Search

Purpose: To evaluate the long-term effects of voice therapy on the life quality of teachers who were discharged or abandoned the voice therapy for dysphonia., Methods: This was a longitudinal study based on analysis of assessments with teachers of municipal schools in Belo Horizonte, who were referred to voice therapy and were discharged or abandoned the speech-language therapy for more than six months. A total of 33 teachers in the discharged group and 20 teachers in the abandoned group were contacted by phone and invited to participate in the study by answering the Voice activity and participation profile, which was forwarded to the researchers and sent via letter., Results: At the moment of the pre speech therapy, the discharged and abandoned groups were homogeneous, except in relation to daily communication parameter. Comparing the discharged group in the pre and post speech-language therapy, it was showed improvements in social communication parameter as well as in the total score. The discharged group presented worsening in self-perception parameter when comparing the average values in the post therapy and current moments, and the group abandoned presented worsening in work, social communication and total score when comparing to the average values in the pre therapy and current moments. The discharged and abandoned groups differ in the present moment in all investigated parameters., Conclusion: Speech-language therapy for dysphonia have long term positive effects on life quality and voice of teachers who were soon discharged from the therapy and in a period of two years on average. Teachers who have abandoned treatment and did not obtain improvement in the voice showed negative impact in life quality and voice in a time of 2 years and 2 months on average.

Tuberculosis (TB) is one of the most common infectious diseases in the world. Mycobacterium tuberculosis infection leads to pulmonary active disease in approximately 5-10% of exposed individuals. Both bacteria- and host-related characteristics influence latent infection and disease. Host genetic predisposition to develop TB may involve multiple genes and their polymorphisms. It was reported previously that interferon gamma (IFN-γ) and nitric oxide synthase 2 (NOS2) are expressed on alveolar macrophages from TB patients and are responsible for bacilli control; thus, we aimed this study at genotyping single nucleotide polymorphisms IFNG+874T/A SNP and NOS2A-954G/C SNP to estimate their role on TB susceptibility and determine whether these polymorphisms influence serum nitrite and NOx(-) production. This case-control study enrolled 172 TB patients and 179 healthy controls. Neither polymorphism was associated with susceptibility to TB. NOS2A-954G/C SNP was not associated with serum levels of nitrite and NOx(-). These results indicate that variants of IFNG+874T/A SNP and NOS2A-954G/C SNP do not influence TB susceptibility or the secretion of nitric oxide radicals in the study population.

This work reports the first data for the vapor pressures at several temperatures of the ionic liquids, [C(N/2)C(N/2)im][NTf(2)] (N = 4, 6, 8, 10, 12) measured using a Knudsen effusion apparatus combined with a quartz crystal microbalance. The morphology and the thermodynamic parameters of vaporization derived from the vapor pressures, are compared with those for the 1-alkyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide series, [C(N-1)C(1)im][NTf(2)] (N = 3 - 9, 11, and 13). It was found that the volatility of [C(N/2)C(N/2)im][NTf(2)] series is significantly higher than the asymmetric cation ILs with the same total number of carbons in the alkyl side chains, [C(N-1)C(1)im][NTf(2)]. The observed higher volatility is related with the lower enthalpy of vaporization. The symmetric cation, [C(N/2)C(N/2)im][NTf(2)], presents lower entropies of vaporization compared with the asymmetric [C(N-1)C(1)im][NTf(2)], indicating an increase of the absolute liquid entropy in the symmetric cation ILs, being a reflection of a change of the ion dynamics in the IL liquid phase. Moreover both the enthalpy and entropy of vaporization of the [C(N/2)C(N/2)im][NTf(2)] ILs, present a clear odd-even effect with higher enthalpies/entropies of vaporization for the odd number of carbons in each alkyl chain ([C(3)C(3)im][NTf(2)] and [C(5)C(5)im][NTf(2)]).

Herein a core scaffold of 1-phenylnaphthalenes and 1,8-diphenylnaphthalenes with different substituents on the phenyl rings was used to study substituent effects on parallel-displaced aromatic π⋅⋅⋅π interactions. The energetics of the interaction was evaluated in gas phase based on the standard molar enthalpies of formation, at T=298.15 K, for the compounds studied; these values were derived from the combination of the results obtained by combustion calorimetry and Knudsen/Quartz crystal effusion. A homodesmotic gas-phase reaction scheme was used to quantify and compare the intramolecular interaction enthalpies in various substituted 1,8-diphenylnaphthalenes. The application of this methodology allowed a direct evaluation of aromatic interactions, and showed that substituent effects on the interaction enthalpy cannot be rationalized solely on classical electrostatic grounds, because no correlation with the σ(meta) or σ(para) Hammett constants was observed. Moreover, the results obtained indicate that aromatic π⋅⋅⋅π interactions are significantly enhanced by substitution, in a way that correlates with the ability of the interacting aryl rings to establish dispersive interactions. A combined experimental and computational approach for calculation of the true aromatic π⋅⋅⋅π interaction energies in these systems, free of secondary effects, was employed, and corroborates the rationale derived from the experimental results. These findings clearly emphasize the role of dispersion and dilute the importance of electrostatic forces on this type of interactions., (Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

In this work, the interplay between structure and energetics in some representative phenylnaphthalenes is discussed from an experimental and theoretical perspective. For the compounds studied, the standard molar enthalpies, entropies and Gibbs energies of sublimation, at T = 298.15 K, were determined by the measurement of the vapor pressures as a function of T, using a Knudsen/quartz crystal effusion apparatus. The standard molar enthalpies of formation in the crystalline state were determined by static bomb combustion calorimetry. From these results, the standard molar enthalpies of formation in the gaseous phase were derived and, altogether with computational chemistry at the B3LYP/6-311++G(d,p) and MP2/cc-pVDZ levels of theory, used to deduce the relative molecular stabilities in various phenylnaphthalenes. X-ray crystallographic structures were obtained for some selected compounds in order to provide structural insights, and relate them to energetics. The thermodynamic quantities for sublimation suggest that molecular symmetry and torsional freedom are major factors affecting entropic differentiation in these molecules, and that cohesive forces are significantly influenced by molecular surface area. The global results obtained support the lack of significant conjugation between aromatic moieties in the α position of naphthalene but indicate the existence of significant electron delocalization when the aromatic groups are in the β position. Evidence for the existence of a quasi T-shaped intramolecular aromatic interaction between the two outer phenyl rings in 1,8-di([1,1'-biphenyl]-4-yl)naphthalene was found, and the enthalpy of this interaction quantified on pure experimental grounds as -(11.9 ± 4.8) kJ·mol(-1), in excellent agreement with the literature CCSD(T) theoretical results for the benzene dimer.

The thermodynamic and structural study of a series of polyphenylbenzenes, from benzene, n(Ph) = 0, to hexaphenylbenzene, n(Ph) = 6, is presented. The available literature data for this group of compounds was extended by the determination of the relevant thermodynamic properties for 1,2,4-triphenylbenzene, 1,2,4,5-tetraphenylbenzene, and hexaphenylbenzene, as well as structural determination by X-ray crystallography for some of the studied compounds. Gas phase energetics in this class of compounds was analyzed from the derived standard molar enthalpies of formation in the gaseous phase. The torsional profiles relative to the phenyl-phenyl hindered rotations in some selected polyphenylbenzenes, as well as the gas phase structures and energetics, were derived from quantum chemical calculations. In the ideal gas phase, a significant enthalpic destabilization was observed in hexaphenylbenzene relative to the other polyphenylbenzenes, due to steric crowding between the six phenyl substituents. A relatively low enthalpy of sublimation was observed for hexaphenylbenzene, in agreement with the decreased surface area able to establish intermolecular interactions. The apparently anomalous low entropy of sublimation observed for hexaphenylbenzene is explained by its high molecular symmetry and the six highly hindered phenyl internal rotations. For the series of polyphenylbenzenes considered, it was shown that the differentiation in the entropy of sublimation can be chiefly ascribed to the torsional freedom of the phenyl substituents in the gas phase and the entropy terms related with molecular symmetry.

For the first time, two distinct trends are clearly evidenced for the enthalpies and entropies of vaporization along the [Cnmim][Ntf2] ILs series. The trend shifts observed for Δ(l)(g)H(m)(o) and Δ(l)(g)S(m)(o), which occur at [C6mim][Ntf2], are related to structural modifications. The thermodynamic results reported in the present article constitute the first quantitative experimental evidence of the structural percolation phenomenon and make a significant contribution to better understanding of the relationship among cohesive energies, volatilities, and liquid structures of ionic liquids. A new Knudsen effusion apparatus, combined with a quartz crystal microbalance, was used for the high-accuracy volatility study of the 1-alkyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide series ([Cnmim][Ntf2], where n = 2, 3, 4, 5, 6, 7, 8, 10, 12). Vapor pressures in the (450–500) K temperature range were measured, and the molar standard enthalpies, entropies, and Gibbs energies of vaporization were derived. The thermodynamic parameters of vaporization were reported, along with molecular dynamic simulations of the liquid phase structure, allowing the establishment of a link between the thermodynamic properties and the percolation phenomenon in ILs.

The authors present the case of a newborn of an Rh-factorsensitized mother, who received early hospital discharge while icteric only to be readmitted at an Emergency Service at five days of age with signs of kernicterus. Despite treatment given, the neonate progressed with a clinical picture of bilirubin encephalopathy. The lack of interaction between the obstetric and neonatal teams, premature hospital discharge, and lack of concern of neonatologists with jaundice in a full-term infant are highlighted as causes of a condition that should have disappeared if there had been adequate prevention.

This work sought to record the impressions of nursing assistants and technicians after submitting to Pap smear screening. This is a descriptive study using a qualitative approach conducted in September and October of 2006 with 35 employees of a public institution, which is a benchmark in gynecology in Fortaleza in the State of Ceará (Brazil). The data was collected through semi-structured interviews containing a recorded leading question and analyzed according to the methodological-theoretical reference of social phenomenology. The testimonials were separated in three groups: an exam that causes discomfort, fear and shame; an exam that causes anxiety about the results; and an exam that "makes me calm and relaxed". Despite the interviewees being part of an institution that cares for the prevention of cervical-uterine cancer in women, negative feelings about the Pap smear test were nonetheless reported. The conclusion reached is that it is important to stage educational campaigns emphasizing the importance of empowerment of patients in order to minimize these aspects.

Nickel hydroxide can provide an outstanding cathode material in alkaline secondary batteries, however the progressive decrease of the charge capacity as a function of the number of oxidation/reduction cycles is a challenging problem to be solved. New improvements on the electrochemical properties of electrode materials can be achieved by exploiting the much better performance of alpha-nickel hydroxide. Such materials were obtained in a stable form by sol-gel method and characterized by thermogravimetric analyses, UV-Vis spectroscopy, X-ray diffractometry, scanning and transmission electron microscopy, cyclic voltammetry and electrochemical quartz crystal microbalance techniques. The results revealed not only the formation of the alpha-Ni(OH)2 phase, but also a much better electrochemical reversibility and stability as compared with similar materials obtained by electrochemical precipitation method.

Electrospray ionization mass spectrometry with variable collision induced dissociation of the isolated [(cation)(2)anion](+) and/or [(anion)(2)cation](-) ions of imidazolium-, pyridinium-, pyrrolidinium-, and piperidinium-based ionic liquids (ILs) combined with a large set of anions, such as chloride, tetrafluoroborate, hexafluorophosphate, trifluoromethanesulfonate, and bis[(trifluoromethyl)sulfonyl]imide, was used to carry out a systematic and comprehensive study on the ionic liquids relative interaction energies. The results are interpreted in terms of main influences derived from the structural characteristics of both anion and cation. On the basis of quantum chemical calculations, the effect of the anion upon the dissociation energies of the ionic liquid pair, and isolated [(cation)(2)anion](+) and/or [(anion)(2)cation](-) aggregates, were estimated and are in good agreement with the experimental data. Both experimental and computational results indicate an energetic differentiation between the cation and the anion to the ionic pair. Moreover, it was found that the quantum chemical calculations can describe the trend obtained for the electrostatic cation-anion attraction potential. The impact of the cation-anion interaction strengths in the surface tension of ionic liquids is further discussed. The surface tensions dependence on the cation alkyl chain length, and on the anion nature, follows an analogous pattern to that of the relative cation-anion interaction energies determined by mass spectrometry.

1. Statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitors, exert anti-inflammatory, anti-oxidant and anti-angiogenic effects. These effects are associated with downregulation of pro-inflammatory/pro-angiogenic molecules and upregulation of endothelial nitric oxide synthase (e-NOS) expression/nitric oxide (NO) production. 2. Using the murine sponge model to induce chronic intraperitoneal inflammatory response, we evaluated the inflammatory components, angiogenic and NO production of the fibrovascular tissue, and their modulation by fluvastatin. 3. Our results showed that fluvastatin (0.6 and 6 mg/kg per day) inhibited haemoglobin (Hb) content 4.9±0.4 (n=15; control) vs 2.2±0.2 (n=6; fluvastatin 0.6) and 1.8±0.2 (n=6; fluvastatin 6.0) and the number of vessels in the treated group when compared with the control group. The inflammatory component, as assessed by myeloperoxidase and N-acetyl-β-d-glucosaminidase activities and by the pro-inflammatory cytokines, tumour necrosis factor-α (TNF-α) and Monocyte chemotactic protein-1 (MCP-1)/CCL2/JE levels, was also decreased by the compound. In the treated group, inhibition of both enzyme activities was 54% and 57%, respectively. The levels of the cytokines (TNF-α and CCL2/JE) intra-implant were decreased relative to the control. In these implants, fluvastatin was also able to increase NO production, as detected with an NO-sensitive electrode. 4. The inhibitory function of fluvastatin on key components of intraperitoneal inflammatory angiogenesis shown in the present study is clearly associated with the modulatory effects of this statin on vascular endothelial growth factor, TNF-α and NO production., (© 2011 The Authors. Clinical and Experimental Pharmacology and Physiology © 2011 Blackwell Publishing Asia Pty Ltd.)

Unlabelled: To improve electrocochleography's diagnostic sensitivity in Meniére's disease - new assessment methods are being studied., Aim: To determine whether or not graphic angle measurement is sensitive and specific to Menière's disease laboratorial diagnosis and if there is an increase in the electrocochleography's sensitivity and specificity when graphic angle measurements are associated with Summating Potential-Action Potential ratio (SP/AP ratio)., Methods: Electrocochleography's was used to analyze 71 ears from 55 subjects: 41 patients with clinical diagnosis of Menière's disease (MD group), and 14 healthy individuals as control (Group C). Graphic results were analyzed initially to obtain the SP/AP ratio; afterwards, through another program graphic angle measurements were calculated., Results: Sensitivity and specificity values of angle measures, SP/AP ratio, and the association between them varied according to the cutoff point, the highest equilibrium between sensitivity and specificity was observed with the values of 166.25 for angle measurement and 27% for SP/AP relation; 62.79% / 60.71% and 74.42% / 67.86%, respectively. The association between measurements showed a sensitivity increase due to the specificity decrease; 88.37% and 50%, respectively., Conclusion: Angle graphic measurement is not sensitive and specific enough for the laboratorial diagnosis of MD. Angle graphic measurement and SP/AP ratio association proved to be higher in sensitivity, in detriment of exam specificity.

Objective: To evaluate retrospectively the microbiological profile of Mycobacterium species isolated from HIV-infected patients attending the HIV/TB reference health care units in São José do Rio Preto, Brazil., Method: Retrospective evaluation of all HIV-1 positive patients whose IAL-SJRP laboratorial analysis was positive for Mycobacterium sp. after diagnosis of HIV Infection, from January 2000 to December 2006., Results: Of 198 patients, acid-fast staining detected mycobacteria early in 41%. Culture revealed 52.5% to be infected with Mycobacterium tuberculosis (MT). 42.4% had non-tuberculous mycobacteria (NTM) and 5.1% had MT/NTM positive cultures. Eleven per cent of MT strains were resistant to at least one of the antimycobacterial drugs and 3.1% were multidrug resistant. 39.4% of isolated mycobacteria were NTM species., Conclusion: Our data may serve as a starting point for further comparisons with other Brazilian regions and other developing countries. The data may provide important clues to the future understanding, prevention and control of such co-infections around the world., (© 2010 Blackwell Publishing Ltd.)

Unlabelled: Bulimia is an eating disorder classified as a mental disorder according to DSM-IV., Aims: The aim of the study was to evaluate vocal and laryngeal abnormalities in patients with bulimia compared to a control group., Materials & Methods: Study control group. Twenty-two women were evaluated, with an age range of 18 to 34 years old. Eleven diagnosed with purging bulimia and 11 in the control group. Both groups underwent an otolaryngological, perception and acoustic evaluation. The statistic analysis was done through a chi-square test and a Kruskall-Wallis non-parametric test, considering 5% as significance level., Results: The bulimic group presented a higher prevalence of laryngeal abnormalities compared to the control group (p=0.000). The group with bulimia had higher GRBSI values (p=0.000) and A (p=0.022) of the GRBASI scale. The results of vocal acoustics analysis of the jitter, shimmer, PPQ and APQ were higher in the bulimic group (p=0.033). No statistical significance difference in the fundamental frequency and NHR were found between both groups., Conclusion: the bulimic patients in this study presented more laryngeal, acoustics and perception evaluation disorders when compared to a control group.

Group-specific component (Gc) variants of vitamin D binding protein differ in their affinity for vitamin D metabolites that modulate antimycobacterial immunity. We conducted studies to determine whether Gc genotype associates with susceptibility to tuberculosis (TB). The following subjects were recruited into case-control studies: in the UK, 123 adult TB patients and 140 controls, all of Gujarati Asian ethnic origin; in Brazil, 130 adult TB patients and 78 controls; and in South Africa, 281 children with TB and 182 controls. Gc genotypes were determined and their frequency was compared between cases versus controls. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were obtained retrospectively for 139 Gujarati Asians, and case-control analysis was stratified by vitamin D status. Interferon (IFN)-gamma release assays were also performed on 36 Gujarati Asian TB contacts. The Gc2/2 genotype was strongly associated with susceptibility to active TB in Gujarati Asians, compared with Gc1/1 genotype (OR 2.81, 95% CI 1.19-6.66; p = 0.009). This association was preserved if serum 25(OH)D was <20 nmol.L(-1) (p = 0.01) but not if serum 25(OH)D was > or =20 nmol.L(-1) (p = 0.36). Carriage of the Gc2 allele was associated with increased PPD of tuberculin-stimulated IFN-gamma release in Gujarati Asian TB contacts (p = 0.02). No association between Gc genotype and susceptibility to TB was observed in other ethnic groups studied.

The methodology for the prediction of properties of environmental relevance of polycyclic aromatic hydrocarbons based on the conductor-like screening model for real solvents (COSMO-RS/COSMOtherm) is presented and evaluated, with a special focus on the aqueous solubility of polycyclic aromatic hydrocarbons and related aromatic hydrocarbons (PAHs). It is shown that the solubility predictions as well as their temperature dependence obtained for a set of 12 polycyclic aromatic hydrocarbons and two related aromatic hydrocarbons are in good agreement with the experimental data. (Subcooled) Vapor pressures, Henry's law constants as well as octanol-water partition coefficients were also estimated and compared with experimental data showing the capability of the model to predict environmental related data with sufficient precision for practical purposes.

Enzyme-linked immunosorbent assay (ELISA) and Western blotting are common techniques used to detect and quantify proteins in Staphylococcus aureus culture supernatants, such as Panton-Valentine leukocidin (PVL). However, protein A (Spa) secreted by most S. aureus strains may interfere with these assays by binding to the capturing and detecting antibodies. Here, we have shown that the addition of diethylpyrocarbonate (DEPC) inhibits the binding of Spa to rabbit anti-PVL used as the capturing antibody in ELISA. In Western blotting, the presence of DEPC prevented the binding of detecting antibody to Spa. These modified ELISA and Western blot techniques should prove useful for detecting and quantifying proteins in S. aureus culture supernatants., (2010 Elsevier B.V. All rights reserved.)

Lung cancer is one of the most commonly diagnosed malignancies and it causes more than 1 million deaths each year worldwide. Small-cell lung cancer (SCLC) accounts for about 15 to 20% of all lung cancers and it is an extremely aggressive cancer, having a response rate of 60-80% with the standard first-line chemotherapy (CT). Topotecan is a topoisomerase I inhibitor currently approved for relapsed SCLC. The authors reviewed the clinical files of SCLC's patients (pts) of a single institution, the Portuguese Institute of Oncology-Porto Centre, in a five year period. The end-points were to evaluate response rates (RR), time to progression (TTP), overall survival (OS) and toxicity profile of topotecan as a second-line treatment of SCLC. From January of 2002 to December of 2006, it was diagnosed 146 pts with SCLC, 32 were submitted to second-line treatment and 23 with topotecan. The RR was 17.4%, median TTP and median survival after topotecan were 2.8 months and 6.3 months, respectively, and median OS was 17.5 months. The incidence of grade 3 and 4 adverse events was 16.6 and 2.6%, respectively. Topotecan showed clinical activity in our unselected daily patients with relapsed SCLC, with acceptable toxicity, in accordance with the published literature.

To investigate the effects of metformin on angiogenesis, on inflammatory cell accumulation and on production of endogenous cytokines in sponge implant in mice. Polyester-polyurethane sponges were implanted in Swiss mice and metformin (40 or 400mg/kg/day) was given orally for six days. The implants collected at day 7 postimplantation were processed for the assessment of hemoglobin (Hb), myeloperoxidase (MPO), N-acetylglucosaminidase (NAG) e collagen used as indexes for angiogenesis, neutrophil and macrophage accumulation and extracellular matrix deposition, respectively. Relevant inflammatory, angiogenic and fibrogenic cytokines were also determined. Metformin treatment attenuated the main components of the fibrovascular tissue, wet weight, vascularization (Hb content), macrophage recruitment (NAG activity), collagen deposition and the levels of transforming growth factor (TGF-beta1) intraimplant. A regulatory function of metformin on multiple parameters of main components of inflammatory angiogenesis has been revealed giving insight into the potential therapeutic underlying the actions of metformin., (Copyright (c) 2009. Published by Elsevier SAS.)

While compelling evidence indicates beneficial effects of statins on inflammatory processes, besides their cholesterol-lowering activities, the actions on angiogenesis are less clear-cut. Our aim was to investigate the effects of atorvastatin on key components of inflammatory angiogenesis in the murine sponge model. Polyester-polyurethane sponges, used as a framework for fibrovascular tissue growth, were implanted in Swiss mice. Atorvastatin (0.6, 3 mg/kg/day) was given orally for 8 days in drinking water. The implants collected at day 9 postimplantation were processed for the assessment of hemoglobin, myeloperoxidase (MPO), N-acetylglucosaminidase (NAG) and collagen. Relevant inflammatory, angiogenic and fibrogenic cytokines were also determined. Atorvastatin treatment resulted in significant decrease in sponge vascularization (Hb content) and in VEGF levels at both doses. Neutrophil influx (MPO activity) was not affected by the compound whereas macrophage recruitment (NAG activity) was inhibited, suggesting a degree of selectivity by atorvastatin for this cell population. The level of CCL2 (MCP1-JE) was decreased only with 0.6 mg/kg. Atorvastatin was also able to reduce collagen deposition and the levels of transforming growth factor (TGF-beta1) intraimplant, dose-dependently. The inhibitory function of atorvastatin on multiple parameters of main components of inflammatory angiogenesis revealed in this study is clearly associated with the modulatory effects of HMG-CoA reductase on VEGF, TNF-alpha and TGF-beta1 production., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)

The specific PDE4 inhibitor (rolipram) has been shown to attenuate excessive accumulation/activation of inflammatory cells and fibroblasts and cytokine production in several pathological conditions through cyclic nucleotide modulation. Here, using the murine sponge model to induce chronic subcutaneous inflammatory response and to elicit the formation of intraperitoneal adhesions we explored the hypothesis that rolipram would exert beneficial effects on decreasing key components of both processes (inflammatory cell recruitment, angiogenesis, and deposition of extracellular matrix component). Two doses of rolipram (0.2 or 2 mg/kg/day) were administered orally for 7 days in groups of mice bearing either subcutaneous or intraperitoneal polyether-polyurethane implants. Rolipram was effective in inhibiting angiogenesis as assessed by hemoglobin content and VEGF levels in subcutaneous implants (about 40% with both doses) but failed to exert this activity in intraperitoneal implants. Conversely, accumulation of neutrophils and macrophages determined by measuring myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) activities intraimplant, respectively, was attenuated only in intraperitoneal implants by the treatment. Levels of TNF-alpha and MCP-1 were also determined and rolipram at both doses decreased the production of both cytokines in intraperitoneal implants. The levels of MCP-1 in the subcutaneous implants were not affected by the treatment. Fibrosis was evaluated by determining the amount of collagen and production of TGF-beta1 intraimplant. Both parameters were attenuated by rolipram. These results have shown differential sensitivity of proliferating tissues to PDE4 inhibitor indicating that this agent may be used to target inflammatory angiogenesis selectively.

Objectives: To review the history of pacifiers and to compile a multidisciplinary literature review, searching for pros and cons with the purpose of providing health professionals with arguments when parents request guidance., Sources: History and art books, as well as non-medical literature and museums were used in the historical survey. Multidisciplinary data were collected from MEDLINE, LILACS, SciELO, and The Cochrane Library. Search criteria were: the keyword "pacifiers" present in articles published in the last 5 years that included abstract and were written in Portuguese, English, or Spanish., Summary of the Findings: There is evidence that their precursors have been used since the Neolithic Period to calm down children. Small balls made of fabric containing food were portrayed in paintings. Other balls made of non-perishable material persisted throughout time. Pacifiers have been used to stimulate sucking or to coordinate this reflex, promoting an earlier beginning of the oral feeding of newborns. Some authors suggest that pacifiers reduce the incidence of the sudden death syndrome, but the topic is controversial. Pacifiers prevent the establishment of breastfeeding and lead to weaning. Their use may cause suffocation, poisoning, or allergies and increases the risk of caries, infections, and intestinal parasitic diseases. Harmful effects are related to frequency, duration, and intensity of the habit. It should be discontinued by the age of 3 or 4 in order not to affect speech and dentition., Conclusions: There are more harmful effects than benefits. It is advisable that health professionals inform parents of the pros and cons of pacifiers so that they can make a conscious decision regarding its use.

The energetic and structural study of three diphenylpyridine isomers is presented in detail. The three isomers, 2,6-, 2,5-, and 3,5-diphenylpyridines, were synthesized via Suzuki-Miyaura methodology based on palladium catalysis, and the crystal structures of the isomers were obtained by X-ray diffraction. The relative energetic stabilities in the condensed and gaseous phases as well as volatilities and structures of the three studied isomers were evaluated, regarding the position of the phenyl groups relative to the nitrogen atom of the pyridine ring. The temperature, standard molar enthalpies, and entropies of fusion were measured and derived by differential scanning calorimetry. The vapor pressures of the considered isomers were determined by a static apparatus based on a MKS capacitance diaphragm manometer. The standard molar enthalpies, entropies, and Gibbs energies of sublimation, at T = 298.15 K, were derived, and the phase diagram near the triple point coordinates were determined for all isomers. The standard (p(o) = 0.1 MPa) molar enthalpies of combustion of all crystalline isomers were determined, at T = 298.15 K, by static bomb combustion calorimetry. The standard molar enthalpies of formation, in the crystalline and gaseous phases, at T = 298.15 K, were derived. The experimental results for the energetics in the gaseous phase of the three compounds were compared and assessed with the values obtained by ab initio calculations at different levels of theory (DFT and MP2) showing that, at this level of theory, the computational methods underestimate the energetic stability, in the gaseous phase, for these molecules. In order to understand the aromaticity in the central ring of each isomer, calculations of NICS (B3LYP/6-311G++(d,p) level of theory) values on the pyridine ring were also performed.

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) threatens public health worldwide, and epidemiologic data suggest that the Panton-Valentine Leukocidin (PVL) expressed by most CA-MRSA strains could contribute to severe human infections, particularly in young and immunocompetent hosts. PVL is proposed to induce cytolysis or apoptosis of phagocytes. However, recent comparisons of isogenic CA-MRSA strains with or without PVL have revealed no differences in human PMN cytolytic activity. Furthermore, many of the mouse studies performed to date have failed to demonstrate a virulence role for PVL, thereby provoking the question: does PVL have a mechanistic role in human infection? In this report, we evaluated the contribution of PVL to severe skin and soft tissue infection. We generated PVL mutants in CA-MRSA strains isolated from patients with necrotizing fasciitis and used these tools to evaluate the pathogenic role of PVL in vivo. In a model of necrotizing soft tissue infection, we found PVL caused significant damage of muscle but not the skin. Muscle injury was linked to induction of pro-inflammatory chemokines KC, MIP-2, and RANTES, and recruitment of neutrophils. Tissue damage was most prominent in young mice and in those strains of mice that more effectively cleared S. aureus, and was not significant in older mice and mouse strains that had a more limited immune response to the pathogen. PVL mediated injury could be blocked by pretreatment with anti-PVL antibodies. Our data provide new insights into CA-MRSA pathogenesis, epidemiology and therapeutics. PVL could contribute to the increased incidence of myositis in CA-MRSA infection, and the toxin could mediate tissue injury by mechanisms other than direct killing of phagocytes.

Keratoacanthoma (KA) is a self-limited benign epithelial proliferative lesion that eventually presents with very similar clinical features to squamous cell carcinoma. Many KA appear in the vermilion border of the lips and therefore dental professionals must be familiar of the disease. This article reports the case of a 40-year-old female patient presenting with an exophytic ulcerative tumor in her lower lip that resolved after incisional biopsy. Photographic documentation of the case is presented and topics that are relevant to the clinical management of the disease are addressed.

Aims: Adhesion formation following abdominal intervention is an abnormal peritoneal healing process. Our aim was to investigate the effects of controlling adhesion development by inhibiting its key components (angiogenesis, inflammation and fibrosis) using phosphodiesterase (PDE) inhibitors., Main Methods: Two PDE inhibitors including cilostazol a PDE3 inhibitor (40 and 400 mg/kg), and pentoxifylline (PTX), a PDE 1-5 inhibitor (50 and 500 mg/kg) were used for a period of 7 days to inhibit angiogenesis, inflammation, and fibrosis in a murine model of sponge-induced peritoneal adhesion. Angiogenesis was assessed by hemoglobin content, vascular endothelial growth factor (VEGF) levels, and morphometric analysis. Accumulation of neutrophils and macrophages was determined by measuring myeloperoxidase (MPO) and N-acetylglucosaminidase (NAG) activities, respectively. Levels of TNF-alpha were also determined. Fibrosis was assessed by determining the amount of collagen in the implant; TGF-beta1 levels in the implant were also measured., Key Findings: Our results show that the treatments attenuated the main components of the adhesion tissue by reducing the amount of fibrovascular tissue that infiltrated the sponge matrix (wet weight). Hemoglobin content and VEGF levels were also decreased by approximately 40%. Neutrophil accumulation was unaffected by the compounds. However, NAG activity was reduced by pentoxifylline, but not by cilostazol. These compounds also decreased the levels of the pro-inflammatory and pro-fibrogenic cytokines TNF-alpha and TGF-beta1, respectively, and collagen synthesis., Significance: Our results suggest that cilostazol and PTX decreased the development of peritoneal adhesions in the model, which might be associated with cyclic nucleotide modulation. Therapies to intervene in these pathways may be beneficial for the prevention of these lesions.

Mycobacterium tuberculosis kills more people than any other single pathogen, with an estimated one-third of the world's population being infected. Among those infected, only 10% will develop the disease. There are several demonstrations that susceptibility to tuberculosis is linked to host genetic factors in twins, family and associated-based case control studies. In the past years, there has been dramatic improvement in our understanding of the role of innate and adaptive immunity in the human host defense to tuberculosis. To date, attention has been paid to the role of genetic host and parasitic factors in tuberculosis pathogenesis mainly regarding innate and adaptive immune responses and their complex interactions. Many studies have focused on the candidate genes for tuberculosis susceptibility ranging from those expressed in several cells from the innate or adaptive immune system such as Toll-like receptors, cytokines (TNF-alpha, TGF-beta, IFN-gamma, IL-1b, IL-1RA, IL-12, IL-10), nitric oxide synthase and vitamin D, both nuclear receptors and their carrier, the vitamin D-binding protein (VDBP). The identification of possible genes that can promote resistance or susceptibility to tuberculosis could be the first step to understanding disease pathogenesis and can help to identify new tools for treatment and vaccine development. Thus, in this mini-review, we summarize the current state of investigation on some of the genetic determinants, such as the candidate polymorphisms of vitamin D, VDBP, Toll-like receptor, nitric oxide synthase 2 and interferon-gamma genes, to generate resistance or susceptibility to M. tuberculosis infection.

The purpose of this study was to determine the clinical and laboratory profiles of canine leishmaniasis in two distinct areas. Dogs from urban and rural areas were examined. The population studied in the metropolitan area included 54 dogs. Of these, 20 (37%) animals did not present with any signs suggestive of visceral leishmaniasis (VL). Among these, only eight were confirmed negative by ELISA (rK39 and CE) and 12 dogs, clinically negative for leishmaniasis, were seropositive by ELISA (rK39 and CE). Thinness, conjunctivitis and onychogryphosis were the most frequent clinical signs in the urban areas, followed by crusty lesions, alopecia, ulcerated lesions, hyperkeratosis and exfoliation. In the metropolitan area human VL cases occurred mainly in 1991, 1992, 1999 and 2000. In the rural areas the ELISA rK39 test detected a seroprevalence of 11.3% and ELISA CE (Leishmania crude extract) of 20.6%. Thirty-nine dogs were examined 6 months after the first visit. Serological exams using rK39 antigen showed seroconversion of only one dog, whereas Leishmania CE showed seroconversion of 13 (33.4%) dogs. In this rural environment 83.3% of the positive dogs were asymptomatic. Lutzomyia intermedia and Lu. longipalpis were the most predominant sandfly vector species. Amastigotes were identified in spleen and liver fragments of symptomatic necropsied animals. PCR amplification of DNA isolated from promastigote culture indicated that the species was Leishmania chagasi. This finding suggests that delayed diagnosis and euthanasia of potentially infectious animals may occur with an increased transmission risk to sandflies and subsequently to humans.

Background: the Vestibular Evoked Myogenic Potential (Vemp) is formed by myogenic neurophysiologic responses activated by high-intensity sound stimulation. The response is registered through surface electromyography of the cervical muscles during muscle contraction. The acoustic stimuli activate the saccular macula, the vestibular inferior nerve and the pathways related to the vestibule-spinal descendant nerves., Aim: to describe Vemp parameters in a normal population., Methods: thirty adults, 13 men and 17 women with no otoneurological complaints were selected. The stimuli were 200 tone burst, with a frequency of 1Hz and intensity of 118 dB Na, band-pass filter ranging from 10Hz to 1500Hz. The first potential biphasic P13-N23 wave was analyzed., Results: no significant difference was observed between the sides of stimulation in terms of latency and amplitude. However, a statistically significant difference was found for amplitude between genders., Conclusion: Vemp demonstrated to be a reliable instrument in the clinical assessment of the vestibular function.

Gestational diabetes mellitus can be controlled and its complications prevented, provided clients take part in self-care actions. The objective of the present study was to identify self care deficiencies in pregnant women suffering from diabetes, and to provide inputs for their educational support. This descriptive study included 12 pregnant women cared at a diabetes and hypertension reference institution in Fortaleza, Ceará, Brazil, in April and May, 2007. Data were collected using a semistructured interview. Analysis was based on Orem's Nursing General Theory. Self-care deficiencies were related to eating habits, physical activities, sleep and rest, and social interaction. Nurses must provide educational support to these patients, evaluate their self-care capacity, and propose actions that involve the family, as well as group activities in health services.

Na(+)/H(+) exchanger (NHE) proteins are involved in intracellular pH and volume regulation and may indirectly influence neurotransmission. The abundant NHE isoform 1 (NHE1) has also been linked to brain cell damage during metabolic stress. It is not known, however, whether NHE1 or other NHE isoforms play a role in striatal dopamine (DA) neurotransmission under normal or metabolic stress conditions. Our study tested the hypothesis that NHE inhibition with cariporide mesilate (HOE-642) modifies striatal DA overflow and DAergic terminal damage in mice caused by the mitochondrial inhibitor malonate. We also explored the expression of NHE1-5 in the striatum and substantia nigra. Reverse microdialysis of HOE-642 elicited a transient elevation followed by a reduction in DA overflow accompanied by a decline in striatal DA content. HOE-642 pre-treatment diminished the malonate-induced DA overflow without reducing the intensity of the metabolic stress or subsequent DAergic axonal damage. Although NHE isoforms 1-5 are expressed in the striatum and midbrain, NHE1 protein was not co-located on nigrostriatal DAergic neurons. The absence of NHE1 co-location on DAergic neurons suggests that the effects of HOE-642 on striatal DA overflow are either mediated via NHE1 located on other cell types or that HOE-642 is acting through multiple NHE isoforms.

Study Design: Cross-seccional analysis., Objective: To define the clinical usefulness of vestibular-evoked myogenic potential (VEMP) in detecting cervical medullar involvement related to human T-cell lymphotropic virus type 1 (HTLV-1) associated myelopathy/tropical spastic paraparesis (HAM/TSP)., Summary of Background Data: VEMP is generated by acoustic or galvanic stimuli, passing through the vestibulo-spinal motor tract, the spinal nerves and recorded by means of surface electrodes on the sternocleidomastoid muscle. HAM/TSP is a progressive inflammatory myelopathy with predominant lesions at the thoracic spinal cord level, although the cervical spine can be affected. VEMP may be of value to investigate cervical myelopathy., Methods: Seventy-two individuals were evaluated of whom 30 HTLV-1 were seronegative and 42 HTLV-1 seropositive (22 asymptomatic, 10 with complaints of walking difficulty without definite HAM/TSP and 10 with definite HAM/TSP). VEMP was recorded using monaural delivered short tone burst (linear rise-fall 1 millisecond, plateau 2 milliseconds, 1 KHz) 118 dB NA, stimulation rate of 5 Hz, analysis time of 60 milliseconds, 200 stimuli, band pass filtered between 10 and 1.500 Hz., Results: VEMP was normal in the seronegative group (30 controls). In the seropositive, abnormal VEMP was seen in 11 of 22 (50%) of the HTLV-1 asymptomatic carriers, in 7 of 10 (70%) of those with complaints of walking difficulty and in 8 of 10 (80%) of the HAM/TSP patients. In this last group, the pattern of response was different. No VEMP response was more frequent when compared with the HTLV-1 asymptomatic group (2-tailed P-value = 0.001)., Conclusion: VEMP may possibly be useful to identify patients with cervical myelopathy and to distinguish variable degrees of functional damage. Minor injury would be related to latency prolongation and major injury to no potential-evoked response.

This is a descriptive, documental survey aimed at analyzing the process indicators of the Prenatal Information System (Sisprenatal) in the municipality of Quixadá, State of Ceará. The records of 1544 pregnant women from 2001 through 2004 were studied. Data were collected from February through April, 2005 in Sisprenatal, located in the Epidemiology sector of the local Health Secretary. The results were presented in a single chart containing absolute and relative frequency. They were analyzed in the light of current literature and the authors' experience. In the period was verified a growing percentage of pregnant women with indicators of at least six appointments, all the basic exams, anti-HIV test, antitetanic immunization and puerperal consultation, from zero percent (2001), to 2.6% (2002), to 5.68% (2003) to 21.11% (2004). Thus it is necessary to improve the use of the system, as well as the systematic reading of the process indicators, in order to obtain subsidies for the enhancement of the quality of prenatal assistance.

This study aims to evaluate the urethral nerve fibers of adult female rats during pregnancy and after vaginal birth, cesarean section or simulated birth trauma. For immunohistochemical analysis of nerve fibers, 70 female rats were distributed in seven groups of ten female rats: group 1, control; group 2, pregnant; group 3, cesarean section; group 4, vaginal birth; group 5, virgin female rats with simulated birth trauma; group 6, cesarean section followed by simulation of birth trauma; and group 7, vaginal birth followed by simulation of birth trauma. The number of nerve fibers in groups 1, 2, and 3 were significantly higher than the other groups. Pregnancy and cesarean section did not cause alterations in the nerve fibers number. Vaginal birth and simulated birth trauma significantly decreased the number of nerve fibers in the female rats' middle urethra.

This study had the aim of investigating occurrences of methemoglobinemia among individuals with glucose-6-phosphate dehydrogenase deficiency during treatment for malaria infection using primaquine. Patients with a diagnosis of malaria caused by Plasmodium vivax or the V+F mixture (Plasmodium vivax + Plasmodium falciparum) were selected. Group 1 consisted of 74 individuals with a clinical diagnosis of methemoglobinemia and Group 2 consisted of 161 individuals without a clinical diagnosis of methemoglobinemia. The glucose-6-phosphate dehydrogenase deficiency rates (numbers of enzymopenic individuals) in Groups 1 and 2 were 51.3% (38) and 8.7% (14) respectively. These data demonstrated a statistically significant association with methemoglobinemia only among the individuals in Group 1 (p<0.05). Investigation of the relationship between methemoglobinemia and glucose-6-phosphate dehydrogenase deficiency showed that there was a possible association such that enzymopenic individuals may develop methemoglobinemia more frequently.

This is a case study which theoretical reference is the Calgary Model of Family Evaluation (CMFE). The aim was to understand the experience of a pregnant woman with vulvar condilomatosis caused by Human Papillomavirus (HPV), and to understand the changes in family dynamics after the clinical and laboratory diagnosis of HPV. The study was conducted at a reference institution in gynecology in Fortaleza, Ceará, Brazil. Data were collected fiom October 2003 through April 2004. Data were analyzed using CMFE, tracing six "developing" events, highlighting that the patient experienced emotional suffering caused by pregnancy and by HPV, as well as physical suffering, due to the surgeries to which she was submitted to. All these facts altered family dynamics.

Osteomas are benign osteogenic lesions with very slow growth, which may arise from proliferation of either cancellous or compact bone. In the jaw, these are uncommon lesions. Excluding the maxillary sinus, there are only eight cases of maxillary osteoma reported in the English-language literature. This paper reports an additional case of maxillary osteoma in a 40-year-old man. We discuss the clinical data from the previously described cases and the main differential diagnoses.

Molecular characterization of Bovine leukemia virus (BLV) isolates from Brazil using the env gene sequences revealed a high conservation of this gene. In most cases the substitutions corresponded to silent transitions. In addition, cystein residues, potential glycosylation sites, neutralization domains and other critical residues involved with the envelope structural domains and viral infectivity were conserved. Most of the substitutions found in the aminoacid sequences of the gp51 protein were localized in the G and H epitopes. Using the SIFT software, it was predicted that they should not alter the protein functions. Phylogenetic analyses showed that partial or complete env gene sequences grouped in three or four phylogenetic clusters, respectively. The sequences from the Brazilian isolates had similar mutation rates as compared to samples from other countries, and belonged to at least two phylogenetic clusters.

The aim of this study was to evaluate the modifications in the amount of collagen, muscular, and elastic fibers in the mid-urethra of adult female rats during the pregnancy and after the natural childbirth, cesarean, and after simulated trauma of childbirth. The authors evaluated the histomorphometric aspects (collagen, muscular, and elastic fibers) in the mid-urethra of 70 animals distributed in seven groups: group 1 (n = 10)--control, group 2 (n = 10)--pregnant female rats, group 3 (n = 10)--female rats submitted to cesarean, group 4 (n = 10)--female rats with natural childbirth, group 5 (n = 10)--virgin female rats with simulated trauma of childbirth, group 6 (n = 10)--female rats submitted to cesarean followed by simulation of childbirth trauma, and group 7 (n = 10)--female rats with natural childbirth followed by simulation of childbirth trauma. The average concentration of collagen and elastic fibers and the collagen/muscular fiber correlation in groups 1, 2, and 3 were similar and significantly inferior to groups 4, 5, 6, and 7. The average of muscular fibers was similar in groups 1, 2, and 3 and significantly superior to groups 4, 5, 6, and 7. Pregnancy and cesarean did not induce alterations in collagen, muscular, and elastic fibers. However, the vaginal delivery and simulation of childbirth trauma determined the decrease in muscular fibers and the increase in collagen and elastic fibers and the correlation collagen/muscular fiber.

The encapsulated yeast Cryptococcus neoformans is a significant cause of meningitis and death in patients with AIDS. Some murine monoclonal antibodies (MAbs) against the glucuronoxylomannan (GXM) component of the C. neoformans capsular polysaccharide can prolong the lives of infected mice, while others have no effect or can even shorten survival. To date, no one has systematically compared the efficacies of antibodies with the same variable regions and different human constant regions with their unique combination of effector functions in providing protection against murine C. neoformans infection. In the present study, we examined the efficacies of anti-GXM MAbs of the four human immunoglobulin G (IgG) subclasses, which have identical variable regions but differ in their capacities to bind the three types of Fc receptors for IgG (FcgammaR), their abilities to activate complement, and their half-lives. IgG2 and IgG4 anti-GXM prolonged the lives of infected BALB/c mice, IgG3 anti-GXM did not affect animal survival, while mice treated with IgG1 anti-GXM died earlier than mice treated with phosphate-buffered saline or irrelevant isotype-matched MAbs. All MAbs decreased serum GXM in infected animals. Effector pathways traditionally believed to be important in defense against microbes, such as opsonophagocytosis and complement binding, negatively correlated with antibody efficacy. It is generally accepted that human IgG1 has the most favorable combination of effector functions for therapeutic use against infections. Therefore, our findings have significant implications for humanization of the mouse IgG1 currently in clinical trials for cryptococcal meningitis and for the design of antibody therapeutics to treat other infectious diseases as well.

Unlabelled: Mismatch Negativity is a functional index of the supratemporal auditory cortex., Aim: The aim of the present study on Mismatch Negativity (MMN) in multiple sclerosis (MS) patients was to evaluate if the MMN can be correlated with cognitive deficits assessed by the Paced Auditory Addition Task--PASAT., Method: a clinical study in forty females and 20 males separated in two groups: control individuals and those with a definite diagnosis of MS underwent a duration and frequency MMN. The MMN latencies and negative amplitudes obtained from the MS group were compared to the ones from the control group. The scores from the Paced Auditory Addition Task were correlated either with the presence or the absence of MMN., Results: MMN was found in 60% of the individuals with multiple sclerosis within the auditory stimulation protocol with varied durations, and in 45 % within the auditory stimulation protocol with frequency variations. There were no statistically significant differences in latencies and amplitudes when compared to controls. We found a statistically significant correlation for the lack of MMN wave together with cognitive disorder asserted by the PASAT., Conclusions: The MMN correlated to the cognitive deficit assessed by the PASAT.

This study aimed at analyzing the problems related to the Human Papillomavirus (HPV) and its relation with the women's health in the family context. It is a study of reflexive analysis related to the theme, starting from a literature review and searching for an association with the reality studied. The educative approach is indispensable in the context of the woman's health, taking into account that when the HPV affects the woman, it causes emotional instability, feelings of guilt and, many times, conjugal disharmony. The nurse plays an essential role in the control of the HPV and must develop actions of promotion and prevention, taking care individually of the family and the community.

Objective: The purpose of this study was to evaluate whether auditory brainstem responses (ABR) in multiple sclerosis (MS) patients were qualitatively different from a normal population., Material and Method: This study analysed 69 subjects, separated into two groups; a control group composed of 20 females and 20 males; and an MS group composed of 20 females and 9 males. The controls had no history of neurological or otorhinolaryngological disorders. All MS patients presented a normal magnetic resonance imaging of the brainstem. A definite diagnosis of MS was given according to Poser's criteria for MS research protocols (1983). The following parameters were used in the study of the ABR of each subject: 2000 clicks of 100 ms at 60 dB equivalent peak of sou nd pressure level (pe SPL) above the psycho-acoustic threshold, obtained with the subject's response to clicks. Both ears were initially stimulated at 11 clicks/s, and then with clicks of same intensity, but with a progressive increase of the stimulus rate to 31, 51, 61 and 71 clicks/s. The analysis of variance with independent factors and repeated measures was used in the statistical analysis of the comparison between group results., Results: The absolute latency of wave III was statistically greater, with a stimulus rate of 51 and 61 clicks/s, in the MS group. The males in the MS group presented a statistically greater absolute latency of wave V with the use of 51 and 61 clicks/s. With stimulus rates above 30 clicks/s, the absolute latency of wave V was also greater for MS females. There were statistically significant differences in the interpeak interval I - III of the control group compared to the MS group, for stimulus rates of 51 and 61 clicks/s, in females and for the stimulus rate of 61 clicks/s in males. This interval was higher in the MS group with these stimulus rates., Conclusion: The results suggest the inclusion of stimulus rates of 51 and 61 clicks/s in the ABR tests of subjects with clinical suspicion of demyelinating diseases like MS.

This study aims at evaluating the usefulness of Orem's theory of self-care, applied to the hypertense woman. The analysis criteria of nursing theories are classified into Internal and External Criteria. The usefulness of the theory, as one of the Internal Criteria, considers that the theory be useful when applied to professional practicing, be it in assistance, teaching, research or in administration. It has been found out that the theory is based on the basic needs of development. The application of the model in the health-disease cycle delimited the usefulness of Orem's self-care theory.

The anatomic study of the facial nerve is closely related to the prevention of nerve injury that may occur in facial surgeries. The purpose of this study is to analyze the most susceptible areas in the face regarding the probability of facial nerve injury, based on the demarcation of its trajectory in the overlying skin. Three hundred cadaveric hemifaces were dissected (172 male, 128 female) and the facial nerve trajectory was followed from the stylomastoids foramen to the mimic muscles. The trajectory of the facial branches was delimited in the overlying skin by six diverging lines, with the following reference points: the upper and lower portions of the tragus, the most cranial wrinkle of the frontal region, the lower facial wrinkle of the frontal muscle, the nasal midpoint, an imaginary point 1 cm caudal to the oral commisura, another imaginary point also caudal to the oral commisura at the lower margin of mandible, and the clavicle midpoint. The temporal branches have the highest probability of being injured, followed by the mandibular marginal and buccal branches. The areas with greater risk of injury are the temporofrontal region (between the hairline and the lateral limit of the frontal muscle), the area near the angle of the mandible, and the preparotid region.