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OBJECTIVE: This study aimed to evaluate the prevalence of ovarian hyperstimulation syndrome (OHSS) and associated risk factors in patients undergoing fertilization cycles at risk of OHSS (≥15 antral follicles or ≥15 oocytes aspirated) and submitted to cryopreservation of all embryos in the Human Reproduction Service of the Pérola Byington Hospital (Referral Center for Women's Health) in São Paulo, SP, Brazil. METHODS: This cross-sectional, institutional, descriptive study of secondary data from patients' charts enrolled in the Assisted Reproduction Service of the Pérola Byington Hospital at risk of OHSS after controlled ovarian stimulation and submitted to cryopreservation of all embryos was conducted between January 2015 and September 2017. RESULTS: OHSS occurred in 47.5% of cycles, all with mild severity, and there were no moderate or severe cases of OHSS. CONCLUSION: The cryopreservation of all embryos is associated with a reduction in moderate and severe forms of OHSS. Risk factors for OHSS should be evaluated prior to initiation of treatment, with less intense stimulation protocols accordingly.

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SUMMARY OBJECTIVE: This study aimed to evaluate the prevalence of ovarian hyperstimulation syndrome (OHSS) and associated risk factors in patients undergoing fertilization cycles at risk of OHSS (≥15 antral follicles or ≥15 oocytes aspirated) and submitted to cryopreservation of all embryos in the Human Reproduction Service of the Pérola Byington Hospital (Referral Center for Women's Health) in São Paulo, SP, Brazil. METHODS: This cross-sectional, institutional, descriptive study of secondary data from patients' charts enrolled in the Assisted Reproduction Service of the Pérola Byington Hospital at risk of OHSS after controlled ovarian stimulation and submitted to cryopreservation of all embryos was conducted between January 2015 and September 2017. RESULTS: OHSS occurred in 47.5% of cycles, all with mild severity, and there were no moderate or severe cases of OHSS. CONCLUSION: The cryopreservation of all embryos is associated with a reduction in moderate and severe forms of OHSS. Risk factors for OHSS should be evaluated prior to initiation of treatment, with less intense stimulation protocols accordingly.

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A articulação temporomandibular está vunerável a várias condições de anormalidades já bastante conhecidas, dentre elas, o deslocamento do disco articular sem redução, considerado pela literatura o mais comum das patologias desta região. A deterioração do quadro pode ser um indicativo da necessidade cirúrgica. Em específico, no deslocamento de disco sem redução, o reposicionamento definitivo pode ser adquirido através de discopexia e artrocentese. O presente trabalho tem como objetivo relatar um caso clínico de deslocamento de disco articular bilateral sem redução, apresentando a importância da fisioterapia associada à abordagem cirúrgia na recuperação da função mandibular, bem como, reforçar a importância de uma abordagem conjunta entre análise clínica e imaginológica para resolução de casos. Paciente feminino cursando com diversos sintomas em face e pescoço de forma progressiva ao longo de dois anos foi submetida a cirurgia na articulação temporo-mandibular, onde foi feita a discopexia através de ancoragem dos discos articulares com parafusos. A avaliação física, assim como, a imaginológica, ajudaram na confirmação do diagnóstico. A abordagem cirurgica adotada no tratamento deste caso foi descrita na literatura desde o final do século XIX. Conclui-se que, o método utilizado no tratamento do deslocamento de disco sem redução deve ser baseado nos sinais e sintomas do paciente, cuja abordagem deve ser readequada de acordo com as mudanças do quadro apresentado. Nesta análise, a abordagem cirúrgica associada à fisioterapia específica para as estruturas musculoesquelética da face trouxeram resultados positivos(AU)

The temporomandibular joint is responsible for several well-known conditions of abnormalities, among them, the joint disc displacement without reduction, considered by the literature the most common pathology of this region. Deterioration of the condition may be indicative of surgical need. Specifically, in displacement disc without reduction, definitive repositioning can be achieved through discopexy and arthrocentesis. The aim of the present study is to report a case of unilateral articular disc displacement without reduction, as well the importance of physiotherapy associated with the surgical approach in the recovery of mandibular function, as well as reinforcing the importance of a joint approach between clinical and imaging analysis for case resolution. Female patient with several symptoms in the face and neck progressively over two years, underwent surgery in the temporomandibular joint, where discopexy was performed by anchoring the articular discs with screws. The physical assessment, as well as the imaging, helped to confirm the diagnosis. The surgical approach adopted in the treatment of this case has been described in the literature since the end of the 19th century. In conclusion, the method used to treat articular disc displacement without reduction should be based on the patient's signs and symptoms, whose approach should be readjusted according to the changes in the presented picture. In this analysis, the surgical approach associated with specific physiotherapy for the musculoskeletal structures of the face brought positive results(AU)

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SUMMARY OBJECTIVE: The aim of this study was to compare the use of micronized vaginal progesterone and oral dydrogesterone in the endometrial preparation for frozen-thawed embryo transfer. METHODS: This was a randomized, controlled, open, two-armed clinical trial, with women undergoing frozen-thawed embryo transfer along with hormone replacement therapy for endometrial preparation, between September 2019 and February 2021. A total of 73 patients were randomly selected and orally administered 40 mg/day dydrogesterone (dydrogesterone group, n=36) or 800 mg/day micronized vaginal progesterone (micronized vaginal progesterone group, n=37), after endometrial preparation with transdermal estradiol. The main outcome was a viable ongoing pregnancy with 12 weeks of gestation as evaluated by ultrasound. RESULTS: The reproductive outcomes in frozen-thawed embryo transfer cycles were similar, with pregnancy rates in the dydrogesterone and micronized vaginal progesterone treatment groups being, respectively, 33.3 and 32.4% at 12 weeks pregnancy (confidence interval= -22.4-20.6, p=0.196). CONCLUSIONS: The use of oral dydrogesterone may be a more patient-friendly approach to endometrial preparation in frozen-thawed embryo transfer cycles, avoiding undesirable side effects and discomfort resulting from vaginal administration, while also providing similar reproductive results.

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OBJECTIVE: The aim of this study was to compare the use of micronized vaginal progesterone and oral dydrogesterone in the endometrial preparation for frozen-thawed embryo transfer. METHODS: This was a randomized, controlled, open, two-armed clinical trial, with women undergoing frozen-thawed embryo transfer along with hormone replacement therapy for endometrial preparation, between September 2019 and February 2021. A total of 73 patients were randomly selected and orally administered 40 mg/day dydrogesterone (dydrogesterone group, n=36) or 800 mg/day micronized vaginal progesterone (micronized vaginal progesterone group, n=37), after endometrial preparation with transdermal estradiol. The main outcome was a viable ongoing pregnancy with 12 weeks of gestation as evaluated by ultrasound. RESULTS: The reproductive outcomes in frozen-thawed embryo transfer cycles were similar, with pregnancy rates in the dydrogesterone and micronized vaginal progesterone treatment groups being, respectively, 33.3 and 32.4% at 12 weeks pregnancy (confidence interval= -22.4-20.6, p=0.196). CONCLUSIONS: The use of oral dydrogesterone may be a more patient-friendly approach to endometrial preparation in frozen-thawed embryo transfer cycles, avoiding undesirable side effects and discomfort resulting from vaginal administration, while also providing similar reproductive results.

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Pacientes com históricos de defeitos ósseos provocados por infecções, malformação congênita, neoplasias, deformação por iatrogenia, radioterapia e trauma buscam contornos faciais mais harmônicos através da reabilitação cirúrgica. Para facilitar a reconstrução maxilofacial dois grupos de materiais podem ser utilizados, os enxertos ósseos e os materiais aloplásticos. O objetivo é relatar um caso incomum de infecção e exposição de material utilizado para enxertia a base de polimetilmetacrilato, bem como a sua posterior reabordagem cirúrgica. Embora o Polimetilmetacrilato aparente ser seguro, ele exibe complicações diversas em função da imunologia do hospedeiro, que poderá reagir de diferentes formas. Desse modo, faz-se necessário ressaltar a importância da prevenção e proservação de cada caso de forma individualizada(AU)

Patients with a history of bone defects caused by infections, congenital malformation, neoplasms, iatrogenic deformation, radiotherapy and trauma seek more harmonious facial contours through surgical rehabilitation. To facilitate maxillofacial reconstruction, two groups of materials can be used, bone grafts and alloplastic materials. The objective is to report an unusual case of infection and exposure of material used for grafting with polymethylmethacrylate, as well as its subsequent surgical approach. Although Polymethylmethacrylate appears to be safe, it exhibits different complications depending on the host's immunology, which may react in different ways. Thus, it is necessary to emphasize the importance of preventing and preserving each case individually(AU)

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Introdução: A osteotomia vertical anterior de mandíbula é um procedimento de extrema versatilidade, podendo ser empregado em casos selecionados nos quais a mecânica ortodôntica tem suas limitações. Em contrapartida, existem estudos que demonstram que as complicações deste procedimento incluem a pseudoartrose, neuropraxia, a possibilidade de problemas periodontais e o fato de que esta técnica nem sempre é útil. Relato de Caso: O objetivo deste trabalho é relatar o caso de uma paciente submetida a cirurgia de osteotomia vertical anterior de mandíbula no ano de 2002, evoluindo sem integração óssea e com mobilidade mandibular durante anos, apresentando como queixa principal, a retração gengival. Sendo proposta no ano de 2018, uma reabordagem cirúrgica, com o uso de enxerto da crista ilíaca e placa de reconstrução. Considerações Finais: Conclui-se que o uso de enxerto ósseo autogéno, associado à redução e fixação com placas de reconstrução, são considerados positivos para o tratamento de pseudoartroses, podendo ser considerados como opção durante o tratamento cirúrgico... (AU)

Introduction: The anterior vertical osteotomy of the mandible is an extremely versatile procedure and can be used in selected cases in which orthodontic mechanics have their limitations. On the other hand, there are studies that demonstrate that the complications of this procedure include pseudoarthrosis, neuropraxia, the possibility of periodontal problems and the fact that this technique is not always useful. Case Report: The objective of this study is to report the case of a patient who underwent surgery for anterior vertical osteotomy of the mandible in 2002, evolving without bone integration and with mandibular mobility for years, presenting as the main complaint, gingival retraction. Being proposed in 2018, a surgical re-approach, with the use of iliac crest graft and reconstruction plate. Final Considerations: It is concluded that the use of autogenous bone graft, associated with reduction and fixation with reconstruction plates, are considered positive for the treatment of pseudoarthrosis, and can be considered as an option during surgical treatment... (AU)

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Introduction Tinnitus is a disorder that affects 10 to 15% of de world's population. Sound therapy performed through hearing aids (HAs) with integrated sound generator (SG) is one of the forms of tinnitus treatment. Objective To analyze the effectiveness of four masking noises in relieving tinnitus in individuals with mild and moderate bilateral sensorineural hearing loss and their influence in speech perception. Methods The participants were 35 individuals with tinnitus and mild and moderate bilateral sensorineural hearing loss, divided into four groups. All groups underwent HA and SG adaptation, being regulated in the combined mode (HA and SG). In group 1 (G1), the white noise stimulus was applied, in group 2 (G2), pink noise was applied, in group 3 (G3), speech noise, and in group 4 (G4), the high tone was applied. All patients were subjected to the following procedures: audiological diagnosis, acuphenometry, tinnitus handicap inventory (THI), visual analogue scale (VAS), and hearing in noise test (HINT). The procedures were performed prior to and after hearing intervention, and after 3 months of use of HA and SG. Results All groups presented a statistically significant difference for the THI, VAS, and HINT pre and postintervention. In the case of the HINT, only pink noise presented a significant difference. However, in the comparation among groups there was no significant difference. Conclusion The present study made it possible to conclude that the four noises were equally effective in relieving tinnitus, with no statistically significant differences between the analyzed groups.

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Durante a formação dentária, distúrbios de desenvolvimento podem acontecer, causando anomalias de número, forma, tamanho, estrutura e posição, além de apresentarem anormalidade no padrão sequencial de irrupção. Uma boa anamnese, associada a palpação e exames de imagens são indispensáveis para um diagnóstico precoce e favorável destas alterações. Os exames de imagem determinarão a relação espacial destes dentes com as estruturas nobres adjacentes. O objetivo deste trabalho é relatar a presença de supranumerário unilateral e impactação bilateral de caninos permanentes, ambas anomalias com proximidade da cavidade nasal e seio maxilar, ressaltando a importância do diagnóstico preciso através de exames clínico e de imagens, que direcionam o planejamento terapêutico específico para cada caso, bem como a associação multidisciplinar para obtenção de um resultado satisfatório do quadro e melhora da qualidade de vida do paciente(AU)

During dental formation, developmental disorders can occur, causing anomalies of number, shape, size and position, in addition to presenting abnormality in the sequential pattern of irruption. Anamnesis associated with palpation are indispensable for an early diagnosis of these alterations. Imaging exams will determine the spatial relationship between these teeth and the adjacent noble structures. The aim of this study was to report the presence of unilateral supernumerary and bilaterally impacted canines, both anomalies with proximity of nasal cavity and maxillary sinus, emphasizing the importance of accurate diagnosis through clinical and imaging exams, that direct the specific therapeutic planning for each case, as well as the multidisciplinary association to obtain satisfactory results and improve the life quality of patients(AU)

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Abstract Introduction Tinnitus is a disorder that affects 10 to 15% of de world's population. Sound therapy performed through hearing aids (HAs) with integrated sound generator (SG) is one of the forms of tinnitus treatment. Objective To analyze the effectiveness of four masking noises in relieving tinnitus in individuals with mild and moderate bilateral sensorineural hearing loss and their influence in speech perception. Methods The participants were 35 individuals with tinnitus and mild and moderate bilateral sensorineural hearing loss, divided into four groups. All groups underwent HA and SG adaptation, being regulated in the combined mode (HA and SG). In group 1 (G1), the white noise stimulus was applied, in group 2 (G2), pink noise was applied, in group 3 (G3), speech noise, and in group 4 (G4), the high tone was applied. All patients were subjected to the following procedures: audiological diagnosis, acuphenometry, tinnitus handicap inventory (THI), visual analogue scale (VAS), and hearing in noise test (HINT). The procedures were performed prior to and after hearing intervention, and after 3 months of use of HA and SG. Results All groups presented a statistically significant difference for the THI, VAS, and HINT pre and postintervention. In the case of the HINT, only pink noise presented a significant difference. However, in the comparation among groups there was no significant difference. Conclusion The present study made it possible to conclude that the four noises were equally effective in relieving tinnitus, with no statistically significant differences between the analyzed groups.

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Mesenchymal stem cells (MSCs), obtained from several anatomical sites, have already been described, characterized and used in therapeutic models for tissue repair. The umbilical cord mesenchymal stem cells, represented by cells from arteries and veins walls, as well as Wharton's jelly are easy to be obtained, highly available, require no invasive procedure, do not present risk to donors and do not present ethical limitation. The aim of this research was to analyze the plasticity of Wharton's jelly mesenchymal stem cells (WJ-MSCs) of goat, evaluating their behavior in vitro and characterizing them immunophenotypically. Thus, tests were performed on colony forming units, viability and cell growth curve, flow cytometry analysis and plasticity potential. Goat umbilical cord matrix cells exhibited fibroblastoid morphology with colony formation and self-renewal ability, always maintaining their undifferentiated state up to the eighth passage (P8). The growth curve kinetics exhibited the LAG, LOG, and DECAY phases, without displaying a PLATEAU phase. The plasticity assay demonstrated positive differentiation for osteogenic, adipogenic and chondrogenic lines, characterized by the synthesis of intracytoplasmic granules or extracellular matrix with the presence of calcium, lipids and proteoglycans. Flow cytometry demonstrated the expression of CD90 and CD105; absence of CD14 expression. It is concluded that the cell population isolated from the Wharton's jelly of goat constitutes a representative sample of mesenchymal stem cells, with great possibilities in the field of regenerative and reproductive medicine.

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A Disostose Cleidocraniana (DC), também conhecida como Displasia Cleidocraniana (DCC), é uma doença autossômica de caráter dominante, relatada pela primeira vez no século XVIII, sendo descrita em 1897 por Pierre Marie e Paul Sainton, relacionando-a a fatores genéticos. Suas manifestações clínicas apresentam-se através do desenvolvimento tardio de estruturas e defeitos ósseos, anormalidades estomatognáticas e craniofaciais. O diagnóstico baseia-se nas características clínicas e imaginológicas e o tratamento odontológico geralmente é cirúrgico, envolvendo a exodontia de unidades supranumerárias e decíduas, em associação com a abordagem ortodôntica. Este trabalho possui como objetivo, relatar o caso clínico sobre as principais manifestações bucais evidenciadas em uma paciente jovem diagnosticado com Displasia Cleidocraniana, bem como demonstrar a importância do diagnóstico preciso para auxílio no sucesso do tratamento e qualidade de vida do paciente(AU)

Cleidocranial Dysostosis (CD), also known as Cleidocranial Dysplasia (DCC), is an autosomal dominant disease, first reported in the 18th century, being described in 1897 by Pierre Marie and Paul Sainton, relating it to genetic factors. Its clinical manifestations appear through the late development of bone structures and defects, stomatognathic and craniofacial abnormalities. The diagnosis is based on clinical and imaging characteristics and dental treatment is usually surgical, involving the extraction of supernumerary and deciduous units, in association with the orthodontic approach. This work aims to report the clinical case about the main oral manifestations evidenced in a young patient diagnosed with Cleidocranial Dysplasia, as well as to demonstrate the importance of accurate diagnosis to aid in the success of the treatment and quality of life of the patient(AU)

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Infecções maxilo-faciais graves são caracterizadas pela disseminação do processo infeccioso aos tecidos adjacentes e espaços fasciais da região de cabeça, pescoço e tórax. Sua principal origem é odontogênica, geralmente resultante de infecção periapical e doença periodontal. Podem variar de infecções bem localizadas de baixa severidade, até infecções graves, com potencial de disseminação para espaços fasciais da cabeça e pescoço, podendo causar o comprometimento de estruturas vitais, septicemia e morte. Essas infecções podem atingir diversos espaços, dentre eles o espaço mastigatório, composto pelos espaços fasciais: submassetérico, pterigomandibular, temporal profundo e temporal superficial. Esses quatro compartimentos do espaço mastigatório, comportamse clinicamente como espaços separados, pois, na maioria dos casos, somente um compartimento torna-se infectado, entretanto, infecções severas ou duradouras podem envolver todos os quatro compartimentos. O objetivo do presente estudo é apresentar o manejo clínico e cirúrgico de infecção odontogênica disseminada para o espaço temporal superficial. Paciente de 51 anos de idade, do sexo feminino, com histórico de infecção odontogênica disseminada para o espaço temporal superficial, tendo como fator etiológico resto radicular da unidade 13. Procedeu-se drenagem ambulatorial do conteúdo associada à antibioticoterapia. Após o período de 07 dias, houve remissão da condição. Apesar de incomum, infecções odontogênicas originadas de dentes anteriores, podem se disseminar para os espaços mastigatórios. Independente de sua origem deve ser tratada de forma imediata, drenando o espaço comprometido, identificando a causa e eliminando-a, e associando o uso de antibióticos como coadjuvante(AU)

Severe maxillofacial infections are characterized by the spread of the infectious process to adjacent tissues and fascial spaces of the head, neck and chest region. Its main origin is odontogenic, usually resulting from periapical infection and periodontal disease. It can range from well-localized infections of low severity to severe infections with potential for dissemination to spread through the facial planes of the head and neck, which can lead to compromised airways, resulting in septicemia and death. These infections can reach several spaces, among them the masticatory space, composed of fascial spaces: subassayeric, pterygomandibular, deep temporal and superficial temporal. These four compartments of the masticatory space behave clinically as separate spaces, since in most cases only one compartment becomes infected, however, severe or long-lasting infections may involve all four compartments. The goal of the present study is to present the clinical management of disseminated odontogenic infection for superficial temporal space. A 51-year-old female patient with a history of odontogenic infection, disseminated to the superficial temporal space, having as the etiological factor the root rest of unit 13. Outpatient drainage of contents and antibiotic therapy-associated was performed. After the period of 07 days, there was remission of the condition. Although uncommon, odontogenic infections originating from anterior teeth may spread to masticatory spaces. Regardless of its origin, it must be treated immediately, draining the compromised space, identifying the cause and eliminating it, and associating the use of antibiotics as a coadjuvante(AU)

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ABSTRACT: Patients submitted to oncological fertility preservation with letrozole and gonadotropins seem to present a higher rate of immature oocytes and lower fertilization rates in comparison to infertile patients submitted to IVF cycles with gonadotropins. The aim of this study was to evaluate the influence of letrozole on oocyte morphology in patients with breast cancer submitted to fertility preservation. METHODS: Retrospective analysis performed at a public tertiary hospital in São Paulo, Brazil. The oocytes were retrieved from patients with breast cancer undergoing fertility preservation (n=69), and from infertile women undergoing in vitro fertilization (n=92). We evaluated 750 oocytes obtained from breast cancer patients submitted to ovarian stimulation with letrozole and gonadotropins, and 699 oocytes from patients without breast cancer submitted to ovarian stimulation for in vitro fertilization with gonadotropins only due to male factor infertility. The mature oocytes retrieved were analyzed for the presence of refractile bodies, ooplasm color and regularity, central granulation degree, cortical granules, zona pellucida staining and regularity, perivitelline space, presence of vacuoles or abnormal smooth-surfaced endoplasmic reticle and oocyte retraction. RESULTS: There was a higher incidence of alterations in oocyte morphology in the letrozole group when compared to the control group: increased perivitelline space (p=0.007), irregular zona pellucida (p<0.001), refractile bodies (p<0.001), dark ooplasm (p<0.001), granular ooplasm (p<0.001), irregular ooplasm (p<0.001) and dense central granulation (p<0.001). CONCLUSION: Letrozole is a risk factor for worse oocyte morphology. However, the clinical impact of ovarian stimulation protocol with combined use of gonadotropins and letrozole for fertility preservation remains unclear in this setting. These data underline the importance of establishing the predictive potential of morphological dimorphisms of human oocytes in IVF outcomes.

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Abstract Introduction Tinnitus is present in a large part of chronic health complaints, and it is considered a public health problem injurious to the individual's quality of life. Considering the increase of the world population associated with an increase of life expectancy, tinnitus remains a cause for medical concern, since during aging the occurrence of auditory impairments due to the deterioration of the peripheral auditory structures and central impairs the quality of life. Objective The aim of the present study was to analyze the applicability of real ear measurements for audiological intervention of tinnitus through specific evaluation, selection, verification and validation of the hearing aids combined with the sound generator. Methods Forty individuals of both genders with hearing loss and tinnitus complaints were deemed eligible to compose the sample. They were enrolled according to clinical symptoms and submitted to the following procedures: anamnesis and previous complaint history, high frequency audiometry, immittanciometry and acuphenometry with the research of psychoacoustic thresholds of pitch, loudness and minimum masking threshold, sound generator, in addition to the application of the Tinnitus Handicap Inventory and Visual Analog Scale tools. The entire sample was adapted with Siemens hearing aids and a sound generator, participated in a counseling session with support of digital material and evaluated in two situations: Initial Assessment (before the hearing aids and sound generator adaptation) and Final Assessment (6 months, after adaptation). The statistical analyzes were descriptive and inferential, adopted a significance level of 5% and the T-Paired Test and the Spearman Correlation test were performed. Results The results showed that there was a benefit with the use of hearing aids combined with a sound generator from the statistically significant values and strong correlations between the sound generator verification data regarding acuphenometry and the nuisance/severity questionnaires. Regarding the verification of the sound generator, it is important to highlight that the entire sample selected the effective acoustic stimulation based on the comfort levels, which was proved in the present study to be a sufficient intensity for positive prognosis, whereas the users' noises were found below the psychoacoustic thresholds of acuphenometry. Conclusion The present study concluded that the audiological intervention with any level of sound stimulus is enough to obtain a positive prognosis in the medium term. Data that specifies that the verification of sound generator was effective at the real ear measurements are important in the evaluation and intervention of the complaint. In addition, it points out that the greater the tinnitus perception, the greater its severity, and the greater the nuisance, the higher the psychoacoustics thresholds of frequency and the minimum threshold of masking.

Resumo Introdução O zumbido está presente em grande parte das queixas crônicas de saúde, é considerado um problema de saúde pública, prejudicial à qualidade de vida do indivíduo. Considerando o aumento da população mundial associado ao aumento da expectativa de vida, a tendência é que o zumbido permaneça como um motivo de preocupação, uma vez que com a idade a ocorrência de prejuízos auditivos decorrentes da deterioração das estruturas auditivas periféricas e centrais ocasiona grande impacto negativo na qualidade de vida. Objetivo Analisar a aplicabilidade das medidas da orelha real para a intervenção audiológica do zumbido através de avaliação específica, seleção, verificação e validação do aparelho de amplificação sonora individual combinada ao gerador de som. Método Quarenta indivíduos de ambos os sexos com perda auditiva e queixa de zumbido foram considerados elegíveis para compor a amostra. Eles foram atendidos conforme a demanda clínica e submetidos aos seguintes procedimentos: anamnese e história pregressa da queixa, audiometria de alta frequência, imitanciometria e acufenometria com pesquisa dos limiares psicoacústicos de pitch, loudness e limiar mínimo de mascaramento, gerador de som, além da aplicação das ferramentas tinnitus handicap inventory e escala visual analógica. Toda a amostra recebeu aparelho de amplificação sonora individual e gerador de som, ambos da marca Siemens, participaram de uma sessão de aconselhamento com apoio de material digital e foram avaliados em duas situações: Avaliação inicial (antes da adaptação dos aparelhos de amplificação sonora individual e gerador de som) e Avaliação final (6 meses após a adaptação). As análises estatísticas foram descritivas e inferenciais, adotou-se um nível de significância de 5% com a realização do teste t pareado e o teste de correlação de Spearman. Resultados Os resultados mostraram que houve benefício com o uso de aparelho de amplificação sonora individual combinado ao gerador de som com base nos valores estatisticamente significantes e fortes correlações entre os dados da verificação do gerador de som em relação à acufenometria e os questionários de incômodo/gravidade. Em relação à verificação do gerador de som, é importante destacar que toda a amostra selecionou a estimulação acústica efetiva baseada nos níveis de conforto e no presente estudo demonstraram ser de intensidade suficiente para o prognóstico positivo, enquanto que os ruídos dos usuários estavam abaixo dos limiares psicoacústicos da acufenometria. Conclusão A intervenção audiológica com qualquer nível de estímulo sonoro é suficiente para obter um prognóstico positivo em médio prazo. Os dados que demonstram que a verificação do gerador de som foi efetiva nas medidas da orelha real são importantes na avaliação e intervenção da queixa. Além disso, mostram que quanto maior a percepção do zumbido, maior a sua gravidade; e quanto maior o incômodo, maiores os limiares de frequência psicoacústica e o limiar mínimo de mascaramento.

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INTRODUCTION: Tinnitus is present in a large part of chronic health complaints, and it is considered a public health problem injurious to the individual's quality of life. Considering the increase of the world population associated with an increase of life expectancy, tinnitus remains a cause for medical concern, since during aging the occurrence of auditory impairments due to the deterioration of the peripheral auditory structures and central impairs the quality of life. OBJECTIVE: The aim of the present study was to analyze the applicability of real ear measurements for audiological intervention of tinnitus through specific evaluation, selection, verification and validation of the hearing aids combined with the sound generator. METHODS: Forty individuals of both genders with hearing loss and tinnitus complaints were deemed eligible to compose the sample. They were enrolled according to clinical symptoms and submitted to the following procedures: anamnesis and previous complaint history, high frequency audiometry, immittanciometry and acuphenometry with the research of psychoacoustic thresholds of pitch, loudness and minimum masking threshold, sound generator, in addition to the application of the Tinnitus Handicap Inventory and Visual Analog Scale tools. The entire sample was adapted with Siemens hearing aids and a sound generator, participated in a counseling session with support of digital material and evaluated in two situations: Initial Assessment (before the hearing aids and sound generator adaptation) and Final Assessment (6 months, after adaptation). The statistical analyzes were descriptive and inferential, adopted a significance level of 5% and the T-Paired Test and the Spearman Correlation test were performed. RESULTS: The results showed that there was a benefit with the use of hearing aids combined with a sound generator from the statistically significant values and strong correlations between the sound generator verification data regarding acuphenometry and the nuisance/severity questionnaires. Regarding the verification of the sound generator, it is important to highlight that the entire sample selected the effective acoustic stimulation based on the comfort levels, which was proved in the present study to be a sufficient intensity for positive prognosis, whereas the users' noises were found below the psychoacoustic thresholds of acuphenometry. CONCLUSION: The present study concluded that the audiological intervention with any level of sound stimulus is enough to obtain a positive prognosis in the medium term. Data that specifies that the verification of sound generator was effective at the real ear measurements are important in the evaluation and intervention of the complaint. In addition, it points out that the greater the tinnitus perception, the greater its severity, and the greater the nuisance, the higher the psychoacoustics thresholds of frequency and the minimum threshold of masking.

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Mesenchymal stem cells have been widely used in the treatment of various chronic diseases. The objective of this survey was to evaluate the therapeutic and regenerative potential of stem cells from adipose tissue (ASCs) in the milk production recovery repair of tissue injury in mastitis goats treated with antimicrobial agents prior to cell therapy. After the diagnosis of mastitis and treatment with gentamicin, eight lactating goats were selected for cellular and subsequent therapy, physical-chemical analysis of milk, ultrasonographic and histopathological examinations. The ASCs were taken from the subcutaneous fat of a young goat cultivated in vitro, marked with Qdots-655 and injected in the left mammary gland, being the right mammary gland used as the control. After 30 days the ultrasonographic and histopathological analyzes were repeated and, in the first lactation period, the physical-chemical analysis of the milk was reapeated. Before the cellular therapy, the physical-chemical quality of the milk was compromised and the ultrasonographic and histopathological analysis revealed a chronic inflammatory process and fibrous tissue. The marking of the ASCs with Qdots enabled the tracking, by fluorescence microscopy (BX41-OLYMPUS), in the mammary tissue. In the ASCs therapy, cultures showed high cellularity and characteristics favorable to preclinical studies; with the therapy the physical-chemical parameters of the milk, fat, protein, temperature and pH showed significant differences among the groups; five animals treated with ASCs reconstituted the functionality of the gland and the connective tissue reduced in quantity and inflammatory infiltrate cells. ASCs have potential for the possible regeneration of fibrous mastitis lesions in the mammary gland, however, it would be necessary to increase injection time for the histopathological analysis, since the reconstitution of the glandular acini within the assessed period was not finalized. ASCs can be used to reestablish milk production in goat with chronic mastitis repair mammary lesions, with potential to be a promising clinical alternative for animal rehabilitation for productivity.

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Resumo Este artigo avalia as relações que os custos escolares diretos e a organização da oferta escolar têm com o desempenho de escolas públicas, aferido pelo Exame Nacional do Ensino Médio (Enem). O estudo se baseia nos determinantes do desempenho escolar a partir do enfoque teórico do chamado "efeito-escola". Trata-se de pesquisa quantitativa, com uso de regressões múltiplas e quantílicas, com modelo de dados em painel, de efeitos fixos. A amostra foi composta por escolas brasileiras, analisadas entre 2012 e 2015. Os resultados indicam que há grande oscilação nos custos escolares diretos entre unidades de uma mesma rede de ensino, sugerindo desigualdade na distribuição dos recursos financeiros; que os custos escolares diretos, no entanto, têm baixa capacidade de explicação dos resultados das escolas no Enem; que mais recursos não se traduzem necessariamente em melhores resultados em termos de desempenho escolar, sugerindo que a forma como são mobilizados (de maneira planejada e com propósito claro) é que pode constituir um diferencial na aprendizagem. Adicionalmente, o estudo propõe uma metodologia para apurar custos escolares diretos.

Resumen Este artículo evalúa las relaciones que los costos escolares directos y la organización de la oferta escolar tienen con el desempeño de escuelas públicas, determinado por el Examen Nacional de la Enseñanza Media (Enem). Se basa en los determinantes del desempeño escolar a partir del enfoque teórico del denominado "efecto-escuela". Se trata de una investigación cuantitativa, con uso de regresiones múltiples y cuantílicas, con modelo de datos en panel, de efectos fijos. La muestra se compuso por escuelas brasileñas, analizadas entre 2012 y 2015. Los resultados encontrados indican que hay gran oscilación en los costos escolares directos entre unidades de una misma red de enseñanza, sugiriendo desigualdad en la distribución de los recursos financieros; que los costos escolares directos, sin embargo, tienen una baja capacidad de explicación de los resultados de las escuelas en el Enem; que más recursos no producen necesariamente mejores resultados de desempeño, sugiriendo que la forma como se movilizan (de manera planificada y con propósito claro) es lo que puede constituir una diferencia en el aprendizaje. De forma adicional, el estudio propone una metodología para determinar costos escolares directos.

Abstract This article evaluates the relationships that direct school costs and the organization of school places have with the performance of public schools, measured by the National High School Examination (Enem). It is based on the determinants of school performance from the school effect approach. This is a quantitative research, using multiple and quantum regressions, with fixed-effects panel data model. The sample was composed of Brazilian schools, analyzed between 2012 and 2015. The results indicate that there is a great oscillation in direct school costs between units of the same educational system, suggesting inequality in the distribution of financial resources. The findings also suggest that direct school costs do not explain the school results in the Enem exam, and that more resources do not necessarily translate into better performance. Finally, the findings indicate that the way in which resources are mobilized (in a planned and purposeful manner) can be the differential for learning. In addition, the study proposes a methodology to calculate direct school costs.

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O cisto radicular (CR) é uma lesão aliada à ativação e proliferação dos restos epiteliais de Malassez através de estímulos inflamatórios, decorrente da propagação bacteriana no interior do canal de um dente necrosado. Acomete em maiores proporções a região anterior do osso maxilar (60,5%), e em mulheres (62,8%) com faixa etária superior a 51 anos de idade (25,6%). Geralmente são lesões assintomáticas, porém quando relacionada à infecção bacteriana pode haver sintomatologia. Para se estabelecer uma adequada forma de tratamento é necessário avaliar o local afetado da lesão e as estruturas anatômicas circunjacentes. O objetivo deste trabalho é relatar os aspectos tomográficos do cisto radicular em dois casos clínicos ratificando a importância desse método de imagem auxiliar na determinação e sucesso do tratamento proposto oferecendo ao paciente um melhor prognóstico. A solicitação de exames radiográficos poderá ser efetuada, devendo-se optar por técnicas de imagens que possam fornecer melhores qualidades de informações. A tomografia computadorizada proporciona, devidos as suas características ideais, a visualização tridimensional de lesões císticas e estruturas próximas. Os aspectos tomográficos encontrados são de imagens hipodensas, bem delimitadas, uniloculares, com halos hiperdensos, com rompimento da cortical óssea em determinados casos(AU)

The root cyst (CR) is an injury allied to the activation and proliferation of the Malassez epithelial remains through inflammatory stimuli, due to the bacterial propagation inside the canal of a necrotic tooth. It affects the anterior region of the maxillary bone (60.5%), and in women (62.8%), with an age above 51 years (25.6%). Usually they are asymptomatic lesions, however when related to the bacterial infection there can be symptomatology. In order to establish an adequate form of treatment it is necessary to evaluate the affected site of the lesion and the surrounding anatomical structures. The objective of this work is to report the tomographic aspects of the radicular cyst in two clinical cases ratifying the importance of this method of auxiliary image in the determination and success of the proposed treatment offering the patient a better prognosis. The request for radiographic examinations may be made, and one should opt for imaging techniques that may provide better qualities of information. Computed tomography provides, due to its ideal characteristics, the three-dimensional visualization of cystic lesions and nearby structures. The tomographic aspects found are hypodense, well delimited, unilocular images with hyperdensed halos, with rupture of the cortical bone in certain cases(AU)

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The agouti has been used as an experimental model in several studies focused on reproductive biology. The umbilical cord, an embryonic attachment that connects the foetus to the placenta, has been reported as an important anatomical site for obtaining stem cells. The objective of this study was to describe macro- and microscopically the umbilical cord of agoutis at different stages of gestation, to expand and cultivate in vitro the progenitor cells and to report their morphological characteristics. Seven cutias were submitted to caesarean section to collect the umbilical cords: five were destined for studies of cord structure in different stages of gestation (30, 35, 50, 75 and 100 days postcoital), and two were collected in the third stage of gestation for isolation and cell culture. The umbilical cord of cutias assumes a spiral arrangement, with veins and arteries on it starting 50 days after coitus. The arteries present an outer layer of smooth muscle fibres in a longitudinal and circular arrangement and a medium layer of smooth muscle fibres with only longitudinal and intimate orientation and coated by the endothelium. The veins consist of longitudinal smooth muscle fibres with an extract of smooth muscle cells, and the endothelium, in all analysed gestational phases, is a structure bounded by simple pavement epithelial tissue originating from the amnion, adhered to Whartons Jelly and forming the umbilical vessels and allantoid duct. The proposed protocol allowed the collection of a high cellular concentration of umbilical cord progenitor cells from viable cutias.(AU)

A cutia vem sendo utilizada como modelo experimental em diversos estudos voltados à biologia reprodutiva. O cordão umbilical, anexo embrionário que une o feto à placenta, tem sido relatado como um importante sítio anatômico para obtenção de células-tronco. O objetivo deste estudo foi descrever macro e microscopicamente o cordão umbilical de cutias, em fases diferentes da gestação, expandir e cultivar in vitro as células progenitoras e relatar suas características morfológicas. Foram utilizadas sete cutias submetidas à cesariana para a coleta dos cordões umbilicais, cinco foram destinadas aos estudos da estrutura do cordão, em diferentes estágios de gestação (30, 35, 50, 75 e 100 dias pós-coito), e duas, no terço final da gestação, para isolamento e cultivo celular. O cordão umbilical de cutia assume disposição espiralada, com veias e artérias sobre ele a partir dos 50 dias após o coito. As artérias apresentam camada externa de fibras musculares lisas, disposição longitudinal e circular, camada média de fibras musculares lisas, apenas com disposição longitudinal e íntima revestida pelo endotélio. As veias constituídas por fibras musculares lisas longitudinais com um extrato de células musculares lisas e pelo endotélio. Em todas as fases gestacionais analisadas é uma estrutura delimitada por tecido epitelial simples pavimentoso, proveniente do âmnio, aderido a Geleia de Wharton e com formação de vasos umbilicais e ducto alantóide. O protocolo proposto permitiu a coleta de células progenitoras do cordão umbilical de cutias, viáveis com elevada concentração celular.(AU)

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