José Luis Ferretti

Mechanical validation of a tomographic (pQCT) index for noninvasive estimation of rat femur bending strength

Cross-sectional moment of inertia (CSMI) and volumetric cortical bone mineral density (vCtBMD) were assessed by peripheral quantitative computed tomography (pQCT) at femur midshafts from 103 Wistar female rats receiving 0 (n = 12) or 15-1000 mu g/kg/day sc of dexamethasone (n = 46) from 5 to 9 weeks of age, or 0 or 80 mg/kg 3/wk of AI(OH)(3) IP (n = 23,22) from 4 to 10 months of age. A bone strength index (BSI), calculated as the product CSMI x vCtBMD, was found to closely correlate (r = 0.94, R(2) = 0.89, p < 0.001) with the actual, mechanically tested bending breaking force of all bones. Correlation and determination coefficients obtained were higher than those usually reported employing different long-bone strength predictive formulae. The curve approached the origin and was linear throughout the wide range of CSMI, vCtBMD and BSI achieved because of age- and treatment-induced differences, showing a very low standard error of the estimate. Instead, different curve slopes and/or intercepts were found in separate analysis between data from each of the experiments when breaking force was correlated with CSMI or vCtBMD alone, or with the DEXA-assessed BMD of the mechanically assayed bone portion. Results suggest that noninvasive assessment of the BSI by means of pQCT technology provides an original tool for a precise and accurate estimation of long-bone bending strength that can be advantageously applied in crosssectional as well as longitudinal, in vivo studies employing animal models.

Determination of femur structural properties by geometric and material variables as a function of body weight in rats. Evidence of a sexual dimorphism.

Femur diaphyses of male and female Wistar rats were densitometrically and biomechanically assayed. The BMD-dependent material properties were better in female than in male bones, but cross-section geometric properties were better in male femurs. As a result, mechanical properties of the integrated diaphyses were better in males, but differences disappeared after statistical adjustment of data to a common body weight. Results evidence a feed-back mechanism locally controlling the strain-dependent bone modelling and the corresponding cross-sectional design as related to bone stiffness, with a set-point adjusted to animal biomass. A sexual dimorphism of bone biomechanics is also described for the species.

Analysis of the Structure and Strength of Bones in Celiac Disease Patients

OBJECTIVE:The aim of this study was to gain insight into the pathogenesis of bone mass loss and weakening affecting patients with celiac disease, according to the new concepts of bone structure/strength and muscle/bone interrelationships.METHODS:We studied serum variables and tomographic indicators of bone structure and strength and regional muscle masses in a series of patients at diagnosis and after 1 yr on a gluten-free diet and in gender- and age-matched controls.RESULTS:At diagnosis, serum levels of calcium and vitamin D were low, and indicators of parathyroid hormone activity and bone formation and resorption were increased. All these parameters were normalized by treatment. Peripheral quantitative CT scans of the distal radius revealed that cortical bone was generally more affected than trabecular bone. The cross-sectional area (CSA) and the volumetric mineral content and density of cortical bone (indicators of cortical tissue mass and mechanical quality), and moments of inertia (CSMI, indicator of the bone architectural design) were in the lower end of normal range in men, and below that in 50% of women. In men, the CSMI/CSA ratio (indicator of the architectural efficiency of distribution of the available cortical tissue) was lower than expected and remained unchanged after treatment. In women, the baseline ratio was normal, but both the ratio and the CSMI were low at diagnosis and normalized after treatment. Both baseline values and the treatment-induced changes of cortical and trabecular bone in the radius and the axis (L3) correlated inversely with serum parathyroid hormone levels. Baseline values or changes in the mineral content of the vertebral bone correlated with the CSA of psoas and spine-extensor muscles. Multiple regression analyses showed that metabolic and mechanical parameters were independent determinants of different aspects of the vertebral bone weakening.CONCLUSIONS:Our results show that bone weakening in celiac disease might result from both 1) a metabolic disturbances of bone remodeling affecting trabecular and cortical bone masses and the mechanical quality of the bone material, and 2) a reduction of muscle strength impairing the modeling-dependent optimization of bone architectural design and mass of cortical bone. Dietary treatment seems to correct almost exclusively the metabolically induced disturbances, which were predominant in women.

Monophasic dose-response curves of betamethasone on geometric and mechanical properties of femur diaphyses in growing rats

The biomechanical repercussion of the corticoid-induced osteopenia (a severe consequence of long-term glucocorticoid therapy) was studied in cortical bone of small rodents. Growing rats receiving 12.5-3200 micrograms/kg/d of betamethasone (BMS) s.c. for 20 days suffered a log-dose related impairment in body weight gain and in mechanical (fracture load, bending stiffness) and cross-sectional properties (area, moment of inertia) of femur diaphyses. No changes in bone material properties (ability to stand stress, elastic modulus, energy absorption per unit volume) were observed. At variance with the biphasic dose-response curves (positive effects at low-medium doses, negative at high doses) previously obtained with cortisol in a similar model, only negative effects on every variable studied were observed in this experiment. Results suggest that BMS effects on cortical bone biomechanics derived mainly or completely from those induced on bone geometry (biomechanical correlate of corticoid-induced osteopenia) in the assayed conditions. Data are compatible with a BMS-induced change in the setpoint of bone mechanostat. Correlation of bone geometric and biomechanical data with body weight gain showed that the anti-anabolic effects of BMS on bone were proportionally less intense than those exerted on the whole biomass.

INTERACCIÓN ENTRE LA NUTRICIÓN Y EL CONTROL BIOMECÁNICO DE LA ESTRUCTURA ÓSEA

Nuevos desarrollos en osteologia estan ejerciendo impacto sobre la interpretacion de algunos aspectos nutricionales de la fisiopatologia, el diagnostico y el tratamiento de todas las enfermedades que reducen la masa o la resistencia esqueletica. En general, esos conceptos se refieren principalmente a 1. los diferentes niveles de complejidad biologica de las estructuras esqueleticas; 2. los verdaderos determinantes de las propiedades biomecanicas del hueso y de los huesos; 3. la forma como los huesos se autoensamblan; 4. el control biologico de la eficiencia biomecanica de la estructura osea; 5. los efectos del entorno mecanico sobre la expresion de los determinantes geneticos de las caracteristicas estructu rales oseas, y 6. la interferencia de factores sistemicos (no-direccionales), endocrino-metabolicos, sobre el control biomecanico de la rigidez y la resistencia oseas. Este trabajo ofrece una vision general de esas cuestiones, focalizada en los fundamentos necesarios para interpretar el papel de la nutricion en la fisiologia y la fisiopatologia oseas, y las interferencias nutricionales con los correspondientes mecanismos

1º Fórum Internacional De Osteología En Odontología

The primless enamel by dentine features are described through transparency, incidence and polarization microscopy. The polatization microscopy, with an uniform and constant thickness, identifies an structural organization distinct in its crystals. Its behavior in the Enamel Caries is like a natural barrier, that offers resistance to the cariogenic desmineralitationIt was done a comparative work to precise the As Ga laser action during the TemporoMandibular Disorders treatment, using pain, noise and mobility to measure the evolution of a twenty pacients group treated with and without laserExitosamente se realizaron las Primera Jornadas Odontologicas de la Facultad de Odontologia de la Universidad Nacional de Cordoba, los dias 13, 14, 15 y 16 de agosto del corriente ano, en el Pabellon Amarillo del Complejo Feriar Cordoba, y auspiciada por el Gobierno de la Provincia de Cordoba.Sub-superficial cariogenic demineralization in cuspidic areas its influence on cavity preparation. The aim of the present work was to analyse ex situ teeth with AD occlusal caries and evaluate surgical treatraent and filling with amalgama to determine if the extension and preparation of the cavity includes in al! its peripheric angle the desmineralized arcas. Thirty human teeth (patient age range 13-25 years, third molars and first premolars) fixed in neutral forrnalina pour 48 hs. and histologyc technique. Cavity carving and filling with amalgama. The sample were sectioned (VL) with carborundum disk. Observed by microscopy lateral incidence. Results: Revelated sub-superficial decalcification PAS + , 40 to 80 micrometers undept and extension 200 to 400 micrometers was not included in cavity preparation, corroborated by MEBSe estudiaron 27 pacientes con sindrome de obstruccion respiratoria. Por medio de telerradiografias laterales se evaluaron dimensiones de nasofaringe midiendo sobre las mismas hipertrofia de cornetes y adenoides. Otros estudios fueron realizados sobre telerradiografias frontales y rinomanometrias. Se realizaron cefalomgramas Ricketts y McNamara. Se obtuvo como resultado que el area libre en respiradores bucales por hipertrofia de cornetes y adenoides disminuye significativamente dificultando el pasaje aereo normal y que el valor medio de H.C. es de 8,2 mm. En el estudio de estructuras profundas el plano palatino, el mandibular, profundidad facial y altura facial inferior fueron los mas significativamente alterados (AU)Se analizan las circunstancias y caracteristicas del terreno oseo en irnplantologia, para llegar a un diagnostico del momento en que se aplicaran los implantes. Segun este analisis se los clasifica en inmediatos y diferidos. Los inmediatos tienen ventajas al reducir el tiempo operatorio y conservacion del proceso alveolar. En esta forma de implantar se pueden emplear recursos complementarios: dilatacion alveolar, injertos oseos autologos recubiertos con periostio, materiales osteotroficos u oseinico mineral, que evita la lisis del coagulo y favorece la coagulacion sanguinea y materiales para reforzar o de refuerzo corno es laesponja de titanio. Los diferidos respecto a su instalacion, pueden tener interrogantes en su pronostico por la existencia de areas osteoliticas que comprometen la instalacion de los implantes. La biopsia del terreno y el efecto estimulante de la cicatrizacion del alveolo quirurgico, son criterios aplicables a este tiempo para la insercion de los implantesEl objetivo general del presente trabajo fue disenar y evaluar modelos graficos directed acyclic (DAG) con estructura de causa suficiente para valorar relaciones causales entre un conjunto de variables clinicas medica-odontologica, psicologicas, moleculo-celulares y los fenotipos multifactoriales de enfermedades complejas. Se evaluaron variables binarias que se incorporaron a un modelo DAG con estructura de causa suficiente para cada patologia.Se realizo el estudio citoquimico y ultraestructural de las glandulas linguales del embrion de pollo con el objeto de analizar el desarrollo morfogenetico y los glicoconjugados elaborados por las mismas para inferir sus posibles significancias histofisiologicas con referencia a las glandulas salivales de esta especie. Se emplearon lengua de embriones de pollo de 7 a 19 dias de incubacion las que se procesaron para su estudio ultraestructural y citoquimico (Rojo de Rutenio, PAS, Alcian blue, Azul de Toluidina). A los 11 dias aparecian esbozos y cordones celulares canalizados cuyas celulas se relacionaban mediante complejos de union. No se detecto reaccion positiva para mucinas. A partir de los 15 dias los acinos estaban bien diferenciados, con granulos secretorios PAS positivos, alcianofilicos y metacromaticos. Poseian organelas tipicas de la sintesis proteica y secrecion luminal Rojo de Rutenio positiva, alcianofilica, metacromatica y PAS positiva. A los 19 dias se detecto un marcado incremento de las mucinas. Estas observaciones demuestran que las glandulas linguales estan citoquimica y ultraestructuralmente diferenciadas desde los 15 dias del desarrollo y contribuiran por medio de los glicoconjugados como ya ha sido establecido a la lubricacion de los alimentos. Ademas podrian iniciar el proceso digestivo de los mismos y protegerian a la mucosa bucal, evitando su deshidratacion y la proliferacion de germenes patogenosEn las pasadas decadas se ha observado un interes creciente en el estudio de las predisposiciones geneticas a las enfermedades complejas, esto ha desembocado en una enorme cantidad de publicaciones epidemiologicas sobre asociaciones entre gen y enfermedad. Sin embargo, no siempre la magnitud de la asociacion entre la presencia de un determinado genotipo y la enfermedad esta determinada, por lo cual es necesario identificar las verdaderas asociaciones geneticas entre la presencia de una enfermedad compleja y los genotipos de las personas. Uno de los puntos en contra de estos estudios son los tamanos de muestra con los que se realizan los estudios y las variantes genotipicas que deben estudiarse por lo cual las revisiones sistematicas y meta-analisis resultan herramientas valiosas para establecer certeramente las asociaciones entre genes y enfermedades. G M T Detect language Afrikaans Albanian Amharic Arabic Armenian Azerbaijani Basque Belarusian Bengali Bosnian Bulgarian Catalan Cebuano Chichewa Chinese (Simplified) Chinese (Traditional) Corsican Croatian Czech Danish Dutch English Esperanto Estonian Filipino Finnish French Frisian Galician Georgian German Greek Gujarati Haitian Creole Hausa Hawaiian Hebrew Hindi Hmong Hungarian Icelandic Igbo Indonesian Irish Italian Japanese Javanese Kannada Kazakh Khmer Korean Kurdish Kyrgyz Lao Latin Latvian Lithuanian Luxembourgish Macedonian Malagasy Malay Malayalam Maltese Maori Marathi Mongolian Myanmar (Burmese) Nepali Norwegian Pashto Persian Polish Portuguese Punjabi Romanian Russian Samoan Scots Gaelic Serbian Sesotho Shona Sindhi Sinhala Slovak Slovenian Somali Spanish Sundanese Swahili Swedish Tajik Tamil Telugu Thai Turkish Ukrainian Urdu Uzbek Vietnamese Welsh Xhosa Yiddish Yoruba Zulu Afrikaans Albanian Amharic Arabic Armenian Azerbaijani Basque Belarusian Bengali Bosnian Bulgarian Catalan Cebuano Chichewa Chinese (Simplified) Chinese (Traditional) Corsican Croatian Czech Danish Dutch English Esperanto Estonian Filipino Finnish French Frisian Galician Georgian German Greek Gujarati Haitian Creole Hausa Hawaiian Hebrew Hindi Hmong Hungarian Icelandic Igbo Indonesian Irish Italian Japanese Javanese Kannada Kazakh Khmer Korean Kurdish Kyrgyz Lao Latin Latvian Lithuanian Luxembourgish Macedonian Malagasy Malay Malayalam Maltese Maori Marathi Mongolian Myanmar (Burmese) Nepali Norwegian Pashto Persian Polish Portuguese Punjabi Romanian Russian Samoan Scots Gaelic Serbian Sesotho Shona Sindhi Sinhala Slovak Slovenian Somali Spanish Sundanese Swahili Swedish Tajik Tamil Telugu Thai Turkish Ukrainian Urdu Uzbek Vietnamese Welsh Xhosa Yiddish Yoruba Zulu Text-to-speech function is limited to 200 characters Options : History : Feedback : Donate CloseA study of Cordobas children population was made to evaluate the percentage of malocclusions and the necessity for treatrnent. 990 children of both sexes, fron first to seventh grade were chosen randomly out of the 16.870 students registered in 1993. Town Hall schools. To gather the data the epidemiological card to register malocclusions of qualitative range was used, made by the University of Dentistry of Montevideo, Uruguay, and this enabled us to determine the morphofunctional characteristics that prevail in temporary, mixed and permanent dentition. The results indicate a prevalence of abnormal lip closure and the presence of habits. The cuantitative register in mixed and permanent dentition to determine the orthodontic abnormality and evaluate the necessitty and priority of treatrnent was used in Buenos Aires by Dr. Teneban, Goto and Morales and it showed an 82% malocclusions and the highest percentage of anomalies in these teeth corresponded to the minor onea. The low percentage ofmalocclusions found in temporary dentition (19, 42%) and its increasing tendency as it evolver into permanent dentition makes us think of the necessity of regular controls from an early age to prevent and intercept malocclusionsA comparative study is made between the canica! external-based parallelizable pillars, prefabricated angled pillars and filtered angled pillars, obtained from calcinable· material. The conical external-based parallelizable pi!Hm; feature a design obtained by the direct, direct-indirect or indirect method, thus obtaining a personal emergence and optimum angulation in the sector to be replaced, with precise indications for the lower-front sector. It achieves a perfect adaptation of two machined surfaces which are either facing each other or in contact, avoiding galvanized corrosion as well as similar effects in the soft tissues. Its construction and constitution in a single piece prevents problems of fatigue and imperfection of the metal due to filteringLa Escuela de Graduados de la Facultad de Odontologia tiene bajo su responsabilidad la Educacion del cuarto nivel. Su principal objetivo es profundizar y actualizar la formacion docente, cientifica y tecnologica, lo cual se logra mediante la reflexion critica, la investigacion y el intercambio sobre los avances en las diferentes especialidades.The effects of the Nd-YAG and C02 lasers on the oral mucosa though the treatment of pathological processes with surgical indication such as leukoplakias, atypicallichens, hemangiomas and cancer with a follow-up of up two years are analizad in this paper. An experimental work in which portions of human oral mucosa were irradiated to acquire experience in the surgical method and to observe histologically the laser effects on the tissues under survey was done previously. Though the treatment of these lesions, beneficia! effects of these lasers such as absence of hemorrhage in al! the treated cases, little pain and edema in the inmediate post-op, scarce recurrence and scarring in the distant controls were observedcastration and simultaneous application of DMBA. Wistar young males were used, in groups of five animales each. They were sacriiiced lZ, Z3 and Z8 days after the experlment was started. The glands werediss~cted and fixed in 10 % formol at Ph. 7 in arder to be . studiedmorphohistochemically and histometrically. The number of mast cells increased in the sublingual gland (SLG) at all the time perlods studied, outnumbering considerably the cell population in the sub maxillary gland (SMG) lZ days after the animals had been castrated. When comparing uncastrated · animals with castrated ones, it is noticed that the most importantdifierences in the mast cell population appear in the SLG. With application of DMBA and simultaneous castration, it is observed that the sublingual gland (which normally has very little receptivity to DMBA in un castrated animals) experiences an atypical tissue response accompanied by anincrease in its mast cell populationLa Revista de la Facultad de Odontologia de la Universidad Nacional de Cordoba nacio con el animo de constituir un espacio de referencia en la investigacion en el campo de la OdontologiaIi describes the child[s ortjopedic treatment that shows the Pierre Robins Sequence (formely called pi erre Robins Syndrome). The treatment starts from the first week of life. The orthopedic trearment is perfomed with an acrylic prothesis which in vestibular area adheres to the superior alveolar ridges, thus showing at a post daming leve! a posterior prolongation appendage as a that coincides with the fissured area. Thanks to it, the tongue finds. This allows the tongue to descend and advance progresively and partly sol ve the micrognatism and the glosoptosis that characterized this pathology, and allows the child to be fed by a nursing bottle. This therapeutic resource, plus the usage of nipples and anatomic pacifiers and an adecuate postura! treatment (supino - prono position), allow a right feeding and also improve breathing problems, that is a characteristic of these children. The orthopedic outlook is a preparation for a successful surgical closing of the cleft, This, together with the phonoauidological treatment and the psychological support allows these children s rehabilitation befo re school age through a multi and interdisciplinary work.The structural and histochemical patterns of the salivary mesenchyma were analysed in relation to the epithelium of the labial glands during the embryonic development to correlata the structural and histochemical characteristics in both tissues during the histogenesis. Samples of h~man fetal lips were analysed using H/E, PAS, Casen, Alcian blue, Tolui dine blue and Methenamine/silver, The process of glandular histogenesis begun between B te 10 weeks. The mesenchy~a surrounding the glandular buds had PAS positiva granulations which were also alcianophilic, met~chromatic and periodatoreactive. Periodatoreactive collagenous fibrillae, reticular cells and nervous fibers of considerable diameter were observad. Basement _membranas were PAS positiva, alcianophilic and di~continu.ous, At 12 weeks the mesenchyma differentiated as loase conne~tive tissue which produced a delicate periglandular capsule with fibra blast and collagenous fibrillae. Froin 20 to 2q weeks ·the ac1n1 wer-i;;structurally and histochemically differentiated as serous, mucous and mixed, It was postulated that the periglandular mesenchyma would play and important role in the morphogenetic process in relation to the hist~chemical identification of molecules which have a specific biological functions in the epithelium-mesenchyma interactions during organogene sisSe estudiaron 22 pacientes de 5 a 12 anos de edad. desde el punto de vista clinico y radiologico, donde existian antecedentes de perdida prematura de piezas temporarias por extt·acciones y/o acc1dentes (luxaciones). Clinicamente se encontro en 17 casos que, cuando la perdida ocurria en piazos mayores a 1os 20 meses de 1a normal erupcion, se detectaba falta de erupcion de los permanentes. Ei criterio Dara hacer e1 diagnostico de erupcion retardada, se hizo tornando en referencia la erupcion del diente homologo. Las radiografias P.Srapica1es, mostraban esta pieza~ dentarias realizando su,trabajo de erupcion en la etapa 1ntraosea, quedando en retencion subli! Ucosa. El estudio ...bistopato1o_gico del tejido blando~ obtenido de la liberacion quirurgica de estos elementos, demostro fibrosis con grados variables de hia1inizacion dei tejido conjuntivo. En 5 casos, con P-lazos inferiores (8 a 12 meses} de tiempo de perdida}, la erupcion fue normal o acelerada. Se concluye que la perdida prematura de dientes tempor?rios cuando acontece en plazos mayores a los 20 meses, determma un retardo de eru~cion. que en los casos seleccionados para este estudio. obedecia a un proceso de fibrosis e hia1inizacion del tejido conjuntivo submucoso y papilar con caracteristicas de brida cicatrizal, que interpretamos como responsable de la retencion submucosa en estos elementosObjetivo: Generar un dialogo de saberes entre docentes y profesionales de diferentes niveles educativos de la provincia de Cordoba para contribuir a la mejora de la ensenanza de las Ciencias Naturales en el nivel primario. Metodos: Se planifico y desarrollo una capacitacion semi-presencial titulada “Viaje al mundo microscopico: Aportes de la microscopia del siglo XXI”, en base a la demanda de los docentes de escuela primaria en relacion a la tematica de la microscopia. Se realizaron encuentros teorico-practicos con utilizacion de microscopios y aparatologia relacionada, complementados con actividades en un aula virtual disenada a tal fin en la plataforma Moodle, con tutorias docentes e interaccion en foros. Resultados: Esta intervencion extensionista, de caracter interdisciplinario e integrado, tuvo un impacto muy positivo en los actores involucrados -profesores primarios y secundarios, formadores de futuros docentes y docentes universitarios- enriqueciendo el conocimiento de problematicas educativas y estrategias para afrontarlas. Conclusiones: Se considera que los ninos seran los principales beneficiarios de esta intervencion extensionista, la cual ha contribuido a promover la equidad y la calidad educativa. Se destaca asimismo que a traves de esta experiencia se genero una valiosa capacidad instalada -sostenible a traves del tiempo- de recursos de estudio y actividades de aplicacion virtuales, que permiten aprovechar el potencial pedagogico de las TIC.Las ciencias de la salud son, por su propia naturaleza intrinseca, un quehacer moral. Todas sus actividades, ya sean la practica clinica, la investigacion, la aplicacion de innovaciones tecnologicas, etc., estan en ultima instancia dirigidas a los seres humanos y sus decisiones tienen la intencion de hacerles bien.The fluoride ability to react with the enamel surface hodroxiapatite, transforming it in a fluorhirdroxiapatite, more strong to the acid action, is in part, the cariopreventive mechanisme of this chemical elemenL This action could be beneficia! for the primary dentition if fluoride supplements are administrated duriog pregnacy with an appropite dosage, specially if the family caries story and the sorrounding conditions alen about potential reisk for the future babyIn the present study it was investigated the histophysiology of the lingual salivary glands in white egret. Glands were processed by conventional histology (hematoxilin-eosin and Masson trichromic) and histochemical techniques including PAS, PAS/neuraminidase, alcian blue, toluidine blue and PNA lectin. The obtained results ha ve indicated the presence of numerous glands located anteroposterior and lateral !O the lingual cartila~e. In the anterior region, gla73ndular lo bes showed tubular structures formed by basophilic cuboidal cells.- In the posterior region a scarce number of mucous adenomers and intraepithelial glands were found. The histochemical reactions indicated the presence of glycoconjugate compounds in the glandular secretion. These glycoconjugates had a high number of terminal sialic acid residues because it was observed a decrease in PAS and alcian blue reactions after neuraminidase digestion. In addition, the affinity by PNA lectin was increased with enzymatic digestion. lt was also detected a strong alician.;philic and metachromatic sulphated groups. These findings showed that the glandular lingual secretion in these bires, present the same types of glycoconjugates as !hose described in mammals. In conclusion, this secretion could play a main role in food lubrication and non-inmune responsesEl articulo contiene los siguientes resumenes: Calidad de hueso y fragilidad por Prof. Jose Luis Ferretti Determinaciones cuantitativas de calidad osea y tratamiento de los estados de fragilidad por Dr. Emilio J. A. Roldan Evaluacion Del Estado Metabolico Del Esqueleto por Dra. Maria Rosa Ulla La Importancia Del Diagnostico En Implanto Logia por Prof. Dr. Miguel Mario Fonseca