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A busca por eficiência na prestação de serviço público deve ser incessante, sobretudo em tempos de grave crise fiscal. O que se pode afirmar a respeito disso nas universidades federais? O objetivo deste estudo é buscar evidências a respeito do nível de eficiência técnica-comparativa das universidades federais brasileiras, por meio da Análise Envoltória de Dados (DEA). O modelo utilizado proposto para o alcance deste objetivo foi o CCR orientado a input. Foram analisados os dados conjuntos do período de 2008 a 2018 em 53 universidades públicas federais e utilizados dados do Sistema Integrado de Administração Financeira do Governo Federal. Verificou-se que a Universidade Federal do Pará foi a mais eficiente - considerada benchmark. São apresentadas sugestões para ganhos de eficiência com base nos resultados obtidos.

This study aimed to investigate the presence of BRAF V600E mutation in mandibular ameloblastoma by comparing the results of molecular detection and immunohistochemical analysis. A 128 cases of mandibular ameloblastoma and 30 cases of dentigerous cyst (control group) were selected for analysis. Detection of BRAF V600E mutation was performed with immunohistochemistry (IHC) and polymerase chain reaction techniques. Clinico-pathologic data were collected in order to investigate possible associations with the mutation. Of the 128 cases submitted to IHC, 81.2% (108 cases) showed positivity for anti-BRAF V600E antibody, whereas 24 were negative (18.8%). Molecular analysis of the BRAF V600E mutation by polymerase chain reaction was possible in 116 cases due to DNA quality. Of these cases, 96 were positive (82.8%) and 20 negative (17.2%). All cases of dentigerous cyst were negative for BRAF V600E mutation in both techniques. Considering the sequencing as a gold standard method, the receiver operating characteristics curve analysis showed sensitivity of 0.99 and specificity of 1 (area under the curve=0.995, standard error=0.006; P

Dentigerous cyst is the most common developmental maxillary cyst, often being associated with impacted third molars. The occurrence of bilateral or multiple lesions is usually associated with syndromes. The present report describes a case of multiple dentigerous cyst affecting both maxilla and mandible in association with impacted third molars in a non-syndromic patient. The complementary use of cone beam computed tomography (CBCT) could provide accurate knowledge for pre-operative radiologic assessment to delineate the extension of the lesion as well as its relationship with adjacent structures. The typical imaging characteristics can be useful for an adequate diagnosis. This type of lesion requires comprehensive pre-operative evaluation and logical operational approach.

Study Design: Mandibular reconstruction is a challenge. Several reconstructive techniques are available, and the individualization of choice for each patient leads to better results and quality of life for the individual. Objective: The aim of this study is to evaluate the characteristics and complications of cases submitted to mandibular reconstruction with autogenous bone graft block of the iliac crest. Methods: Records of 45 patients undergoing mandibular reconstruction with autogenous bone graft block of the iliac crest were analyzed from January 2000 to December 2014. The data collected included age, gender, etiology and graft size, surgical approach, complications, comorbidities, and habits and addictions. Analysis of variance, chi-square test, and Fisher exact test were used for analysis of the variables with a significance level of P < .05. Results: The success rate of the 45 charts analyzed was 75.6%. No statistical differences were found between age and presence of complications, between defect size and presence or absence of complications, and between type of surgical approach and presence or absence of complications. Conclusion: According to our study, medical history may influence postoperative complications and require attention, though further studies should be performed to further elucidate the relationship between diseases and postoperative complications.

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Planaltina, Programa de Pós-Graduação em Gestão Pública, 2021. O Novo Regime Fiscal (NRF), instituído na Constituição Federal de 1988 por meio da Emenda Constitucional no 95/2016, visa estabelecer limites para os gastos públicos com o intuito de alcançar o equilíbrio fiscal. A regra impede o aumento real das despesas primárias, que passam a ser ajustadas pelo Índice Nacional de Preços ao Consumidor Amplo (IPCA). Neste trabalho foi utilizada a pesquisa de abordagem quantitativa, mediante utilização de estatística descritiva. Este trabalho busca analisar os efeitos do NRF sobre o perfil de aplicação dos recursos nas despesas discricionárias da Universidade de Brasília (UnB). Foram coletados dados do Sistema Integrado de Administração Financeira (Siafi) por meio do sistema Tesouro Gerencial, bem como dos Relatórios de Gestão da UnB e do TCU, no período entre 2008 e 2019. Foram analisados indicadores de finanças públicas da União e da UnB, assim como os indicadores de gestão, instituídos pelo Tribunal de Contas da União (TCU), aplicados à UnB. The New Fiscal Regime (NRF), established in the Federal Constitution of 1988 through Constitutional Amendment No. 95/2016, with a view to establishing limits for public spending in order to achieve fiscal balance. The rule prevents the real increase in primary expenditure, which is now adjusted by the Índice Nacional de Preços ao Consumidor Amplo (IPCA). In this work, the research of a quantitative approach was used, through the use of descriptive statistics . This work seeks to analyze the effects of the NRF on the application profile of resources in discretionary expenses at the University of Brasília (UnB). Data were collected from the Sistema Integrado de Administração Financeira (Siafi) through the Treasury Managerial system, as well as from the Management Reports of UnB and TCU, in the period between 2008 and 2019. Public finance indicators of the Union and UnB were analyzed, as well as the management indicators, established by the Tribunal de Contas da União (TCU), applied to UnB.

Sclerosing polycystic adenosis (SPA) is a rare benign lesion of the salivary glands which appears histologically similar to sclerosing adenosis and fibrocystic disease of the mammary gland. To date, 67 cases of SPA have been reported in the literature, with the lesion arising in the minor salivary glands in only 9. The present report describes the 10th case of SPA. The patient was a 39-year-old Brazilian man who presented with an asymptomatic nodule on the ventral surface of the tongue. Based on a clinical diagnosis of benign salivary gland neoplasm, an excisional biopsy of the lesion was performed. Histopathological examination showed lobular proliferation of ductal and acinar elements surrounded by a fibrosclerotic stroma. Many of the ductal structures exhibited cystic dilatation and were surrounded by periductal fibrosis, which is consistent with SPA findings. No recurrence of the disease was observed after a 5-year follow-up. A literature review is also discussed, focusing on both the etiology of SPA and the treatment options available.

Encephalocele is defined as protrusion of cranial contents beyond the normal confines of the skull. Although most encephalocele cases have a congenital etiology, fractures of the skull base can cause traumatic encephalocele. In most encephalocele cases, the bone defect presents reduced dimensions and the endoscopic treatment is generally performed to reconstruct the area using mucosal and/or fat grafts. This article sought to report on a rare case of traumatic encephalocele associated with an extensive defect of the anterior skull base. This case was treated via transcranial access, and reconstruction was performed using titanium mesh in conjunction with a pericranium flap.

Dissertation proposal presented as partial requirement for obtaining the Master’s degree in Information Management, with a specialization in Business Intelligence and Knowledge Management This report has been built as a thesis proposal based on the work previously developed and submitted to the 18th Conferência da Associação Portuguesa de Sistemas de Informação (CAPSI 2018) and later published in the books “Modelos Preditivos & Segurança Pública”, by Teresa Rodrigues and Marco Painho and “Information Systems for Industry 4.0”, by Isabel Ramos, Rui Quaresma, Paulo Silva and Tiago Oliveira. The original work was conceived in the scope of the SIM4SECURITY project; it proposed a set of techniques and predictive models for analyzing security by using geospatial data and quantifiable indicators. The current work not only aims to report on the Business Intelligence tools and techniques developed in the aforementioned project, but also, it should take us one step further on establishing a common framework for structuring, quantifying and visualizing data, with the purpose of analyzing social and economic indicators and their impact on crime rates in Portugal. The framework developed herein could constitute as a strong decision support tool by helping security forces on optimizing resources allocation, tailoring more efficient security policies and finding patterns, challenges and threats in the social landscape for the next years to come.

Objectives: This study aimed to verify the presence of polyomavirus BK (BKPyV) in the saliva of kidney transplant recipients and to correlate it with blood viremia. Material and Methods: We have conducted a cross-sectional study with a sample involving 126 renal transplant recipients. 126 samples of saliva and 52 samples of blood were collected from these patients. Detection and quantification of BKPyV were performed using a real-time PCR. To compare the presence of BKPyV in blood and saliva, the binomial proportion test was used. To verify associations between salivary shedding BKPyV and post-transplant periods (in months), the Mann-Whitney test was used. Spearman's correlation was used to correlate the viral load in the saliva with blood of kidney transplant recipients. Results: The mean age of the study group was 51.11±12.45 years old, and 69 participants (54.8%) were female, with a mean post-transplantation time of 4.80±6.04 months. BKPyV was quantified in several samples of saliva and blood, with medians of 1,108 cp/mL and 1,255 cp/mL, respectively. Only 16/52 (30.8%) participants presented BKPyV in blood, and 59/126 (46.8%) excreted the virus in saliva (p=0.004). BKPyV shedding was found in patients at a shorter post-transplantation period (3.86±5.25, p=0.100). A weak correlation was observed between viral quantification in saliva and blood (Spearman's correlation coefficient=0.193). Conclusion: The results of this study suggested that, although saliva excretes more BKPyV than blood, there is no reliable correlation between salivary shedding and blood viremia, showing two independent compartments of viral replication.

The calcifying epithelial odontogenic tumour (CEOT) is an extremely rare benign neoplasia, accounting for approximately 1% of all odontogenic tumours. CEOT can have two clinical manifestations: central or intraosseous (94% of the cases) and peripheral or extraosseous (6% of the cases). Although the latter is less common, the peripheral variant has been described as an insidious lesion, since it is usually asymptomatic and may be erroneously mistaken with gingival hyperplasia, hamartomas, or even metastasis of malignant neoplasia. We report a case of a young male patient presenting with a peripheral CEOT in the mandibular posterior region, mimicking a located gingival inflammation.

Background: Zika virus (ZIKV) sexual transmission and prolonged viral shedding in semen have been previously reported, suggesting a strong viral affinity for genital tissues. A transient impact of ZIKV on male fertility was shown in animal and human studies. Methods: Adult male patients with confirmed ZIKV infection diagnosed in the city of Araraquara, Brazil during the epidemic season of 2016 were invited one year after the acute infection to respond to a questionnaire of genital symptoms and to provide a semen sample for molecular ZIKV testing and spermogram analysis, as well as a serum sample for hormonal testing. Results: 101 of 187 tested patients had positive ZIKV RT-PCR in plasma and/or urine samples (54%, 72 women and 29 men). Of 15 adult male participants for whom telephone contact was successful, 14 responded to the questionnaire of genital symptoms and six consented to provide a semen sample at a median of 12 months after the acute infection. We report abnormal spermogram results from patients one year after confirmed ZIKV infection. Conclusions: Our findings suggest a possible long-term detrimental effect of ZIKV infection on human male fertility that has to be further explored in well-characterized samples from cohort studies conducted in ZIKV-endemic areas.

In some cases of dentofacial deformities such as vertical maxillary excess, administration of botulinum toxin has been used as an effective minimally invasive technique to improve the aesthetic disorder of gummy smile. This article presents a case of a woman with excessive gingival exhibition during the smile related to vertical maxillary excess and hyperactive upper lip elevator muscles. This patient was treated using botulinum toxin type A (BT) to camouflage the deformity and improve her facial aesthetic. This therapeutic option proved to be effective and should be a good alternative for patients.

O ameloblastoma é um tumor odontogênico agressivo, localmente invasivo e altamente recorrente. Estudos demonstram que é a neoplasia odontogênica benigna mais comum e eventualmente pode apresentar comportamento de lesões malignas. A detecção da mutação BRAF V600E tem sido demonstrada como uma das principais vias de proliferação tumoral dos ameloblastomas. Portanto, a identificação desses marcadores poderão ser úteis para elaborar estratégias mais eficientes de tratamento dessa patologia, bem como melhorar a qualidade de vida dos pacientes. Este estudo pesquisou a mutação BRAF V600E, por meio da técnica de imunohistoquimica, em ameloblastomas mandibulares bem como correlacionou com dados clínicos e imaginológicos relevantes. A amostra consistiu de 84 casos diagnosticados como ameloblastoma e localizados na mandíbula dos acervos do Serviço de Patologia Cirúrgica do Departamento de Estomatologia da FOUSP e do Serviço de Cirurgia Bucomaxilofacial do Hospital Erasto Gaertner, Curitiba, PR. Os blocos obtidos foram submetidos a reação imunohistoquímica para detectar a mutação da proteína BRAF e foram coletados todos os dados clínicos e imaginológicos dos pacientes como sexo, idade, tamanho do tumor, localização mandibular, aspecto radiográfico, tipo e subtipo histológico e status do tumor. Análise estatística foi realizada buscando estabelecer correlação entre o marcador BRAF e dados clínicos e imaginológicos. Como resultados, dos 84 pacientes, 44 eram pacientes do sexo masculino (52,38%) e 40 feminino (47,62%). A mediana da idade encontrada foi de 25,5 anos sendo que em 42 casos foi observada idade inferior a mediana (50%) e 42 superior (50%). Com relação a presença ou ausência da mutação BRAF V600E, 66 casos apresentaram positividade para o marcador estudado (78,57%) e 18 foram negativos (21,43%). Ao relacionar a expressão de BRAF com as variáveis, foi observado significância estatística para a variável localização (P= 0,0353) e tamanho do tumor (P=0,008). Não foi observado resultados com significância estatística com relação às variáveis sexo (P=0,969), idade (P=1,0), aspecto radiográfico (P=0,977), padrão histológico (P=0,910), subtipo histológico (P=0,5141) e status do tumor (P=0,336). Os autores concluíram que a mutação BRAF V600E é comum em ameloblastomas mandibulares e é mais frequente tumores maiores de 4 cm e na região posterior de mandíbula. Além disso, independe do tipo histológico do tumor, idade e sexo do paciente, aspecto radiográfico e status do tumor (primário x recorrente). Ameloblastoma is an aggressive odontogenic tumour, being locally invasive and highly recurrent. Studies have demonstrated that it is the most common benign odontogenic neoplasia, sometimes exhibiting behaviour of malignant lesions. Detection of BRAF V600E mutation has been shown to be one of the main proliferation pathways of ameloblastomas. Therefore, the identification of these markers can be useful to elaborate more efficient treatment strategies for this pathology as well as to improve the patient\'s quality of life. This study investigated the BRAF V600E mutation in mandible ameloblastomas by using the immunohistochemical technique and by correlating clinical and imaging data of the patients. The sample consisted of 84 cases diagnosed as mandibular ameloblastoma, with all blocks being obtained from the Surgery Pathology Service of the FOUSP Department of Stomatology and the Maxillofacial Surgery Unit of the Erasto Gaertner Hospital, Curitiba, PR. The blocks were submitted to immunohistochemical reaction for detection of BRAF protein mutation, with clinical and imaging data such as age, gender, tumour size, mandibular location, radiographic aspect, histological type and subtype, and tumour status were collected. Statistical analysis was performed in order to establish a correlation between BRAF marker and clinical and imaging data. The results showed that, of the 84 patients, 44 were male (52.38%) and 40 female (47.62%). The median age was 25.5 years old, with 42 cases having age below the median (50%) and 42 above it (50%). With regard to the presence or absence of BRAF V600E mutation, 66 cases were found to be positive for the marker (78.57%) and 18 were negative (21.43%). The correlation between BRAF expression and variables showed statistical significances for mandibular location (P = 0.0353) and tumour size (P = 0.008), whereas no statistical significance was observed for gender (P = 0.969), age (P = 1.0), radiographic aspect (P = 0.977), histological pattern (P = 0.910), histological subtype (P = 0.5141) and tumour status (P = 0.336). The authors concluded that BRAF V600E mutation is common in mandibular ameloblastomas, with tumours larger than four cm being more frequent in the posterior region of the mandible. In addition, this pathology occurs regardless of histological type of the tumour, age, gender, radiographic aspect and tumour status.

This study aimed to investigate the presence of BRAF V600E mutation in mandible ameloblastomas by correlating clinical and imaging data on the cases studied. Eighty-four cases diagnosed as mandibular ameloblastoma were selected for analysis. The specimens were submitted to immunohistochemistry for detection of BRAF V600E mutated protein. Clinical-pathological data such as age, gender, tumour size, mandibular location, radiographic aspects, histological type and sub-type, and tumour status were collected. The clinical-pathological parameters were categorised and analysed according to BRAF V600E detection. Of the 84 patients, 78.6% (66 cases) demonstrated positivity for anti-BRAF V600E antibody, whereas 18 were negative (21.4%). The correlation between BRAF expression and variables showed statistical significances for mandibular location (P = 0.0353) and tumour size (P = 0.008), whereas no statistical significance was observed for gender, age, radiographic aspect, histological pattern, histological sub-type and tumour status. Multivariate logistic regression revealed a significant risk for BRAF positivity in tumours with posterior mandibular location (OR = 7.23, P = 0.0451) and size > 4 cm (OR = 7.29, P = 0.0150). BRAF V600E mutation is common in mandibular ameloblastomas, especially in cases of tumours larger than 4 cm and in the posterior region of the mandible. In addition, this mutation can occur regardless of histological type of the tumour, age, gender, radiographic aspect and tumour status. The association between clinical-pathologic features and BRAF V600E mutation in ameloblastomas may provide directions for the treatment of this neoplasia. The use of BRAF inhibitors for targeted therapy could lead to an establishment of an alternative compared to the resective surgery.

Ameloblastoma is an aggressive odontogenic tumour, which is locally invasive and highly recurrent. Studies show that ameloblastoma is a benign odontogenic neoplasia, being relatively rare and occasionally presenting behaviour of malignant lesions. In addition to these particularities, the histological diagnosis of ameloblastoma can be challenging when the tumour shows high rates of mitosis, absence of nuclear pleomorphism, basilar hyperplasia and neural invasion. In order to help in the diagnosis, prognosis and treatment of this neoplasia, some immunohistochemical markers were shown to be associated with tumoural epithelium. The identification of these markers as well as of their association with clinical signs can be useful to elaborate more efficient treatment strategies and to control this pathology, including improvement of the quality of life of patients affected by this neoplasia. This article aims to review some markers associated with specific molecular pathways, bone remodelling, cell proliferation, apoptosis, cell signalling and tumour suppression.

The calcifying epithelial odontogenic tumour (CEOT) is an extremely rare benign neoplasia, accounting for approximately 1% of all odontogenic tumours. CEOT can have two clinical manifestations: central or intraosseous (94% of the cases) and peripheral or extraosseous (6% of the cases). Although the latter is less common, the peripheral variant has been described as an insidious lesion, since it is usually asymptomatic and may be erroneously mistaken with gingival hyperplasia, hamartomas, or even metastasis of malignant neoplasia. We report a case of a young male patient presenting with a peripheral CEOT in the mandibular posterior region, mimicking a located gingival inflammation.

O ameloblastoma é um tumor odontogênico localmente agressivo, com altas taxas de recorrência. Raramente o ameloblastoma apresenta aspecto histológico semelhante ao queratocisto odontogênico devido à presença de áreas queratinizadas. O objetivo deste estudo é relatar um caso de ameloblastoma na mandíbula, diagnosticado e tratado incorretamente como um queratocisto odontogênico devido a características macroscópicas incomuns e aspectos histológicos raros que prejudicaram um correto diagnóstico. Relato de caso: Paciente do sexo feminino, 57 anos, apresentando lesão assintomática no ângulo mandibular esquerdo tratado inicialmente com biópsia incisional e descompressão. Os achados histológicos mostraram um aspecto sugestivo de queratocisto odontogênico. No pós operatório de 3 anos, a paciente retornou com uma nova lesão no lado esquerdo da mandíbula e foi então submetida a curetagem. Desta vez, as seções histológicas mostraram um padrão de ameloblastoma e, devido a este fato, a paciente permaneceu com um seguimento de 6 meses. No pós operatório de 4 anos da segunda operação, a paciente retornou apresentando nova recidiva. A biópsia mostrou um ameloblastoma e a mesma foi submetida a ressecção mandibular e reconstrução como tratamento. Após o procedimento final, a recuperação foi sem intercorrências e a paciente passou por um pós-operatório de quatro anos sem recidivas. Conclusão: Este caso destaca a importância de se realizar uma biópsia e um exame adequado por profissional especializado, devido à possibilidade de lesões atípicas que ocorrem restritas à região da cabeça e pescoço. The ameloblastoma is a locally aggressive odontogenic tumour that has high recurrence rates. It rarely presents a histological aspect similar to the odontogenic keratocyst, because of the presence of keratinised areas. This study aimed to report a case of ameloblastoma in the mandible, diagnosed and treated incorrectly as an odontogenic keratocyst because of unusual macroscopic characteristics and rare histological aspects that impaired a correct diagnosis. Case report: A 57-year-old female patient, presenting an asymptomatic lesion at the left mandibular angle, was treated by incisional biopsy and decompression. The histological sections showed an aspect suggesting odontogenic keratocyst. At the 3-year postoperative period, the patient returned with a new lesion on the left side of the mandible and was then subjected to curettage. The histological sections showed a pattern of ameloblastoma and, because of this, the patient remained with a 6-month follow-up. At the 4-year postoperative period after the second operation, the patient returned with a new recurrence. The biopsy showed an ameloblastoma and the patient was submitted to mandibular resection and reconstruction as treatment. After the final procedure, the recovery was uneventful and the patient is now undergoing a postoperative period of four years, without recurrences. Conclusion: This case highlights the importance of carrying out a proper biopsy and an adequate examination by a specialised professional, because of the possibility of atypical lesions occurring restricted to the head and neck region.

Penetrating injuries caused by rubber projectiles are classified as low-velocity injuries. When the midface is affected, these can cause fractures, eye injuries, and even blindness. Unlike conventional projectiles, the removal of rubber projectiles involving the orbit and correction of associated fractures are mandatory for preventing infection and anophthalmic orbit syndrome, which is characterized by enophthalmos of the prosthesis, superior sulcus depression, and lower eyelid ptosis. This article aims to describe a case of penetrating injury by rubber projectile, associated with the removal and late reconstruction of the orbital walls, and to show the results obtained.

To determine the frequency of cytomegalovirus (CMV) viremia in patients with acquired immunodeficiency syndrome (AIDS) and untreated CMV retinitis using conventional cell culture isolation and the sensitive CMV antigenemia assay.We examined 24 AIDS patients with ophthalmologic diagnosis of untreated CMV retinitis and 24 AIDS patients without present or past retinitis (control patients) from three medical centers between September 1992 and March 1994. Cytomegalovirus antigenemia was detected by an indirect peroxidase staining in 300,000 cytocentrifuged neutrophils, using a mixture of murine monoclonal antibodies directed against the pp65 lower matrix protein of CMV.Positive antigenemia was demonstrated in eight (33.3%) of the 24 retinitis patients and in none of the 24 control patients (P.001). Only two of the eight antigenemia-positive patients had a concurrent positive CMV isolation from blood leukocytes by conventional cell culture assay.These results emphasize the risk of extraocular disease in AIDS patients with CMV retinitis because the virus is often present in peripheral blood leukocytes. The CMV antigenemia assay may be a simple and rapid means of identifying those patients with unilateral retinitis at highest risk of developing CMV retinitis of the fellow eye or of visceral CMV disease if intravitreal injections or implants are used as sole treatment for CMV retinitis.

O líquen plano é uma desordem comum do epitélio escamoso estratificado que acomete as mucosas oral e genital, a pele, as unhas e o couro cabeludo. O líquen plano oral (LPO) afeta mulheres de meiaidade e apresenta padrões e distribuição característicos, como estriações brancas, pápulas ou placas brancas, eritema, erosões e bolhas, que podem estar associadas a medicações e/ou materiais dentários no paciente. O diagnóstico clínico somente poderá ser feito se a doença apresentar padrões clássicos, como lesões concomitantes na mucosa oral e na pele. O diagnóstico laboratorial por meio do exame histopatológico se caracteriza pela presença de projeções do epitélio em forma de dentes de serra e corpos de Civatte, e possibilita excluir condições de displasia e malignidade. A imunofluorescência direta é utilizada em suspeita de outras doenças, como pênfigo e penfigoide. O LPO é tratado com agentes anti-inflamatórios, principalmente, corticosteroides tópicos, e novos agentes e técnicas têm-se demonstrado eficazes. A transformação maligna do LPO e sua incidência exata permanecem controversas. Este trabalho tem como objetivo apresentar, com base na revisão da literatura, a etiopatogenia, o diagnóstico clínico, exames complementares e complicações do LPO.

O líquen plano é uma desordem comum do epitélio escamoso estratificado que acomete as mucosas oral e genital, a pele, as unhas e o couro cabeludo. O líquen plano oral (LPO) afeta mulheres de meiaidade e apresenta padrões e distribuição característicos, como estriações brancas, pápulas ou placas brancas, eritema, erosões e bolhas, que podem estar associadas a medicações e/ou materiais dentários no paciente. O diagnóstico clínico somente poderá ser feito se a doença apresentar padrões clássicos, como lesões concomitantes na mucosa oral e na pele. O diagnóstico laboratorial por meio do exame histopatológico se caracteriza pela presença de projeções do epitélio em forma de dentes de serra e corpos de Civatte, e possibilita excluir condições de displasia e malignidade. A imunofluorescência direta é utilizada em suspeita de outras doenças, como pênfigo e penfigoide. O LPO é tratado com agentes anti-inflamatórios, principalmente, corticosteroides tópicos, e novos agentes e técnicas têm-se demonstrado eficazes. A transformação maligna do LPO e sua incidência exata permanecem controversas. Este trabalho tem como objetivo apresentar, com base na revisão da literatura, a etiopatogenia, o diagnóstico clínico, exames complementares e complicações do LPO. Lichen planus is a common disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Oral Lichen Planus (OLP) affects middle-aged women and shows distribution patterns and characteristics such as white striations, white plaques or papules, erythema, blisters and erosions, and may be associated with medication and/or dental materials used by the patient. The clinical diagnosis can only be made if the disease presents classical patterns such as concomitant lesions in the oral mucosa and skin. The laboratory diagnosis is histopathologically characterized by the presence of projections of the epithelium in the form of sawtooth and Civatte bodies and allows the exclusion of dysplasia and malignancy. Direct immunofluorescence is used when there is suspicion of other diseases, such as pemphigus and pemphigoid. OLP is treated with anti-inflammatory agents, particularly topical corticosteroids; new agents and techniques have proved effective. The malignant transformation of OLP and its exact incidence remain controversial. This work aims at presenting, through literature review, the etiopathogenesis, clinical diagnosis, laboratory tests, and complications of OLP.

Lichen planus is a common disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Oral Lichen Planus (OLP) affects middle-aged women and shows distribution patterns and characteristics such as white striations, white plaques or papules, erythema, blisters and erosions, and may be associated with medication and/or dental materials used by the patient. The clinical diagnosis can only be made if the disease presents classical patterns such as concomitant lesions in the oral mucosa and skin. The laboratory diagnosis is histopathologically characterized by the presence of projections of the epithelium in the form of sawtooth and Civatte bodies and allows the exclusion of dysplasia and malignancy. Direct immunofluorescence is used when there is suspicion of other diseases, such as pemphigus and pemphigoid. OLP is treated with anti-inflammatory agents, particularly topical corticosteroids; new agents and techniques have proved effective. The malignant transformation of OLP and its exact incidence remain controversial. This work aims at presenting, through literature review, the etiopathogenesis, clinical diagnosis, laboratory tests, and complications of OLP.

HHV-6 is the etiological agent of Exanthem subitum which is considered the sixth most frequent disease in infancy. In immuno-compromised hosts, reactivation of latent HHV-6 infection may cause severe acute disease. We developed a Sybr Green Real Time PCR for HHV-6 and compared the results with nested conventional PCR. A 214 pb PCR derived fragment was cloned using pGEM-T easy from Promega system. Subsequently, serial dilutions were made in a pool of negative leucocytes from 10-6 ng/µL (equivalent to 2465.8 molecules/µL) to 10-9 (equivalent to 2.46 molecules/µL). Dilutions of the plasmid were amplified by Sybr Green Real Time PCR, using primers HHV3 (5' TTG TGC GGG TCC GTT CCC ATC ATA 3)'and HHV4 (5' TCG GGA TAG AAA AAC CTA ATC CCT 3') and by conventional nested PCR using primers HHV1 (outer): 5'CAA TGC TTT TCT AGC CGC CTC TTC 3'; HHV2 (outer): 5' ACA TCT ATA ATT TTA GAC GAT CCC 3'; HHV3 (inner) and HHV4 (inner) 3'. The detection threshold was determined by plasmid serial dilutions. Threshold for Sybr Green real time PCR was 24.6 molecules/µL and for the nested PCR was 2.46 molecules/µL. We chose the Real Time PCR for diagnosing and quantifying HHV-6 DNA from samples using the new Sybr Green chemistry due to its sensitivity and lower risk of contamination. HHV-6 é o agente etiológico do Exantema Súbito e considerado a sexta doença mais comum na infância. Em indivíduos imunocomprometidos, a reativação da infecção latente pode causar doença aguda ou morte. Padronizamos PCR em Tempo Real utilizando a química Sybr Green na detecção do HHV-6 e comparamos os resultados com a PCR convencional. Um fragmento de 214 pb foi clonado através do kit pGEM-T do sistema Promega. Com este clone, foram feitas diluições seriadas em um pool de leucócitos negativos a partir de 10-6 ng/µL (equivalente a 2465,8 moleculas/µL) até 10-9 (equivalente a 2,46 moleculas/µL). As diluições foram amplificadas por PCR em Tempo Real utilizando Sybr Green, com primers HHV3 5' TTG TGC GGG TCC GTT CCC ATC ATA 3' e HHV4 5' TCG GGA TAG AAA AAC CTA ATC CCT 3' e pelo método convencional, PCR nested usando primers HHV1 (externo): 5' CAA TGC TTT TCT AGC CGC CTC TTC 3'; HHV2 (externo): 5' ACA TCT ATA ATT TTA GAC GAT CCC 3', HHV3 (interno) e HHV4 (interno): 5' TCG GGA TAG AAA AAC CTA ATC CCT 3'. O limite de detecção foi determinado pelas diluições seriadas do plasmídio contendo um fragmento de HHV6: para o ensaio com Sybr Green, foi de 24,6 moleculas/µL e para a PCR nested, 2,46 moleculas/µL. Elegemos o PCR em Tempo Real - Sybr Green como método diagnóstico e quantitativo do HHV-6 devido a sua boa sensibilidade e menor risco de contaminação.

INTRODUCTION: Prolonged survival of patients under HAART has resulted in new demands for assisted reproductive technologies. HIV serodiscordant couples wish to make use of assisted reproduction techniques in order to avoid viral transmission to the partner or to the newborn. It is therefore essential to test the effectiveness of techniques aimed at reducing HIV and HCV loads in infected semen using molecular biology tests. METHODS: After seminal analysis, semen samples from 20 coinfected patients were submitted to cell fractioning and isolation of motile spermatozoa by density gradient centrifugation and swim-up. HIV and HCV RNA detection tests were performed with RNA obtained from sperm, seminal plasma and total semen. RESULTS: In pre-washing semen, HIV RNA was detected in 100% of total semen samples, whereas HCV RNA was concomitantly amplified in only one specimen. Neither HIV nor HCV were detected either in the swim-up or in the post-washing semen fractions. CONCLUSIONS: Reduction of HIV and/or HCV shedding in semen by density gradient centrifugation followed by swim-up is an efficient method. These findings lead us to believe that, although semen is rarely found to contain HCV, semen processing is highly beneficial for HIV/HCV coinfected individuals. O aumento da sobrevida dos pacientes que utilizam terapêutica antiretroviral altamente eficaz (HAART- Highly Active Antiretroviral Therapy) trouxe uma nova demanda de casais sorodiscordantes que desejam filhos. Como esses casais não podem abandonar o uso de preservativos, torna-se indispensável tratar o sêmen infectado com técnicas laboratoriais eficazes que além de isolar os melhores espermatozóides, reduzam a carga viral do HIV e HCV a níveis indetectáveis. Para isso, são utilizadas técnicas de semen washing, associadas a testes ultra sensíveis de biologia molecular. Após análise seminal, sêmen de 20 pacientes co-infectados HIV-HCV foram submetidos a fracionamento celular e isolamento de espermatozóides móveis através de método de densidade de gradiente descontínuo e swim-up. Posteriormente, testes para detecção do RNA do HIV e HCV foram aplicados nos sêmens totais e frações seminais obtidas. Em fase pré semen washing, o HIV foi detectado em 100% dos semens totais. Contrariamente, o HCV foi detectado em apenas uma amostra. Em fase pós semen washing, o HIV e HCV não foram detectados em nenhuma das frações seminais. A redução do HIV e do HCV através de semen washing mostra-se um método eficaz a indivíduos co-infectados HIV-HCV, apesar do encontro do HCV no sêmen ser raro.

INTRODUCTION: Prolonged survival of patients under HAART has resulted in new demands for assisted reproductive technologies. HIV serodiscordant couples wish to make use of assisted reproduction techniques in order to avoid viral transmission to the partner or to the newborn. It is therefore essential to test the effectiveness of techniques aimed at reducing HIV and HCV loads in infected semen using molecular biology tests. METHODS: After seminal analysis, semen samples from 20 coinfected patients were submitted to cell fractioning and isolation of motile spermatozoa by density gradient centrifugation and swim-up. HIV and HCV RNA detection tests were performed with RNA obtained from sperm, seminal plasma and total semen. RESULTS: In pre-washing semen, HIV RNA was detected in 100% of total semen samples, whereas HCV RNA was concomitantly amplified in only one specimen. Neither HIV nor HCV were detected either in the swim-up or in the post-washing semen fractions. CONCLUSIONS: Reduction of HIV and/or HCV shedding in semen by density gradient centrifugation followed by swim-up is an efficient method. These findings lead us to believe that, although semen is rarely found to contain HCV, semen processing is highly beneficial for HIV/HCV coinfected individuals. O aumento da sobrevida dos pacientes que utilizam terapêutica antiretroviral altamente eficaz (HAART- Highly Active Antiretroviral Therapy) trouxe uma nova demanda de casais sorodiscordantes que desejam filhos. Como esses casais não podem abandonar o uso de preservativos, torna-se indispensável tratar o sêmen infectado com técnicas laboratoriais eficazes que além de isolar os melhores espermatozóides, reduzam a carga viral do HIV e HCV a níveis indetectáveis. Para isso, são utilizadas técnicas de semen washing, associadas a testes ultra sensíveis de biologia molecular. Após análise seminal, sêmen de 20 pacientes co-infectados HIV-HCV foram submetidos a fracionamento celular e isolamento de espermatozóides móveis através de método de densidade de gradiente descontínuo e swim-up. Posteriormente, testes para detecção do RNA do HIV e HCV foram aplicados nos sêmens totais e frações seminais obtidas. Em fase pré semen washing, o HIV foi detectado em 100% dos semens totais. Contrariamente, o HCV foi detectado em apenas uma amostra. Em fase pós semen washing, o HIV e HCV não foram detectados em nenhuma das frações seminais. A redução do HIV e do HCV através de semen washing mostra-se um método eficaz a indivíduos co-infectados HIV-HCV, apesar do encontro do HCV no sêmen ser raro.

This study evaluates the transmission of CMV infection in 120 children aged 1 to 15 years with Down syndrome who attended a day-care center for handicapped children in São Paulo, Brazil. A blood sample was obtained from each children at the beginning of the study for detection of IgG and IgM cytomegalovirus (CMV) antibodies by an immunofluorescence assay. Samples of saliva and urine were obtained every 3 months from the children with CMV antibodies to detect shedding of the virus by culture in human foreskin fibroblasts, by detection of pp65 CMV-antigen and by a nested PCR assay. The prevalence of anti CMV-IgG antibodies was 76.6% (92/120), and IgM anti-CMV antibodies were detected in 13% (12/92) of the seropositive children. During the first viral evaluation, CMV was detected in the urine and/or saliva in 39/90 (43.3%) of the seropositive children. In the second and third evaluations, CMV was detected in 41/89 (46%) and in 35/89 (39.3%) children, respectively. Detection of CMV was shown both in urine and saliva in 28/39 (71.8%), 19/41(46.3%) and 20/35 (57.1%) of the children excreting the virus, respectively. Additionally, in 33/49 (67.4%) of the excreters CMV could be demonstrated in urine or saliva in at least two out of the three virological evaluations carried out sequentially in a six month period. Of the 28 initially seronegative children, 26 were re-examined for anti-CMV IgG antibodies about 18 months after the negative sample; seroconversion was found in 10/26 (38.5%). Taking all 536 samples of urine or saliva examined by virus culture and pp65 antigen detection during the study into account, 159 (29.6%) were positive by virus culture and 59 (11%) gave a positive result with the pp65 assay. These data demonstrate the high prevalence of CMV shedding and the high risk of CMV infection in children with Down syndrome attending a day-care center for mentally handicapped patients. The virus culture was more sensitive than the pp65 CMV antigen assay for CMV detection in both urine and saliva samples. O objetivo do presente estudo foi avaliar a prevalência de infecção pelo CMV em 120 crianças de 1-15 anos de idade, com síndrome de Down, que frequentavam uma instituição para atendimento de crianças portadoras de deficiência mental em São Paulo, Brasil. Uma amostra de sangue foi obtida de cada criança no início do estudo para detecção de anticorpos anti-CMV (IgG e IgM) por imunofluorescência indireta. Das crianças positivas para anticorpos IgG, 3 amostras de saliva e urina foram obtidas com intervalo de 3 meses entre elas, para detectar presença do CMV por cultura em fibroblastos humanos, detecção de antígeno pp65 do CMV ou reação em cadeia por polimerase (PCR). A prevalência de anticorpos IgG na admissão foi de 76,6% (92/120) e anticorpos IgM foram detectados em 13% (12/92) das amostras IgG positivas. Durante a primeira avaliação virológica, CMV foi detectado na urina e/ou saliva de 43,3% (39/90) das crianças soropositivas. Na segunda e terceira avaliações CMV foi demonstrado em 41/89 (46%) e 35/89 (39,3%) das crianças, respectivamente. Nestas avaliações, presença do CMV foi documentada tanto na urina quanto na saliva em 28/39 (71,8%), 19/41 (46,3%) e 20/35 (57,1%) das crianças excretoras. Além disso, 33/49 (67,4%) das crianças estavam excretando CMV na saliva ou urina em pelo menos duas das tres avaliações virológicas realizadas durante o estudo. Aproximadamente 18 meses após a primeira coleta, soroconversão para IgG anti-CMV foi documentada em 10/26 (38,5%) das crianças inicialmente soronegativas. Levando em conta todas as 536 amostras de urina ou saliva examinadas por isolamento viral e detecção de antígeno pp65 do CMV, observou-se que 159 (29,6%) foram positivas por isolamento viral e 59 (11%) foram positivas por pesquisa de antígeno pp65. Este estudo demonstra que há uma alta taxa de excreção do CMV na urina e saliva em crianças com síndrome de Down que frequentam creches, e um alto risco de infecção por este vírus em crianças susceptíveis que frequentam estas instituições. O isolamento viral mostrou-se mais sensível que a detecção de antígeno pp65 do CMV, tanto em amostras de urina quanto em amostras de saliva.