Resumen Introducción: El angioedema hereditario es una enfermedad genética autosómica dominante, asociada con aumento de las concentraciones de bradicinina. Se clasifica en tres tipos, de acuerdo con la enzima C1-INH. El diagnóstico se establece por las manifestaciones clínicas y los estudios de laboratorio. El tratamiento consiste profilaxis a corto y largo plazo, y protocolo para el control de las crisis. Reporte del caso: Paciente femenina de 40 años, que acudió al servicio de Urgencias por edema labial, sin reacción al tratamiento con corticosteroides. Se detectaron concentraciones bajas de IgE, C4 e inhibidores de la esterasa C1. Se estableció el diagnóstico de angioedema hereditario. Actualmente se mantiene en tratamiento profiláctico con danazol y plasma fresco congelado para el control de las crisis. Conclusiones: El angioedema hereditario es una enfermedad que afecta considerablemente la calidad de vida; por tanto, debe diagnosticarse de forma oportuna y establecer un plan de tratamiento eficaz, con la intención de prevenir o reducir las complicaciones.

Abstract Introduction: Hereditary angioedema is an autosomal dominant genetic disease, associated with increased levels of bradykinin. It is classified into 3 types according to the C1-INH enzyme. The diagnosis is clinical and laboratory. Its treatment is divided into short- and long-term and crisis prophylaxis. Case report: 40-year-old female patient who came to the emergency service for labial edema without resolution with corticosteroids. The tests for IgE, C4 and C1 esterase inhibitors had a low result. She currently uses danazol prophylactically and fresh frozen plasma in crises. Conclusion: Since it is a disease that considerably affects the quality of life, hereditary angioedema must be diagnosed and an effective treatment plan made to prevent or reduce its complications.

RESUMO Osteocondroma é um dos tumores ósseos mais comuns, mas raramente acomete o côndilo mandibular. Dependendo dos sintomas e duração do Osteocondroma o manejo da lesão pode variar desde a excisão do tumor até a realização da condilectomia com a remoção do tumor. O objetivo deste trabalho é relatar um caso clínico de Osteocondroma acometendo o côndilo da mandíbula em um paciente de 39 anos de idade, ressaltando as etapas para a realização do diagnóstico, procedimentos cirúrgicos e follow-up de 3 anos. Ao exame clínico observou-se severo desvio mandibular para o lado direito, desoclusão do lado esquerdo, abertura de boca reduzida, abrasão dentária compatível com bruxismo e classe III. Após a realização de tratamento cirúrgico e o período de acompanhamento de 3 anos foi possível observar a resolução do caso em imagens de tomografia computadorizada de feixe cônico. Conclusão: Pode-se concluir que a terapia proposta resultou em sucesso e o paciente continua em acompanhamento periódico.

ABSTRACT Osteochondroma is one of the most common benign bone tumours. However, it a rare in the mandibular condyle. Depending on the symptoms and duration of the osteochondroma, the management ranges from excision of the tumor alone to condylectomy along with tumor excision. This paper presents a case of Osteochondroma after surgical treatment affecting the mandible of a 39-year-old man and highlights the diagnosis, surgical procedures and 3-year follow-up period. At the clinical examination, the patient presented severe mandibular lateral deviation to the right, left side disocclusion with a slight oral opening limitation, dental abrasion compatible with bruxism and class III. After 3-year follow-up 3 years later revealed that the surgical management posed was successful for Osteochondroma and the patient is currently under regular review.

Abstract Dental-skeletal anomalies are treated by combining orthodontic treatment with orthognathic surgery. This mainly involves performing sagittal osteotomy of the mandibular branch. This technique offers many advantages, but its main disadvantage is paraesthesia of the inferior alveolar nerve. There are several treatments focused on promoting neurological recovery, one of which is low intensity laser. The aim of this study was to make a clinical evaluation of the efficacy of low intensity laser therapy in the neurosensory recovery of tissues after sagittal osteotomy of the mandible. A group of twelve patients with the need of surgical correction of their dental-skeletal anomaly underwent orthognathic surgery with bilateral mandibular sagittal osteotomy. Patients were treated unilaterally and blinded with a low intensity infrared GaAlAs laser of 808 nm, and compared with the contralateral site as a control group, following the course of the inferior dental nerve. The parameters used were of 100 mW of power, irradiation of 3.6 W/cm2, 2.8 J of energy per point, an energy density of 100 J/cm2, to 28s in each point with a distance of 1 cm between points. The treatment included two sessions per week with a minimum of 10 sessions, starting 48 h after surgery. Mechanical and thermal evaluations were performed in the first, fourth, seventh and tenth sessions. A significant improvement was observed in the subjective response of the patients on the treated side. The treatment of neurosensory disorders with low-intensity infrared laser has been shown to be effective in accelerating recovery, providing greater patient comfort, and presenting advantages over other existing methods.

Resumen Las anomalías dentoesqueléticas son tratadas combinando el tratamiento de ortodoncia con la cirugía ortognática, principalmente, mediante la osteotomía sagital de rama mandibular. Esta técnica ofrece muchas ventajas, pero dentro de sus principales desventajas se encuentra la parestesia del nervio dentario inferior. Existen varios tratamientos enfocados a promover la recuperación neurológica y uno de ellos es el tratamiento con láser de baja intensidad. Esta investigación tuvo como objetivo hacer una evaluación clínica de la eficacia de la terapia con láser de baja intensidad en la recuperación neurosensorial de los tejidos tras la osteotomía sagital de la mandíbula. Un grupo de 12 pacientes con necesidad de corrección de su anomalía dentoesquelética fueron intervenidos con cirugía ortognática mediante la osteotomía sagital de rama mandibular bilateral. Los pacientes fueron tratados en el postoperatorio de manera unilateral y ciega con láser infrarrojo de baja intensidad de 808 nm, medio activo de gaaias, y comparados con el lado contralateral como control, siguiendo el recorrido del nervio dentario inferior. Los parámetros utilizados fueron de 100 mW de potencia, irradiación de 3,6 W/cm2, 2,8 J de energía por punto, una densidad de energía de 100 J/cm2, a 28 s en cada punto con una distancia de 1 cm entre puntos, 2 sesiones por semana, con un mínimo de 10 sesiones a partir de las 48 horas después de la cirugía. Se realizaron evaluaciones mecánicas y térmicas en la primera, cuarta, séptima y décima sesión. Se observó una mejora significativa en la respuesta subjetiva de los pacientes en el lado tratado. El tratamiento de los trastornos neurosensoriales con el láser de baja intensidad de infrarrojos ha demostrado ser eficaz en la aceleración de la recuperación, proporciona una mayor comodidad al paciente y presenta ventajas sobre otros métodos existentes.

RESUMO A reconstituição da cartilagem articular danificada por doenças de desenvolvimento, trauma e osteoartrite tem sido um grande desafio na veterinária. O objetivo do presente estudo foi avaliar o uso da cartogenina, uma molécula capaz de induzir diferenciação de células mesenquimais em condrócitos, associado ou não à técnica de microfratura na reparação de defeitos condrais induzidos na tróclea femoral de equinos. Foram utilizados seis equinos pesando em média (±DP) 342±1,58kg, com idade de 7,2±1,30 anos e escore corporal de 7,1±0,75, os quais foram submetidos à videoartroscopia para indução da lesão condral de 1cm2 na tróclea lateral do fêmur e à realização da técnica de microperfuração do osso subcondral de ambos os joelhos. Foram realizadas quatro aplicações semanais com 20µM de cartogenina intra-articular em um dos joelhos (grupo tratado) e solução de ringer com lactato na articulação contralateral (grupo controle). Os animais foram submetidos a avaliações física, radiográfica, ultrassonográfica, por um período de 60 dias. Não houve qualquer diferença estatística entre as articulações tratadas e as controle. A terapia com cartogenina, segundo protocolo utilizado, não produziu melhora clínica em lesões osteocondrais induzidas e tratadas com microperfurações na tróclea lateral do fêmur em equinos.

ABSTRACT Articular cartilage reconstruction is still a challenge in Veterinary Medicine. The aim was to evaluate the therapeutic effects of kartogenin, a small molecule that promotes chondrocyte differentiation, in the repair of induced chondral defects pretreated with subchondral drilling. Six horses with a mean (± SD) weight of 342 ± 1.58Kg, aging 7.2 ± 1.30 years, and with a mean 7.1 ± 0.75 body score condition were used. In both stifles, a 1cm2 chondral defect was induced in the lateral femoral trochlea followed by treatment with subchondral drilling. Four intra-articular injections with kartogenin (20mM) were performed weekly in one stifle (treated group). The same procedure using saline solution was performed in the contralateral joint (control group). Clinical, radiographic, ultrasound evaluations were performed for a period of 60 days. No statistical differences were detected between groups in any of the studied variables. Although kartogenin has shown to improve articular cartilage repair in laboratory animal models, the same was not observed in this equine model. In conclusion, the kartogenin therapy, according to the used protocol, did not promote any clinical benefit in equine femoral trochlear defects pretreated with subcondral drilling.

Resumo Neste estudo avaliou-se a presença de espécies de Biomphalaria na bacia do Ribeirão do Melo, municípios de Rio Espera e Capela Nova, sudeste do estado de Minas Gerais, e sua relação com os canais de irrigação presentes na região. Em 17 desses canais foi realizada uma caracterização limnológica, morfológica e hidrológica durante um ciclo sazonal anual. Espécimes de Biomphalaria foram coletados e encaminhados ao Centro de Pesquisas René Rachou/FIOCRUZ (Belo Horizonte, MG) para identificação e exame parasitológico. Dos 17 canais estudados, foram identificados seis como criadouros do caramujo, sendo que em um dos canais coexistiam as espécies B. tenagophila (primeiro registro para a bacia) e B. glabrata. Os resultados indicaram que a baixa vazão e a velocidade do fluxo foram os fatores que contribuíram para a ocorrência pontual dos caramujos na bacia. Estas características hidrológicas foram modificadas por ação antropogênica, através da canalização de trechos lóticos do ribeirão do Melo. Os resultados destacam a necessidade do manejo adequado e monitoramento constante da bacia hidrográfica, sujeita a condições sanitárias inadequadas, como forma de prevenção da ocorrência e propagação da esquistossomose.

Abstract This study analyzed the presence of Biomphalaria in Melo creek basin, Minas Gerais state, and its relationship to irrigation canals. Seventeen of these canals were used to determine a limnological, morphological and hydrological characterization during an annual seasonal cycle. Biomphalaria samples were sent to René Rachou Research Center/FIOCRUZ for identification and parasitological examination. Six canals were identified as breeding areas for mollusks and in one of them it was registered the coexistence of B. tenagophila (first report to this basin) and B. glabrata species. Results indicated that the low flow rate and speed of water flow were the main characteristics that contributed to this specific growth of the mollusks in the area. These hydraulic characteristics were created due to anthropogenic action through the canalization of lotic areas in Melo creek, which allowed ideal ecological conditions to Biomphalaria outbreak. The results emphasize the need of adequate handling and constant monitoring of the hydrographic basin, subject to inadequate phytosanitary conditions, aiming to prevent the occurrence and propagation of schistosomiasis.

Objective: To analyze the results of an epidemiological study of nasal fractures treated in a private hospital in the center of the city of São Paulo, Brazil. Material and method: The population included in the study were patients admitted to one of the hospitals of the Residence-Department of Oral and Maxillofacial Surgery and Traumatology, from January-2008 to October-2010 diagnosed with nasal fracture. Factors analyzed for the study were gender, age, etiology, clinical signs, symptoms, type of treatment, and post-operative condition. Results: As regards the etiology, 22 cases were associated with motorcycle accidents, 18 car accidents, 38 cases of assault, 27 cases described injuries after falling from their own height, 23 cases of sport injury, and 10 cases for accidents at work. The patients most affected were between the ages of 21 to 30 years; with a majority of male patients (112 cases).The most common clinical manifestations were epistaxis and swelling in the nasal dorsum. In 93 cases, the patients underwent closed surgical reduction, associated with nasal packing and external fixation. Conclusion: This study presents fundamental information regarding nasal fractures, emphasizing the surgical approach and surgical planning. It is also important to take into account the importance of organizing the attendance sequence of these patients, considering these protocols and procedures as an option for other hospitals to improve their routine protocols for these types of trauma.

Objetivo: Analizar los resultados de un estudio epidemiológico de las fracturas nasales tratadas en un hospital de la zona sur de São Paulo, para mejorar la secuencia de tratamiento. Materiales y métodos: Se evaluaron los pacientes ingresados en un hospital privado que forma parte de la Residencia de Cirugía Maxilofacial, de enero de 2008 a octubre de 2010 con diagnóstico de fractura nasal. Los factores analizados para la elaboración del estudio fueron: sexo, edad, etiología, manifestaciones clínicas, tipo de tratamiento y poscondiciones operatorias. Resultados: Como etiología, 22 casos de accidentes de motocicletas, 18 accidentes de tráfico, 38 casos de agresión física, 27 de caída, 23 traumatismo deportivo y 10 casos de accidentes de trabajo. La edad de la mayoría de los pacientes afectados osciló entre 21 y 30 años, con la mayoría del sexo masculino (112 casos). La manifestación clínica más frecuente es el sangrado y edema en el dorso nasal. En 93 casos, los pacientes recibieron reducción quirúrgica sin sangre, con taponamiento nasal asociada con fijación externa con yeso. Conclusión: Este estudio proporciona datos básicos sobre las fracturas nasales, importantes para el abordaje terapéutico y la planificación, así como la mejora en la organización y el cuidado de estos pacientes, y la misma puede servir como un parámetro entre los diversos servicios hospitalarios para proporcionar una mejora continua en el servicio y la rutina quirúrgica.

Objective. The objective of this study was to establish the thermographic profile of the lower limbs in elite young soccer players. Method. One hundred soccer players from the U-19 categories of a first division Brazilian football club (15.5 ± 1.37 years; 67.93 ± 9.62 kg; 177.49 ± 8.67 cm) participated in the study. Two thermograms allowed us to record maximum and average skin temperatures (T SK) in four body regions of interest (ROIs) of the lower limbs corresponding to the anterior and posterior view of the leg and thigh. The Wilcoxon test was used to compare bilateral T SK differences with a significance level of α < 0.05. Results. Average values of T SK in the anterior view were as follows: right thigh 30.2 ± 1.9°C, left thigh 30.2 ± 1.9°C, right leg 29.8 ± 1.8°C, and left leg 29.9 ± 1.8°C. In the posterior view, the values were as follows: right thigh 30.3 ± 1.8°C, left thigh 30.2 ± 1.8°C, right leg 29.6 ± 1.9°C, and left leg 29.4 ± 1.9°C. The statistical analysis did not show significant differences between sides in the selected ROIs for average or maximum temperatures. A histogram of T SK frequencies for each ROI allowed establishment of values for hyper-and hypothermia. Conclusion. The elite young soccer players analyzed showed contralateral thermal symmetry. The average T SK differences for paired ROIs were each < 0.2°C. Each ROI exhibited a specific thermal profile. The registered T SK indicated a normal thermal profile of the athletes.

Objetivo. El objetivo de este estudio es establecer el perfil termográfico de los miembros inferiores en jóvenes jugadores de fútbol de élite. Método. En el estudio participaron 100 jugadores de fútbol de categorías sub-19 de clubes de fútbol brasileños de primera división (15,5 ± 1,37 años; 67,93 ± 9,62 kg; 177,49 ± 8,67 cm). Mediante dos termogramas se obtuvieron las temperaturas máximas y medias de la piel (T SK) de cuatro regiones corporales de interés (RDI) correspondientes a la vista anterior y posterior de la pierna y del muslo. Se empleó el test de Wilcoxon para comparar las diferencias de la T SK bilateral, con un nivel de significación α < 0,05. Resultados. Los valores medios de la T SK en la vista anterior fueron los siguientes: muslo derecho 30,2 ± 1,9°C, muslo izquierdo 30,2 ± 1,9°C, pierna derecha 29,8 ± 1,8°C y pierna izquierda 29,9 ± 1,8°C. En la vista posterior, los valores fueron los siguientes: muslo derecho 30,3 ± 1,8°C; muslo izquierdo 30,2 ± 1,8°C; pierna derecha 29,6 ± 1,9°C y pierna izquierda 29,4 ± 1,9°C. El análisis estadístico no mostró diferencias significativas en las temperaturas medias o máximas tomadas en las RDI elegidas. Un histograma de las frecuencias de T SK para cada RDI permitió establecer valores para hiper e hipotermia. Conclusión. Los jóvenes jugadores de fútbol de élite analizados mostraron simetría térmica contralateral. La T SK media para pares de RDI era para cada uno < 0,2°C. Cada RDI mostró un perfil térmico específico. La T SK mostró un perfil térmico normal de los atletas.

Introduction: The temporomandibular joint (TMJ) can be affected by injuries that alter its morphology and compromise its normal function, and in some cases leading to the need for surgery to resect it and rebuild it. The reconstruction of the TMJ bone articular defects has been a challenge for the maxillofacial surgeon. It can be achieved by using alloplastic materials. Among these, we highlight the total temporomandibular joint prosthesis, developed until achieving its current form and composition, and which has led to the establishment of clear protocols for its use. Among these, we highlight the W.Lorenz™ prosthesis with a high technology and specific details that lead to an increased clinical and functional improvement. Objective: To study the important clinical and functional aspects observed in surgically treated patients. Materials and Methods: This study evaluated 15 patients between 24 to 44 years, who underwent TMJ replacement surgery with 23 TMJ implants, 8 bilateral and 7 unilateral, between the years 2000 to 2008. All surgeries were performed by the same surgeon. Results: A large increase in functional improvement was observed, particularly in the cases of TMJ ankylosis. Conclusions: Many more studies and monitoring should be conducted to establish, especially in the long term, that these prostheses offer the stomatognathic system an effective and durable physiology.

Introducción: La articulación temporomandibular (ATM) puede ser afectada por alteraciones que comprometan su morfología y fisiología normales, llevando al cirujano, en algunos casos, a la necesidad de resecarla y reconstruirla. La reconstrucción de los defectos óseos de la ATM ha sido un desafío para el cirujano maxilofacial y puede ser realizada utilizando injertos autógenos o materiales aloplásticos. Entre estos materiales resaltamos la prótesis total de ATM, que en su forma y composición actual cumplen las exigencias de reposición funcional. Entre las diferentes prótesis, resaltamos el modelo de la prótesis W. Lorenz®, de alta tecnología y con detalles específicos que determinan una gran mejoría clínica y funcional. Objetivo: Este estudio evalúa los aspectos clínicos y funcionales observados en pacientes tratados quirúrgicamente. Materiales y métodos: En este estudio fueron evaluados 15 pacientes entre 24 y 44 años de edad, sometidos a colocación de 23 prótesis totales de ATM, siendo 8 bilaterales y 7 unilaterales entre el año 2000 y el año 2008, siendo todas las cirugías realizadas por el mismo cirujano. Resultados: Se observó una gran mejoría funcional, particularmente en los casos de anquilosis de ATM. Conclusiones: Se deben realizar más estudios y seguimientos clínicos para establecer a largo plazo si estas prótesis ofrecen realmente una mejoría efectiva para el sistema estomatognático, con una fisiología duradera.