Abstract Introduction One of the paths in the investigation of congenital sensorineural hearing loss (CSNHL) is to try to characterize its etiology through the inner ear evaluation using high resolution computer tomography (CT) scans. With minor malformation, it is not always possible for a simple visual inspection to recognize if the structure in the inner ear is normal or not. Objective To verify if measurements of the inner ear are predictive of sensorineural hearing loss (SNHL) and suggest cutoff points of size limits. Methods Retrospective cross-sectional study of inner ear CT scan measurements of 214 patients, 50 with congenital SNHL (CSNHL) and 164 acquired SNHL (ASNHL) (control group). Results In the CSNHL group, central bony island (CBI) were 0.48 mm smaller (p < 0.001), cochlear nerve aperture was (CNA) 0.10 mm smaller (p < 0.001), and cochlea height was (CH) 0.15 mm smaller (p < 0.001). Vestibular aqueduct (VA) and cochlea width (CW) were similar between groups (0.70 vs 0.72, p = 0.19, and 7.20 vs 7.15 p = 0.23). The predictive cutoff points for CSNHL were CBI = 3.6 mm, CAN = 1.4 mm, CH = 3.4 mm, CW = 7.0 mm, and VA = 0.9 mm. Conclusion Congenital sensorineural hearing loss determined a decrease in CBI, opening of the cochlear nerve (OCN), and CW. Thus, these measures, at the cutoff points indicated, should make us aware of the diagnosis of congenital hearing loss. (CSNHL (CT scans malformation (SNHL limits crosssectional cross sectional 21 patients 5 16 ASNHL (ASNHL control group. group . group) (CBI 048 0 48 0.4 0.001, 0001 0.001 , 001 0.001) CNA (CNA 010 10 0.1 (CH 015 15 0.001. (VA (CW 0.70 070 70 (0.7 072 72 0.72 019 19 0.19 720 7 20 7.2 715 7.1 0.23. 023 0.23 23 0.23) 36 3 6 3. 14 1 4 1. 34 7. 09 9 0. OCN, OCN (OCN) Thus measures indicated 2 04 000 0.00 00 01 0.7 07 (0. 71 02 0.2 (OCN 0.0 (0 (

Abstract Objective To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Methods Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Conclusions Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy. evidencebased based adults methods search citations studies inclusion Physicians Associations Association s interventions parts 1 (1 tests syndrome tumors (2 procedures grafting longterm long term nonsurgical non etiology dysfunction therapy (

Abstract Objectives: To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: 1) Diagnosis – audiologic and radiologic; 2) Treatment – hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices - bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). Conclusions: The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness. Objectives evidencebased based Methods methods search citations studies inclusion Physicians Associations Association s interventions Results parts 1 radiologic AIDS therapy surgery boneanchored bone anchored implants CI. . (CI) Conclusions elucidated it pregnancy benefit stapedotomy deafness (CI

Abstract This study aimed to evaluate the effect of light attenuation through ceramic veneers and resin cement on degree of conversion (DC), cohesive strength (CS), and microshear bond strength (μSBS) of experimental adhesive systems. Experimental etch-and-rinse and self-etch adhesives were combined with different ratios of camphorquinone (CQ) and diphenyl(2,4,6-trimethylbenzoyl) phosphine oxide (TPO) photoinitiators: CQ-only; 3CQ:1TPO; 1CQ:1TPO; 1CQ:3TPO and TPO-only. Square-shaped ceramic veneer (IPS Empress Esthetic, Ivoclar Vivadent) (n = 10; 10mm long x 10mm wide x 0.5mm thick) and resin cement specimens (Variolink Esthetic LC, Ivoclar Vivadent) (n = 10; 10 mm long x 10 mm wide and 0.3 mm thick) were prepared. Light transmittance of a multiple-peak LED (Bluephase G2, Ivoclar Vivadent) was measured through restorative materials using a spectrometer (n = 5). Adhesive specimens were analyzed for DC, CS, and μSBS by light-curing the adhesive with or without (control) ceramic veneer, and with resin cement fixed to output region of the light-curing tip (n = 10). Data were submitted to ANOVA and Tukey’s test (α = 0.05). Total light transmittance through the restorative materials was attenuated, and this attenuation was more evident for the violet spectrum. The DC for the TPO groups in ratios up to 1CQ:1TPO was similar to the control. 1CQ:3TPO showed lower values for CS. μSBS was reduced for all groups with light attenuation, but lower values were observed for 1CQ:3TPO and TPO-only. In conclusion, light transmission was reduced with interposed restorative materials. Adhesives combined with CQ and TPO up to 1CQ:1TPO showed greater cure efficiency and mechanical properties compared with a higher amount of TPO.

Resumo O termo “distresse” psicológico tem sido utilizado na literatura para se referir a uma variável contínua operacionalizada por meio dos sintomas de depressão, ansiedade e estresse. Esta pesquisa propõe a utilização da Escala de Depressão, Ansiedade e Estresse (DASS-21) para avaliação do distresse psicológico. Comparou-se o ajuste de diferentes modelos de medidas propostos a DASS-21 por meio da análise fatorial confirmatória e verificou-se os parâmetros dos itens com o Andrich rating scale model. Uma amostra não clínica de 530 participantes (idade: M = 24,35, DP = 6,55, 71,89% mulheres), respondeu ao instrumento. Os resultados indicaram melhor adequação do modelo bifactor composto por três fatores específicos (depressão, ansiedade e estresse) e um fator geral (distresse psicológico geral), conforme hipótese teórica. A avaliação das propriedades dos itens possibilitou melhor compreensão da organização do contínuo representado pelo construto distresse psicológico (severidade dos sintomas). Conclui-se que a versão brasileira da DASS-21 é uma medida adequada do distresse psicológico geral.

Abstract The term distress has been used to refer to a continuous variable operationalized through symptoms of depression, anxiety, and stress. In this study, psychological distress is measured using the Depression, Anxiety, and Stress Scale (DASS-21). Confirmatory Factor Analysis compared the fit of different measurement models for the DASS-21, with the parameters of the items verified through the Andrich rating scale model. A non-clinical sample of 530 participants (mean age=24.35±6.55 years; 71.89% women) responded to the instrument. According to the theoretical hypothesis, the results indicated a better fit for the bifactor model, composed of three specific factors (depression, anxiety, and stress) and a general factor (general psychological distress). The assessment of the item properties allowed for a better understanding of the organization of the continuum represented by the construct psychological distress. It is possible to conclude that the Brazilian version of the DASS-21 is an adequate measure for psychological distress.

Resumen El término distrés psicológico se ha utilizado en la literatura para referirse una variable continua operada por medio de los síntomas de depresión, ansiedad y el estrés. En esta investigación el distrés psicológico se mide a través de la Escala de Depresión, Ansiedad y Estrés (DASS-21). El Análisis Factorial Confirmatorio comparó el ajuste de diferentes modelos de medición para la DASS-21 y los parámetros de los ítems se verificaron a través de la Andrich rating scale model. Una muestra no clínica de 530 participantes (24,35 ± 6,55, 71,89% mujeres), respondieron al instrumento. Los resultados indicaron una mejor adecuación del modelo bifactor compuesto por tres factores específicos (depresión, ansiedad y estrés) y un factor general (distrés psicológico general), lo que correspondió con la expectativa teórica. La evaluación de las propiedades del ítem permitió una mejor comprensión de la organización del continuo representado por el constructo distrés psicológico. Se concluye que la versión brasileña DASS-21 es una medida adecuada del distrés psicológico general.

A autoagressão pode ser definida como o ato deliberado de se envenenar ou provocar lesões em si mesmo sem intenção suicida. Embora este comportamento envolva atos não letais, a literatura destaca a associação da autoagressão com ideação suicida e impulsividade. Este estudo teve como principais objetivos adaptar transculturalmente para o português brasileiro e estimar as primeiras evidências de validade e precisão do Questionário de Impulsividade, Auto-dano e Ideação Suicida para Adolescente QIAIS-A. Participaram do estudo 198 adolescentes com idade entre 12 a 19 anos (M= 14,02±1,55, 51,6% meninas), de escolas públicas do interior estado de Pernambuco - Brasil, que responderam ao QIAIS-A, à Escala de Depressão Ansiedade e Estresse (DASS) e à Escala de satisfação com a vida (ESV). Os diferentes métodos empregados para avaliação das propriedades psicométricas das escalas (Análise Paralela, Análise Fatorial Exploratória, coeficientes alfa de Cronbach e Omega de Mcdonald, Correlação de Pearson e Análise de Rede) indicaram estrutura bidimensional das escalas de Impulsividade e Autoagressão e estrutura unidimensional para Ideação Suicida, corroborando as expectativas teóricas, bons índices de consistência interna, evidências de validade convergente (DAS) e Divergente (ESV), e sugestões práticas para intervenções diante ao comportamento autoagressivo em adolescentes. Os resultados sugerem que a QIAIS-A em sua versão brasileira é uma medida adequada para avaliação da impulsividade, autoagressão e ideação suicida.

Self-harm is defined as a deliberate act of poisoning or causing injury to yourself with non-suicidal intent. Although this behavior involves non-lethal acts, specialized literature highlights the association of self-harm to suicidal ideation and impulsiveness. The objectives of this study were to conduct a cross-cultural adaptation to the Brazilian Portuguese and to estimate the first validity evidences and reliability of the Questionnaire of Impulsiveness, Self-harm and Suicidal Ideation in Adolescents QIAIS-A. The sample consisted of 198 students from public schools in the countryside of the state of Pernambuco - Brazil, with ages ranging from 12 to 19 years (M= 14,02±1,55, 51,6% girls). The participants answered the QIAIS-A, the Depression Anxiety and Stress Scale (Dass), and the Satisfaction with life Scale (ESV). The different methods employed to assess the psychometric properties of the scales (Parallel Analysis, Exploratory Factor Analysis, Cronbachs alpha coefficients and Mcdonald's Omega, Pearson Correlation and Net Analysis) indicated two-dimensional structure for the scales of Impulsiveness and Self-harm, and unidimensional structure for Suicidal Ideation, corroborating theoretical expectations, good indices of internal consistency, convergent validity evidences (DAS) and divergent (ESV), and practical suggestion for interventions against self-harm behavior in adolescents. The results suggest that the brazilian version of the QIAIS-A is an appropriate tool for the assessment of impulsiveness, self-harm and suicidal ideation.

Resumo O objetivo nesse estudo foi utilizar o isobornil metacrilato (IBOMA) como monômero combinante ou substituinte na matriz resinosa de resinas compostas odontológicas. Para tanto, a matriz resinosa foi formulada com 60 % em peso de BisGMA e 40 % em peso de monômero diluente. O TEGDMA foi utilizado como único monômero diluente para o grupo controle com 40 % em peso, enquanto a substituição total de TEGDMA foi feita com 40 % em peso de IBOMA. Na combinação de IBOMA e TEGDMA foram utilizados 20 % em peso de cada monômero. Na matriz resinosa, 65 % em peso de partículas de carga foi adicionado. O grau de conversão (GC) utilizando FT-IR, a resistência flexural (RF), o módulo flexural (MF), a contração de polimerização por formação de gap (FG) utilizando Microscopia Confocal à Laser, a Dureza Knoop (DK) e a degradação em solvente (DS) foram avaliados. Todos os dados foram analisados utilizando ANOVA e teste de Tukey (α=0.05; b=0.2). Os resultados demonstraram que reduzindo ou substituindo o TEGDMA utilizando o IBOMA não afetou o GC (p=0.085), a RF (p=0.886) ou o MF (p=0.414). Ainda, quando o IBOMA foi utilizado como um monômero combinante ou substituinte, menor FG foi observada em comparação ao controle contendo apenas TEGDMA como monômero diluente (p=0.032). Contudo, apesar de todos os compósitos terem apresentados redução na DK durante o teste de DS, a combinação de IBOMA e TEGDMA demonstrou uma redução na DK similar ao grupo (p=0.001), enquanto a substituição total de TEGDMA com IBOMA reduziu a DK após DS (p=0.041). Dessa forma, a combinação do IBOMA e TEGDMA parece reduzir DS e a FG sem afetar as propriedades de resinas compostas.

Abstract The aim of this study was to use the isobornyl methacrylate (IBOMA) as a combining or substituent diluent monomer in the resin matrix of dental resin composites. Thus, the resin matrix was formulated with 60 wt% of BisGMA and 40 wt% of diluent monomers. TEGDMA as the only diluent monomer was used as control with 40 wt%, while total substitution of TEGDMA was done with 40 wt% of IBOMA. The combination of IBOMA and TEGDMA was done with 20 wt% of each monomer. To the resin matrix, 65 wt% of filler particles was added. Degree of conversion (DC) using FT-IR, flexural strength (FS), flexural modulus (FM), polymerization shrinkage by gap formation (GF), Knoop hardness (KH) and solvent degradation (SD) were evaluated. Data were analyzed using ANOVA and Tukey’s test (α=0.05; b=0.2). The results showed that reducing or substituting TEGDMA using IBOMA did not affect the DC (0.085), FS (p=0.886) or FM (p=0.414). Also, when IBOMA was used, lower GF was found in comparison to the control containing only TEGDMA as the diluent monomer (p=0.032). However, even though all composites presented reduction in KH during the SD test, the combination of IBOMA and TEGDMA showed similar reduction in KHN in comparison to the control group (p=0.001), while the total substitution of TEGDMA with IBOMA decreased KHN after SD (p=0.041). Thus, the combination of IBOMA and TEGDMA seem to reduce SD and GF without affecting the properties of resin composites.

ABSTRACT Objectives: This observational study analyzed telomerase reverse transcriptase (pTERT) mutations in 45 fine-needle aspiration (FNA) specimens obtained from thyroid nodules followed by postoperatively confirmation of papillary thyroid cancer (PTC) diagnosis, examining their relationship with clinicopathologic aspects and the BRAFV600E mutation. Subjects and methods: Clinical information was collected from patients who presented to Ribeirao Preto University Hospital for surgical consultation regarding a thyroid nodule and who underwent molecular testing between January 2010 to October 2012. Tests included a DNA-based somatic detection of BRAFV600E and pTERT mutations. Results: We found coexistence of pTERTC228T and BRAFV600E mutations in 8.9% (4/45) of thyroid nodules. All nodules positive for pTERT mutations were BRAFV600E positives. There was a significant association between pTERTC228T/BRAFV600E with older age and advanced stage compared with the group negative for either mutation. Conclusions: This series provides evidence that FNA is a reliable method for preoperative diagnosis of high-risk thyroid nodules. pTERTC228T/BRAFV600E mutations could be a marker of poor prognosis. Its use as a personalized molecular medicine tool to individualize treatment decisions and follow-up design needs to be further studied.

Recombinant human interferon beta 1b (rhIFNβ-1b) is clinically used to treat multiple sclerosis. A reversed-phase liquid chromatography (RP-LC) method was carried out on a Jupiter C4 column (250 mm × 4.6 mm i.d.). The mobile phase A consisted of 0.1% trifluoroacetic acid (TFA) in water, and the mobile phase B was acetonitrile with 0.1% TFA run at a flow rate of 1.0 mL/min. A size exclusion liquid chromatography (SE-LC) method was carried out on a BioSep-SEC-S 2000 column (300 mm × 7.8 mm i.d.). The mobile phase consisted of 1 mM monobasic potassium phosphate, 8 mM sodium phosphate dibasic and 200 mM sodium chloride buffer pH 7.4, run isocratically at a flow rate of 0.8 mL/min. Retention times were 31.87 and 17.78 min, and calibration curves were linear over the concentration range of 1-200 µg/mL (r2 = 0.9998) and 0.50-200 µg/mL (r2 = 0.9999), respectively, for RP-LC and SE-LC, with detection at 214 nm. Liquid chromatography (LC) methods were validated and employed in conjunction with the in vitro bioassay to assess the content/potency of rhIFNβ-1b, contributing to improve the quality control and to ensure the efficacy of the biotherapeutic.

ResumoIntrodução:Há controvérsias quanto à qualidade de vida (QV) de pacientes renais crônicos tratados com diferentes métodos dialíticos.Objetivo:Comparar a QV de pacientes renais crônicos em diálise peritoneal (DP) e hemodiálise (HD).Métodos:Estudo transversal nos três centros de diálise de Pelotas/RS. Pacientes em DP foram entrevistados após consulta mensal de rotina e os em HD, entre 1ª-2ª horas da sessão dialítica, com questionário estruturado. QV foi avaliada com Short-Form Health Survey (SF-36). Médias dos oito domínios do SF-36 foram comparadas entre os grupos.Resultados:Dos 345 pacientes elegíveis (63 em DP e 282 em HD), foram entrevistados 317 (8% de perdas/recusas). Cerca da metade nos dois grupos estava em diálise há no máximo 3 anos. Havia maioria de mulheres em DP e de homens em HD. Pacientes em DP relataram menos "dor" do que os em HD (escores médios 76,5 e 64,3, respectivamente; p = 0,0040). Não houve diferença nos demais domínios do SF-36.Discussão:A utilização de HD em Pelotas é um pouco menor que a detectada pelo Censo Brasileiro de Diálise (2011), sendo o uso de DP semelhante ao de alguns países europeus. Melhor escore no domínio "dor" entre pacientes em DP é consistente com o observado em outros estudos, embora haja também relatos de nenhuma diferença entre as modalidades e de vantagens da DP em outros domínios que não foram detectados no atual estudo.Conclusão:É semelhante a QV dos pacientes em DP ou HD, exceto no domínio dor, que foi menos intensa entre os pacientes em DP.

AbstractIntroduction:There are controversies regarding differences in quality of life (QOL) of chronic renal disease patients treated with different dialytic methods.Objective:To compare QOL among chronic renal disease patients in peritoneal dialysis (PD) and in hemodialysis (HD).Methods:Cross-sectional study in all the three centers of dialysis in Pelotas/Brazil. Patients in PD were interviewed after the monthly-routine-consultation and those in HD between the 1nd-2rd hours of the dialysis session by employing structured questionnaires. QOL was assessed with Short-Form Health Survey (SF-36). Means in the eight SF-36 domains were compared between groups.Results:Among 345 eligible patients (63 in PD and 282 in HD) 317 were interviewed (8% losses/refusals). About half of patients in both groups were in dialysis treatment for 3 years at most. There were more women in PD and more men in HD. Patients in PD reported less "pain" than those in HD (mean scores 76.5 and 64.3, respectively; p = 0.0040). There was no difference for the remaining SF-36 domains.Discussion:Utilization of HD in Pelotas is a bit lower than detected at the Brazilian Dialysis Census (2011), whereas the frequency of PD is similar to frequency observed in some European countries. The higher score on "pain" among patients in PD is consistent with findings from other studies although no difference and even additional advantages of PD over HD have already been reported.Conclusion:QOL is similar among patients in DP or in HD, except in terms of pain, that was less severe in PD patients.

As aderências pulmonares em cães são sequelas comuns após trauma penetrante, fratura costal, infecção, intervenção cirúrgica, entre outras que prejudicam eventuais intervenções ou reintervenções. Neste estudo, pretendeu-se verificar, em cães, a eficiência da solução de cloreto de sódio (NaCl) 0,9%, adicionada ou não com dexametasona, na prevenção de aderências após toracotomia intercostal. Para isso, foram utilizados três cães, em estudo piloto, e 15 cães, separados em três grupos (A, B, C), submetidos a toracotomia no quinto espaço intercostal esquerdo. Nos cães do grupo A, foi feita somente a toracotomia e a toracorrafia; nos do grupo B, foram realizadas a toracotomia e a toracorrafia e injeção na cavidade pleural ipsolateral de 1mg kg-1 de dexametasona, diluída em 10ml de NaCl a 0,9%. Nos do grupo C, além da toracotomia e toracorrafia, foram injetados no tórax 10ml kg-1 de solução de NaCl a 0,9%. Após 15 dias, foi efetuada videotoracoscopia transdiafragmática para se determinar a presença e o escore de aderências entre o pulmão e a parede costal. Os resultados demonstraram presença de aderências na maioria dos animais do grupo A e reduzida a nenhuma aderência nos demais grupos. Na avaliação estatística, foi aplicado o teste qui-quadrado, com nível de significância de 5%. O uso de solução de NaCl a 0,9% adicionada ou não com dexametasona no espaço pleural evita ou reduz aderências pulmonares após a toracotomia intercostal.

Pulmonary adhesions in dogs are a common sequel after surgical intervention, undermining any interventions. This study aimed to determine in dogs, the efficacy of sodium chloride solution 0.9% with or without dexamethasone in order to prevent adhesions after intercostal thoracotomy. Fifteen dogs were separated into three groups of five animals, A, B and C and underwent thoracotomy in the fifth left intercostal space. Three other dogs were submitted to a previous study. In the dogs of Group A it was performed only a thoracotomy and thoracorraphy; in group B, it was performed a thoracotomy, thoracorraphy and injection into the pleural cavity of isotonic sodium chloride (10ml) and dexamethasone (1mg kg-1). In the dogs of the group C, it was performed the thoracotomy thoracorraphy and injected isotonic sodium chloride (10ml kg-1) into the pleural cavity. After 15 days of thoracotomy, it was performed transdiaphragmatic thoracocospy to determine the presence and score of adhesions between the lung and chest wall. The results demonstrated the presence of adhesions in the majority of group A and reduced or no adhesions in the other groups. For statistical evaluation, it was pplied the chi-square test with significance level of 5% (P≤0.05). The sodium chloride solution 0.9% with or without dexamethasone in the pleural space prevented or reduced lung adhesions after intercostal thoracotomy.

O autor relata um caso de hiperceratose focal acral, afecção do grupo das ceratodermias marginais caracterizada por erupção papulosa ou em placa nas bordas palmoplantares que se inicia geralmente antes dos 20 anos de idade, com predomínio na raça negra. Seu principal diagnóstico diferencial é a acroceratoelastoidose de Costa que dela se distingue apenas por não apresentar elastorrexe na histopatologia.

The author reports a case of focal acral hyperkeratosis, an affection of the group of keratodermas, characterized by papular or plaque eruption in the palmoplantar borders whose onset is usually before 20 years of age, and predominates among black-skinned patients. The main differential diagnosis is acrokeratoelastoidosis of Costa, differing from the former only for not presenting elastorrhexis in histopathology.

Os autores relatam um caso de vitiligo generalizado com áreas normocrômicas residuais tratadas com sucesso com solução de fenol 88%.

Authors relate a case of generalized vitiligo with residual normochromic patches succesfully treated with 88% solution of phenol.