We examined the relationship between grip strength declines and muscle-tendon responses induced by long-term performance of a high-repetition, low-force (HRLF) reaching task in rats. We hypothesized that grip strength declines would correlate with inflammation, fibrosis and degradation in flexor digitorum muscles and tendons. Grip strength declined after training, and further in weeks 18 and 24, in reach limbs of HRLF rats. Flexor digitorum tissues of reach limbs showed low-grade increases in inflammatory cytokines: IL-1beta after training and in week 18, IL-1alpha in week 18, TNF-alpha and IL-6 after training and in week 24, and IL-10 in week 24, with greater increases in tendons than muscles. Similar cytokine increases were detected in serum with HRLF: IL-1alpha and IL-10 in week 18, and TNF-alpha and IL-6 in week 24. Grip strength correlated inversely with IL-6 in muscles, tendons and serum, and TNF-alpha in muscles and serum. Four fibrogenic proteins, TGFB1, CTGF, PDGFab and PDGFbb, and hydroxyproline, a marker of collagen synthesis, increased in serum in HRLF weeks 18 or 24, concomitant with epitendon thickening, increased muscle and tendon TGFB1 and CTGF. A collagenolytic gelatinase, MMP2, increased by week 18 in serum, tendons and muscles of HRLF rats. Grip strength correlated inversely with TGFB1 in muscles, tendons and serum; with CTGF-immunoreactive fibroblasts in tendons; and with MMP2 in tendons and serum. Thus, motor declines correlated with low-grade systemic and musculotendinous inflammation throughout task performance, and increased fibrogenic and degradative proteins with prolonged task performance. Serum TNF-alpha, IL-6, TGFB1, CTGF and MMP2 may serve as serum biomarkers of work-related musculoskeletal disorders, although further studies in humans are needed. / Biomedical Sciences

Connective tissue growth factor (CTGF/CCN2) and bone morphogenetic protein (BMP)-2 are both produced and secreted by osteoblasts. Both proteins have been shown to have independent effects in regulating osteoblast proliferation, maturation and mineralization. However, how these two proteins interact during osteoblast differentiation remains unknown. In Chapters 2 and 3, we utilized two cell culture model systems, osteoblasts derived from CTGF knockout (KO) mice and osteoblasts infected with an adenovirus, which over-expresses CTGF (Ad-CTGF), to investigate the effects of CTGF and BMP-2 on osteoblast development and function in vitro. To observe differences in osteoblast maturation and mineralization, we performed alkaline phosphatase (ALP) staining and activity and alizarin red staining, respectively. Contrary to a previously published report, osteoblast maturation and mineralization were similar in osteogenic cultures derived from KO and wild type (WT) calvaria in the absence of BMP-2 stimulation. Interestingly, in KO and WT osteoblast cultures stimulated with BMP-2, the KO osteoblast cultures exhibited increased alkaline phosphatase staining and activity and had larger, fused nodules stained with alizarin red than WT osteoblast cultures. This increase in osteoblast differentiation was accompanied by increased protein levels of phosphorylated Smad 1/5/8 and mRNA expression levels of bone morphogenetic protein receptor Ib. These data confirm enhanced osteoblast maturation and mineralization in BMP-2 induced KO osteoblast cultures. We also examined osteoblast differentiation in cultures that were infected with Ad-CTGF and in control cultures. Continuous over-expression of CTGF resulted in decreased ALP staining and activity, alizarin red staining, and mRNA expression of osteoblast markers in both unstimulated and BMP-2 stimulated cultures. Impaired osteoblast differentiation in cultures over-expressing CTGF was accompanied by decreased protein levels of phosphorylated Smad 1/5/8. In addition to the functional assays that we performed on WT and KO osteoblast cultures, we performed ChIP assays to investigate differences in binding occupancy of transcription factors on the Runx2 and Osteocalcin promoters in BMP-2 induced WT and KO osteoblast cultures. We demonstrate that in BMP-2 induced WT and KO osteoblast cultures, there was greater Smad 1 and JunB occupancy on the Runx2 promoter and Runx2 occupancy on the Osteocalcin promoter in BMP-2 induced KO osteoblast cultures compared to WT cultures. Collectively, the data demonstrate that CTGF acts to negatively regulate BMP-2 induced signaling and osteoblast differentiation. In Chapter 4, we synthesized an active His-tagged BMP-2 recombinant protein to track surface binding of BMP-2 in CTGF WT and KO osteoblasts. We amplified mature BMP-2 in genomic DNA, which was inserted correctly into a pET-28b(+) vector. We ran a SDS-PAGE gel and stained with Coomassie blue to show that we successfully induced BMP-2 in bacteria cells, extracted the protein using urea, and purified and eluted the protein using Nickel charged agarose beads and imidazole elution buffer. Furthermore, by Western blot analysis using anti-His antibody, we confirmed the presence of the His-tag on the BMP-2 protein. Lastly, ALP staining on osteoblast cultures stimulated with our synthesized BMP-2 exhibited increased staining compared to the unstimulated osteoblast cultures, which confirmed the activity of our His-tagged BMP-2 protein. Future studies utilizing this protein will demonstrate that CTGF acts as an extracellular antagonist by limiting the amount of BMP-2 available for receptor binding. / Cell Biology

Bibliografische Beschreibung Knepper, Robert Darstellung des Verlaufs der Arteria palatina major unter dem Aspekt der Entnahme autologer Bindegewebstransplantate aus dem Gaumen Universität Leipzig, Dissertation 68 Seiten, 43 Literaturangaben, 42 Abbildungen, 12 Tabellen, 4 Anlagen Referat: Die sich stets weiterentwickelnden Verfahren zahnärztlicher Chirurgie bringen auch neue Anforderungen an den Operateur mit sich. Vor allem im Bereich der ästhetischen Korrektur von weichgewebigen Defekten im Bereich des Zahnhalteapparates gilt es, auf dem neuesten Stand zu sein, um moderne Zahnheilkunde anbieten zu können. Profunde Kenntnisse zur Topographie anatomischer Strukturen sind dabei für den Zahnarzt, den Spezialisten für Parodontologie und den Oralchirurgen unabdingbar. Um die dafür notwendige praktische Anleitung zu erhalten, können Mediziner am Institut für Anatomie der Universität Leipzig Kurse absolvieren, so z.B. auch angehende zahnärztliche Implantologen. Hierbei interessiert die Teilnehmer neben dem praktischen Vorgehen auch der Verlauf von Gefäßen und Nerven im Operationsgebiet. Anatomische Atlanten stellen die betreffenden Areale idealisiert und ohne Berücksichtigung der individuellen Variationsbreite dar. Zugänge, wie sie in der Klinik benötigt werden, finden sich selten. Aus diesem Grund wurde in der vorliegenden Arbeit an sechs vollständigen und 21 geteilten humanen Kopfpräparaten (alle Ethanol-Glycerin fixiert) die A. palatina major präpariert und der klinischen Situation gegenübergestellt. Diese Arterie wurde gewählt, da ihr Versorgungsgebiet – der Gaumen – die bevorzugte Spenderregion autologer Bindegewebstransplantate ist. Dadurch wird die Lücke der oft unzureichenden Verknüpfung der klinischen Situation mit dem anatomischen Korrelat geschlossen. Des Weiteren wurde an diesen Präparaten eine in der Literatur als sicher beschriebene Entnahmestelle vermessen und die Werte den bekannten gegenübergestellt. Um diese Messwerte beurteilen zu können, wurde außerdem die Frage gestellt, inwieweit die Fixierung der Präparate deren Beschaffenheit verändert. Dies wurde in einem Versuch mit dentalen Volumentomogrammen von frisch angefertigten und anschließend fixierten Präparaten untersucht. Auf Grund der Tatsache, dass Humanpräparate nur für einen begrenzten Zeitraum zur Verfügung stehen, ist ein wesentlicher Aspekt dieser makroskopisch-anatomischen Arbeit die fotografische Dokumentation der präparierten Gefäßstrecken, bei der ästhetische u.a. Gesichtspunkte beachtet werden müssen. Da dies auch für andere makroskopische Arbeiten am Institut für Anatomie von Interesse ist, wurde dieser Teil so ausführlich beschrieben, dass er als Anleitung dienen kann.

O Cimento de Ionômero de Vidro (CIV) é um material restaurador utilizado na Odontologia Minimamente Invasiva pois, além de apresentar propriedade adesiva à estrutura dental, apresenta propriedades tais como liberação e absorção de íons flúor, compatibilidade biológica com os tecidos bucais e coeficiente de expansão térmica similar ao da dentina. No entanto, o CIV apresenta baixa resistência mecânica, alta suscetibilidade à perda e ao ganho de água nas primeiras 24 horas (sinérese e embebição), período prolongado de presa e polimento ruim. Apesar desse material ter sido introduzido na Odontologia há mais de 40 anos, sua fórmula original vem sofrendo alterações, com o objetivo principal de aprimorar as propriedades mecânicas e alcançar melhores resultados clínicos. Dentre os CIV convencionais, destaca-se o EQUIA&reg; Forte Fil (GC Corporation, Tokyo, Japan), material elaborado com o objetivo de aprimorar as características físicas e estéticas do seu antecessor EQUIA&reg; Fil. No entanto, até o momento não existem trabalhos biológicos avaliando o desempenho do EQUIA&trade; Forte e Ketac&trade; Universal Aplicap&trade;. O objetivo deste estudo foi avaliar a resposta do tecido conjuntivo subcutâneo de camundongos isogênicos após implante de diferentes cimentos de ionômero de vidro (EQUIA&reg; Forte Fil, EQUIA&reg; Fil e Ketac&trade; Universal Aplicap&trade;). Foram utilizados 87 camundongos isogênicos da linhagem BALB/c divididos em 12 grupos, sendo 9 experimentais (Ketac, E. Fil e E. Forte nos períodos de 7, 21 e 63 dias) e 3 controles (tubos de polietileno vazios, nos mesmos períodos). Decorridos os períodos experimentais, a porção do tecido conjuntivo subcutâneo circundante ao material implantado foi removida e submetida ao processamento histotécnico e à coloração com hematoxilina e eosina. Foi realizada a descrição da reação tecidual em contato com cada material, análise semi-quantitativa do fibrosamento e do infiltrado inflamatório e análise quantitativa da espessura do tecido reacional granulomatoso em contato com o material testado ou tubo de polietileno. Os dados foram analizados estatisticamente (&alpha;=0,05), utilizando o teste de Kruskal-Wallis, seguido pelo Pós-teste de Dunn. Inicialmente, o fibrosamento não foi diferente entre os materiais testados (p>0,05), porém passou a ser diferente aos 21 dias, com o controle apresentando o estágio mais avançado de fibrosamento, e chegando ao final do experimento com o Grupo EQUIA&reg; Forte Fil com estágio mais avançado de fibrosamento, em comparação ao grupo EQUIA&reg; Fil (p<0,05). O infiltrado inflamatório, por sua vez, não apresentou diferença entre os materiais testados ao longo dos períodos experimentais (p>0,05). A área do tecido reacional granulomatoso foi maior para o Grupo E. Forte, diferindo do controle em todos os períodos avaliados (p<0,05). De acordo com os resultados obtidos, concluiu-se que todos os cimentos à base de ionômero de vidro testados apresentaram compatibilidade tecidual, de acordo com os diferentes parâmetros avaliados / The Glass Ionomer Cement (GIC) is a restorative material used in Minimally Invasive Dentistry. Besides it presenting adhesive properties to the dental structure, GIC has properties such as release and absorption of fluoride ion, biological compatibility with buccal tissues and expansion coefficient similar to that of dentin. However, GIC presents low mechanical resistance, high susceptibility to loss and water gain in the first 24 hours (syneresis and imbibition), prolonged setting time and poor polishing. Although this material was introduced in Dentistry more than 40 years ago, its original formula has undergone changes, with the main objective of improving the mechanical properties and achieving better clinical results. Among the conventional GIC, we highlight EQUIA&reg; Forte Fil, a material developed with the aim of improving the physical and aesthetic characteristics of its predecessor EQUIA&reg; Fil. However, there are no biologic researches evaluating the performance of EQUIA&reg; Forte and Ketac&trade; Universal Aplicap&trade;. The aim of this study was to evaluate the subcutaneous connective tissue response of isogenic mice after implanting different glass ionomer cements (EQUIA&reg; Forte Fil, EQUIA&reg; Fil and Ketac&trade; Universal Aplicap&trade;). Eighty-seven isogenic mice of the BALB/c were divided into 12 groups, 9 were experimental (Ketac, E. Fil and E. Forte at 7, 21 and 63 days) and 3 controls (empty polyethylene tubes at the same experimental time). After the experimental periods, the portion of the subcutaneous connective tissue surrounding the implanted material was removed and subjected to histotechnical processing and staining with hematoxylin and eosin. A description of the tissue reaction in contact with each material, semi-quantitative analysis of f collagen fiber formation and inflammatory infiltrate and quantitative analysis of the tissue thickness of the granulomatous reaction tissue in contact with the tested material or polyethylene tube were performed. Data were analyzed statistically (&alpha;=0.05) using the Kruskal-Wallis test, followed by the Dunn Post test. Initially, the collagen fiber formation was not different between the tested materials (p>0.05), but it became different at 21 days, with the control presenting the most advanced stage of collagen fiber formation, and reaching the end of the experiment with the EQUIA&reg; Forte Fil group with a more advanced stage of collagen fiber formation, compared to the EQUIA&reg; Fil group (p<0.05). Inflammatory infiltrate, on the other hand, showed no difference between the materials tested during the experimental periods (p>0.05). The tissue thickness was larger for the EQUIA&reg; Forte Fil group, differing from the control group in all evaluated periods (p<0.05). According to the results obtained, it was concluded that all the glass ionomer - based cements tested showed tissue compatibility, according to the different parameters evaluated

A ordem Cetacea compreende golfinhos e baleias, mamíferos totalmente adaptados ao ambiente aquático. A língua de duas espécies de cetáceos, Pontoporia blainvillei e Sotalia fluviatilis, foram utilizadas para descrição da morfologia das papilas linguais e da superfície de interface epitélio-tecido conjuntivo da lâmina própria, empregando as técnicas de microscopia de luz e eletrônica de varredura. As línguas foram fixadas e divididas em três porções: rostral, médio e caudal e processadas conforme os protocolos das técnicas utilizadas. A língua da Pontoporia blainvillei e Sotalia fluviatilis estava revestida por um epitélio estratificado queratinizado, sendo possível observar as camadas basal, espinhosa, granulosa e córnea. Pode-se notar que na língua, o tecido conjuntivo denso apresentava vasos sanguíneos e profundamente relacionado com o tecido muscular. A superfície de interface epitélio-tecido conjuntivo da lâmina própria apresentou papilas conjuntivas de várias formas. Elas correspondem às papilas filiformes e valadas, mostrando feixes de fibras colágenas em disposição original. Na microscopia de luz polarizada revelou-se fibras colágenas do tipo I e III. No terço médio e caudal de ambas as espécies foram encontradas ácinos de glândulas salivares. As amostras tratadas com solução de hidróxido de sódio, tiveram a camada epitelial removida, e as papilas conjuntivas foram observadas em aspecto tridimensional. Foi possível observar que a superfície dorsal de ambas as espécies é totalmente recoberta por papilas conjuntivas de aspecto filiforme. Observa-se também a presença dos forames dos ductos das glândulas salivares nas porções média e caudal da língua, sendo eles mais numerosos nos filhotes. Morfometricamente, as papilas conjuntivas apresentaram maior comprimento na espécie Sotalia fluviatilis do que na Pontoporia blainville. Foi observado somente na espécie Pontoporia blainvillei estruturas conjuntivas arredondadas na região média e caudal. Embora as áreas dessas estruturas tenham sido maiores na região caudal que na média, estatisticamente estes resultados não foram significativos (P&gt;0,05). / The Cetacea order comprises dolphins and whales, mammals totally adapted to the aquatic ambient. The tongue of two cetaceans species, Pontoporia blainvillei and Sotalia fluviatilis, was studied for description of the morphology of the lingual papillae and of interface epithelium the connective tissue surface, using the light and scanning electron microscopic techniques. The tongues were fixed and divided in three portions: rostral, medium and caudal and treated according to the protocols of techniques used. The tongues of the Pontoporia blainvillei and Sotalia fluviatilis were covered by keratinized stratified epithelium, being that is possible to verify the basal, spinosa, granular and cornetiel ayers. In the tongue the dense connective tissue of lamina propria showed blood vessels and muscular layer was deeply related. The interface epithelium-connective tissue surface of the lamina propria presented connective tissue papillae which are various in shape. They correspond to the filiform and vallate papillae showing the collagen fibers bunches in original disposition. In the polarized light microscopy revealed collagen fibers type I and III. In the medium and caudal third of both species various groupins of salivary gland acini. The samples treated with sodium hydroxide solution, the epithelial layer was removed and the connective tissue papillae were observed in three-dimensional SEM images. It was possible to observe that the dorsal surface of the both species is totally covered by connective tissue papillae of filiform aspect. We observed also the presence of the ducts of the salivary glands in the media and caudal portions of the tongue, being them more numerous in pups. Morphometric analysis showed that the connective tissue papillae presented larger length in the Sotalia fluviatilis than in the Pontoporia blainville samples. The round connectives structures in the media and caudal portions were observed only the Pontoporia blainvillei species. Although, the areas of those structures have been major in the caudal region than media, and these results were not signifficant (P&gt;0,05).

As diferentes técnicas cirúrgicas propostas para tratamento das recessões mostram resultados variáveis, especialmente em áreas de recessão profunda. O objetivo deste estudo é avaliar a efetividade da técnica de enxerto ósseo em neoformação (EONF) como uma alternativa de tratamento em recessões classe I ou II de Miller. Para tanto, foram selecionados indivíduos de ambos os sexos com idade entre 18 e 45 anos apresentando pelo menos um sítio com recessão >4mm e que apresentassem ao menos um dente condenado ou rebordo desdentado que possibilitasse confecção de alvéolo cirúrgico, (grupo teste). Os pacientes foram divididos em dois grupos, de acordo com o tratamento: teste (n=35)- técnica de EONF e controle (n=30)- enxerto de tecido conjuntivo subepitelial (ETCS). O exame clínico foi realizado por examinador único na visita inicial e 1, 3, 6 e 9 meses pós-operatórios, de acordo com as medidas de profundidade de sondagem (PS), nível de inserção clínica (NIC), recessão da margem gengival (R), sangramento à sondagem (SS), índice de placa (IPl) e quantidade de gengiva ceratinizada (GC). Os resultados obtidos demonstraram que as duas técnicas cirúrgicas são igualmente efetivas, segundo o teste t, na diminuição da recessão (-2,77±0,16 x -3,20±0,24; p=0,14). O EONF foi mais efetivo na redução da PS (-0,85±0,10 x 0,24±0,12; p<0,0001), SS (-0,65±0,21 x 0,00±0,13; p=0,01), IPl (-1,57±0,25 x 0,43±0,31; p<0,0001) e no ganho de inserção clínica (-3,74±0,26 x -2,95±0,19; p=0,024), mas menos efetivo no aumento da faixa de gengiva ceratinizada (0,48±0,13 x 1,43±0,17, p<0,0001). A análise intra-grupo mostrou que houve melhora significativa de todos os parâmetros clínicos (p<0,05; ANOVA) nos grupos teste e controle, com exceção do IPI (p=0,577), SS (p=2,19) e PS (p=1,05) no grupo controle. Esses resultados sugerem que a técnica de granulação óssea é efetiva para o tratamento de recessões gengivais profundas, possibilitando redução da recessão e, possivelmente, regeneração dos tecidos periodontais. / Different surgical techniques have been proposed for root coverage, showing varying results, especially in areas of extense recessions. The aim of this study is to evaluate the effectiveness of the newly forming bone technique (NFB) as an alternative treatment of Millers class I or II recessions. Both gender patients aged 18-45 years presenting at least one site with recession >4 mm and one condemned tooth or edentulous ridge allowing the surgical creation of an alveolus (test group) were selected. The sample was divided into two groups, according to the root coverage procedure: test (n=35) - NFB and control (n=30)- subepithelial connective tissue graft (SCTG). Clinical examinations were performed by a single trained examiner at baseline and 1, 3, 6 and 9 months after surgery according to probing depth (PD), clinical attachment level (CAL), recession (R), bleeding on probing (BOP), plaque index (PI) and keratinized gingiva width (KG). The analysis by t test have shown that both techniques are effective in the reduction of recession (-2,77±0,16 x - 3,20±0,24; p=0,14). The NFB technique was more effective in the reduction of PD (-0,85±0,10 x 0,24±0,12; p<0,0001), BOP (-0,65±0,21 x 0,00±0,13; p=0,01), PI (-1,57±0,25 x 0,43±0,31; p<0,0001) and gain of CAL (-3,74±0,26 x - 2,95±0,19; p=0,024), but less effective in the increase of KG width (0,48±0,13 x 1,43±0,17, p<0,0001). Intra-group analysis showed a significant improvement of all clinical parameters (p<0,05; ANOVA) for both groups, except for PI (p=0,4267), BOP (p=2,19) and PD (p=1,05) in control group. These results suggest that the NFB technique is effective to the treatment of large recession defects, allowing the reduction of recession and, possibly, regeneration of periodontal tissues.

Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2018-09-24T18:07:05Z No. of bitstreams: 1 Thairis Alves de Queiroz.pdf: 1672979 bytes, checksum: 3d395d90a185b8380d687991081b3e73 (MD5) / Made available in DSpace on 2018-09-24T18:07:05Z (GMT). No. of bitstreams: 1 Thairis Alves de Queiroz.pdf: 1672979 bytes, checksum: 3d395d90a185b8380d687991081b3e73 (MD5) Previous issue date: 2018-08-08 / Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2018-09-24T18:07:09Z No. of bitstreams: 1 Thairis Alves de Queiroz.pdf: 1672979 bytes, checksum: 3d395d90a185b8380d687991081b3e73 (MD5) / Made available in DSpace on 2018-09-24T18:07:09Z (GMT). No. of bitstreams: 1 Thairis Alves de Queiroz.pdf: 1672979 bytes, checksum: 3d395d90a185b8380d687991081b3e73 (MD5) Previous issue date: 2018-08-08 / As afecções osteomusculares (CID:10 de M00 a M25 e M40 a M99) representam uns dos principais agravos à saúde no Brasil sendo de extrema preocupação, tanto do ponto de vista epidemiológico quanto em custos a saúde pública. E as doenças sistêmicas do tecido conjuntivo que também compõe o Capitulo XIII (CID:10 de M30 a M36) embora consideradas raras, são doenças com características complexas e multifatorial. Além de fatores de risco conhecidos para estas doenças, os poluentes do ar podem desencadear uma resposta de estresse oxidativo, levando a inflamação sistêmica. O presente estudo objetivou avaliar a correlação entre a exposição aos poluentes atmosféricos monitorados e o possível efeito sobre as internações por DSOTC (Doenças do Sistema Osteomuscular e do Tecido Conjuntivo), em crianças e adultos internados em hospitais do SUS no estado de São Paulo, no período de 2011 a 2016. Trata-se de um estudo do tipo ecológico de séries temporais, utilizando o modelo de regressão de Poisson e uma estrutura de defasagem de distribuição polinomial de até 14 dias após a exposição aos poluentes. Durante o período estudado foi constatado um total de 54.982 casos de internação por DSOTC na cidade de São Paulo, sendo as faixas etárias de 20 a 59 anos e 60 anos ou mais predominantes e mais vulneráveis aos efeitos a exposição aos poluentes. Os poluentes apresentam-se dentro dos limites impostos pelo Decreto Estadual nº 59.113 de 23/04/2013, exceto o ozônio (O3) que ultrapassou 296 vezes o limite imposto que é de 140 µg/m3. E quando comparados aos padrões impostos pela OMS, 3 dos 5 poluentes analisados ultrapassaram os limites diários estabelecidos, que são o O3, PM10 e NO2. O PM10 ultrapassou 288 vezes o nível diário permitido durante o período analisado. Com efeitos agudos e tardios para o número total de internações por DSOTC e para as faixas estarias de 20 a 59 e de 60 anos ou mais, com um aumento médio de 1,31% (IC 95%: 0,52- 2,09) no 13º dia sobre o número de internações por DSOTC. Ressaltando que dos 5 poluentes analisados 4 apresentaram efeito significativo sobre as internações por DSOTC no número total e em, pelo menos, uma das faixas etárias estipuladas, e que os padrões estabelecidos atualmente no estado de São Paulo não podem ser considerados seguros em relação a saúde humana, reforçando a necessidade de novos parâmetros que minimizam os efeitos adversos dos poluentes ar. / Musculoskeletal diseases (ICD 10th Revision from M00 to M25 and M40 to M99) are epidemiological relevant and economically impact the Brazilian Public Health System (SUS). The systemic diseases of connective tissue (ICD 10 th Revision from M30 to M36), although considered rare, are diseases with complex, multifactorial traits with serious commitments. Beyond well-known risk factors for these diseases, air pollutants can trigger an oxidative stress response leading to systemic inflammation. The present study aimed to evaluate the correlation between exposure to air pollutants and the possible worsening of DMSCT (Diseases of the Musculoskeletal System and Connective Tissue) in children and adults admitted to hospitals of the SUS in the State of São Paulo, from 2011 to 2016. In this ecological time series study, the effects of air pollutants on the outcomes were assessed using generalized linear Poisson regression model with a third-degree polynomial distributed lag model, controlling for weather variables, seasonality and days of the week. During the studied period was contacted a total of 54,982 cases of hospitalization for DSOTC in the city of São Paulo, being the age groups of 20 to 59 years and 60 years or more prevalent and more vulnerable to the effects exposure to pollutants. The pollutants are within the limits imposed by State Decree No. 59,113 of 23/04/2013, except the ozone (O3) that exceeded the limit imposed to 296 times is 140 µ g/m3. And when compared to the standards imposed by the who, 3 of the 5 pollutants examined exceeded daily limits laid down, which are the O3, PM10 and NO2. The PM10 exceeded 288 times the daily permitted level during the period under examination. With acute and late effects to the total number of hospitalizations for DSOTC and for the tracks would be of 20 to 59 and 60 years or more, with an average increase of 1.31% (95% CI: 0.52-2.09) on the 13th day on the number of hospitalizations by DSOTC. Noting that the pollutant analyzed 5 4 showed significant effect on hospitalizations for DSOTC in total number and in at least one of the stipulated age groups, and that the standards set in the State of São Paulo cannot be considered safe in relation to human health, reinforcing the need for new parameters that minimize the adverse effects of air pollutants.

Orientador: Álvaro Francisco Bosco / Banca: Valdir Gouveia Garcia / Banca: Maria José Hitomi Nagata / Banca: Márcio Zaffalon Casati / Banca: Márcio Fernando de Moraes Grisi / Resumo: O objetivo do presente estudo foi avaliar histológica e histometricamente o padrão de cicatrização de defeitos de deiscência periodontal tratados com enxerto de tecido conjuntivo subepitelial (ETC) ou matriz dérmica acelular (MDA), cada qual comparado ao tratamento com Retalho posicionado Coronal (RPC). Foram utilizados 10 cães, divididos em dois grupo de 5. Defeitos de deiscência óssea (6x8 mm) foram criados nos caninos superiores e os grupos divididos seguindo um modelo de boca dividida de acordo com o tratamento. Em um grupo de 5 cães foi realizado o tratamento com ETC e no lado contralateral RPC e o outro grupo de 5 cães foi tratado com MDA e RPC no lado contralateral. Após 3 meses pós-operatórios os animais foram submetidos à eutanásia e os blocos processados para análise histológica e histométrica. Os parâmetros histométricos avaliados incluíram extensão de tecido epitelial (TE), nova inserção (NITC) e aposição de tecido conjuntivo (ATC), novo cemento (NC) e novo osso (NO). Os dados histométricos transformados em porcentagem, foram estatisticamente analisados pelo teste ANOVA, seguido pelo teste de Tukey... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The aim of the present study was to evaluate histologically and histometrically the healing pattern of periodontal dehiscence defects treated with Subepithelial Connective Tissue Graft (CTG) or Acellular Dermal Matrix (ADM), when compared to the Coronally Positioned Flap (CPF). Dehiscence bone defects (6x8mm) were created bilaterally in the maxillary canine area of dogs (n=10, divided in 2 groups). By means of a split mouth test design, a group of 5 dogs was randomly allocated to receive subepithelial connective tissue graft (CTG) in one of the sides and a coronally positioned flap (CPF) in the opposing side. The remaining 5 dogs had acellular dermal matrix graft (ADM) as a treatment in either one of the sides and CPF on the other side. Three months after surgery, dogs were euthanized and blocks of interest were processed. The histometric parameters for the latter included lenght of epithelial tissue (ET), new attachment (NACT) and connective tissue aposition (CTA), new cementum (NC), and new bone (NB). Histometric data were converted to percentage and statistically analyzed by ANOVA followed by Tukey test at a p<0.05. No significant difference was detected in the following parameters for both groups: ET yielding... (Complete abstract click electronic access below) / Doutor

Orientador: Álvaro Francisco Bosco / Banca: Maria José Hitomi Nagata / Banca: Valdir Gouveia Garcia / Banca: Mário Taba Júnior / Banca: Marcio Zaffalon Casati / Resumo: O objetivo do presente estudo foi avaliar histológica e histometricamente a cicatrização de defeitos de deiscência periodontal associados ao aplainamento radicular tratados com enxerto de tecido conjuntivo subepitelial (ETC) ou Membrana Bioabsorvível (MB), cada qual comparado ao tratamento com Retalho Posicionado Coronal (RPC). Foram utilizados 12 cães, divididos em dois grupos de 6. Defeitos de deiscência óssea (6x8 mm) e o aplainamento radicular foram realizados nos caninos superiores e os grupos divididos, seguindo um modelo de boca dividida de acordo com o tratamento. Os caninos esquerdos serviram como controle (RPC), onde o retalho foi somente posicionado coronalmente. Os caninos direitos receberam os tratamentos com ETC ou MB. Após 3 meses pósoperatórios os animais foram submetidos à eutanásia e os blocos processados para análise histológica e histométrica. Os parâmetros histométricos avaliados incluíram extensão de tecido epitelial (TE), extensão da nova inserção de tecido conjuntivo (NITC) e extensão da aposição de tecido conjuntivo (ATC), extensão de novo cemento (NC) e extensão de novo osso (NO). Histologicamente, o grupo MB mostrou significativamente maiores NC, NO e NITC (4.12±1.24; 2.44±0.78; 1.80±0.39, respectivamente) em comparação ao grupo RPC (1.04±0.43; 0.93±0.23; 0.71±0.45, respectivamente) (P<0.05) e significativamente menor ATC (0.29±0.33) comparado aos grupos RPC (2.79±1.74) e ETC (2.62±1.52) (P<0.05). A NITC no grupo ETC (0.71±0.36) foi significativamente menor, enquanto a ATC (2.62±1.52) e TE (1.70±0.53) foram significativamente maiores comparado ao grupo MB (1.80±0.39; 0.29±0.33; 1.00±0.35, respectivamente) (P<0.05). Dentro dos limites deste estudo, concluiuse que o grupo MB mostrou melhores resultados histológicos de nova inserção de tecido conjuntivo, formação de novo osso e novo cemento em relação aos grupos RPC e ETC. / Abstract: The aim of the present study was to evaluate histologically and histometrically the healing of periodontal dehiscence defects associated to root planing treated with subepithelial connective tissue graft (CTG) or Bioabsorbable Membrane (BM), each one compared to the treatment with Coronally Positioned Flap (CPF). Twelve dogs were used, divided into two groups of six elements. Bone dehiscence defects (6x8 mm) and root planing were accomplished in the upper canine and the groups were divided, following a model of divided mouth according to the treatment used. Left canine were used as control (CPF), where the flap was only coronally positioned. Right canine received treatments with CTG or BM. After three postoperative months, the animals were euthanized and the blocks were processed for histological and histometrical analysis. The evaluated histometric parameters included lenght of epithelial tissue (TE), new attachment (NACT) and connective tissue aposition (CTA), new cementum (NC), and new bone (NB). Histologically, group BM showed significant higher values of NC, NO and NITC (4.12±1.24; 2.44±0.78; 1.80±0.39, respectively) in comparison to the group CPF (1.04±0.43; 0.93±0.23; 0.71±0.45, respectively) (P<0.05) and significant lower values of ATC (0.29±0.33) in comparison to the groups CPF (2.79±1.74) and CTG (2.62±1.52) (P<0.05). NITC in group CTG (0.71±0.36) was significantly lower, while ATC (2.62±1.52) and TE (1.70±0.53) were significantly higher in comparison to group BM (1.80±0.39; 0.29±0.33; 1.00±0.35, respectively) (P<0.05). Within the limits of this study, it can be concluded that group BM showed better histological results of connective tissue new attachment, new bone and new cementum formation in comparison to groups CPF and CTG. / Doutor

Dermatomiosite é doença idiopática inflamatória crônica que afeta musculatura estriada, pele e outros órgãos. Este trabalho tem o objetivo de caracterizar os pacientes com a doença encontrados no HC-FMUSP no período de janeiro de 1992 a dezembro de 2002, avaliando a classificação, as manifestações cutâneas e sistêmicas, achados laboratoriais, terapêuticos e evolutivos em relação à literatura. Este estudo foi baseado nos dados obtidos dos prontuários de 109 pacientes com critérios diagnósticos definidos por Bohan e Peter e modificados por Drake. Os pacientes foram divididos em cinco grupos: 23 dermatomiosites juvenis, 59 dermatomiosites primárias idiopáticas, 6 dermatomiosites amiopáticas, 7 dermatomiosites associada a neoplasias e 14 dermatomiosites associadas a outras doenças do tecido conectivo. Sessenta pacientes foram caracterizados como diagnóstico definido, 33 como possíveis, 4 como prováveis e 12 como amiopáticos. A maior representação foi do sexo feminino (85/109) e a idade média do diagnóstico da doença foi de 36 anos. Manifestações cutâneas foram observadas em todos os pacientes; em relação às alterações sistêmicas a manifestação muscular mais freqüente foi a perda de força proximal (88%); manifestação pulmonar mais comum foi a pneumopatia intersticial (16,5%) e a manifestação digestiva mais observada foi a gastrite (20,2%). Documentaram-se neoplasias durante o seguimento da doença em 6,42% dos casos, sendo mais freqüente nos pacientes acima de 60 anos (71,4%).A enzima muscular alterada na maioria dos casos foi a desidrogenase lática (78,6%). Realizou-se biópsia cutânea em 68 pacientes com alterações compatíveis ao exame anatomopatológico em 78% dos casos. Dentre os casos, 53 pacientes se submeteram à biópsia muscular e 96% deles apresentaram miosite ao exame anatomopatológico. Das 58 eletroneuromiografias efetuadas, mostrou-se padrão miopático compatível com a enfermidade em 81% dos casos. A terapia mais utilizada foram os esteróides e a mortalidade foi de 14,7%, sendo as causas de óbito mais freqüentes a neoplasia maligna, septisemia e infecção pulmonar. / Dermatomyositis is a chronic idiopathic inflammatory disorder which affects the striated skeletal muscles, the skin, and other organs. This present study aims at characterizing the patients who have been affected by this disease and were under treatment at HCFMUSP from January, 1992 to December, 2002 Its classification, the cutaneous and systemical manifestations, as well as laboratorial, therapeutical and evolutive findings were checked out in accordance with the literature. The base for this study was the data obtained from the analysis of 109 patients´records who met not only Bohan\'s and Peter\'s criteria for dermatomyositis diagnosis but also the ones modified by Drake. The patients were divided into five groups: 23 juvenile dermatomyositis, 59 idiopatic primary dermatomyositis, 6 amyopatic dermatomyositis, 7 dermatomyositis associated to malignancy and 14 dermatomyositis associated to connective tissue disorder Sixty of these patients were classified as definite diagnostic, 33 as possible, 4 as probable and 12 as amyopathic. Most patients were female (85/109) and the average age for the diagnosis of the illness was 36. Skin manifestations were observed in all patients, while regarding the systemical alterations, the most frequent was the loss of proximal strength (88%). As the lung manifestation, the most common was an interstitial pneumopathy (16,5%) and as the digestive manifestation, the one which was more commonly observed was gastritis (20,2%). Neoplasies were documented after the following up of the disease in 6,42% of the cases, which was more frequent in patients over 60 years of age (71,4%). The muscle enzyme modified in the majority of the cases was the lactic dehydrogenize (78,6%). Skin biopsy procedure was carried out in 68 patients who showed compatible changes to anatomo-pathological exam in 78% of the cases; 53 patients went under muscular biopsy and 96 % of them proved to have myositis after anatomo-pathological exams. From the fifty-eight electroneuromiographies that were carried out, 81% of the cases showed to have compatible myopathic patterns. Steroidal drugs were the most common therapy used. The mortality rate was 14,7% and the most usual causes of death were malignant neoplasm, sepsis and pulmonary infection.