Cícero de Andrade Urban

Platelet-rich plasma (PRP) impairs the craniofacial bone repair associated with its elevated TGF-β levels and modulates the co-expression between collagen III and α-smooth muscle actin.

Transforming growth factor‐β (TGF‐β) is considered the main inducer of both the α‐smooth muscle actin (α‐SMA) phenotype and collagen synthesis and deposition and plays a significant role in the tissue repair and the development of fibrosis. Since the PRP constitutes an important source of TGF‐β and its efficacy on the craniofacial bone repair remains controversy, the aim of this study was to evaluate the effect of PRP in the presence of levels of TGF‐β on PRP samples, as well as in the presence of collagen III and α‐SMA+ cells, while comparing these results by means of a histomorphometric analysis of the bone matrix and fibrous deposition on the bone repair. Four bone defects of 16 mm2 were created on the calvarium of 21 rabbits. The surgical defects were treated with either particulate autograft, particulate autograft mixed with PRP and PRP alone. Animals were euthanized at 15, 30, and 45 days postoperative. Histomorphometric and immunohistochemical analyses were performed to assess repair time, as well as the expression of collagen III, and α‐SMA. The histomorphometric results demonstrated intensive deposition of fibrous tissue while hinder bone deposition occurred in PRP groups. These results coincided with higher values of the TGF‐β on the PRP sample, also larger occurrence of diffuse collagen III deposition and higher presence of α‐SMA+ cells spread among the fibrous tissue. Thus, the higher levels of TGF‐β associated with the both expression of collagen III and α‐SMA on defect treated with PRP suggest that its biomaterial induce an effect that can be considered similarly to a fibroproliferative disorder.

Platelet-rich plasma diminishes calvarial bone repair associated with alterations in collagen matrix composition and elevated CD34+ cell prevalence

The interaction between platelets and both type I and III collagens plays an important role in modulating platelet adhesion and aggregation, also contributing to the chemotaxis of CD34+ cells. The interaction with type III collagen can maintain high levels of collagen and alter the biology of bone repair when the PRP is used. The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) and autograft on the presence of type III and type I collagens, the ratio between them, as well as the presence of CD34+ progenitor cells, while comparing these results by means of a histomorphometric analysis of the bone tissue. Four bone defects (8.0mm in diameter and 2.0mm in depth) were produced on the calvarium of 23 rabbits. The surgical defects were treated with either autogenous bone grafts, autogenous bone grafts with PRP and PRP alone. Animals were euthanized at 2, 4 or 6 weeks post-surgery. Histological, histomorphometric and immunohistochemical analyses were performed to assess repair time, as well as the expression of type I and III collagens, and number of progenitor CD34+ cells. Data were analyzed using the ANOVA and Student-Newman-Keuls test (alpha=5%). An enlarged granulation and medullary tissue areas in the PRP groups were observed. The use of PRP in this study hindered bone deposition, also enhanced type III to type I collagen ratio and the chemotaxis of CD34+ progenitor cells, similarly to a thrombogenic effect.

Genetic polymorphisms in oestrogen metabolic pathway and breast cancer: a positive association with combined CYP/GST genotypes.

The cytochrome P450 family (CYPs) and the glutathione S-transferase (GSTs) enzymes play an important role in the metabolism of environmental carcinogens and of oestrogen and can affect breast cancer risk. In this study we examine the role of the genes CYP1A1, CYP17, CYP2D6, GSTM1, GSTP1 and GSTT1 in breast cancer risk in Brazilian women. The study population consisted of 102 incident breast cancer cases and 102 healthy controls. Genotyping analyses were performed by PCR-based methods. A significant finding was observed between GSTP1 Ile-Val polymorphism and breast cancer risk (OR = 1.81; CI 95% = 1.04–3.16). A significant association was observed between women with 0–2 risk genotypes and those with 4 or more risk genotypes (OR = 2.42; CI 95% = 1.13–5.18) when the potential combined effects of the risk genotypes were examined. No significant differences between cases and controls were found correlating the genotypes and the clinical-histopathological parameters. In conclusion, in our population only GSTP1 was associated with breast cancer risk. However, when the genes were tested in combination, a significant association in the breast cancer risk was observed.

Cárie precoce e severa na infância: uma abordagem integral

OBJETIVO: Fornecer informacoes para auxiliar o medico pediatra a reconhecer os fatores de risco para o inicio da carie precoce na infância e da carie severa na infância (CSI), possibilitando a intervencao precoce de tais fatores, e, assim, evitar a instalacao dessa doenca prevenivel e as suas consequencias. FONTES DOS DADOS: As informacoes foram coletadas a partir de artigos cientificos publicados nas bases de dados SciELO, MEDLINE e PUBMED nos ultimos 25 anos, livros tecnicos e publicacoes de consenso de organismos internacionais. As palavras-chave utilizadas foram: early childhood caries, severe early childhood caries, dental caries e children. SINTESE DOS DADOS: A CSI e uma forma de carie dentaria que afeta bebes e criancas. E infecciosa, de etiologia multifatorial e de desenvolvimento rapido, iniciando logo apos a erupcao dos dentes. Por apresentar fatores de risco local e sociocultural, deve ser considerada como sintoma de uma alteracao na crianca e de falta de cuidados adequados. Suas manifestacoes incluem dor, abscessos e dificuldades mastigatorias, afetando a alimentacao e o sono da crianca. Alem disso, afeta tambem sua saude geral, fala e autoestima. CONCLUSOES: A CSI e uma doenca com metodos preventivos estabelecidos, que devem ser introduzidos o mais precocemente possivel, por meio de programas preventivos na comunidade e no nucleo familiar. Os profissionais que atendem bebes e criancas devem estar atentos aos casos com risco para o desenvolvimento da doenca carie e interceder a fim de se obter saude.

Fragmented adipose tissue graft for bone healing: histological and histometric study in rabbits' calvaria

Objective The adipose tissue represents an important reservoir of stem cells. There are few studies in the literature with which to histologically evaluate whether or not the adipose tissue graft is really a safe option to achieve bone repair. This study histologically analyzed the effect of fragmented autogenous adipose tissue grafts on bone healing in surgically created, critical-size defects (CSD) in a rabbit’s calvaria. Study design Forty-two New Zealand rabbits were used in this study. CSD that were 15 mm in diameter were created in the calvarium of each animal. The defects were randomly divided into two groups: in Group C (control), the defect was filled only by a blood clot and, in Group FAT (i.e., fragmented adipose tissue), the defect was filled with fragmented autogenous adipose tissue grafts. The groups were divided into subgroups (n = 7) for euthanasia at 7, 15, and 40 days after the procedure had been conducted. Histologic and histometric analyses were performed. Data were statistically analysed with ANOVA and Tukey’s tests (p < 0.05). Results The amount of bone formation did not show statistically significant differences seven days after the operation, which indicates that the groups had similar amounts of mineral deposition in the earlier period of the repair. Conversely, a significant of amount of bone matrix deposition was identified in the FAT group at 15 and 40 days following the operation, both on the border and in the body of the defect. Such an outcome was not found in the control group. Conclusion In this study, an autologous adipose tissue graft may be considered as likely biomaterial for bone regeneration, since it positively affected the amount of bone formation in surgically created CSD in the rabbits’ calvaria 40 days after the procedure had been performed. Further investigations with a longer time evaluation are warranted to determine the effectiveness of autologous adipose tissue graft in the bone healing. Key words:Adipose tissue, bone regeneration, rabbits, critical defects.

Nonprocessed adipose tissue graft in the treatment of dehiscence bone defects in rabbit tibiae: a pilot study.

Objective:To evaluate the bone repair of surgically created dehiscence-type defects (3 × 5 mm) around dental implants in rabbit tibia using nonprocessed adipose tissue graft or autogenous bone graft. Materials and Methods:The bone defects were randomly assigned to 3 groups: blood clot (C), autogenous bone (AB), and nonprocessed adipose tissue (AT). After 3 months, the animals were euthanized. Histomorphometric analyses were performed, and the results were analyzed with analysis of variance and Tukey tests (P ⩽ 0.05). Statistics were performed for the percentage of the bone-to-implant contact (BIC) and bone area (BA) within the limits of the threads. Results:The results for BIC in the AT (37.75% ± 28.03%) and C (40.57 ± 13.71%) groups were statistically similar, whereas the AB group had the greatest percentage of BIC (83.37% ± 11.85%). For all groups, the BA percentage was similar (61.48% ± 30.89% in AT; 72.90% ± 14.10% in C; 84.23% ± 11.96% in AB), with no statistically significant differences. Conclusion:Nonprocessed adipose tissue is not a comparable substitute for autogenous bone in the treatment of dehiscence bone defects around titanium dental implants.

Oncoplastic and reconstructive breast surgery

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Differential loss of heterozygosity profile on chromosome 3p in ductal and lobular breast carcinomas

The 2 main histologic types of infiltrating breast cancer, invasive lobular and invasive ductal carcinoma, are morphologically and clinically distinct. Studies revealed that different patterns of gene expression and loss of heterozygosity can also distinguish these 2 subtypes. A whole-genome study using single nucleotide polymorphism array found a significantly higher frequency of loss of heterozygosity on 3p in invasive ductal carcinoma when compared with invasive lobular carcinoma. In this study, we performed a loss of heterozygosity analysis of the 3p chromosome region in ductal and lobular breast tumors. Seven microsatellite markers were evaluated in a series of 136 sporadic breast cancer cases (118 invasive ductal carcinoma and 18 invasive lobular carcinoma) and correlated with clinical-histopathologic parameters from the patients. A significantly higher frequency of loss of heterozygosity was observed in invasive ductal carcinoma (65.3%) when compared with invasive lobular carcinoma (38.9%). When the markers were analyzed separately, loss of heterozygosity at 3 of them, D3S1307 in 3p26.3, D3S1286 in 3p24.3, and D3S1300 in 3p14.2, were significantly more frequent in ductal than in lobular tumors. D3S1307 marker showed the highest frequency of loss of heterozygosity in invasive ductal carcinoma (46.2%), and associations between loss of this marker and loss of estrogen and progesterone receptors were found in these samples. Our results confirm the observations that invasive ductal carcinoma has a higher frequency of loss of heterozygosity events across the 3p region than invasive lobular carcinoma and show that specific losses on 3p26.3, 3p24.3, and 3p14.2 regions are more frequent in ductal than in lobular tumors. We discuss our data in relation to the known tumor suppressor genes that are mapped at the 3p loci investigated and their present relevant roles in breast cancer.

Oncoplastic in a pre-paradigm era: a Brazilian perspective in an American problem.

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Nonprocessed Adipose Tissue Graft in the Treatment of Peri-Implant Osseous Defects in the Rabbit's Tibiae: A Pilot Study

We hypothesized that a new technique using nonprocessed adipose tissue could regenerate bone around dental implants. Eighteen rabbits received 1 implant per tibia surrounded by a surgically created osseous defect. The defects were assigned for treatment into 3 groups: C, AT, and AB. The percentages of bone-to-implant contact were 17.64% ± 16.22% (AB), 3.54% ± 7.08% (AT), and 12.71% ± 10.11% (C) (ρ = 0.25). The use of adipose tissue around surgically created peri-implant osseous defects interferes with bone formation.