT assay (p<0.05). A gradual decrease of the inflammatory response according to the periods was observed and AHP was the only that presented giant cells (7-day period). Collagen fibers condensation increased according to the periods, with no differences among sealers. There was an increase at ALP activity and mineralized nodules deposition according to periods. HAp and α-TCP presented higher values for ALP activity at 5 days and at 5, 10, and 15 days for AR and were different from AHP (p<0.05). α-TCP presented superior values at 10 and 15 days compared to HAp and AHP for AR (p<0.05). At 90 days, α-TCP and control (empty cavity) showed high bone deposition compared to AHP (p<0.05). α-TCP and HAp, in a methacrylate-based sealer, presented biocompatibility and bioactivity, with the potential to be used as endodontic sealers in clinical practice. Further investigations are required to gain information on the physicochemical properties of these sealers formulation before its clinical implementation.

https://doi.org/10.1590/0103-6440202103761 458 downloads

Caracterização de genótipos de soja com resistência parcial à ferrugem da soja
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Juliatti, Fernando Cezar

; Mesquita, Ana Carolina Oliveira

; Teixeira, Fernanda Gabriela

; Beloti, Igor Forigo

; Mota, Lara Caroline Borges Moreira

; Fonseca, Leandro Jamerson

; Sousa, Luciana Alves de

; Souza, Maria Stella Xavier de Araújo

; Silva, Nathália Salgado

; Zancan, Nayara Lima Baute

; Morais, Tâmara Prado de

Summa Phytopathologica

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sep 2019, Volume 45 N. 3 Pages 313 - 319

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A ferrugem asiática da soja (FAS), causada pelo fungo Phakopsora pachyrhizi, é uma das doenças mais severas na cultura. Dentre as estratégias para seu manejo propõe-se a utilização de genótipos com resistência horizontal ou parcial, ainda restritos no mercado, mas promissores pela durabilidade da resistência. O objetivo deste trabalho foi avaliar a resistência de diferentes genótipos de soja à ferrugem asiática para futura utilização em programas de melhoramento. Na safra 2015/2016, foram avaliados 11 genótipos de soja provenientes do LAGER-UFU e a cultivar Desafio 8473 (padrão de suscetibilidade) frente à infecção artificial e natural de P. pachyrhizi no campo. Com os dados de severidade da FAS, calculou-se a área abaixo da curva de progresso da doença (AACPD). O percentual de área foliar afetada e os valores da AACPD dos genótipos avaliados oscilaram de 1,56 a 80,75 e de 380,62 a 975,62, respectivamente. Os genótipos L-210, L-166, L-268, L-203, L-279, L-224, L-216 e L-218 apresentam menores valores de AACPD, indicando resistência parcial, enquanto os genótipos L-144, L-104, L-266 e a cv. Desafio 8473 apresentaram maiores valores de AACPD, portanto, com menor resistência parcial ou suscetíveis. Ainda assim, os genótipos L-144, L-104 e L-266 apresentaram coeficientes de progresso da severidade da doença de 1,8 a 2,0 vezes menores comparativamente à cv. Desafio 8473. Conclui-se que os genótipos do Programa de Melhoramento Genético da UFU (LAGER-UFU), apresentam potencial de utilização no desenvolvimento de cultivares de soja resistentes à P. pachyrhizi.

ABSTRACT Asian soybean rust (ASR), caused by the fungus Phakopsora pachyrhizi, is one of the most severe diseases that affect the crop. Among management strategies is the use of genotypes with horizontal or partial resistance, which are still restricted in the market but promising due to their resistance durability. The objective of this study was to evaluate the resistance of different genotypes to Asian soybean rust for future use in breeding programs. In the 2015/2016 crop season, 11 soybean genotypes from LAGER-UFU and cv. Desafio8473 (susceptibility pattern) were evaluated for artificial and natural infection by P. pachyrhizi in the field. ASR severity data were used to calculate the area under the disease progress curve (AUDPC). The percentage of affected leaf area and the AUDPC values of the evaluated genotypes ranged from 1.56 to 80.75% and from 380.62 to 975.62, respectively. The genotypes L-210, L-166, L-268, L-203, L-279, L-224, L-216 and L-218 have lower AUDPC values, indicating partial resistance, while the genotypes L-144, L-104, L-266 and cv. Desafio 8473 showed higher AUDPC values and therefore lower partial resistance or susceptibility. Even so, the genotypes L-144, L-104 and L-266 showed coefficients of disease severity progress 1.8 to 2.0-fold lower than those of cv. Desafio 8473. In conclusion, the genotypes from UFU Breeding Program (LAGER-UFU) showed potential to be used in the development of soybean cultivars resistant to P. pachyrhizi.

https://doi.org/10.1590/0100-5405/190552 1326 downloads

Influence of photobiomodulation therapy on root development of rat molars with open apex and pulp necrosis
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ZACCARA, Ivana Maria

; JARDINE, Alexander Pompermayer

; MESTIERI, Letícia Boldrin

; QUINTANA, Ramiro Martins

; JESUS, Luciano

; MOREIRA, Maria Stella

; GRECCA, Fabiana Soares

; MARTINS, Manoela Domingues

; KOPPER, Patrícia Maria Poli

Brazilian Oral Research

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2019, Volume 33 elocation e084

Abstract: En | Text: En | PDF: En

Abstract This study aimed to evaluate the role of photobiomodulation (PBM) in apexification and apexogenesis of necrotic rat molars with an open apex. Rat molars were exposed to the oral environment for 3 weeks. Canals were rinsed with 2.5% NaOCl and 17% EDTA, filled with antibiotic paste and sealed. After 7 days, canals were rinsed and divided into six groups (n=6): mineral trioxide aggregate (MTA); blood clot (BC); human dental pulp stem cells (hDPSC); MTA+PBM; BC+PBM; and hDPSC+PBM. In hDPSC groups, a 1% agarose gel scaffold was used. Two groups were not exposed: healthy tooth+PBM (n = 6), healthy tooth (n = 3); and one was exposed throughout the experiment: necrotic tooth (n = 3). In PBM groups, irradiation was performed with aluminum gallium indium phosphide (InGaAlP) diode laser for 30 days within 24-h intervals. After that, the specimens were processed for histological and immunohistochemical analyses. Necrotic tooth showed greater neutrophil infiltrate (p < 0.05). Necrotic tooth, healthy tooth, and healthy tooth+PBM groups showed absence of a thin layer of fibrous condensation in the periapical area. All the other groups stimulated the formation of a thicker layer of fibers (p < 0.05). All groups formed more mineralized tissue than necrotic tooth (p < 0.05). PBM associated with MTA, BC, or hDPSC formed more mineralized tissue (p < 0.05). MTA+PBM induced apexification (p < 0.05). Rabbit polyclonal anti-bone sialoprotein (BSP) antibody confirmed the histological findings of mineralized tissue formation, and hDPSC groups exhibited higher percentage of BSP-positive cells. It can be concluded that PBM improved apexification and favored apexogenesis in necrotic rat molars with an open apex.

https://doi.org/10.1590/1807-3107bor-2019.vol33.0084 1476 downloads

Immediate laser-induced hemostasis in anticoagulated rats subjected to oral soft tissue surgery: a double-blind study
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CAMPOS, Flavio Halak de Oliveira

; FERREIRA, Lorraine Braga

; ROMANO, Marcelo Munhoes

; MOREIRA, Maria Stella

; EDUARDO, Carlos de Paula

; RAMALHO, Karen Müller

Brazilian Oral Research

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2018, Volume 32 elocation e56

Abstract: En | Text: En | PDF: En

Abstract Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients’ health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.

https://doi.org/10.1590/1807-3107bor-2018.vol32.0056 1990 downloads

Spatial distribution of low birthweight infants in Taubaté, São Paulo, Brazil
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Nascimento, Luiz Fernando C.

; Costa, Thais Moreira

; Zöllner, Maria Stella A. da C.

Revista Paulista de Pediatria

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dec 2013, Volume 31 N. 4 Pages 466 - 472

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

OBJETIVO: Identificar o padrão de distribuição espacial de recém-nascidos (RN) com baixo peso no município de Taubaté, São Paulo. MÉTODOS: Estudo epidemiológico do tipo ecológico e exploratório, com dados da Secretaria Municipal de Saúde de Taubaté, relativos ao período de 1º de janeiro de 2006 a 31 de dezembro de 2010. Utilizou-se a declaração de nascidos vivos para obter os dados de nascimentos com peso inferior a 2500g e uma base digital de setores censitários para a análise. Calculou-se o Índice de Moran Global (IM), construindo-se mapas temáticos para a distribuição dos RN com baixo peso, dos postos de saúde e dos setores, de acordo com a prioridade de atendimento (Mapa de Moran). A significância estatística adotada foi α=5%. Efetuou-se a análise espacial pelo programa TerraView. RESULTADOS: Verificaram-se 18.915 nascidos vivos no período de estudo e 1.817 apresentavam baixo peso (9,6%). A prevalência de baixo peso ao nascer no período variou de 9,3 a 9,8%. Incluíram-se 1.185 RN que tinham endereços conhecidos e compatíveis com a base digital (65,2% do total com baixo peso). O IM para neonatos com baixo peso foi de 0,12, com p<0,01; para a distribuição dos postos de saúde, obteve-se IM =-0,07, com p=0,01. O Mapa de Moran identificou 11 setores censitários que devem ser objeto de intervenção pelo gestor de saúde, os quais se situam na periferia da cidade. CONCLUSÕES: A análise espacial identificou a distribuição dos RN com baixo peso por setores censitários e os setores com alta prioridade de intervenção.

OBJECTIVE: To identify the spatial pattern of low birth weight infants in the city of Taubaté, São Paulo, Southeast Brazil. METHODS: Ecological and exploratory study, developed with the data acquired from the Health Department of Taubaté, regarding the period from January 1st 2006 and December 31st 2010. Birth certificates were used to obtain the data from infants weighing less than 2500g. A digital basis of census tracts was applied and the Global Moran index (IM) was estimated. Thematic maps were built for the distribution of low birth weight, health centers and tracts, according to the priority care (Moran map). The adopted statistical significance was α=5% and TerraView software conducted the spatial analysis. RESULTS: There were 18,915 live births during the study period, with 1,817 low birth weight infants (9.6%). The low birth weight infants' prevalence during the period ranged from 9.3 to 9.8%. A total of 1,185 infants with known addresses, compatible with the digital base (65.2% of low birth weight infants), were included. The IM for low birth weight was 0.12, with p<0.01; regarding the health centers distribution, IM was -0.07, with p=0.01. The Moran map identified 11 census tracts with high priority for intervention by health managers, located in the outskirts of the city. CONCLUSIONS: The spatial analysis identified the low birth weight distribution by census tracts and the sectors with a high priority for intervention.

OBJETIVO: Identificar el estándar de distribución espacial de recién nacidos (RN) con bajo peso en el municipio de Taubaté, São Paulo. MÉTODOS: Estudio epidemiológico de tipo ecológico y exploratorio, con datos de la Secretaría Municipal de Salud de Taubaté, relativos al periodo de 1 de enero de 2006 a 31 de diciembre de 2010. Se utilizó la declaración de nacidos vivos, para obtención de los datos de nacimientos con peso inferior a 2.500g, y una base digital de sectores censitarios para el análisis. Se calculó el Índice de Moran Global (IM), construyéndose mapas temáticos para la distribución de los RN con bajo peso, de los puestos de salud y de los sectores, conforme a la prioridad de atención (Mapa de Moran). La significancia estadística adoptada fue α=5%. Se efectuó el análisis espacial por el programa TerraView. RESULTADOS: Se verificaron 18.915 nacidos vivos en el periodo de estudio y 1.817 presentaban bajo peso (9,6%). La prevalencia de bajo peso al nacer en el periodo varió de 9,3 a 9,8%. Se incluyeron 1.185 RN que tenían direcciones conocidas y compatibles con la base digital (65,2% del total con bajo peso). El IM para neonatos con bajo peso fue de 0,12, con p<0,01; para la distribución de los puestos de salud, se obtuvo IM=-0,07, con p<0,01. El Mapa de Moran identificó 11 sectores censitarios que deben ser objeto de intervención por el gestor de salud, que se ubican en las afueras de la ciudad. CONCLUSIONES: El análisis espacial identificó la distribución de los RN con bajo peso por sectores censitarios y los sectores con alta prioridad de intervención.

https://doi.org/10.1590/S0103-05822013000400008 2461 downloads

Effect of laser phototherapy in the prevention and treatment of chemo-induced mucositis in hamsters
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Lopez, Talita Christine Camilo

; Martins, Manoela Domingues

; Pavesi, Vanessa Christina Santos

; Ferreira, Leila Soares

; Bussadori, Sandra Kalil

; Moreira, Maria Stella

; Marques, Marcia Martins

Brazilian Oral Research

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jul 2013, Volume 27 N. 4 Pages 342 - 348

Abstract: En | Text: En | PDF: En

The aim of this study was to investigate the effect of laser phototherapy (LPT) in the prevention and/or treatment of oral mucositis induced by 5-fluorouracil (5-FU; Eurofarma, São Paulo, Brazil) in hamsters. Ninety-six hamsters were divided into four groups (n = 24): Control (no treatment); Preventive [LPT from day (D) D-5 to D+5]; Therapeutic (LPT from D+5 to D+15); and Combined (preventive plus therapeutic LPT from D-5 to D+15). The animals received an intraperitoneal injection of 5-FU on Days 0 and 2. The pouch mucosa was scratched on Days 3 and 4. The irradiation parameters were: indium-gallium-aluminum-phosphide (InGaAlP) diode laser (MM Optics, São Carlos, Brazil) (660 nm), beam area of 0.036 cm2, 40 mW, 1.11 W/cm2, 6.6 J/cm2, power density applied daily of 39.6 J/cm2, in punctual mode (six points and six seconds per point) and contact mode, one application per day. The animals were sacrificed on Days 0, 5, 10 and 15 (n = 6) and weighed, and the pouch mucosa was removed for histopathological analysis. Clinical and corresponding histological scores were compared using ANOVA and Tukey's test (p ≤0.05). Similar weight losses ranging from 5% to 10% occurred in all groups. The therapeutic group had significantly lower clinical and histological scores than the other groups at Day 10. This study showed that positive effects on oral mucositis management were obtained only when LPT was applied in the therapeutic protocol (from D+5 to D+15 after chemotherapy).

https://doi.org/10.1590/S1806-83242013005000019 3060 downloads

Diretrizes brasileiras para o diagnóstico de narcolepsia
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Alóe, Flávio

; Alves, Rosana Cardoso

; Araújo, John F.

; Azevedo, Alexandre

; Bacelar, Andrea

; Bezerra, Márcio

; Bittencourt, Lia Rita Azeredo

; Bustamante, Guilherme

; Cardoso, Tânia Aparecida Marchiori de Oliveira

; Eckeli, Alan L.

; Fernandes, Regina Maria França

; Goulart, Leonardo

; Pradella-Hallinan, Márcia

; Hasan, Rosa

; Sander, Heidi Haueisen

; Pinto Jr., Luciano Ribeiro

; Lopes, Maria Cecília

; Minhoto, Gisele Richter

; Moraes, Walter

; Moreira, Gustavo Antônio

; Pachito, Daniela

; Pedrazolli, Mário

; Poyares, Dalva

; Prado, Lucila

; Rizzo, Geraldo

; Rodrigues, R. Nonato

; Roitman, Israel

; Silva, Ademir Baptista

; Tavares, Stella Márcia Azevedo

Brazilian Journal of Psychiatry

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sep 2010, Volume 32 N. 3 Pages 294 - 305

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Este artigo relata as conclusões da reunião de consenso com médicos especialistas sobre diagnóstico de narcolepsia baseada na revisão dos artigos sobre narcolepsia listados no Medline entre 1980 e 2010. A narcolepsia é uma doença crônica de início entre a primeira e segunda décadas de vida do indivíduo. Os sintomas essenciais são cataplexia e sonolência excessiva. A cataplexia é definida como episódios súbitos, recorrentes e reversíveis de fraqueza da musculatura esquelética desencadeados por situações de conteúdo emocional. Os sintomas acessórios são alucinações hipnagógicas, paralisia do sono e sono fragmentado. Critérios de diagnóstico clínico de acordo com a Classificação Internacional dos Transtornos do Sono são de sonolência excessiva e cataplexia. Recomenda-se a realização de polissonografia seguida do teste de latência múltipla do sono em um laboratório de sono para confirmação e diagnóstico de comorbidades. Quando não houver cataplexia, deve haver duas ou mais sonecas com sono REM no teste de latência múltipla do sono. Tipagem HLA-DQB1*0602 positiva com níveis de hipocretina-1 abaixo de 110pg/mL devem estar presentes para o diagnóstico de narcolepsia sem cataplexia e sem sonecas com sono REM.

This manuscript contains the conclusion of the consensus meeting on the diagnosis of narcolepsy based on the review of Medline publications between 1980-2010. Narcolepsy is a chronic disorder with age at onset between the first and second decade of life. Essential narcolepsy symptoms are cataplexy and excessive sleepiness. Cataplexy is defined as sudden, recurrent and reversible attacks of muscle weakness triggered by emotions. Accessory narcolepsy symptoms are hypnagogic hallucinations, sleep paralysis and nocturnal fragmented sleep. The clinical diagnosis according to the International Classification of Sleep Disorders is the presence of excessive sleepiness and cataplexy. A full in-lab polysomnography followed by a multiple sleep latency test is recommended for the confirmation of the diagnosis and co-morbidities. The presence of two sleep-onset REM period naps in the multiple sleep latency test is diagnostic for cataplexy-free narcolepsy. A positive HLA-DQB1*0602 with lower than 110pg/mL level of hypocretin-1 in the cerebrospinal fluid is required for the final diagnosis of cataplexy- and sleep-onset REM period -free narcolepsy.

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Diretrizes brasileiras para o tratamento da narcolepsia
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Alóe, Flávio

; Alves, Rosana Cardoso

; Araújo, John F.

; Azevedo, Alexandre

; Bacelar, Andrea

; Bezerra, Márcio

; Bittencourt, Lia Rita Azeredo

; Bustamante, Guilherme

; Cardoso, Tania Aparecida Marchiori de Oliveira

; Eckeli, Alan L.

; Fernandes, Regina Maria França

; Goulart, Leonardo

; Pradella-Hallinan, Márcia

; Hasan, Rosa

; Sander, Heidi Haueisen

; Pinto Jr., Luciano Ribeiro

; Cecília Lopes, Maria

; Minhoto, Gisele Richter

; Moraes, Walter

; Moreira, Gustavo Antônio

; Pachito, Daniela

; Pedrazolli, Mário

; Poyares, Dalva

; Prado, Lucila

; Rizzo, Geraldo

; Nonato Rodrigues, R.

; Roitman, Israel

; Ademir Baptista, Silva

; Tavares, Stella Márcia Azevedo

Brazilian Journal of Psychiatry

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sep 2010, Volume 32 N. 3 Pages 305 - 314

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Este artigo relata as conclusões da reunião de consenso da Associação Brasileira de Sono com médicos especialistas brasileiros sobre o tratamento da narcolepsia, baseado na revisão dos artigos sobre narcolepsia publicados entre 1980 e 2010. Os objetivos do consenso são valorizar o uso de agentes avaliados em estudos randomizados placebo-controlados, emitir recomendações de consenso para o uso de outras medicações e informar pontos importantes a respeito da segurança e efeitos adversos das medicações. O tratamento da narcolepsia é baseado em diversas classes de agentes, estimulantes para sonolência excessiva, agentes antidepressivos para cataplexia e hipnóticos para sono noturno fragmentado. Medidas comportamentais são igualmente importantes e recomendadas universalmente. Todos os ensaios clínicos terapêuticos foram classificados de acordo com o nível de qualidade da evidência. Recomendações terapêuticas individualizadas para cada tipo de sintoma e recomendações gerais foram formuladas pelos autores. Modafinila é indicada como a primeira escolha para o tratamento da sonolência diurna. Agentes de segunda escolha para o tratamento da sonolência excessiva são metilfenidato de liberação lenta seguido pelo mazindol. Reboxetina, clomipramina, venlafaxina, desvenlafaxina e os inibidores seletivos de recaptação de serotonina em doses altas são a primeira escolha para o tratamento da cataplexia. Hipnóticos são utilizados para o tratamento do sono noturno fragmentado. Antidepressivos e hipnóticos são igualmente utilizados para o tratamento das alucinações hipnagógicas e paralisia do sono.

This manuscript contains the conclusion of the consensus meeting of the Brazilian Sleep Association with Brazilian sleep specialists on the treatment of narcolepsy based on the review of medical literature from 1980 to 2010. The manuscript objectives were to reinforce the use of agents evaluated in randomized placebo-controlled trials and to issue consensus opinions on the use of other available medications as well as to inform about safety and adverse effects of these medications. Management of narcolepsy relies on several classes of drugs, namely, stimulants for excessive sleepiness, antidepressants for cataplexy and hypnotics for disturbed nocturnal sleep. Behavioral measures are likewise valuable and universally recommended. All therapeutic trials were analyzed according to their class of evidence. Recommendations concerning the treatment of each single symptom of narcolepsy as well as general recommendations were made. Modafinil is the first-line pharmacological treatment of excessive sleepiness. Second-line choices for the treatment of excessive sleepiness are slow-release metylphenidate followed by mazindol. The first-line treatments of cataplexy are the antidepressants, reboxetine, clomipramine, venlafaxine, desvenlafaxine or high doses of selective serotonin reuptake inibitors antidepressants. As for disturbed nocturnal sleep the best option is still hypnotics. Antidepressants and hypnotics are used to treat hypnagogic hallucinations and sleep paralysis.

33291 downloads

10.

Identificação molecular da uva 'Goethe' de Urussanga - SC por marcadores microssatélites
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Schuck, Mariane Ruzza

; Moreira, Flavia Maia

; Voltolini, José Afonso

; Guerra, Miguel Pedro

; Grando, Maria Stella

; Silva, Aparecido Lima da

Revista Brasileira de Fruticultura

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sep 2010, Volume 32 N. 3 Pages 825 - 831

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A variedade Goethe é símbolo da vitivinicultura da região de Urussanga, sul do Estado de Santa Catarina, a qual, atualmente, busca a Indicação Geográfica da Uva e do Vinho Goethe. Para isto, um dos requisitos necessários é a identificação precisa do material genético. Os marcadores microssatélites constituem a ferramenta molecular mais utilizada para a identificação varietal de videira em todo o mundo e têm a capacidade de produzir um perfil genético único para cada material vitícola. O objetivo deste trabalho foi caracterizar duas seleções de uva 'Goethe', presentes no município de Urussanga, por meio de marcadores moleculares microssatélites, visando a atender aos requisitos de denominação de origem e indicação de procedência controlada. A extração do DNA genômico foi realizada a partir de folhas jovens e ramos de nove acessos de cada seleção de 'Goethe Classica' e 'Goethe Primo' provenientes de uma coleção pública e de oito coleções privadas da região de Urussanga. Dez loci microssatélites VVS2, VVMD5, VVMD7, VVMD27, VrZAG62, VrZAG79, VVMD25, VVMD28, VVMD31 e VVMD32 foram genotipados através de eletroforese capilar. As análises realizadas mostraram que as duas variantes da uva 'Goethe' apresentaram um perfil molecular idêntico e único, isto é, representam a mesma variedade e sem nenhuma correspondência com variedades descritas anteriormente na literatura e nos bancos de dados consultados. As diferenças fenotípicas observadas provavelmente são devidas a mutações somáticas em regiões funcionais do genoma, fenômeno que dá origem aos clones em videira.

'Goethe' grape is a symbol of the viticulture of Urussanga region, South of Santa Catarina State, which is currently claiming the geographical indication of the grape and wine Goethe. Microsatellite markers are the biotechnological tool most used for molecular identification of grapevine varieties worldwide. These markers have the potential of generate unique DNA profiles for all the diverse grape genotypes. The aim of this work was to characterize two selections of the grapevine 'Goethe' from Urussanga, using microsatellite markers. Genomic DNA was extracted from young leaves and branches of nine accessions of each selection "Goethe Clássica and 'Goethe Primo' maintained at one public and eight private collections of Urussanga. Ten microsatellite loci VVS2, VVMD5, VVMD7, VVMD27, VrZAG62, VrZAG79, VVMD25, VVMD28, VVMD31 and VVMD32 were genotyped by capillary electrophoresis. Results showed that the two variants of 'Goethe' have an identical molecular profile which doesn't match any other DNA profile of grapevines previously described in literature or available in databases. The phenotypic differences observed are probably due to somatic mutations in functional regions of the genome, a phenomenon which leads to the creation of clones in grape.

2749 downloads

11.

Avaliação de desempenho e integração docente-assistencial nos hospitais universitários
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Lobo, Maria Stella de Castro

; Lins, Marcos Pereira Estellita

; Silva, Angela Cristina Moreira da

; Fiszman, Roberto

Revista de Saúde Pública

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aug 2010, Volume 44 N. 4 Pages 581 - 590

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

OBJETIVO: Avaliar o desempenho e a integração entre as dimensões de assistência e de ensino dos hospitais universitários brasileiros. MÉTODOS: Um modelo de data envelopment analysis em redes (network DEA) foi elaborado para aferir o desempenho de hospitais universitários federais, o qual permite considerar a relação entre as dimensões de ensino e de assistência, simultaneamente. Foram utilizados os dados do Sistema de Informação dos Hospitais Universitários do Ministério da Educação, referentes ao segundo semestre de 2003, e os resultados do modelo network foram comparados àqueles dos modelos DEA tradicionais para avaliação das vantagens da nova proposta metodológica. RESULTADOS: A eficiência dos hospitais avaliados variou entre 0,19 e 1,00 (média = 0,54). O escore dimensional mostrou que os hospitais priorizam o ganho de eficiência assistencial. Observou-se que há necessidade de dobrar o número de alunos de medicina e de aumentar os residentes em 14% para que se tornem eficientes na dimensão de ensino. CONCLUSÕES: O modelo mostrou utilidade de aplicação tanto para os gestores das unidades, visando à integração docente-assistencial, como para os órgãos reguladores, na definição de políticas e incentivos.

OBJECTIVE: To assess the performance and integration between the health care and teaching dimensions in Brazilian university hospitals. METHODS: A network data envelopment analysis (DEA) model was designed to measure the performance of federal university hospitals, which enables the relationship between the teaching and health care dimensions to be considered simultaneously. Data from the Ministry of Education Information System of University Hospitals, in the second semester of 2003, were used. Results of the network model were compared to those of classical DEA models to assess the advantages of the new methodological proposal. RESULTS: The efficiency of the hospitals assessed varied between 0.19 and 1.00 (mean = 0.54). The dimensional score showed that hospitals prioritize the gain in health care efficiency. It was observed that there was a need to double the number of medical students and increase the number of residents by 14% to obtain efficiency in the teaching dimension. CONCLUSIONS: The model was useful for both unit managers, aiming to integrate teaching and health care, and regulatory organizations, when defining policies and incentives.

OBJETIVO: Evaluar el desempeño y la integración entre las dimensiones de asistencia y de enseñanza de los hospitales universitarios brasileros. MÉTODOS: Un modelo de data envelopment analysis en redes (network DEA) fue elaborado para contrastar el desempeño de hospitales universitarios federales, permitiendo considerar la relación entre las dimensiones de enseñanza y de asistencia, simultáneamente. Fueron utilizados los datos del Sistema de Información de los Hospitales Universitarios del Ministerio de Educación de Brasil, correspondientes al segundo semestre de 2003, y los resultados del modelo network fueron comparados con aquellos modelos DEA tradicionales para evaluación de las ventajas de la nueva propuesta metodológica. RESULTADOS: La eficiencia de los hospitales evaluados varió entre 0,19 y 1,00 (promedio=0,54). El escore dimensional mostró que los hospitales priorizan la ganancia de eficiencia asistencial. Se observó que, para obtener eficiencia en la dimensión de enseñanza, hay necesidad de duplicar el número de alumnos de medicina y de aumentar los residentes en 14% para que se tornen eficientes en la dimensión de enseñanza. CONCLUSIONES: El modelo mostró utilidad de aplicación tanto para los gestores de las unidades, buscando la integración docente-asistencial, como para los órganos reguladores, en la definición de políticas e incentivos.

3602 downloads Cited 1 time in SciELO

12.

Avaliação de desempenho e integração docente-assistencial nos hospitais universitários
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Lobo, Maria Stella de Castro

; Lins, Marcos Pereira Estellita

; Silva, Angela Cristina Moreira da

; Fiszman, Roberto

Revista de Saúde Pública

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aug 2010, Volume 44 N. 4 Pages 581 - 590

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

6801 downloads Cited 1 time in SciELO

13.

Outbreak of resistant Acinetobacter baumannii: measures and proposal for prevention and control
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Romanelli, Roberta Maia de Castro

; Jesus, Lenize Adriana de

; Clemente, Wanessa Trindade

; Lima, Stella Sala Soares

; Rezende, Edna Maria

; Coutinho, Rosane Luiza

; Moreira, Ricardo Luiz Fontes

; Neves, Francelli Aparecida Cordeiro

; Brás, Nelma de Jesus

Brazilian Journal of Infectious Diseases

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oct 2009, Volume 13 N. 5 Pages 341 - 347

Abstract: En | Text: En | PDF: En

Acinetobacter baumannii colonization and infection, frequent in Intensive Care Unit (ICU) patients, is commonly associated with high morbimortality. Several outbreaks due to multidrug-resistant (MDR) A. baumanii have been reported but few of them in Brazil. This study aimed to identify risk factors associated with colonization and infection by MDR and carbapenem-resistant A. baumannii strains isolated from patients admitted to the adult ICU at HC/UFMG. A case-control study was performed from January 2007 to June 2008. Cases were defined as patients colonized or infected by MDR/carbapenem-resistant A. baumannii, and controls were patients without MDR/carbapenem-resistant A. baumannii isolation, in a 1:2 proportion. For statistical analysis, due to changes in infection control guidelines, infection criteria and the notification process, this study was divided into two periods. During the first period analyzed, from January to December 2007, colonization or infection by MDR/carbapenem-resistant A. baumannii was associated with prior infection, invasive device utilization, prior carbapenem use and clinical severity. In the multivariate analysis, prior infection and mechanical ventilation proved to be statistically significant risk factors. Carbapenem use showed a tendency towards a statistical association. During the second study period, from January to June 2008, variables with a significant association with MDR/carbapenem-resistant A. baumannii colonization/infection were catheter utilization, carbapenem and third-generation cephalosporin use, hepatic transplantation, and clinical severity. In the multivariate analysis, only CVC use showed a statistical difference. Carbapenem and third-generation cephalosporin use displayed a tendency to be risk factors. Risk factors must be focused on infection control and prevention measures considering A. baumanni dissemination.

8162 downloads

14.

Molecular characterization of grapevine from Santa Catarina, Brazil, using microsatellite markers
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Schuck, Mariane Ruzza

; Moreira, Flavia Maia

; Guerra, Miguel Pedro

; Voltolini, José Afonso

; Grando, Maria Stella

; Silva, Aparecido Lima da

Pesquisa Agropecuária Brasileira

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may 2009, Volume 44 N. 5 Pages 487 - 495

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O objetivo deste trabalho foi caracterizar a diversidade de videiras em Santa Catarina, por meio de marcadores moleculares microssatélites ("simple sequence repeats" - SSR). Amostras de DNA foram coletadas a partir de folhas e ramos de acessos de coleções de germoplasma públicas e privadas, nos municípios de Urussanga, Nova Trento, Rodeio, São Joaquim, Campos Novos, Videira e Água Doce. Dez loci SSR (VVS2, VVMD5, VVMD7, VVMD27, VrZAG62, VrZAG79, VVMD25, VVMD28, VVMD31 e VVMD32) foram analisados por eletroforese capilar. Foram produzidos perfis moleculares de 190 acessos de videira (europeus, americanos e híbridos), e 67 genótipos foram individualizados. Os dados foram comparados entre si e com aqueles disponíveis em literatura e em bancos de dados online, para a identificação de correspondências e casos de sinonímia e homonímia. Quarenta perfis moleculares corresponderam a variedades conhecidas, e 27 genótipos foram descritos pela primeira vez. A existência de um germoplasma típico, composto principalmente de variedades americanas e híbridas, é um fator importante para a viticultura local. A aplicação desses resultados poderá contribuir para o controle de qualidade e a certificação de mudas. Além disso, aumentar a precisão no que tange à caracterização genética da videira, auxiliará os programas de melhoramento genético.

The objective of this work was to characterize the grape germplasm in Santa Catarina, Brazil, using microsatellite DNA markers (simple sequence repeats - SSR). The DNA samples were collected from leaves and shoots of accessions of public and private collections from the counties Urussanga, Nova Trento, Rodeio, São Joaquim, Campos Novos, Videira, and Água Doce. Ten SSR loci (VVS2, VVMD5, VVMD7, VVMD27, VrZAG62, VrZAG79, VVMD25, VVMD28, VVMD31, and VVMD32) were analysed by capillary electrophoresis. Molecular profiling was conducted for 190 grapevines (European, American, and hybrids), and 67 genotypes were obtained. The data were compared with each other and with those from the literature and from online databases, in order to identify varieties and discover cases of synonymy and homonymy. Forty molecular profiles corresponded to known varieties, while 27 genotypes were described for the first time. The existence of typical germplasm composed mainly of American and hybrid varieties is an important finding for local viticulture. Applications of the results rely on quality control and certification at the nursery level. Increasing precision in the characterization of grapevine genotypes may help breeding programs.

2624 downloads Cited 2 times in SciELO

15.

O uso da Análise Envoltória de Dados (DEA) para avaliação de hospitais universitários brasileiros
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Lins, Marcos Estellita

; Lobo, Maria Stella de Castro

; Silva, Angela Cristina Moreira da

; Fiszman, Roberto

; Ribeiro, Vagner José de Paula

Ciência & Saúde Coletiva

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aug 2007, Volume 12 N. 4 Pages 985 - 998

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

De modo a demonstrar como a modelagem por Análise Envoltória de Dados (DEA) permite aferir o desempenho dos hospitais e subsidiar a avaliação da implantação da Política de Reestruturação dos Hospitais de Ensino, desenvolve-se um estudo de caso com os 31 hospitais gerais pertencentes a universidades federais brasileiras. Consideram-se indicadores de assistência, ensino e pesquisa e utiliza-se o programa IDEAL (Interactive Data Envelopment Analysis Laboratory) como ferramenta de avaliação de desempenho. O IDEAL, desenvolvido no país, é o único no mundo capaz de prover a visualização tridimensional da fronteira de produtividade, facilitando a análise exploratória e escolha das variáveis pertinentes, assim como a compreensão dos resultados do modelo (multiplicador e envelope) pelo especialista e decisor. A título de exemplo, é apresentado o benchmark dos hospitais universitários por meio de indicadores de resultado (outputs), que consideram as diferenças estruturais e/ou as demandas regionais (inputs). A modelagem também permite indicar as mudanças necessárias para as unidades ineficientes (alterações nos vetores de inputs e/ou outputs) e gerar recomendações sobre a distribuição dos recursos públicos baseada em qualidade/eficiência.

In order to demonstrate how DEA modeling can be helpful for hospital performance assessments conducted in compliance with Brazil's Teaching Hospital Policy, a case study is presented of 31 general hospitals linked to Federal Universities. It considers data on assistance, teaching and research and the use of the IDEAL (Interactive Data Envelopment Analysis Laboratory) software as a tool for assessing their efficiency. Developed in Brazil, this unique software provides a three-dimensional view of the productivity frontier, for easier exploratory analyses and selection of pertinent variables, with a better understanding of the outputs of the model (multiplier and envelope) for specialists and decision-makers. As an example, a University Hospital benchmark is presented through outputs that take structural and regional input differences into consideration. This modeling also indicates the changes required in the inefficient units (alterations to input and/or /output vectors), setting forth recommendations on public financing based on quality/efficiency.

2222 downloads Cited 11 times in SciELO

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