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Tarsal tunnel syndrome is an entrapment neuropathy of the tibial nerve within the tarsal tunnel that lies beneath the retinaculum on the medial side of the ankle. It is often underdiagnosed. Talus bipartitus is a rare anatomical variant; only a few cases have been described in medical literature. We report a case of a 36-year-old female with tarsal tunnel syndrome secondary to a talus bipartitus undergoing surgical treatment with good clinical outcome. To our knowledge, talus bipartitus presenting as tarsal tunnel syndrome has no previous reports. Image studies and physical examination are crucial to reach precise diagnosis.

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BACKGROUND AND OBJECTIVE: Peri-implant diseases are a growing concern among clinicians. Epidemiological studies following recently recommended case definitions for peri-implant diseases are emerging worldwide. Although a small number of studies on the prevalence of peri-implant diseases has been conducted in Brazil, no information on the extent and severity of the condition has been made available so far. The objective of this study was to estimate the prevalence, extent and severity of peri-implant diseases in patients treated in a university setting in Brazil. MATERIAL AND METHODS: Patients with dental implants with at least 1 year in function were clinically and radiographically examined and classified according to recently recommended case definitions. A descriptive analysis on the prevalence, extent and severity of the peri-implant status at patient and implant level was performed. Risk indicators for peri-implantitis were also identified with binary logistic regression analysis. RESULTS: Of the 211 participating individuals, 4 (1.9%) presented peri-implant health, 8 (3.8%) clinical stability, 115 (54.5%) mucositis and 84 (39.8%) peri-implantitis. Of the 748 implants analyzed, 47 (6.3%) presented peri-implant health, 30 (4%) clinical stability, 518 (69.2%) mucositis and 153 (20.5%) peri-implantitis. The extent of implants with peri-implantitis and peri-implant mucositis was 41.5% and 90.4%, respectively. Severe peri-implantitis was found in 36 patients (17.1%) and 67 implants (9%). Gender male, number of implants ≥4, implants installed in the maxilla, cemented prosthesis and keratinized mucosa width <2 mm were significantly associated with the event peri-implantitis. CONCLUSION: In the studied population, the prevalence, extent and severity of the peri-implant diseases were similar to those reported elsewhere. Peri-implant diseases were a common finding, with only 5.7% of patients and 10.3% of implants presenting peri-implant health or clinical stability. About 17% of patients studied presented the severe form of peri-implantitis.

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OBJECTIVE: To analyze marginal bone loss (MBL) and clinical parameters around narrow-diameter implants (NDIs - 3.3 mm) made of titanium/zirconium alloy (TiZr) in comparison with commercially pure titanium (cpTi) installed in the molar region of the mandible after 1 year in function. MATERIALS AND METHODS: Ten patients participated in the study. A TiZr and a cpTi NDI were randomly installed in contralateral molar sites of the mandible of each patient in a split-mouth design. Eight weeks after healing, all metal-ceramic single crowns were adapted to the implants and patients were enrolled in a plaque control program. MBL at the mesial and distal aspects of the implants were evaluated by comparing periapical radiographs taken immediately after prosthesis installation (T1) and 1 year after loading (T2). Clinical probing depth, bleeding on probing, suppuration, visible plaque and implant mobility were evaluated to determine implant success and survival rates. RESULTS: Mean MBL at the interproximal aspects of TiZr implant sites was 0.32 ± 0.27 mm, while at cpTi implant sites mean MBL was 0.35 ± 0.24 mm (P = 0.60). Both TiZr and cpTi NDIs presented 100% implant survival and success rates, with no significant differences in the clinical parameters studied (P > 0.05). CONCLUSION: TiZr and cpTi NDIs presented similar outcomes after 1 year in function in the molar region of the mandible. The results suggest that TiZr and cpTi NDIs may be equally used to support single crowns in the posterior area of the mouth. However, further studies with longer follow-up periods are necessary to confirm these findings.

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RESUMO O presente estudo teve como objetivo avaliar a atividade antibacteriana, antioxidante e citotóxica da espécie Opuntia cochenillifera (L.) Mill. Foi realizada a prospecção fitoquímica e espectroscopia de absorção de infravermelho (IV) dos extratos etanólicos brutos e frações dos cladódios grande e pequeno. A atividade antioxidante foi avaliada pelo método da capacidade sequestradora de radicais livres utilizando o radical sintético 2,2-difenil-1-picrilhidrazila (DPPH). A atividade citotóxica foi obtida através do método colorimétrico do Metiltetrazolium (MTT). Já a atividade antibacteriana foi avaliada pelo método de microdiluição em caldo para determinar a concentração inibitória mínima (CIM) frente às estirpes bacterianas Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa e Escherichia coli. A prospecção fitoquímica revelou principalmente a presença de fenóis, esteroides livres, alcaloides, alcanos, além de outras classes químicas. O IV apresentou grupos funcionais como alcanos, carbonilas, grupos de metila, duplas ligações de carbono, grupamentos alquilamina, entre outros. Sobre a citotoxicidade na concentração de 100 μg/mL, os dois extratos brutos, todas as frações do cladódio grande e as frações de clorofórmio e metanol do cladódio pequeno não apresentaram toxicidade. Os extratos brutos e frações do cladódio grande e pequeno, não demonstraram atividade antibacteriana e nem antioxidante. Esses resultados podem fornecer suporte para pesquisas futuras, visando outras atividades biológicas da presente espécie vegetal.

ABSTRACT The purpose of this study was to evaluate the antibacterial, antioxidant, and cytotoxic activity of Opuntia cochenillifera (L.) Mill. A phytochemical screening and infrared (IR) absorption spectroscopy were performed in the crude ethanolic extracts and fractions of large and small cladodes. The antioxidant activity was evaluated through the qualitative method of free-radical scavenging capacity using the synthetic radical 2,2-diphenyl-1-picrylhydrazyl (DPPH). The cytotoxic activity was obtained by the cell viability assay using methyl thiazolyl tetrazolium (MTT). Antibacterial activity was evaluated by broth microdilution method to determine the minimum inhibitory concentration (MIC) against the bacterial strains Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli. The phytochemical screening mainly revealed the presence of phenols, flavonoids, free steroids, alkaloids, alkanes, and other chemical classes. The IR spectroscopy presented functional groups such as alkanes, carbonyls, methyl groups, carbon double bonds, and alkylamino groups, among others. Regarding cytotoxicity in the concentration of 100 μg/mL, neither the crude extracts, the fractions of the large cladode, nor the chloroform and methanol fractions of small cladode presented toxicity. The crude ethanolic extracts and fractions of large and small cladode showed no antibacterial or antioxidant activity. These results may provide support for future research aimed at other biological activities of this plant species.

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OBJECTIVE: The aim of the present 10-year retrospective study was to evaluate the success and survival rates of narrow diameter implants (NDIs) placed in combination with a split-crest technique. MATERIALS AND METHODS: Twenty-one healthy individuals who received prosthetic rehabilitation supported by narrow diameter implants (NDIs) installed in atrophic maxillary posterior areas immediately after split-crest procedure were included in the study. Six to eight weeks after implant placement, the prosthetic rehabilitations were delivered. Periapical radiographs were taken at the 6-month and 10-year time interval after implant loading to assess bone marginal level around the implants. In addition, survival and success indexes were also obtained at these time intervals. RESULTS: Forty NDIs were placed in 21 patients. At the end of the 10-year follow-up period, seven patients had dropped out, two implants were lost, and nine prostheses presented some type of deficiency (ceramic fracture or retaining screw fracture). At the 10-year time interval, the implant survival rate was 97% and the success rate was 95%. The marginal bone loss at the 6-month and 10-year time intervals was, respectively, 0.47 (SD 0.91) mm and 1.93 (SD 0.93) mm. CONCLUSION: Narrow diameter implants installed immediately after split-crest procedure may successfully support prosthetic rehabilitations after long-time intervals.

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OBJECTIVE: The aim of the present prospective clinical study was to evaluate and to compare the success and survival rates of narrow diameter implants made of titanium-zirconium alloy and commercially pure titanium. MATERIALS AND METHODS: Forty-two healthy adult patients scheduled for implant-supported single restorations were included in the study. In each patient, a titanium-zirconium alloy (Test group) or a commercially pure titanium (Control group) narrow diameter implants was installed in the posterior regions of the jaws. After 8 weeks of healing, all metal-ceramic single crowns were adapted to the implants and the patients enrolled in a plaque control program. The survival and success rates of the implants and the success rate of the implant-supported prosthesis were evaluated following 1 year of loading. Furthermore, mobility (M), suppuration (S), clinical probing depth (CPD), and bleeding on probing (BoP) were measured around the implants at 6 weeks of healing (T1) and 12 months after loading (T2). RESULTS: In T2, survival and success rates for both groups were 95.2%. The corresponding value for the success rate of the implant-supported prosthesis was 100% in both groups. The average CPD was the following: 2.29 (±0.52) and 2.59 (±0.52) (P < 0.05) in the Test and Control groups, respectively, at T1; and 3.0 mm (±0.74) and 3.07 mm (±0.90) (P > 0.05) in the Test and Control groups, respectively, at T2. There was no statistically significant difference between groups concerning about S, M, and BoP at T1 and T2 (P > 0.05). CONCLUSION: The present study suggests that, in a short-term follow-up, narrow diameter implants made of either titanium-zirconium alloy or commercially pure titanium may be used to support single crowns in the posterior portions of the jaws.

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BACKGROUND AND OBJECTIVE: Successful root-coverage treatment depends on the thickness of the donor tissue. This study aimed to evaluate the thickness of donor tissue after augmentation of the connective tissue in the palatal area by implantation of lyophilized collagen sponge (Hemospon(®) ). MATERIAL AND METHODS: Ten patients with an indication for root coverage, whose palate was deficient in adequate connective tissue, were recruited. The procedure was carried out in two stages. In the first stage, the palatal thickness in the donor site was measured at three standardized points (points 1, 2 and 3), from the distal of the canine to the distal of the first molar, and the lyophilized collagen sponge was inserted. In the second stage, the palatal thickness over the implant was measured (at points 1, 2 and 3), two biopsies of the palatal mucosa were collected - one over the implant (experimental sample) and the other on the contralateral side (control sample) - and then root-coverage treatment was performed. Analyses consisted of clinical assessment of the palatal measurements before and after sponge implantation, and histological assessment of the experimental and control biopsy samples. Data were analyzed using the Wilcoxon test. RESULTS: Both analyses showed a significant increase in mean thickness, of 1.08 mm of neoformed tissue in the clinical analysis (the tissue at point 2 was the thickest of the three points) and of 0.53 mm in the histological analysis. CONCLUSION: The insertion of lyophilized collagen sponge induced a significant increase in the thickness of palatal connective tissue.

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Leprosy is caused by Mycobacterium leprae, which induces chronic granulomatous infection of the skin and peripheral nerves. The disease ranges from the tuberculoid to the lepromatous forms, depending on the cellular immune response of the host. Chemokines are thought to be involved in the immunopathogenesis of leprosy, but few studies have investigated the expression of chemokine receptors on leukocytes of leprosy patients. In the present study, we evaluated 21 leprosy patients (M/F: 16/5) with a new diagnosis from the Dermatology Outpatient Clinic of the University Hospital, Federal University of Minas Gerais. The control group was composed of 20 healthy members (M/F: 15/5) of the community recruited by means of announcements. The expression of CCR2, CCR3, CCR5, and CXCR4 was investigated by flow cytometry on the surface of peripheral blood lymphocytes. There was a decrease in percentage of CD3+CXCR4+ and CD4+CXCR4+ lymphocytes in the peripheral blood of leprosy patients (median [range], 17.6 [2.7-41.9] and 65.3 [3.9-91.9], respectively) compared to the control group (median [range], 43.0 [3.7-61.3] and 77.2 [43.6-93.5], respectively). The percentage of CD4+CXCR4+ was significantly lower in patients with the tuberculoid form (median [range], 45.7 [0.0-83.1]) of the disease, but not in lepromatous patients (median [range], 81.5 [44.9-91.9]). The CXCR4 chemokine receptor may play a role in leprosy immunopathogenesis, probably directing cell migration to tissue lesions in tuberculoid leprosy patients.

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Leprosy is caused by Mycobacterium leprae, which induces chronic granulomatous infection of the skin and peripheral nerves. The disease ranges from the tuberculoid to the lepromatous forms, depending on the cellular immune response of the host. Chemokines are thought to be involved in the immunopathogenesis of leprosy, but few studies have investigated the expression of chemokine receptors on leukocytes of leprosy patients. In the present study, we evaluated 21 leprosy patients (M/F: 16/5) with a new diagnosis from the Dermatology Outpatient Clinic of the University Hospital, Federal University of Minas Gerais. The control group was composed of 20 healthy members (M/F: 15/5) of the community recruited by means of announcements. The expression of CCR2, CCR3, CCR5, and CXCR4 was investigated by flow cytometry on the surface of peripheral blood lymphocytes. There was a decrease in percentage of CD3+CXCR4+ and CD4+CXCR4+ lymphocytes in the peripheral blood of leprosy patients (median [range], 17.6 [2.7-41.9] and 65.3 [3.9-91.9], respectively) compared to the control group (median [range], 43.0 [3.7-61.3] and 77.2 [43.6-93.5], respectively). The percentage of CD4+CXCR4+ was significantly lower in patients with the tuberculoid form (median [range], 45.7 [0.0-83.1]) of the disease, but not in lepromatous patients (median [range], 81.5 [44.9-91.9]). The CXCR4 chemokine receptor may play a role in leprosy immunopathogenesis, probably directing cell migration to tissue lesions in tuberculoid leprosy patients.

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Neste trabalho, avaliou-se o perfil fitoquímico e a toxicidade preliminar frente a larvas de Artemia salina do extrato etanólico de frutos de Solanum lycocarpum. O extrato foi submetido à análise fitoquímica preliminar para identificação das principais classes de metabolitos secundários presentes e testado frente a larvas de A. salina para obtenção das concentrações letais médias (CL50%). Os testes fitoquímicos demonstraram a presença de fenóis, taninos, saponinas, alcalóides e esteroides livres. O extrato foi fracionado em diferentes solventes para a avaliação da toxicidade frente à A. salina, apresentando considerável citotoxicidade na fração hidroalcoólica (CL50% = 285,546 µg/mL).

The phytochemical profile of ethanolic extract of Solanum lycocarpum fruits was analyzed and preliminary toxicity tests were performed against brine shrimp larvae. The extract was subjected to preliminary phytochemical analysis to identify the main classes of secondary metabolites and tested against the larvae of A. salina to obtain the median lethal concentrations (LC50%). The phytochemical tests showed the presence of phenols, tannins, saponins, alkaloids and free steroids. The extract was fractionated with various solvents for toxicity testing against the larvae and the hydroalcoholic fraction showed considerable cytotoxicity (CL50% = 285.546 µg/mL).

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A biópsia hepática com agulha tru-cut guiada por videolaparoscopia foi realizada em 12 caprinos machos, castrados, clinicamente sadios, sem raça definida, divididos em dois grupos, um (G1) com cinco animais de 12 meses e pesos entre 20 e 36,4 kg e outro (G2) com sete de seis meses e pesos entre 14,6 e 19,6 kg. Cada animal foi submetido à anestesia geral intravenosa seguida de laparoscopia pelo flanco direito. Após a visibilização do fígado, foi introduzida a agulha de biópsia hepática tru-cut no décimo primeiro espaço intercostal direito, a aproximadamente 12cm ventral à coluna vertebral, para punção e remoção de fragmento do lobo hepático direito. Foram feitos hemogramas e exames bioquímicos sanguíneos no pré-jejum e às 24, 48 e 72 horas após a intervenção cirúrgica. Em todos os constituintes sanguíneos analisados não foram observadas diferenças (P>0,05) entre os grupos. As alterações observadas no hemograma e na bioquímica sanguínea de caprinos submetidos à biópsia hepática com agulha tru-cut guiada por videolaparoscopia foram de baixa magnitude e, nos dois grupos, observou-se leucocitose, neutrofilia e aumento do teor plasmático de fibrinogênio às 24 horas pós-cirúrgica, indicando a ocorrência de processo inflamatório intra-abdominal discreto, não mais observado na 48ª hora pós-operatória.PALAVRAS-CHAVE: Hematologia. Biópsia hepática. Bioquímica sanguínea. Caprino. Videol

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A biópsia hepática com agulha tru-cut guiada por videolaparoscopia foi realizada em 12 caprinos machos, castrados, clinicamente sadios, sem raça definida, divididos em dois grupos, um (G1) com cinco animais de 12 meses e pesos entre 20 e 36,4 kg e outro (G2) com sete de seis meses e pesos entre 14,6 e 19,6 kg. Cada animal foi submetido à anestesia geral intravenosa seguida de laparoscopia pelo flanco direito. Após a visibilização do fígado, foi introduzida a agulha de biópsia hepática tru-cut no décimo primeiro espaço intercostal direito, a aproximadamente 12cm ventral à coluna vertebral, para punção e remoção de fragmento do lobo hepático direito. Foram feitos hemogramas e exames bioquímicos sanguíneos no pré-jejum e às 24, 48 e 72 horas após a intervenção cirúrgica. Em todos os constituintes sanguíneos analisados não foram observadas diferenças (P>0.05) entre os grupos. As alterações observadas no hemograma e na bioquímica sanguínea de caprinos submetidos à biópsia hepática com agulha tru-cut guiada por videolaparoscopia foram de baixa magnitude e, nos dois grupos, observou-se leucocitose, neutrofilia e aumento do teor plasmático de fibrinogênio às 24 horas pós-cirúrgica, indicando a ocorrência de processo inflamatório intra-abdominal discreto, não mais observado na 48ª hora pós-operatória.

The videolaparoscopic guided hepatic biopsy with tru-cut needle was performed in 12 castrated male goats, healthy, without defined breed, divided in two groups: one (G1) with five 12-month-old animals with weights ranging from 20 to 36.4 kg, and the other (G2) with seven 6-month-old animals with weights between 14.6 and 19.6 kg. Each animal received total intravenous anesthesia and was submitted to laparoscopy in the right flank. After visibilization of the liver, a tru-cut hepatic biopsy needle was applied in the right eleventh intercostal space around 12cm ventral of the spinal column for punching and removal of a fragment from the right hepatic lobe. Hemograms and blood biochemical exams were performed during the pre-fasting period and again at 24, 48 and 72 hours after the surgery. The blood alterations observed in goats submitted to videolaparoscopic guided hepatic biopsy with tru-cut needle were of low magnitude and, in all analyzed blood components, no significant differences (P>0.05) were observed among the groups. In both groups, it was observed leucocytosis with incresead neutrophils and plasmatic fibrinogen levels in the first 24 hours after the biopsy procedure, indicating the presence of a discrete intraabdominal inflammatory process; no more noticed in the 48th postoperative hour.

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The present report describes a case of cutaneous protothecosis caused by Prototheca wickerhamii in a non-immunocompromised female from the state of Bahia, Brazil. This is the second case described in Brazil. Dermatological examination revealed diffusely infiltrated erythematous plaques on the flexor aspect of the right arm and forearm. The authors emphasize the pathological aspects that can lead to misdiagnosis this condition. The patient was successfully treated with fluconazole.

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We report the fifth case of subcutaneous zygomycosis caused by Basidiobolus haptosporus in Brazil. The lesion appeared as a tumor in the right mandibular area mimicking Burkitt's lymphoma of the jaw. In this patient evaluation of cellular immunity with the lymphoblastic transformation test yielded normal results.

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