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Seriously ill infants often display protein-calorie malnutrition due to the metabolic demands of sepsis and respiratory failure. Glutamine has been classified as a conditionally essential amino acid, with special usefulness in critical patients. Immunomodulation, gut protection, and prevention of protein depletion are mentioned among its positive effects in such circumstances. With the intent of evaluating the tolerance and clinical impact of a glutamine supplement in seriously ill infants, a prospective randomized study was done with nine patients. Anthropometric and biochemical determinations were made, and length of stay in the intensive care unit (ICU), in the hospital, and under artificial ventilation, and septic morbidity and mortality were tabulated. Infants in the treatment group (n=5) were enterally administered 0.3 g/kg of glutamine, whereas controls received 0.3 g/kg of casein during a standard period of five days. Septic complications occurred in 75% of the controls (3/4) versus 20% of the glutamine-treated group (1/5, p<=0.10), and two patients in the control group died of bacterial infections (50% vs. 0%, p<=0.10). Days in the ICU, in the hospital, and with ventilation numerically favored glutamine therapy, although without statistical significance. The supplements were usually well tolerated, and no patient required discontinuation of the program. The conclusion was that glutamine supplementation was safe and tended to be associated with less infectious morbidity and mortality in this high-risk population.

The authors report the magnetic resonance imaging diagnostic features in two cases with respectively lumbar epidural hematoma and cavernous hemangioma of the lumbar epidural space. Enhanced MRI T1-weighted scans show a hyperintense signal rim surrounding the vascular lesion. Non-enhanced T2-weighted scans showed hyperintense signal.

Under the scanning electron microscope, the characteristics of the buccal surface enamel of human non-erupted deciduous molars were evaluated after using 15, 30, and 45 seconds of phosphoric acid etching time. The teeth were extracted, kept in a 70% alcohol solution and later dehydrated and metallized for analysis with the scanning electron microscope JEOL, JSM-6.100. The in vitro experiment with 35% phosphoric acid revealed that there is a tendency of predominance of interprismatic enamel dissolution or type II pattern with 15 and 45 seconds etching time. The dissolution of the interprismatic enamel was more pronounced when an acid etching time of 45 seconds was used. The enamel surface demonstrated type I and type II patterns when acid etching time was 30 seconds

Growth hormone (GH) and glutamine (GLN) are considered bowel trophic factors and are used experimentally after bowel resection. Their clinical uses in short bowel syndrome (SBS) are still not standardized. It is of interest to verify metabolic, nutritional and side effects of the association of GH and GLN in SBS. Three patients, 39 (A), 33 (B), and 01 years old (C) underwent bowel resection with jejunum anastomosis 15 cm (A) and 60 cm (B) distant from the Treitz angle, and 40 cm (C) preserving the ileo cecal valve. GH Saizen (Serono - A), Genotropin (Pharmacia - B), and Norditropin (Novonordisk C) were administered in doses of 0.14 mg /kg/day. GLN (0.4 g/kg/day) was given orally for 10 days (A), 30 days (B) and 60 days to patient C (0.28 g/kg/day). Central TPN and adequate oral diet was administered according to the bowel adaptation phase. On the first day after beginning treatment patient A exhibited symptoms of hypoglycemia. There were no other side effects. After treatment, body weight was higher and analysis by bioelectrical impedance showed more lean mass and less fat mass compared to pre-treatment measurements. Nitrogen retention was progressively higher with treatment. Simultaneous treatment with GH and GLN does not cause significant side effects, and is associated with a favorable distribution of the body compartments and nitrogen retention in patients with the short bowel syndrome.

The purpose of this study was to assess the flexor-extensor group of muscles of the knee in young athletes diagnosed with a total rupture of the anterior cruciate ligament (ACL). Eighteen knees of 18 athletes (14 men and 4 women) with an average age of 21.6 years (range 16-32 years) were assessed with a Cybex 6000 model isokinetic apparatus. The average interval between occurrence of the injury and assessment was 10.2 months (range 2 - 48 months). There was an associated meniscal injury in eight of the knees. Athletes with any other kind of associated injury, limitation, or blockage of the movement of the joint, significant pain during the exam, or interval between injury and exam of less than two months were excluded from the study. The parameters studied were the peak torque-velocity and flexor-extensor relationships at the constant angular velocities of 60°/sec and 240°/sec. Previous warming-up was done by means of an ergometric bicycle and adaptation with 3 submaximal repetitions. The contra-lateral side, which presented no injury, was used as control. Peak torque (PT) at the constant velocity of 60°/sec was greater than that at 240°/sec for knees with and without injuries. However, there was no significant difference between the injured and uninjured sides at 60°/sec or at 240°/sec. The average value for the flexor-extensor relationship at 60°/sec on the injured was 60% (( 6), compared to 57% (( 10) on the contra-lateral side. At 240°/sec, the average value was 75% ((10) on the injured side, and 65% ((12) on the contra-lateral side. In conclusion, despite the complete rupture of the ACL of one knee, the average values for the flexor-extensor relationship were similar on the injured and uninjured sides at the velocity of 60°/sec. As the velocity increased, an increase in the values for the flexor-extensor relationship of the knee also occurred, indicating a tendency of the performance of the flexor muscle group to approach that of the extensor muscle group, and this tendency was more pronounced on the side of the injury.

In order to evaluate density, radiographic contrast and dose of radiation exposure, the author analyzed 80 radiographs containing 640 optical density data of the images of a penetrometer, exposed to the radiation beam with combinations between D and E periapical films, aluminum and copper/aluminum filters, and circular or rectangular collimators. The data obtained were analyzed by ANOVA and allowed the following conclusions: 1) aluminum filtration resulted in improved image contrast; 2) the use of group D film and an aluminum filter produced improved image contrast quality; 3) the rectangular collimator contributed to the production of improved contrast and to the reduction of radiation exposure, but did not affect density; 4) the combination of copper/aluminum filter, E group film and rectangular collimation significantly reduced radiation exposure.

Neste trabalho, foi estudado o efeito do berílio sobre a microestrutura e a temperatura de fusão em ligas Ni-Cr-Mo-Co e suas propriedades de corrosão. O estudo consistiu na obtenção das diversas ligas através de fusão sob vácuo, seguidas de forjamento em condições industriais. Após o forjamento, as ligas foram tratadas termicamente em diversas temperaturas e resfriadas em água, ar e forno. Nas ligas Ni-Cr-Mo-Co, a presença do Be altera a microestrutura, proporcionando a formação de fases intermetálicas. Foi constatado que, nas ligas estudadas, o Be abaixa a temperatura de fusão e as torna susceptíveis à corrosão por pite

Hypoalbuminemia may cause interstitial edema and hemodilution, which we hypothesized may influence serum sodium levels. Our purpose was to compare serum sodium levels of hospitalized adults with or without hypoalbuminemia. All sodium and albumin serum levels of 142 adults hospitalized at general medical wards over a six-month period were searched at a University Hospital mainframe computer. Relevant laboratory data and clinical details were also registered. Hypoalbuminemia was defined by serum albumin concentration < 3.3 g/dl Fisher, Mann-Whitney, and Student's t tests were applied to compare groups with or without hypoalbuminemia. Ninety-nine patients, classified as hypoalbuminemic, had lower blood hemoglobin (10.68 ± 2.62 vs. 13.54 ± 2.41), and sodium (135.1 ± 6.44 vs. 139.9 ± 4.76mEq/l) and albumin (2.74 ± 0.35 vs. 3.58 ± 0.28g/dl) serum levels than non-hypoalbuminemic (n=43). Pearson's coefficient showed a significant direct correlation between albumin and sodium serum levels (r=0.40) and between serum albumin and blood hemoglobin concentration (r=0.46). Our results suggest that hypoalbuminemic adults have lower serum sodium levels than those without hypoalbuminemia, a phenomenon that may be at least partially attributed to body water retention associated with acute phase response syndrome.

O objetivo deste trabalho in vitro foi avaliar a rugosidade e o perfil de restaurações de amálgama obtidas com a reutilização de uma mesma matriz de aço inoxidável. A rugosidade superficial e o perfil proximal de amálgamas, obtidos com três tipos de limalhas com variação da pressão de condensação, foram avaliados e submetidos à análise estatística. É importante notar que uma mesma matriz foi reutilizada 15 vezes para cada grupo testado. O aumento constante da rugosidade da primeira até a última utilização, assim como a alteração do perfil evidenciam a deformação progressiva da matriz, alterando significantemente a lisura e o perfil desejados na face proximal. Os resultados obtidos mostram, portanto, que as matrizes de aço devem ser consideradas materiais descartáveis.

O objetivo deste estudo foi verificar a resistência à remoção por tração e a infiltração marginal de coroas totais fundidas cimentadas com cimento de ionômero de vidro, em dentes reconstruídos com duas formulações de cimento de ionômero de vidro, ou seja, Cermet e "mistura milagrosa", em comparação às coroas totais cimentadas em dentes com preparo para coroa total (sem reconstrução). Foram selecionados trinta molares superiores recém-extraídos, dez para cada condição experimental. Uma liga do sistema prata/estanho (M3) foi utilizada para obtenção das coroas totais. As amostras foram submetidas a ciclagens térmicas nas temperaturas de 5ºC, 37ºC e 55ºC, por sessenta minutos, durante sete dias. Para a última ciclagem térmica, foi utilizado o corante Rhodamina B a 0,1%, em solução aquosa. A seguir, as amostras foram lavadas e mantidas em condições ambientais por vinte e quatro horas, para serem levadas à máquina de ensaios universal, para os testes de remoção por tração axial. A análise de variância mostrou diferença estatisticamente significante, no nível de 5%, dos dentes sem reconstrução (controle), com relação aos dentes reconstruídos com "mistura milagrosa" e dentes reconstruídos com Cermet. Os dentes sem reconstrução apresentaram maior média aos testes de resistência por tração. Verificou-se, pela comparação individual entre as condições avaliadas, que o grupo reconstruído com "mistura milagrosa" e Cermet não mostrou diferença estatisticamente significante. Da mesma forma, foram elaboradas comparações individuais entre as condições avaliadas dos escores de infiltração, em que se pôde observar que houve significância entre os grupos de "mistura milagrosa" e Cermet com o grupo controle (dentes sem reconstrução). Os dentes reconstruídos com "mistura milagrosa" e Cermet não mostraram diferenças estatisticamente significantes entre si

Mega-organs, primarily in the digestive tract, are well known to occur in chronic Chagas disease. Acute experimental infection with Trypanosoma cruzi results in parasitism of a wide range of cells, tissues, and organs, including the urinary bladder. Infection of BALB/c mice with 100,000 bloodstream forms of the Y strain of T. cruzi induced acute infection with intense parasitism of all layers of the urinary bladder. Parasites were found in the mucosa, lamina propria, muscular, adventitial connective, and fat tissue. Desquamate epithelial cells with amastigotes in the bladder lumen were also found. After 60 days of infection, mice inoculated with 50 bloodstream forms developed dilated, thin-walled bladders that had inflammatory infiltrates and foci of fibrosis replacing areas of damaged muscular layer. These lesions result from direct damage to the muscle fibers by the T. cruzi, leading to myosites, muscle damage, and scarring. Direct damage of paraganglia cells secondary to parasitism, leading to dilatation, damage of muscle fibers, and scarring with replacement of muscular tissue with connective tissue, should also be considered as a cause of functional disturbance of the urinary bladder.

The bond strength of dentin adhesives to dentin has increased after each generation. Although dentin substratum is part of the bonding process, little importance has been given to measure dentin cohesive strength. The aim of this study was to evaluate the cohesive strength of dentin in human canines. Seventeen non carious canines were selected. All of them had been extracted for more than one year. The teeth were ground until dentin square samples with approximately 2 X 2 mm were obtained. They were embedded in acrylic resin and subjected to shear stress, in a Wolpert Machine, at a crosshead speed of 0.5 mm/min. The mean cohesive strength of dentin in shear mode was 33.95 (+-9.72) MPa. The fracture surfaces were observed under a X40 magnification. A finite element analysis was performed to observe the stress distribution as related to the shear test. The failure pattern was compatible with the shear test and also with the stress distribution in the finite element analysis

Foi realizada uma pesquisa visando a avaliação morfológica e o local de inserção dos frênulos labiais superiores e inferiores. A amostra foi constituída de 100 pacientes em condições sócio-econômicas semelhantes, tendo-se observado que o frênulo labial simples foi o mais prevalente, inserindo o superior na gengiva inserida e o inferior, na mucosa alveolar. A distância média da inserção, em relação à borda gengival livre, foi de 4,4 mm para o superior e de 5,6 mm para o inferior. Foi possível, nessas áreas, manter o controle clínico da placa bacteriana

Oxacillin-resistant Staphylococcus aureus (ORSA) infection is an important cause of hospital morbidity and mortality. The objective of this study was to identify the main factors associated with death in patients colonized or infected with Staphylococcus aureus in a cancer center. A matched-pair case-control study enrolled all patients infected or colonized with ORSA (cases) admitted to the Hospital do Câncer in Rio de Janeiro from 01/01/1992 to 12/31/1994. A control was defined as a patient hospitalized during the same period as the case-patients and colonized or infected with oxacillin-susceptible Staphylococcus aureus (OSSA). The study enrolled 95 cases and 95 controls. Patient distribution was similar for the two groups (p > or = 0.05) with respect to gender, underlying diseases, hospital transfer, prior infection, age, temperature, heart and respiratory rates, neutrophil count, and duration of hospitalization. Univariate analysis of putative risk factors associated with mortality showed the following significant variables: admission to the intensive care unit (ICU), presence of bacteremia, use of central venous catheter (CVC), ORSA colonization or infection, pneumonia, use of urinary catheter, primary lung infection, prior use of antibiotics, mucositis, and absence of cutaneous abscesses. Multivariate analysis showed a strong association between mortality and the following independent variables: admission to ICU (OR [odds ratio]=7.2), presence of Staphylococcus bacteremia (OR=6.8), presence of CVC (OR=5.3), and isolation of ORSA (OR=2.7). The study suggests a higher virulence of ORSA in comparison to OSSA in cancer patients.

A hipersensibilidade é a sensibilidade exagerada da dentina quando exposta ao meio bucal, que se torna permeável à ação de estímulos agressivos. O diagnóstico é feito através da anamnese e da inspeção clínica minuciosa. O tratamento pode ser feito pelo profissional ou pelo próprio paciente sob orientação, dependendo do caso. Ela ocorre comumente no final da terceira década, sendo ligeiramente mais freqüente nas mulheres do que nos homens.

O presente trabalho teve o objetivo de avaliar a eficácia do bastão de gelo e do tetrafluoroetano na determinação da vitalidade pulpar em 594 dentes humanos cariados, restaurados e íntegros de 72 pacientes, com idade variável entre 47 e 60 anos. Verificou-se que a aplicação do gás de tetrafluoroetano propiciou maior índice de acerto quando comparado com o bastão de gelo, havendo diferença estatisticamente significante entre os dois agentes térmicos utilizados (p &lt;&lt; 0,01).

Biochemical and hematimetric indicators of inflammation and cell damage were correlated with bilirubin and hepatic and pancreatic enzymes in 30 chronic male alcoholics admitted into psychiatric hospital for detoxification and treatment of alcoholism. Aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, alkaline phosphatase, and total bilirubin were altered, respectively, in 90%, 63%, 87%, 23% and 23% of the cases. None of the indicators of inflammation (lactic dehydrogenase, altered in 16% of the cases; alpha-1 globulin, 24%; alpha-2 globulin, 88%; leucocyte counts, 28%) was correlated with alterations of bilirubin or liver enzymes. Lactic dehydrogenase was poorly sensitive for detection of hepatocytic or muscular damage. Alterations of alpha-globulins seemed to have been due more to alcohol metabolism-induced increase of lipoproteins than to inflammation. Among indicators of cell damage, serum iron, increased in 40% of the cases, seemed to be related to liver damage while creatine phosphokinase, increased in 84% of the cases, related to muscle damage. Hyperamylasemia was found in 20% of the cases and significantly correlated with levels of bilirubin, alkaline phosphatase and gamma-glutamyltransferase. It was indicated that injuries of liver, pancreas, salivary glands, and muscle occurred in asymptomatic or oligosymptomatic chronic alcoholics.

O presente estudo objetivou investigar os hábitos dietéticos de um grupo de acadêmicos de Odontologia em relação ao açúcar, analisando a influência dos conhecimentos adquiridos durante o curso. Os dados foram coletados através de questionários aplicados a 140 acadêmicos recém-ingressantes e formandos da Universidade Federal de Goiás. Observou-se que o consumo de sacarose foi mais freqüente entre os recém-ingressantes (92%) do que entre os formandos (80%) (p &lt;&lt; 0,05). Sessenta por cento dos formandos relataram ter reduzido a ingestão após o ingresso no curso, e a grande maioria pretende recomendar restrição de açúcar aos próprios filhos (97,5%) e aos futuros pacientes (87%), visando uma melhor saúde bucal e geral (77%). Concluiu-se que os conhecimentos adquiridos não levam necessariamente à mudança dos hábitos dietéticos entre os acadêmicos de Odontologia, apesar de influenciarem em sua intenção de conduta junto aos futuros filhos e pacientes

The purpose of this study was to explore the relationship between the intensity of acid reflux and severity of esophageal tissue damage in a cross-sectional study of patients with gastroesophageal reflux disease (GERD). Seventy-eight patients with were selected in accordance with the strict 24-hour ambulatory esophageal pHmetry (24h-pHM) criteria and distributed into three age groups: Group A: 14 - 24 years of age. Group B: 25 - 54; and Group C: 55 - 64. The 24h-pHM was carried out in accordance with DeMeester standardization, and the Savary-Miller classification for the diagnosis of reflux esophagitis was used. The groups were similar in 24h-pHM parameters (p > 0.05), having above normal values. For the study group as a whole, there was no correlation between age group and intensity of acid reflux, and there was no correlation between intensity of acid reflux and severity of esophageal tissue damage. However, when the same patients were sub-grouped in accordance with the depth of their epithelial injury and then distributed into age groups, there was a significant difference in esophagitis without epithelial discontinuity. Younger patients had less epithelial damage than older patients. Additionally, although there was a significant progression from the least severe to the moderate stages of epithelial damage among the age groups, there was no apparent difference among the age groups in the distribution between the moderate stages and most severe stages. The findings support the conclusion that the protective response of individuals to acid reflux varies widely. Continued aggression by acid reflux appears to lead to the exhaustion of individual mechanisms of epithelial protection in some patients, but not others, regardless of age or duration of the disease. Therefore, the diagnosis and follow-up of GERD should include both measurements of the quantity of refluxed acid and an assessment of the damage to the esophageal epithelium.