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Current farm systems rely on the use of Plant Protection Products (PPP) to secure high productivity and control threats to the quality of the crops. However, PPP use may have considerable impacts on human health and the environment. A study protocol is presented aiming to determine the occurrence and levels of PPP residues in plants (crops), animals (livestock), humans and other non-target species (ecosystem representatives) for exposure modelling and impact assessment. To achieve this, we designed a cross-sectional study to compare conventional and organic farm systems across Europe. Environmental and biological samples were/are being/will be collected during the 2021 growing season, at 10 case study sites in Europe covering a range of climate zones and crops. An additional study site in Argentina will inform the impact of PPP use on growing soybean which is an important European protein-source in animal feed. We will study the impact of PPP mixtures using an integrated risk assessment methodology. The fate of PPP in environmental media (soil, water and air) and in the homes of farmers will be monitored. This will be complemented by biomonitoring to estimate PPP uptake by humans and farm animals (cow, goat, sheep and chicken), and by collection of samples from non-target species (earthworms, fish, aquatic and terrestrial macroinvertebrates, bats, and farm cats). We will use data on PPP residues in environmental and biological matrices to estimate exposures by modelling. These exposure estimates together with health and toxicity data will be used to predict the impact of PPP use on environment, plant, animal and human health. The outcome of this study will then be integrated with socio-economic information leading to an overall assessment used to identify transition pathways towards more sustainable plant protection and inform decision makers, practitioners and other stakeholders regarding farming practices and land use policy.
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Praguicidas , Animais , Argentina , Produtos Agrícolas/metabolismo , Ecossistema , Europa (Continente) , HumanosRESUMO
BACKGROUND: The aims of this study were to evaluate the efficacy of alveolar corticotomy (AC) and piezocision (PZ) in accelerating maxillary canine retraction, and their effects on multiple bone remodeling expression in gingival crevicular fluid (GCF). A split-mouth, randomized controlled clinical trial was performed at the Department of Orthodontics of Pontifical Catholic University of Minas Gerais, Brazil. Eligibility criteria included orthodontic need for first maxillary premolars extractions, followed by canine retraction. Fifty-one adult patients were recruited and randomly assigned to 3 groups (allocation ratio 1:1:1). Random allocation of surgical or control interventions to each side of the maxillary arch was also conducted: G1 - AC × Control, G2 - PZ × Control, and G3 - AC × PZ. Both the definition of the group and the decision of the experimental or control sides were randomized by the software. Intraoral digital scans were performed before, 7 and 14 days after the beginning of canine retraction, and subsequently, at every 14 days until a maximum period of 6 months. GCF samples were collected before, and 1, 2, 4, 8, and 12 weeks. The primary outcome consisted in the cumulative distal movement of the canines and was measured by digital model superimposition. The secondary outcome consisted in GCF bone remodeling samples that were quantified in a multiplex immunoassay. The measurements examinator was properly blinded. RESULTS: Forty-seven patients, 19 males and 28 females, were analyzed (mean age 20.72, SD = 6.66, range 15 to 38). Statistically significant differences in canine distal movement between AC and control in G1 were not observed (p > 0.05). In G2, PZ showed lower cumulative incisal and cervical measurements than control from the 2nd to the 24th week (p < 0.05). In G3, PZ showed a lower cumulative incisal and cervical measurements than AC from the16th to the 24th week (p < 0.05). In all groups, differences on biomarkers expression occurred at specific timepoints (p < 0.05), but a distinct pattern was not observed. CONCLUSIONS: AC and PZ were not effective to accelerate maxillary canine retraction and did not induce a distinct pattern of biomarker expression. TRIAL REGISTRATION: NCT03089996 . Registered 24 March 2017 - Registered.
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Líquido do Sulco Gengival , Boca , Adulto , Remodelação Óssea , Brasil , Hematopoiese Clonal , Feminino , Humanos , Masculino , Adulto JovemRESUMO
OBJECTIVES: To investigate the relationship between the use of social networking sites (SNSs) on patient perceptions, acceptance, and expectations of treatment using temporary anchorage devices (TADs) and to compare differences between patients from the United Kingdom and Brazil. MATERIALS AND METHODS: Cross-sectional questionnaires were administered to 39 participants at orthodontic practices in the United Kingdom and Brazil about patients' use of SNSs, exposure to TADs on SNSs, and thoughts on extractions, jaw surgery, or TADs as treatment options. RESULTS: UK patients prefer for clinicians to have SNS profiles (P = .022). Most UK and Brazilian patients want to see their clinician's work online (76.7%) and use SNSs to get information about treatment options (76.6%). There was a statistically significant difference in Brazilian patients' acceptance of TADs as a treatment option compared with UK patients, particularly if it meant avoiding extractions (P = .002), avoiding jaw surgery (P = .004), or reducing treatment time (P = .010). Knowledge of TADs was greater in Brazilian patients (P < .001). CONCLUSIONS: Patients use SNSs to obtain information about treatments and prefer clinicians to have social media accounts. Patients exposed to TADs on SNSs are more likely to accept them as an orthodontic treatment option. UK patients have less knowledge of TADs and are therefore less sure to consider TADs as an option. Brazilian patients are more confident in considering the use of TADs. Clinicians should consider increasing their social media presence to accommodate patients' expectations and acceptance of TADs.
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Procedimentos de Ancoragem Ortodôntica , Mídias Sociais , Brasil , Estudos Transversais , Humanos , Desenho de Aparelho Ortodôntico , Reino UnidoRESUMO
BACKGROUND: The aim of this systematic review was to evaluate the effects of piezocision in accelerating orthodontic tooth movement (OTM) and its possible adverse effects. MATERIAL AND METHODS: The Databases Medline, Embase, CENTRAL and LILACS were searched until March 2019, for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that used piezocision associated with orthodontic treatment. A manual search was also performed. The search, studies selection, assessment of risk of bias and data collection were carried out by two independent reviewers. RESULTS: Eleven publications were included in this review (4 CCTs and 7 RCTs). No study presented low risk of bias. Different types of tooth movement were evaluated: lower anterior alignment, en-masse retraction, overall orthodontic treatment and canine distalization. A total of 240 participants were analyzed in the included studies. Seven studies found significant acceleration in the piezocision group, while two studies found no differences. Adverse effects regarding patient's satisfaction, pain perception, or worsening of periodontal parameters were not observed. There was no consensus concerning anchorage loss and root resorption. CONCLUSIONS: The literature does not provide high-quality evidence to confirm that Piezocision results in significant OTM acceleration. Therefore, high-quality RCTs should be conducted to allow reliable conclusions about the effects of piezocision in orthodontics. Key words:Piezosurgery, tooth movement techniques, orthodontics.
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This article reports the camouflage retreatment of an adult patient presenting an asymmetric Class III malocclusion and posterior open bite. Sliding jigs (SJs) associated with intermaxillary elastics were used. The long-term stability of the excellent results suggests that the use of SJs to correct asymmetric posterior occlusions may be effective.
Assuntos
Má Oclusão Classe III de Angle/terapia , Mordida Aberta/terapia , Ortodontia Corretiva/métodos , Humanos , Masculino , Má Oclusão Classe III de Angle/complicações , Mordida Aberta/complicações , Ortodontia Corretiva/instrumentação , Retratamento , Resultado do TratamentoRESUMO
ABSTRACT Objective: The aim of this study was to evaluate the skeletal and dental effects of rapid maxillary expansion (RME) in cleft patients using two types of expanders. Methods: Twenty unilateral cleft lip and palate patients were randomly divided into two groups, according to the type of expander used: (I) modified Hyrax and (II) inverted Mini-Hyrax. A pretreatment cone-beam computed tomographic image (T0) was taken as part of the initial orthodontic records and three months after RME, for bone graft planning (T1). Results: In general, there was no significant difference among groups (p > 0.05). Both showed a significant transverse maxillary expansion (p < 0.05) and no significant forward and/or downward movement of the maxilla (p > 0.05). There was greater dental crown than apical expansion. Maxillary posterior expansion tended to be larger than anterior opening (p < 0.05). Cleft and non-cleft sides were symmetrically expanded and there was no difference in dental tipping between both sides (p > 0.05). Conclusions: The appliances tested are effective in the transverse expansion of the maxilla. However, these appliances should be better indicated to cleft cases also presenting posterior transverse discrepancy, since there was greater expansion in the posterior maxillary region than in the anterior one.
RESUMO Objetivo: o objetivo deste estudo foi avaliar os efeitos esqueléticos e dentários da expansão rápida da maxila (ERM) em pacientes fissurados, utilizando dois tipos de disjuntores. Métodos: vinte pacientes com fissura labiopalatal unilateral foram aleatoriamente divididos em dois grupos, de acordo com o tipo de aparelho utilizado: (1) Hyrax modificado e (2) Mini-Hyrax invertido. Tomografias computadorizadas de feixe cônico foram obtidas antes do tratamento (T0), como parte da documentação ortodôntica inicial, e três meses após a ERM, para o planejamento de enxertia óssea (T1). Resultados: não houve diferença significativa entre os grupos (p>0,05). Ambos apresentaram significativa expansão transversal da maxila (p<0,05), sem significativa movimentação anterior e/ou inferior da maxila (p>0,05). Houve uma maior expansão transversal das coroas em relação à expansão nos ápices. A tendência observada foi uma maior expansão na região posterior da maxila, em comparação à anterior (p<0,05). Avaliando o deslocamento dos lados fissurado e não fissurado, a expansão ocorreu de maneira simétrica e não houve diferença na inclinação dentária entre os lados (p>0,05). Conclusões: os aparelhos testados são eficazes na expansão transversal da maxila em pacientes fissurados. Porém, esses aparelhos seriam melhor indicados para casos de fissura labiopalatal com atresia transversal posterior, uma vez que a expansão foi maior na região posterior da maxila do que na região anterior.
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Humanos , Masculino , Feminino , Criança , Aparelhos Ortodônticos , Técnica de Expansão Palatina/instrumentação , Fissura Palatina/terapia , Palato/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Tomografia Computadorizada de Feixe CônicoRESUMO
OBJECTIVE:: The aim of this study was to evaluate the skeletal and dental effects of rapid maxillary expansion (RME) in cleft patients using two types of expanders. METHODS:: Twenty unilateral cleft lip and palate patients were randomly divided into two groups, according to the type of expander used: (I) modified Hyrax and (II) inverted Mini-Hyrax. A pretreatment cone-beam computed tomographic image (T0) was taken as part of the initial orthodontic records and three months after RME, for bone graft planning (T1). RESULTS:: In general, there was no significant difference among groups (p > 0.05). Both showed a significant transverse maxillary expansion (p < 0.05) and no significant forward and/or downward movement of the maxilla (p > 0.05). There was greater dental crown than apical expansion. Maxillary posterior expansion tended to be larger than anterior opening (p < 0.05). Cleft and non-cleft sides were symmetrically expanded and there was no difference in dental tipping between both sides (p > 0.05). CONCLUSIONS:: The appliances tested are effective in the transverse expansion of the maxilla. However, these appliances should be better indicated to cleft cases also presenting posterior transverse discrepancy, since there was greater expansion in the posterior maxillary region than in the anterior one.
Assuntos
Fissura Palatina/terapia , Aparelhos Ortodônticos , Técnica de Expansão Palatina/instrumentação , Criança , Fissura Palatina/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Palato/diagnóstico por imagemRESUMO
Fluctuating asymmetry is a biological phenomenon defined by directionally departures from perfect symmetry and is hypothesized to indicate the inability of an organism to maintain precise development. Furthermore, its measurement permits evaluation of levels of stress during development of organisms, since asymmetric patterns indicate a stressful environment during ontogeny. This study aimed to assess whether there is significant difference between body sides in two bat species adapted to urban environments and if there is significant difference in levels of asymmetry in various body regions. Bats, Artibeus planirostris (n = 89) and Sturnira lilium (n = 36), were studied. In most body parts, there was no significant difference between sides, suggesting that species adapted to a human environment were not hampered. Moreover, we observed that bat forelimbs had the lowest levels of asymmetry (p 0.05 between the hindlimb and forelimb, and p 0.01 between the head and forelimb, on females of S. lilium). Some studies suggest a ranking of importance of body parts based on the degree of asymmetry. This study highlighted the importance of the forelimbs in bats and suggested that they are not hampered by adaptation to human environments.(AU)
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Animais , Quirópteros/anatomia & histologia , Quirópteros/crescimento & desenvolvimento , Adaptação Biológica , Adaptação a Desastres , Área UrbanaRESUMO
Fluctuating asymmetry is a biological phenomenon defined by directionally departures from perfect symmetry and is hypothesized to indicate the inability of an organism to maintain precise development. Furthermore, its measurement permits evaluation of levels of stress during development of organisms, since asymmetric patterns indicate a stressful environment during ontogeny. This study aimed to assess whether there is significant difference between body sides in two bat species adapted to urban environments and if there is significant difference in levels of asymmetry in various body regions. Bats, Artibeus planirostris (n = 89) and Sturnira lilium (n = 36), were studied. In most body parts, there was no significant difference between sides, suggesting that species adapted to a human environment were not hampered. Moreover, we observed that bat forelimbs had the lowest levels of asymmetry (p 0.05 between the hindlimb and forelimb, and p 0.01 between the head and forelimb, on females of S. lilium). Some studies suggest a ranking of importance of body parts based on the degree of asymmetry. This study highlighted the importance of the forelimbs in bats and suggested that they are not hampered by adaptation to human environments.
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Animais , Adaptação Biológica , Adaptação a Desastres , Quirópteros/anatomia & histologia , Quirópteros/crescimento & desenvolvimento , Área UrbanaRESUMO
INTRODUCTION: The purpose of this study was to evaluate the skeletal and dental changes in the maxillae of patients with clefts treated with 3 expanders: hyrax, fan-type, and inverted mini-hyrax supported on the first premolars. METHODS: Thirty patients with unilateral cleft lip and palate with transverse maxillary deficiency were divided into 3 groups, according to the type of expander that they used. Cone-beam computed tomography images were taken before and 3 months after expansion, and the paired t test was used to evaluate the changes in each group. RESULTS: The subjects in the inverted mini-hyrax group showed significant forward displacement of the maxilla (P <0.05). On the transversal plane, the hyrax group showed greater expansion in the posterior region than in the anterior region (P <0.05). However, the fan-type and the inverted mini-hyrax groups showed significantly greater maxillary expansion anteriorly than posteriorly (P <0.05). There was a greater tendency for buccal inclination of the supporting teeth when the fan-type was used. The cleft and the noncleft sides expanded symmetrically with all appliances, and there was no difference in dental tipping between these sides (P >0.05). CONCLUSIONS: The hyrax expander showed better results for cleft patients requiring anterior and posterior maxillary expansion. The inverted mini-hyrax most effectively restricted posterior expansion, optimizing anterior expansion without causing as much buccal tipping of the supporting teeth as did the fan-type.
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Fenda Labial/complicações , Fissura Palatina/complicações , Tomografia Computadorizada de Feixe Cônico/métodos , Desenho de Aparelho Ortodôntico , Técnica de Expansão Palatina/instrumentação , Dente/diagnóstico por imagem , Pontos de Referência Anatômicos/diagnóstico por imagem , Cefalometria/métodos , Criança , Arco Dental/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Masculino , Má Oclusão/etiologia , Má Oclusão/terapia , Maxila/diagnóstico por imagem , Cavidade Nasal/diagnóstico por imagem , Ápice Dentário/diagnóstico por imagem , Coroa do Dente/diagnóstico por imagemRESUMO
A expansão rápida da maxila é um procedimento rotineiramente utilizado para aumentar a dimensão transversa do arco superior. Diversos disjuntores já foram descritos para esta finalidade. Com o intuito de amenizar ou eliminar efeitos colaterais verticais de disjuntores bandados, foi desenvolvido o disjuntor com cobertura oclusal. Este artigo tem o objetivo de descrever uma técnica laboratorial que aperfeiçoa a confecção do disjuntor com cobertura oclusal, bem como ilustrar sua aplicação clínica na correção de severa deficiência transversa associada à dimensão vertical aumentada.
Rapid maxillary expansion is routinely used in Orthodontics to increase the transverse dimension of the maxillary arch. Different types of expanders have been described in the literature. The bonded expander was introduced as an attempt to minimize or eliminate the vertical side effects often registered with the traditional banded expanders. The purpose of this article is to describe a laboratory technique that facilitates the bonded expander fabrication and to illustrate its clinical application to correct a severe transverse maxillary deficiency associated with an increased vertical dimension.
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Humanos , Feminino , Criança , Má Oclusão , Ortodontia , Técnica de Expansão PalatinaRESUMO
O número de indivíduos adultos que vem procurando por tratamento ortodôntico nas últimas décadas é crescente. O tratamento desses pacientes, muitas vezes, apresenta dificuldades adicionais à má oclusão e, dentre as mais comuns, estão aquelas que envolvem problemas nos tecidos periodontais. Quando tais fatores estão associados à má oclusão severa, como a de etiologia esquelética, a correção ortodôntica torna-se ainda mais complexa. O objetivo do presente artigo é descrever uma abordagem interdisciplinar de uma paciente com mordida aberta esquelética e dentária severas, bem como comprometimento estético também derivado da presença de múltiplas recessões gengivais e abfrações, que resultou em importante ganho em estética facial e dentária, assim como em significativa melhora funcional.
The number of adults seeking for orthodontic treatment has consistently increased in the past decades. Treatment of these patients may be more challenging if the periodontal tissues exhibit limitations. When these factors are associated to severe skeletal malocclusions, the orthodontic treatment becomes even more complex. The purpose of the present study was to report an interdisciplinary approach implemented in the treatment of a patient with a severe skeletal open bite and a compromised aesthetic condition that was also derived from the presence of multiple periodontal recessions and abfractions, which resulted in a significant intra and extra-oral aesthetics improvement as well as in functional enhancement.
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Humanos , Feminino , Adulto , Mordida Aberta , Ortodontia , Cirurgia OrtognáticaRESUMO
UNLABELLED: The purpose of this paper is to present a case report of an adult Class III patient presenting bilateral congenitally missing maxillary lateral incisors that compromised occlusal function as well as smile and facial esthetics. After the interdisciplinary diagnosis, spaces for prosthetic substitution were opened with the help of miniscrews. The orthodontic therapy achieved a better dental relationship, and the final interdisciplinary treatment results represented a significant improvement in function and both dental and facial esthetics. CLINICAL SIGNIFICANCE: The interdisciplinary treatment of orthodontics and restorative dentistry is very important because the two complement each other in search of the best for the patient. This case demonstrates very well that where orthodontics provided the best tooth position prior to implant placement and restorations.
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Anodontia/terapia , Incisivo/anormalidades , Má Oclusão Classe III de Angle/terapia , Equipe de Assistência ao Paciente , Adulto , Parafusos Ósseos , Cefalometria/métodos , Coroas , Implantes Dentários para Um Único Dente , Prótese Dentária Fixada por Implante , Estética Dentária , Seguimentos , Humanos , Carga Imediata em Implante Dentário , Masculino , Maxila , Miniaturização , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Planejamento de Assistência ao Paciente , Sorriso , Técnicas de Movimentação Dentária/instrumentação , Resultado do TratamentoRESUMO
The interceptive orthodontic treatment of patients with complex dentofacial abnormalities is frequently inefficient and produces less than ideal outcomes. Therefore, postponing therapy to a single-phase surgical-orthodontic approach might be considered a reasonable option. However, other relevant aspects of the patient's quality of life, such as possible psychosocial problems and functional impairments, should also be considered before deciding whether to intercept a severe dentofacial malocclusion while the patient is still growing, or wait and treat later. This case report describes the nonsurgical treatment of a young patient with a severe Class III open-bite malocclusion associated with a cervical cystic lymphangioma. Despite the poor interceptive therapy prognosis, a 2-phase approach was effective. A reflection about giving up efficiency in favor of effectiveness, functional rehabilitation, and the patient's quality of life is included.
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Má Oclusão Classe III de Angle/terapia , Ortodontia Interceptora/métodos , Planejamento de Assistência ao Paciente , Qualidade de Vida , Cefalometria/métodos , Pré-Escolar , Eficiência , Estética , Aparelhos de Tração Extrabucal , Músculos Faciais/fisiopatologia , Feminino , Seguimentos , Humanos , Lábio/fisiopatologia , Linfangioma Cístico/complicações , Macroglossia/complicações , Má Oclusão Classe III de Angle/psicologia , Má Oclusão Classe III de Angle/reabilitação , Mastigação/fisiologia , Desenvolvimento Maxilofacial/fisiologia , Mordida Aberta/psicologia , Mordida Aberta/reabilitação , Mordida Aberta/terapia , Desenho de Aparelho Ortodôntico , Técnica de Expansão Palatina/instrumentação , Prognóstico , Hábitos Linguais/terapia , Neoplasias da Língua/complicações , Resultado do TratamentoRESUMO
PURPOSE: The current study sought to evaluate the influence of the length of the mini-implant on its mechanical properties. MATERIALS AND METHODS: A total of 405 mini-implants from the same manufacturer were divided into 3 groups (n = 135) according to whether they were 6, 8, or 10 mm in length. An insertion torque test was performed using minipig osseous tissue of different cortical thicknesses (1 mm to 6 mm). To assess the maximum fracture torque during insertion, the mini-implants were inserted into swine femoral cortical bone. A digital torque gauge was positioned perpendicularly to the bone surface to measure this parameter. To evaluate the deformation and subsequent fracture due to a bending force, the mini-implants were subjected to loading orthogonal to their length at a speed of 0.5 mm per minute. RESULTS: The insertion torque increased with increasing screw length and increasing cortical bone thickness. There were no statistically significant differences between the different implant lengths with respect to the insertion torque force required for fracture (P > .05) or the forces required for deformation (P > .05) and fracture (P > .05) when submitted to flexion. CONCLUSIONS: Increasing the length of the screw does not increase its mechanical strength, but can efficiently reinforce the initial stability of mini-implants.
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Implantes Dentários , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico , Ligas , Análise de Variância , Animais , Parafusos Ósseos , Ligas Dentárias , Análise do Estresse Dentário , Falha de Equipamento , Fêmur/cirurgia , Suínos , Porco Miniatura , Titânio , TorqueRESUMO
A mordida cruzada posterior completa por vestibular, conhecida como mordida de Brodie, é uma má oclusão rara e com indicação clara de abordagem interceptora. Entretanto, os desafios encontrados durante a terapia deste tipo de má oclusão são inúmeros, especialmente a elevada taxa de recidiva e as limitações mecânicas inerentes à expansão mandibular e contração maxilar. Este artigo apresenta um caso clínico que ilustra a abordagem interceptora e corretiva de uma mordida de Brodie, associada a uma má oclusão de Classe II, mordida profunda de uma criança de 7 anos de idade, com o objetivo de contribuir na terapia de casos semelhantes. Uma reflexão acerca da eficácia e eficiência da interceptação das mordidas cruzadas posteriores vestibulares é também apresentada
Posterior buccal cross bite, also called scissors bite or Brodie bite, is a rare malocclusion with clear indication of interceptive approach. However, several challenges are found during its treatment, specially the high relapse rate and the mechanical limitations of expanding mandibular arch and contracting maxillary arch. Therefore, this paper reports the orthodontic interceptive and corrective treatment of 7 year-old girl, with a Class II, deep bite, Brodie bite. A reflection about effectiveness and efficiency of such therapy was also presented.
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Humanos , Feminino , Criança , Crescimento , Má Oclusão , OrtodontiaRESUMO
UNLABELLED: To evaluate the results from surgical treatment of hip dislocation through the anteromedial approach, in patients with arthrogryposis multiplex congenita (AMC). METHODS: The medical files and radiographs of seven children with AMC who presented hip dislocation (total of 10 dislocated hips) were retrospectively reviewed. Pre and postoperative joint mobility was evaluated by summing the joint range of motion in flexion and abduction. The acetabular angle and height of the femoral neck before the operation, and the continuity of the Shenton arc, Sharp angle and center-edge (CE) angle after the operation, were evaluated radiographically. When avascular necrosis was identified, it was classified in accordance with Ogden and Bucholz. RESULTS: The mean age of the children at the time of the surgery was 5.5 months (range: 3 to 11 months). The mean duration of follow-up for the patients was 9.5 years (range: 2 to 13 years). The mean amplitude of the sum of the joint range of motion in flexion and abduction in the preoperative examination was 108° (range: 70° to 155°) and postoperatively, it was 125° (range: 75° to 175°). In the last evaluation, eight hips were found to be centered and two were subluxated. Two hips had been subjected to Salter iliac osteotomy. Two hips (20%) had presented significant signs of Ogden type IV avascular necrosis. Eight hips had good results while two were fair. CONCLUSION: We consider that the anteromedial approach is a good option for treating hip dislocation in very young patients with arthrogryposis multiplex congenita.
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OBJETIVO: Avaliar os resultados do tratamento cirúrgico da luxação do quadril através do acesso anteromedial em pacientes com artrogripose múltipla congênita (AMC). MÉTODOS: Retrospectivamente foram revisados os prontuários e radiografias de sete crianças com AMC que apresentavam luxação do quadril, totalizando 10 quadris luxados. Foi avaliada a mobilidade articular pré e pós-operatória através da somatória do arco de mobilidade articular em flexão e abdução. Radiograficamente foram avaliados, no pré-operatório, o ângulo acetabular e a altura do colo do fêmur e, no pós-operatório, a continuidade do arco de Shenton, ângulo de Sharp e ângulo CE (centro borda). Quando foi identificada a necrose avascular, esta foi classificada segundo Ogden e Bucholz. RESULTADOS: A média de idade das crianças na ocasião da cirurgia era de 5,5 meses (três a 11 meses). O seguimento médio dos pacientes foi de 9,5 anos (dois a 13 anos). A média de amplitude de movimento da somatória do arco de mobilidade articular em flexão e abdução no exame pré-operatório foi de 108º (70 a 155º) e no pós-operatório foi de 125º (75º a 175º). Na última avaliação, oito quadris estavam centrados e dois subluxados. Dois quadris foram submetidos a uma osteotomia de ilíaco do tipo Salter. Dois quadris apresentaram sinais significativos de necrose avascular Ogden tipo IV. Oito quadris foram considerados como bons resultados e dois como regulares. CONCLUSÃO: Consideramos a via anteromedial uma boa opção para tratamento da luxação de quadril em pacientes de baixa idade com artrogripose múltipla congênita.
OBJECTIVE: To evaluate the results of the surgical treatment of hip dislocation through the anteromedial approach in patients with arthrogryposis multiplex congenita (AMC). METHODS: A retrospective review of the charts and radiographs of 7 children with AMC that presented dislocation of the hiprevised, totalling 10 dislocated hips. : Pre and postoperative articular mobility, was evaluated by summing the joint range-of-motion arc of flexion and abduction. , Pre-operatively, the acetabular angle and height of the neck of femur were evaluated radiographically and postoperatively, the continuity of the arc of Shenton, acetabular angle, Sharp angle and CE angle. The presence of avascular necrosis was classified according to Ogden and Bucholz. RESULTS: The average of age of the children at the time of the surgery was 5.5 months (3 to 11 months). The average follow-up time for the patients was 9.5 years (2 to 13 years). The average of the amplitude of movement of the sum of the joint mobility arc in flexion and abduction in the pre-operative examination was 108º (70º to 155 º) and postoperatively it was 125º (75º 175º). In the last evaluation, eight hips were centered and two were subluxated. Two hips had been submitted to a Salter iliac osteotomy. Two hips (20 percent) had presented significant signs of Ogden type IV avascular necrosis . Eight hips had good results while two were fair. CONCLUSION: We consider the antero-medial approach a good option for the treatment of the dislocation of the hip in patients of low congenital age with arthrogryposis multiplex congenita.
Assuntos
Humanos , Masculino , Feminino , Lactente , Artrogripose , Luxação do Quadril , Procedimentos Cirúrgicos OperatóriosRESUMO
BACKGROUND: Gluconacetobacter diazotrophicus Pal5 is an endophytic diazotrophic bacterium that lives in association with sugarcane plants. It has important biotechnological features such as nitrogen fixation, plant growth promotion, sugar metabolism pathways, secretion of organic acids, synthesis of auxin and the occurrence of bacteriocins. RESULTS: Gluconacetobacter diazotrophicus Pal5 is the third diazotrophic endophytic bacterium to be completely sequenced. Its genome is composed of a 3.9 Mb chromosome and 2 plasmids of 16.6 and 38.8 kb, respectively. We annotated 3,938 coding sequences which reveal several characteristics related to the endophytic lifestyle such as nitrogen fixation, plant growth promotion, sugar metabolism, transport systems, synthesis of auxin and the occurrence of bacteriocins. Genomic analysis identified a core component of 894 genes shared with phylogenetically related bacteria. Gene clusters for gum-like polysaccharide biosynthesis, tad pilus, quorum sensing, for modulation of plant growth by indole acetic acid and mechanisms involved in tolerance to acidic conditions were identified and may be related to the sugarcane endophytic and plant-growth promoting traits of G. diazotrophicus. An accessory component of at least 851 genes distributed in genome islands was identified, and was most likely acquired by horizontal gene transfer. This portion of the genome has likely contributed to adaptation to the plant habitat. CONCLUSION: The genome data offer an important resource of information that can be used to manipulate plant/bacterium interactions with the aim of improving sugarcane crop production and other biotechnological applications.
Assuntos
Genoma Bacteriano , Gluconacetobacter/genética , Saccharum/microbiologia , Hibridização Genômica Comparativa , DNA Bacteriano/genética , Ilhas Genômicas , Biblioteca Genômica , Gluconacetobacter/metabolismo , Dados de Sequência Molecular , Fixação de Nitrogênio/genética , Análise de Sequência de DNA , SimbioseRESUMO
The one-stage surgical treatment for developmental dysplasia of the hip-consisting of open reduction, femoral shortening, and pelvic osteotomy-is a demanding procedure, one that is more challenging, technically, than a staged procedure. It can, however, be done safely and effectively, providing good conditions for proper development of the hip joint in the older child who has untreated developmental dysplasia of the hip.