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Carvacrol, a phenolic monoterpene found in essential oils of plants of the Lamiaceae family, emerges as an alternative acaricide of plant origin. Its acetylation was proposed to obtain a derivative compound with a better pharmacological profile and lower toxicity to non-target organisms. The present study aimed to assess the preclinical safety of acetylcarvacrol after dermal application in Wistar rats, through the examination of hematological and biochemical parameters, as well as histopathological analysis of the skin, liver and kidney. For this, twenty rats were distributed into four groups with five animals each. Three groups received treatment with different concentrations of the substance (26, 52, and 104 µL/mL) based on the lethal concentration for Rhipicephalus sanguineus ticks, and one group (Control) received only the vehicle. Acetylcarvacrol was applied daily to a trichotomized skin area for 21 days. No changes in hematological parameters were observed. Regarding biochemical analysis, a slight increase in urea and alanine transaminase levels was noted. No significant changes were observed in the kidney and liver, although the rats had developed cumulative irritant contact dermatitis at the application site, as corroborated by the histopathological analysis of the skin. In general, the results showed that the dermal application of acetylcarvacrol in the experimental conditions described here is safe. However, it can cause signs of mild systemic toxicity and skin irritation at high concentrations, suggesting that this product should be used in lower therapeutic doses and that the development of less aggressive formulations, including the combination with other acaricides, is desirable.

Sickle cell anemia is a hereditary disease caused by sickle-shaped red blood cells that can lead to vaso-occlusive crises. Treatment options are currently limited, highlighting the need to develop new clinical approaches. Studies demonstrated that elevated levels of fetal hemoglobin (Hb F) are associated with a reduction of mortality and morbidity in sickle cell anemia patients. In light of this, researchers have been trying to elucidate the transcriptional regulation of Hb F to develop new therapeutic interventions. The present study aimed to present the main transcription factors of Hb F and discuss the clinical feasibility of these molecular targets. Two search strategies were used in the PubMed, SciELO, and LILACS databases between July and August 2023 to conduct this review. Manual searches were also conducted by checking references of potentially eligible studies. Eligibility criteria consisted of clinical trials and cohort studies from the last five years that investigated transcription factors associated with Hb F. The transcription factors investigated in at least four eligible studies were included in this review. As a result, 56 eligible studies provided data on the BCL11A, LRF, NF-Y, GATA1, KLF1, HRI, ATF4, and MYB factors. The studies demonstrated that Hb F is cooperatively regulated by transcription factors with the BCL11A factor appearing to be the most specific target gene for γ-globin induction. Although these data are promising, there are still significant gaps and intervention limitations due to the adverse functions of the target genes. New studies that clarify the aspects and functionalities of Hb F regulators may enable new clinical approaches for sickle cell anemia patients.

Introdução: Desde 11 de março de 2020, quando a Organização Mundial da Saúde (OMS) declarou a pandemia de COVID-19, o mundo passou a vivenciar um desafio sanitário global. Em um cenário de escassez de recursos em saúde, os escores de alerta precoce, entre eles o modified early warning score (MEWS) e o triage early warning score (TREWS), surgem como ferramentas efetivas na detecção de indivíduos em estado de gravidade. Ambos, por meio da pontuação dos sinais vitais, reconhecem a deterioração clínica dos pacientes. O TREWS avalia, além dos sinais vitais, a necessidade de suplementação de oxigênio e a idade. Objetivo: Investigar a capacidade dos escores MEWS e TREWS em predizer gravidade e mortalidade em pacientes internados com COVID-19. Método: Nesse estudo observacional retrospectivo, pacientes internados com COVID-19 no Instituto de Infectologia Emílio Ribas (IIER) foram incluídos. Os escores MEWS e TREWS de admissão dos pacientes no IIER foram analisados, assim como as características demográficas, a presença de comorbidades e a caracterização do esquema vacinal para COVID-19 desses pacientes. Resultados: O estudo incluiu 579 pacientes, com predominância masculina (60,45%) e idade média de 52,54 anos. Comorbidades como Diabetes Mellitus (23,32%) e Hipertensão Arterial Sistêmica (41,28%) foram frequentes. A maioria dos pacientes não apresentavam esquema vacinal completo para COVID-19 (65,28%). Fatores como idade maior que 70 anos (p < 0,001), presença de comorbidades, incluindo doença renal crônica (p = 0,039), diabetes mellitus (p = 0,028), hipertensão arterial sistêmica (p < 0,001), e a sobreposição de duas ou mais comorbidades (p = 0,024) aumentaram o risco de óbito. Os escores MEWS e TREWS de admissão foram mais elevados em pacientes que vieram a óbito (p < 0,001). Observou-se que a presença de MEWS de admissão ≥ 3 aumenta em 2,43 vezes as chances de óbito (p < 0,001; OR = 2,43) e em 1,80 vezes as chances de internação em Unidade de Terapia Intensiva (UTI) (p = 0,002; OR = 1,80). Pacientes com TREWS de admissão ≥ 5 apresentaram 2,47 vezes mais chances de necessitarem de internação em UTI (p < 0,001; OR = 2,47) e 4,44 vezes mais chances de virem a óbito (p < 0,001; OR = 4,44). Conclusão: MEWS e TREWS de admissão demonstram grande utilidade na detecção precoce de pacientes críticos. Além disso, a presença de comorbidades influencia a incidência de desfechos graves nos pacientes internados com COVID-19.

The present work explores the feasibility of producing blooms and beam blanks in a continuous casting machine using a single support rollers setup, aiming to eliminate the need for specialized setups for each geometry. The current practice requires frequent roll replacements during production switches, leading to reduced machine availability and safety risks.To assess the viability of the new approach, a 2D mathematical model for heat transfer and solidification was developed for both blooms and beam blanks. Simulations with the current and the new setup were performed, and their results analyzed. The model was validated with experiments during production campaigns at the steel melting shop. The model accurately predicts the casting process, with solid fraction deviation of 6% for blooms and 16% for beam blanks, and temperature difference between the model and thermal imaging measures values are between 20 °C and 70 °C.The heat transfer simulation results show that a single rollers setup can yield minimal variations in the temperature related operational parameters, supporting the feasibility of this approach. In addition to the thermal analysis performed in this work, mechanical stress and strain assessments need to be performed to further investigate the suggested solution and they will be the topic of future works.The findings provide valuable insights for the steel industry, as this type of feasibility study is a relatively unexplored area. Furthermore, the models developed can also be used to optimize process parameters, study defects formation during continuous casting and in the development of new products.

Introdução: Lesões genitais sugerem disseminação por via hematogênica em paciente com leishmaniose difusa ou inoculação direta do parasito quando há lesão isolada. Ainda que essa apresentação seja incomum, é necessário investigar hábito de dormir nu ou fazer necessidades fisiológicas ao ar livre em áreas endêmicas. Objetivo: O objetivo deste trabalho é apresentar um caso de LTA, ocorrido no norte brasileiro (região endêmica da doença), no segundo semestre de 2021, com lesão cutânea em região genital, possibilitando a discussão de aspectos clínicos e epidemiológicos, ressaltando alguns dos diagnósticos diferenciais, bem como particularidades do tratamento medicamentoso da doença. Método: Relato de caso. Paciente do sexo masculino, 52 anos, de procedência mista (intercala períodos em zona rural e outros em zona urbana), comparece à Unidade Básica de Saúde (UBS), no segundo semestre do ano de 2021, com queixa de lesão única e indolor em região peniana há 40 dias, evoluindo com aumento de tamanho neste período. Resultados: Discussão: Na maioria dos casos, as lesões cutâneas da LTA se apresentam em regiões expostas do corpo, caracterizadas por serem únicas ou em pequeno número. Geralmente é indolor, possui formato arredondado, chega a medir centímetros, tem base eritematosa, infiltrada e consistência firme, com bordas delimitadas e elevadas, fundo avermelhado e granulações grosseiras (SAÚDE, 2017), o que lembra o aspecto clínico da lesão sifilítica. No caso presente, o principal diagnóstico diferencial foi o de sífilis, no entanto, este diagnóstico foi excluído quando houve a associação dos aspectos epidemiológicos e clínicos com o exame de raspado de lesão evidenciando a presença de amastigotas. Conclusão: O caso relatado revela aspectos do processo diagnóstico que devem ser ressaltados. Dentre esses aspectos têm-se a importância de considerar diagnósticos diferenciais baseados na epidemiologia local, ou seja, ponderar sobre as possíveis etiologias da doença que em outras regiões geográficas seriam improváveis, mas, que se tornam opções plausíveis nas regiões endêmicas. Outro aspecto é o valoroso papel da anamnese bem conduzida e detalhada que permite direcionar todo o processo diagnóstico. No caso em questão, foram especuladas etiologias relacionadas às infecções sexualmente transmissíveis, devido à localização da lesão ser em região genital, porém, ao se averiguar os aspectos da lesão, os dados da anamnese relacionados aos hábitos da vida sexual e os aspectos epidemiológicos. Ag. Financiadora: Tropical Infectologia. Nr. Processo: 12.

Objective: Respiratory syncytial virus is a pathogen frequently involved in nosocomial outbreaks. Although several studies have reported nosocomial outbreaks in neonatal intensive care units, molecular epidemiology data are scarce. Here, the authors describe two consecutive respiratory syncytial virus outbreaks caused by genotypes ON-1 and NA-2 in a neonatal intensive care unit in São Paulo, Brazil. Methods: A prospective search for respiratory syncytial virus was performed after diagnosing the index case and four other symptomatic newborns in the neonatal intensive care unit. Nasopharyngeal aspirate samples of all patients in the neonatal intensive care unit were tested for 17 respiratory viruses using real-time reverse transcriptase polymerase chain reaction. Genotyping was performed using nucleotide sequencing. Results: From May to August 2013, two different outbreaks were detected in the neonatal intensive care unit. A total of 20 infants were infected with respiratory syncytial virus-A (ten and 14 with ON-1 and NA-2 genotypes, respectively). The mean age of the infants was 10 days, mean birth weight was 1,961 g, and the mean gestational age was 33 weeks. Risk factors (heart disease, lung disease, and prematurity) were present in 80% and 85.7% of infants in the ON-1 and NA-2 groups, respectively. In total, 45.8% of infants were asymptomatic and 20.8% required mechanical ventilation. Coinfections were not detected during the outbreaks. Conclusions: Infants in a neonatal intensive care unit who develop abrupt respiratory symptoms should be tested for respiratory viruses, especially respiratory syncytial virus. Even in the absence of severe symptoms, respiratory syncytial virus detection can prevent nosocomial transmission through infection control measures. A better understanding of respiratory syncytial virus molecular epidemiology is essential for developing new vaccines and antiviral drugs against respiratory syncytial virus. Resumo: Objetivo: O vírus sincicial respiratório é um patógeno frequentemente envolvido em surtos nosocomiais. Embora vários estudos tenham relatado tais surtos em unidades de terapia intensiva neonatal, os dados epidemiológicos moleculares são escassos. Neste artigo, descrevemos dois surtos consecutivos de vírus sincicial respiratório causados pelos genótipos ON-1 e NA-2 em uma unidade de terapia intensiva neonatal em São Paulo, Brasil. Métodos: Uma busca prospectiva por vírus sincicial respiratório foi realizada após o diagnóstico do caso índice e outros quatro recém-nascidos sintomáticos na unidade de terapia intensiva neonatal. Amostras de aspirado nasofaríngeo de todos os pacientes da unidade de terapia intensiva neonatal foram testadas para 17 vírus respiratórios com reação em cadeia da polimerase via transcriptase reversa em tempo real. A genotipagem foi realizada utilizando sequenciamento de nucleotídeos. Resultados: De maio a agosto de 2013, foram detectados dois surtos diferentes na unidade de terapia intensiva neonatal. Vinte e quatro crianças foram infectadas com vírus sincicial respiratório-A (10 e 14 com os genótipos ON-1 e NA-2, respectivamente). A média da idade dos lactentes era de 10 dias, o peso médio ao nascer foi de 1961 g e a idade gestacional média de 33 semanas. Fatores de risco (doença cardíaca, doença pulmonar e prematuridade) estavam presentes em 80% e 85,7% dos bebês nos grupos ON-1 e NA-2, respectivamente. No total, 45,8% dos lactentes eram assintomáticos e 20,8% necessitaram de ventilação mecânica. Não foram detectadas coinfecções durante os surtos. Conclusões: Bebês em unidade de terapia intensiva neonatal que desenvolvem sintomas respiratórios abruptos devem ser testados para vírus respiratórios, especialmente o vírus sincicial respiratório. Mesmo na ausência de sintomas graves, a detecção de vírus sincicial respiratório pode prevenir a transmissão nosocomial através de medidas de controle de infecção. Um melhor entendimento da epidemiologia molecular do vírus sincicial respiratório é essencial para o desenvolvimento de novas vacinas e drogas antivirais contra o vírus sincicial respiratório. Keywords: Respiratory syncytial virus, ON-1, NA-2, Outbreak, Neonatal intensive care unit, Palavras-chave: Vírus sincicial respiratório, ON-1, NA-2, Surto, Unidade de terapia intensiva neonatal

Background & Aims: Chrononutrition is an emerging area that suggests that late eating time is associated with poor nutritional and metabolic outcomes. However, epidemiological studies are scarce on this topic. The aim of this study was to characterize the chrononutrition patterns in a large and representative US population (NHANES 2015-2016 and 2017-2018) of adults and elderly and investigate their association with obesity and metabolic disorders that make up the metabolic syndrome., Methods: A total of 7379 adults and elderly individuals were included in the analysis. Meal timing data were collected through two 24-h dietary recalls in both cycles. Poisson regression adjusted for confounders was used to evaluate the association between chrononutrition variables (eating duration and tertiles of first and last meal timing, eating midpoint and eating occasions) and obesity, abdominal obesity and metabolic parameters from metabolic syndrome., Results: Adults with a longer eating duration (>12 h) had a higher prevalence of abdominal obesity (IRR, 1.15; 95% CI, 1.03-1.28) when compared with those who ate their meals in a shorter eating duration (≤12 h). In addition, adults in the third tertile of the time of the last meal (mean 22:03) had a higher prevalence of abdominal obesity (IRR, 1.12; 95% CI, 1.01-1.25) compared to first tertile. Adults with later eating midpoints (second and third tertile) had a higher prevalence of elevated fasting glucose (IRR, 1.30; 95% CI, 1.07-1.59 and IRR, 1.65; 95% CI, 1.22-2.22, respectively). Among the elderly, participants with a longer eating duration (>12 h) had a higher prevalence of elevated triglycerides (IRR, 2.74; 95% CI, 1.25-5.96) when compared with those elderly who ate their meals in a shorter eating duration (≤12 h)., Conclusion: These findings suggest that a long eating duration and late first and last meal timing are chrononutrition patterns associated with cardiometabolic risks in free-living Americans., Competing Interests: Conflict of interest and funding statement The authors declare no conflict of interest., (Copyright © 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

This study aimed to evaluate the use of different adhesive substances in an method to monitor the development of C. felis felis eggs. Three adhesive substances were selected: cyanoacrylate, stick glue, and liquid silicone. The eggs were obtained from a laboratory colony and placed on a thin layer of adhesive substance on the lid of a Petri dish to prevent contact with the larval growth substrate. One hundred eggs were used for each adhesive substance. The development of the eggs was monitored for three consecutive days, during which larval hatching and egg characteristics were observed. Of the 100 eggs incubated for each adhesive substance, 64, 51, and 76 larvae hatched and survived from the stick glue, cyanoacrylate, and liquid silicone plates, respectively. After 30 days of incubation, 59, 45, and 68 hatched adults were observed, respectively, in these groups. The mean hatching of larvae and adults between the liquid silicone and cyanoacrylate groups differed statistically (p < 0.05). This study demonstrated positive results, and that liquid silicone was the most easily applicable adhesive substance on the plate and interfered less with egg development, therefore having the best larval recovery compared to incubated eggs compared to the other substances., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Somatic resource banks play a crucial role in the conservation of genetic diversity, allowing for the preservation of biological samples from different populations. Puma somatic cells can be recovered from these banks and used in assisted techniques toward enhancing their multiplication and conservation. In response to the population reduction of this ecologically importance species, we aimed to evaluate the capacity of cryopreservation of somatic tissues on the maintenance of the integrity and quality of the cells recovered after culture, with the aim of establishing a somatic tissue bank that will allow for the safeguarding of a wide genetic sampling of pumas. Cryopreservation increased the thickness of the corneum layer in the tissues, and the number of perinuclear halos and empty gaps. Nevertheless, cryopreservation was able to maintain normal fibroblast patterns, even showing an increase in the percentage of collagen fibers. Cryopreservation maintained the proliferative potential of the tissues and the parameters evaluated during in vitro culture, mainly regarding the viability, proliferative activity, and apoptosis levels. Nevertheless, cells from cryopreserved tissues showed decreased metabolism and mitochondrial membrane potential when compared to cells from non-cryopreserved tissues. In summary, we demonstrated for the first time that puma somatic tissues subjected to cryopreservation are viable and maintain tissue integrity, featuring minimal changes after warming. Although viable somatic cells are obtained from these tissues, they undergo alterations in their metabolism and mitochondrial membrane potential. Improvements in the conservation conditions of somatic samples are needed to increase the quality of somatic tissue banks in this species., (Copyright © 2021 Elsevier Inc. All rights reserved.)

This work describes the development of polysaccharide-coated liposomes to modulate the delivery of epidermal growth factor (EGF), with the aim to produce different EGF release profiles depending on the milieu of infected wounds. For this purpose, cationic liposomes were coated with one layer of sodium alginate (ALG) followed by one layer of chitosan (CHI) using the layer-by-layer (LbL) technique. The coated liposomes exhibited apparent hydrodynamic diameters of 278 ± 36 and 216 ± 96 nm for Lip-ALG and Lip-ALG-CHI, respectively. Thus, it appears that adding the CHI layer compacted the Lip-ALG one. The incorporation efficiency of EGF was a maximum of 55% for liposomes with a polymeric coating. In vitro release experiments showed that Lip-ALG-CHI exhibits a higher release rate constant under acidic pH conditions, resembling those of infected tissue. Using an ex vivo model of EGF release in porcine ear skin, these liposomes were found to accumulate in the epidermis. Thus, coated liposomes could represent a local EGF delivery mechanism to promote healing., (Copyright © 2020 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

To optimize the protocols for assisted reproductive techniques (ARTs) in collared peccary (Pecari tajacu Linnaeus, 1758), we evaluated various conditions for oocyte in vitro maturation (IVM) and chemical activation. Initially, we assessed the IVM rates, cumulus-oocyte complex (COC) quality, and oocyte morphometry in the absence or presence of epidermal growth factor (EGF). There was no difference between the COCs matured in absence or presence of EGF for the expansion of cumulus cells (97.6% ± 1.2 vs. 100% ± 0.0), presence of first polar body (65.9% ± 1.2 vs. 70.5% ± 1.8), nuclear status in second metaphase (62.5% ± 11.6 vs. 68.4% ± 4.9), cytoplasmic maturation (100.0% ± 0.7 vs. 75.0% ± 0.7), reactive oxygen species levels (0.5 ± 0.2 vs. 0.3 ± 0.1), and mitochondrial membrane potential (1.1 ± 0.2 vs. 1.1 ± 0.1). However, the zona pellucida thickness of matured COCs was reduced in the presence of EGF. Thus, the EGF group was used for further experiments. The oocytes were artificially activated with ionomycin and four secondary activator combinations [6-dimethylaminopurine (6D), 6D and cytochalasin B (6D + CB), cycloheximide (CHX), and CHX and CB (CHX + CB)]. The effect of immature COCs based on cumulus cell layers and cytoplasm homogeneity (GI and GII or GIII COCs) on embryonic development and quality was evaluated. There was no difference in the cleavage rates among the groups of secondary activators. The cleavage rates of embryos derived from GI/GII and GIII COCs were greater than 72.2% and 25.0%, respectively. Moreover, treatment with CHX showed a reduction in the cleavage rate of embryos derived from GIII COCs when compared to the cleavage rate of embryos derived from GI/GII COCs (P < 0.05). Nevertheless, higher rates of blastocyst/total GI and GII COCs were observed in the 6D group (27.6% ± 0.3) compared to CHX group (6.9% ± 0.3). Additionally, only 6D treatment resulted in the production of embryos derived from GIII COCs (25.0% ± 0.2). The percentage of the ICM/total cell ratio was also greater in blastocysts derived from 6D (42.5% ± 19.0), 6D + CB (37.9% ± 21.9), and CHX + CB (43.8% ± 19.6) groups when compared to CHX (3.6% ± 0.1) group. Thus, the combination of ionomycin and 6D could produce collared peccary embryos by activation of both GI/GII COCs and GIII COCs. These optimized IVM conditions using EGF and chemical activation using ionomycin and 6D in collared peccaries form the first steps for establishing ARTs to conserve this species., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Introduction: Surgically assisted rapid palatal expansion (SARPE) is the procedure of choice for treatment of adults with transverse maxillary deficiency greater than 7 mm. There is no consensus about the dentoskeletal effect of an orthodontic retainer on the outcome of SARPE. Our objective was to assess the effectiveness of an orthodontic retainer on dentoskeletal stability., Methods: Ninety digitized dental casts of 30 adults undergoing SARPE were divided into 2 groups-no retention (n = 15) and retention (n = 15)-and assessed. The dental casts were obtained at 3 checkpoints: (1) 7 days on average before SARPE (preoperatively), (2) 4 months after expansion, and (3) 10 months after expansion was completed. The retention patients received a transpalatal arch just after expander removal, at checkpoint 2. The transpalatal arch was kept for 10 months after completion of the expansion (checkpoint 3 and end of the study). The dental casts were scanned with a Vivid 9i 3D laser scanner (Konica Minolta, Wayne, NJ). The distances measured were premolar and molar intercusp distances, premolar and molar intercervical distances, premolar and molar inter-WALA (Will Andrews and Lawrence Andrews) ridge distances, and palate height at the maxillary first molar., Results: The planned maxillary expansion was within the expected amount (P <0.05). Palatal height at the 4-month checkpoint decreased by 0.79 mm (4.38%) (P <0.001) and again at the 10-month checkpoint by 0.38 mm (0.98%) (P >0.05) but not significantly in both groups. The premolar intercusp distance had a relapse at checkpoint 3 of 1.84 mm (7.18%) (P <0.001) in the no-retention group. Both groups had average relapses of 0.95 mm in the premolar intercervical distances, of 0.88 mm in the premolar inter-WALA ridge distances, of 1.04 mm in the molar intercusp distances, of 0.74 mm in the molar intercervical distances, and of 0.84 mm in the molar inter-WALA ridge distances (P <0.05) at checkpoint 3., Conclusions: The analysis of relapse in both groups suggests that the use of a transpalatal arch as a retaining device does not improve dento-osseous stability., (Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Objectives: Evidence shows that repetitive transcranial magnetic stimulation (rTMS) changes cortical inhibition (CI) and excitability and that these changes may relate to its therapeutic effects. This study aimed to investigate the effects of differing durations or 'doses' of rTMS on cortical inhibition and excitability in healthy subjects., Methods: Four different experiments were conducted: 1 session of 1200 pulses of 1 or 20 Hz active or sham rTMS; 10 sessions of 1 or 20 Hz active or sham rTMS, 1200 pulses/session; 1 session of 3600 pulses of 1 or 20 Hz active or sham rTMS; 1 session of 6000 pulses of 20 Hz active or sham rTMS. Measures of cortical inhibition and excitability included short-interval intracortical inhibition, long interval cortical inhibition, cortical silent period (CSP), motor evoked potential amplitude, resting motor threshold and intracortical facilitation., Results: Only 6000 pulses of 20 Hz rTMS lead to a significant lengthening of the CSP and therefore potentiation of CI. There were no changes to excitability measures., Conclusion: Only high frequency rTMS potentiated CI. Longer treatment durations are required to produce such changes., Significance: Studies investigating the therapeutic effects of rTMS may benefit from extended dosing with increased number of pulses per session. CSP lengthening may be used to guide treatment response., (Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: The aim of this study was to classify the opening of the midpalatal suture (MPS) after surgically assisted rapid maxillary expansion (SARME) with disjunction of the pterygomaxillary suture through computed tomography (CT) analysis., Study Design: Seventy adults with bilateral transverse deficiency of the maxilla underwent SARME with pterygomaxillary disjunction. Seventy tomographies were performed before the surgery and 70 were performed after the final activation. The Hass appliance was used in 29 patients and Hyrax in 41 patients. The MPS opening was classified into 2 types: type I, total MPS opening from the anterior nasal spine to the posterior nasal spine, and type II, total MPS opening from the anterior nasal spine to the transverse palatine suture, with partial or nonexistent opening posterior to transverse palatine suture., Results: Type I opening was observed in 22 patients (31.5%), and type II opening in 48 patients (68.5%). In 5 cases, the opening posterior to the transverse palatine suture was paramedian., Conclusion: Computed tomography allows the evaluation and classification of midpalatal suture openings after SARME with pterygomaxillary disjunction in type I (total) and type II (partial) MPS openings., (Copyright (c) 2010 Mosby, Inc. All rights reserved.)