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Biomass, photosynthetic activity, and biomolecule composition in Chlorella fusca (Chlorophyta) cultured in a raceway pond operated under greenhouse conditions. J Biotechnol 2023; 367:98-105. [PMID: 37059304 DOI: 10.1016/j.jbiotec.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 04/16/2023]
Abstract
Raceways are widely used as microalgae culture systems due to their low cost, but they are not the best option for biomass yield. Understanding in situ photosynthetic performance can be a first step to increase their biomass productivity. This study aimed at comparing the real time photosynthetic activity in a greenhouse raceway culture (250L) with discrete measurements under laboratory conditions. We evaluated the photophysiology and biochemical composition of Chlorella fusca culture up to 120h. In situ photosynthetic activity was continuously monitored and compared to discrete ex situ measurements; biochemical compounds were measured daily. The results showed a final biomass density of 0.45gL-1 (5 days - 120h) and an increase of the electron transport rate (ETR) up to 48h but decreased thereafter. When the relative ETR was estimated considering the absorption coefficient (a) positive correlations of this parameter with photosynthetic capacity, cell density, biomass, biocompounds and antioxidant activity were obtained, whereas no correlation was detected without considering a. In situ photosynthesis monitoring showed higher absolute maximal ETR (10 - 160 μmol m-3s-1) than discrete ex situ measurements. We demonstrated the importance of considering the light absorption coefficient for expressing photosynthetic capacity and showed that C. fusca can produce, in the short-term, bioactive compounds that are correlated to photosynthetic conditions.
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Acute total occlusion of the unprotected left main coronary artery – patient characteristics and outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Acute total occlusion of the unprotected left main coronary artery (ATOLMCA) is a dramatic entity with very high mortality. Owing to its infrequency, there is limited and inconsistent data regarding this population.
Purpose
To describe the clinical presentation, short- and long-term outcomes of patients with ATOLMCA.
Methods
This retrospective multicentric cohort study included all patients presenting with acute (<12h) myocardial infarction (MI) due to ATOLMCA (Thrombolysis In Myocardial Infarction - TIMI=0) between January 2008 and December 2020 in three tertiary hospitals.
Results
In the period of the study, 11,036 emergent coronary angiographies were performed in the participating centers, 59 of which were ATOLMCA (0.5%). Mean age of patients at the time of the event was 61.2 (±12.2) years. Seventy-three percent were male. At presentation, 72.9% of patients were in cardiogenic shock, and aborted cardiac arrest occurred in 27.1%. Right dominance was present in all patients except one, who had a balanced dominance. Primary percutaneous coronary intervention (PCI) was performed in 89.8% of the patients, with angiographic success being achieved in 55.6% of the procedures. Overall, the in-hospital mortality rate was 57.6%. Mortality was significantly higher in patients without angiographic criteria for PCI success (87.5 vs 36.7%, p<0.001). Among survivors, 91.7% were still alive at 1-year and 66.7% at 5 years of follow-up.
Conclusion
Patients with ATOLMCA have a dismal prognosis. Most patients present with cardiogenic shock, and a significant number develop cardiac arrest during the acute phase. Despite medical care, in-hospital mortality is high. Patients with left dominance may not even reach the hospital. Among survivors, long term outcomes are reasonable. Further studies are needed in order to improve the management and outcomes of patients with ATOLMCA.
Funding Acknowledgement
Type of funding sources: None.
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Percutaneous valve commissurotomy in mitral stenosis patients: a 20 years follow-up. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous valve commissurotomy (PMC) is a viable alternative to mitral valve surgery in the treatment of patients with clinically significant mitral stenosis (MS). Although rheumatic MS incidence has decreased in developed countries, it remains a prevalent healthcare problem in Cardiology clinics
Purpose
To evaluate the early and long-term results of PMC in patients with rheumatic MS and to compare long-term events between patients with and without pulmonary hypertension (PH).
Methods
We retrospectively analysed all consecutive patients between 1991 and 2008 with clinically significant rheumatic MS undergoing PMC. Clinical and echocardiographic data were collected at baseline and during long-term follow-up. MACE was a composite of adverse events defined as all-cause mortality, mitral valve re-intervention or hospitalization for a cardiovascular cause.
Results
A total of 124 patients were enrolled: 87% were female, with a mean age at the time of repair of 46±11 year-old and a mean follow-up of 20±6 years. Before the procedure, 34% were in NYHA class ≥ III and 81% had a Wilkins score ≤8; all patients had preserved biventricular systolic function, 83% presented PH, mean transvalvular gradient (TVG) and mitral valve area (MVA) were 12.8 mmHg and 1.0 cm2, respectively. Most of the procedures were successful (91%) and without complications (94%), with a mean MVA improvement of 0.9 cm2 and reduction of 8.5 mmHg in TVG and 9.7 mmHg in pulmonary artery systolic pressure (PASP) after PMC.
During long-term follow-up, 42% of patients were submitted to re-intervention (most of them surgically) and 24% died. In patients non-submitted to re-intervention, TVG and PASP remained similar with early post-procedure evaluation (p=0.109 and p=0.777, respectively), while MVA reduced over time, yet still statistically superior to baseline MVA (1.6 cm2 vs 1.0 cm2, p<0.001). Concerning time-to-event analysis, approximately 80% of patients kept uneventful after 10 years; after 30 years, more than 20% continued MACE-free and approximately 50% were alive. Regarding PH presence at time of PMC, there was no significant difference in MACE events and all-cause mortality between the two groups (Log Rank, p=0,846 and p=0.661, respectively).
Conclusion
PMC was safe and effective in clinically significant rheumatic MS. After a long-term follow-up patients maintained the reduction in TVG and PASP and a smaller but significative improvement in MVA. Most of the patients were free from adverse events after 10 years and half were alive after 30 years. There was no difference in all-cause mortality and in a composite of all-cause death, mitral valve re-intervention or cardiovascular hospitalization concerning PH presence.
Funding Acknowledgement
Type of funding sources: None.
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Long-term success in percutaneous valve commissurotomy – is Wilkins score over 9 a definitive limit? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous valve commissurotomy (PMC) is an established treatment in patients with significative mitral stenosis (MS). Although rheumatic MS incidence has decreased in the last century, it remains a prevalent pathology worldwide. The Wilkins score (WS) is a reference in echocardiographic assessment of MS; a score ≤8 is considered a predictor of treatment success and score between 9 and 11 is a “grey zone” (WGZ) in which doubts persists regarding PMC success.
Purpose
To evaluate the early and long-term results of PMC in patients with rheumatic MS and to compare long-term events between patients with WS ≤8 and patients in WGZ.
Methods
We retrospectively analysed all patients between 1991 and 2008 with significative rheumatic MS undergoing PMC. Data were collected at baseline and during long-term follow-up. M ACE was defined as a composite of all-cause mortality, mitral valve re-intervention or cardiovascular hospitalization.
Results
In our cohort, 124 patients were included. Most were female (87%), mean age at the time of repair was 46±11 year-old and mean follow-up was 20±6 years. Before the procedure, 81% had WS ≤8 and 19% were in WGZ. Both groups had similar baseline characteristics, namely age at first intervention, NYHA class and follow-up time. All patients had preserved biventricular systolic function, 83% presented PH, mean transvalvular gradient (TVG) and mitral valve area (MVA) were 12.8 mmHg and 1.0 cm2, respectively. Most of the procedures were successful (91%) and without complications (94%). Mean MVA improvement was similar in both groups [0.9 cm2 in WS ≤8 and 0.8 cm2 in WGZ, t(102)=0.173, p=0.863]; there was also no significative difference in TVG and PASP reduction after PMC. During long-term follow-up, re-intervention and mortality occurred in 40% and 23% in WS ≤8 and in 50% and 29% in WGZ, respectively, and none of these differences was statistically significant (p=0.389 and p=0.544, respectively). Concerning time-to-event analysis, approximately 80% of patients kept uneventful and >90% alive after 10 years in both groups and no significant difference in M ACE events and all-cause mortality between WS ≤8 and WGZ was observed (Log Rank, p=0,419 and p=0.950, respectively).
Conclusion
PMC was safe and effective in clinically significant rheumatic MS in both WS ≤8 and WS 9–11, with similar MVA improvement. After 10 years, approximately 80% of patients were MACE-free and >90% alive in both groups. There was no difference in all-cause mortality and in a composite of all-cause death, mitral valve re-intervention or cardiovascular hospitalization concerning WS groups.
Funding Acknowledgement
Type of funding sources: None.
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20 year-follow up of mitral stenosis patients after percutaneous valve commissurotomy: moderate disease of other valves as predictor for re-intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Percutaneous valve commissurotomy (PMC) is a viable alternative to mitral valve (MV) surgery in the treatment of patients with clinically significant mitral stenosis (MS). About 40% of patients treated with PMC will require at least one reintervention (either PMC or MVS) along time.
Purpose
To evaluate the long-term results of PMC in patients with rheumatic MS.
Methods
We retrospectively analysed all consecutive patients between 1991 and 2008 with clinically significant rheumatic MS undergoing PMC. Clinical and echocardiographic data were collected at baseline and during early and long-term follow-up. MACE was a composite of adverse events defined as all-cause mortality, MV re-intervention or cardiovascular hospitalization.
Results
A total of 124 patients were enrolled: 108 (87%) were female, with a mean age at the time of PMC of 46±11 years.
At baseline, 34% patients were in NYHA class ≥ III and 81% had a Wilkins score ≤8; all patients had preserved biventricular systolic function and 83% presented pulmonary hypertension. Regarding associated valve disease, 46 patients had mild tricuspid regurgitation (TR), 19 mild aortic regurgitation (AR), 14 moderate IT and 5 moderated AR.
Most of the procedures were successful (91%) and without complications (94%), with median improvement in MV area of 0.9 cm2 (IQR 0.5) and median reductions in mean transmitral gradient (MTG) of 6 mmHg (IQR 6) and in pulmonary artery systolic pressure (PASP) of 8 mmHg (IQR 10) early after PMC.
During the mean follow-up of 20±6 years, 52 (42%) of patients had MV re-intervention (86% surgery and 14% re-PMC), 37 (30%) were hospitalized and 30 (24%) died. Concerning time-to-event analysis, approximately 80% of patients kept MACE-free after 10 years; after 30 years, more than 20% continued MACE-uneventful, approximately 50% were alive and about 45% were free from re-intervention.
Considering patients submitted to surgical re-intervention, 9 underwent MV valvuloplasty and the others MV replacement with mechanical (32) or biological prothesis (11). At the same procedure, 23 patients were submitted to tricuspid annuloplasty, 9 to other valve replacement and one to coronary artery bypass graft.
Using Cox regression, we found that the presence of moderate disease of other valves at PMC time was associated with a 2.3-fold greater rate of re-intervention compared to patients with none or mid disease of other valves (HRcrude 2.3; 95% IC 1.221–4.331, p=0.017). After adjusting for the success of the PMC and for mitral regurgitation after PMC, the observed effect remained significant (HRadjusted = 2.7; 95% CI 1.417–5.233, p=0.003).
Conclusion
PMC was safe and effective in clinically significant rheumatic MS. Most of the patients were free from adverse events after 10 years and half were alive after 30 years. Still, about 40% required re-intervention, with moderate disease of other valves as its independent predictor.
Funding Acknowledgement
Type of funding sources: None.
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The role of coronary collateral circulation in patients presenting with acute left main coronary artery occlusion. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Acute occlusion of the unprotected left main coronary artery (LMCA) is an uncommon occurrence associated with a dismal prognosis. Whereas the role of early recruited coronary collateral circulation (CC) in prognosis of ST-segment elevation acute myocardial infarction (STEMI) patients is still controversial, it seems to be important in patients with acute LMCA occlusion. This study aimed to evaluate the coronary CC in patients with acute LMCA occlusion and its impact in short and long-term outcomes.
Methods
In a retrospective two-center study, we identified 7630 patients with STEMI or high-risk non-ST segment elevation myocardial infarction who underwent emergent coronary angiography between January 2008 and December 2020. Among this cohort, we analyzed 83 patients who presented with unprotected LMCA acute occlusion (Thrombolysis In Myocardial Infarction – TIMI ≤2) and classified them in 2 groups based on the degree of CC through the right coronary artery as seen in the emergent angiography: patients with no filling of collateral vessels or filling of collateral vessels without any epicardial filling of the occluded vessel [Rentrop class 0–1 (71 patients)]; and patients with partial or complete epicardial filling by collateral vessels [CC Rentrop class 2–3 (12 patients)].
Results
Compared to patients with CC Rentrop 0–1, patients with CC Rentrop 2–3 presented significantly later to medical attention (symptom to coronary angiography time 8.7 vs 4.3 hours, p=0.02). Despite that, patients with CC Rentrop 2–3 had a significantly lower prevalence of cardiogenic shock at admission (16.7 vs 57.7%, p=0.01). During hospitalization, Killip class III-IV presentation (33.3 vs 88.7%, p<0.001) and inotropic/vasopressor therapy use (25.0 vs 69.0%, p=0.01) were less frequent in CC Rentrop 2–3 patients. The CC Rentrop 2–3 group had a significantly lower in-hospital (16.7 vs 53.5%, p=0.02) and 30-day mortality (9.1 vs 52.2%, p=0.01). In patients surviving hospitalization there was no significant difference in 1-year (30.0 vs 19.4%, p=0.48) and 5-year mortality (70.0 vs 77.4%, p=0.68).
Conclusion
A well-developed coronary CC was associated to lower short-term mortality in patients presenting with acute occlusion of the unprotected LMCA. Nevertheless, in patients surviving index-event, there was no difference in the long-term outcomes. Further studies are needed to clarify if clinical approach (eg. early short-term mechanical circulatory support) of patients with CC Rentrop 0–1 should be different from those with CC Rentrop 2–3 in order to improve the outcomes of the former patients.
Funding Acknowledgement
Type of funding sources: None.
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Cardiogenic shock in patients presenting with acute left main coronary artery occlusion. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
Acute myocardial infarction (AMI) due to left main coronary artery (LMCA) occlusion is a rare event, often catastrophic. Limited data are available about management and outcomes of patients with acute LMCA occlusion, including those presenting with cardiogenic shock (CS) at hospital admission. This study sought to describe patients with AMI due unprotected LMCA occlusion presenting with CS and to evaluate their in-hospital outcomes and 1-year mortality.
Methods
In this retrospective 2-center study, we identified 7630 patients with ST-segment elevation myocardial infarction (STEMI) or hight risk non-ST segment elevation myocardial infarction who underwent to emergent coronary angiography between January 2008 and December 2020. Among this cohort, we analysed 94 patients who presented with unprotected LMCA occlusion (Thrombolysis In Myocardial Infarction – TIMI ≤2) and divided them in 2 groups according to presence of signs of cardiogenic shock at admission: CS and no-CS.
Results
Of 94 patients with AMI due LMCA occlusion, 52 patients presented with CS (53.3%). Mean age was 62.8±11.5 years in CS and 62.0±15.9 years in no-CS patients, p=0.766. In both groups, most patients were male. STEMI presentation was more frequent in CS group (80.4% vs. 52.4%, p=0.004). Severe systolic dysfunction of left ventricle was more frequent in CS patients (81.1% vs. 33.3%, p<0.001). Compared to no-CS patients, CS group shown more often TIMI=0 (67.3% vs. 26.2%, p<0.001), collateral coronary circulation Rentrop 0–1 (95.3% vs. 75.0%, p=0.008), and slow-reflow/no-reflow phenomena (30.6% vs 3.8%, p=0.019) in emergent coronary angiography. The need of invasive mechanical ventilation (68.9% vs. 21.4%, p<0.001), and haemodialysis (20.5% vs. 2.4%, p=0.010) were more prevalent in CS patients. Likewise, mechanical circulatory support (MCS) was more frequently used in patients presented with CS (52.9% vs. 26.2%, p=0.009). In subgroup analysis, MCS implantation was not a survival predictor in CS patients (Odds ratio: 3.9 [95% confidence interval: 0.4 to 36.3], p=0.229). Ultimately, in-hospital mortality (78.8% vs. 16.7%, p<0.001) was higher in CS patients. On the other hand, in hospital survivors, there was no significant differences in 1-year mortality (11.1% vs. 23.5%, p=0.42) between both groups.
Conclusions
Nearly half of patients with AMI due LMCA occlusion presented with CS signs at first medical evaluation. This subgroup of patients had higher in-hospital mortality compared to those without CS, despite MCS implantation. Whether the use of a specific MCS device or whether early use of MCS can change the outcome remains to be elucidated. CS patients who survive to index-hospitalization, had similar long-term outcomes compared to no-CS patients. Further studies are imperative in this population to refine initial medical treatment in order to improve their prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Antinociceptive and anti-inflammatory activities of Hymenaea martiana Hayne (Fabaceae) in mice. BRAZ J BIOL 2021; 82:e240359. [PMID: 34105646 DOI: 10.1590/1519-6984.240359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/13/2020] [Indexed: 11/22/2022] Open
Abstract
Hymenaea martiana is a species popularly known in Northeastern Brazil as "jatobá" and used in folk medicine to treat pain and inflammation. The aim of this work was to evaluate the antinociceptive and anti-inflammatory activity of H. martiana. In the present study, we carried out an investigation about the effects of the crude ethanolic extract (Hm-EtOH) and the ethyl acetate fraction (Hm-AcOEt) in models of nociception and inflammation in mice. Chemical (acetic acid-induced writhing and formalin) and thermal stimuli (hot plate) were used for the evaluation of antinociceptive activity, while for the anti-inflammatory profile paw edema induced by carrageenan was used, along with leukocyte migration to the peritoneal cavity. The presence of the flavonoid astilbin in the samples was characterized through HPLC-DAD-MS analysis. Hm-EtOH and Hm-AcOEt (100, 200 and 400 mg.kg-1, i.p.) significantly reduced the number of abdominal contortions and decreased the paw licking time in the formalin test. In the hot plate, the extract increased the latency time of animals. Hm-EtOH and Hm-AcOEt inhibited significantly the increase in the edema after the administration of carrageenan. Hm-EtOH and Hm-AcOEt inhibited leukocyte migration in the peritonitis test. HPLC-DAD-MS analysis of Hm-EtOH and Hm-AcOEt revealed the presence of the flavonoid astilbin in the samples. According to the results of this study, both Hm-EtOH and Hm-AcOEt have antinociceptive and anti-inflammatory activities, which could be related with the presence of flavonoid in the extracts. The results reinforce the popular use of this plant.
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Effect of treatment of pneumonia and otitis media with tildipirosin or florfenicol + flunixin meglumine on health and upper respiratory tract microbiota of preweaned Holstein dairy heifers. J Dairy Sci 2021; 104:10291-10309. [PMID: 34099293 DOI: 10.3168/jds.2020-19945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/19/2021] [Indexed: 01/02/2023]
Abstract
The objective of this randomized clinical study was to compare the effect of 2 antimicrobial interventions, tildipirosin or florfenicol + flunixin meglumine, used for treatment of pneumonia and extralabel treatment for otitis on health parameters and upper respiratory tract (URT) microbiota of preweaned Holstein calves. Housed preweaned Holstein heifers diagnosed with either otitis or pneumonia were assigned into 1 of 2 treatment groups, receiving a single subcutaneous injection of either 4 mg/kg of tildipirosin (TLD; n = 444) or 40 mg/kg of florfenicol combined with 2.2 mg/kg of a nonsteroidal anti-inflammatory, flunixin meglumine (FLF; n = 442). Calves were enrolled and treated on the day of diagnosis of the first case of pneumonia or otitis. If a calf had a recurrent case, the opposite drug was administered, respecting an interval of 5 d between drug injections. Blood samples for leukocyte counts were collected at 0, 2, 4, and 6 d after treatment, and rectal temperature was measured daily during the 5 d after treatment. Ear scores were observed from calves with otitis. Additionally, swabs of the URT were collected from a subset of 20 calves in each treatment group at d 0, 3, 6, 9, and 11 following enrollment for analysis of URT microbiota through next-generation sequencing of the 16S rRNA gene and quantitative PCR. Swabs were also collected from a comparative group of 20 healthy calves that did not receive any drug. No differences were observed between groups for recurrence risk of either pneumonia (TLD = 32.4%; FLF = 29.7%) or otitis (TLD = 72.7%; FLF = 73.6%). Similarly, no differences were observed for the total number of treatments for pneumonia (TLD = 1.45; FLF = 1.42) or otitis (TLD = 2.96; FLF = 3.07). On the other hand, both drugs reduced rectal temperature, ear scores, and leukocyte counts, with FLF calves having a greater reduction in rectal temperature within 4 d after treatment. Both TLD and FLF reduced the total bacterial load when compared with healthy untreated calves, but no differences were observed between treatment groups. Furthermore, compared with the untreated group, treated calves had lower mean relative abundances (MRA) of the genera Mannheimia, Moraxella, and Pasteurella within 11, 9, and 3 d after treatment, respectively; however, no significant differences were observed between TLD and FLF. On the other hand, MRA of Mycoplasma was not decreased by both treatments compared to untreated animals, and a higher MRA was observed in the TLD group during 11 d after treatment in comparison to FLF and untreated calves. Based on this data, we concluded that both drugs used in the study were effective in reducing rectal temperature, ear scores, leukocyte counts, and MRA of the genera Mannheimia, Pasteurella, and Moraxella in the URT, and calves treated with FLF had a greater reduction in rectal temperature.
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Conduction disturbances after TAVR - a 1-year follow-up. Europace 2021. [DOI: 10.1093/europace/euab116.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Transcatheter aortic valve replacement (TAVR) is an established procedure to treat patients (pts) with symptomatic severe aortic stenosis. Although conduction disturbances remain the most frequent complication, there is a lack of consensus on their management, which leads to significant differences in permanent pacemaker (PPM) implantation rates between centers.
Purpose
To evaluate new conduction disturbances and PPM implantation in pts undergoing TAVR, peri-procedure and up to 1 year.
Methods
We retrospectively analyzed all pts who underwent TAVR at a tertiary center from October 2014 to November 2019; pts with a previous PPM were excluded (n = 30). Clinical and ECG data were collected at presentation and up to 1 year after implantation, including systematic interrogation of implanted PPM.
Results
340 pts underwent TAVR (57% female, mean age 80 ± 8years). CoreValve Evolut R was the most used valve (41% of pts), followed by CoreValve Evolut Pro (21%) and Acurate Neo (13%). Of the 77% pts who were in sinus rhythm pre-TAVR, 79% had normal atrioventricular (AV) conduction and 20% 1st degree AV block (AVB); 60% had no intraventricular (IV) conduction disturbance, 9% left bundle branch block (LBBB), 7% right bundle branch block (RBBB) and 7% RBBB plus fascicular block.
After TAVR, 50.9% of pts exhibited new conduction disturbances. Regarding AV conduction, 12.4% of pts developed advanced AVB and 20% of pts without previous disturbances developed 1st degree AVB. Concerning IV conduction, the most frequent disturbance was de novo LBBB (n = 109, 32,2%) which resolved in 56% of cases after 6 months. Among pts with previous RBBB, 42% developed advanced AVB; the presence of previous RBBB was the major risk factor for advanced AVB [OR = 8.5 (95% CI 4.1-17.5; p < 0.001)] and PPM implantation [OR = 5.2 (95% CI 2.7-10.0; p < 0.001)], followed by previous 1st degree AVB [OR = 2.3 (95% CI 1.2-4.4; p = 0.016) for PPM implantation]; previous FA or LBBB were not associated with advanced AVB or PPM implantation.
Overall, 19% of pts implanted a PPM post-TAVR (n = 63). The main reason was advanced AVB (60%), followed by LBBB plus 1st degree AVB (22%), isolated LBBB (5%) and alternating bundle branch block (ABBB) (5%). At first PPM evaluation, pts with advanced AVB had a median percentage of ventricular pacing (VP) of 80% (52% had VP >90% and 14% <1%) and one year after-TAVR the median percentage of VP was 83%. Concerning pts with LBBB plus 1st degree AVB, median VP at first assessment was 4% (38% had < 1% of VP). In pts with isolated LBBB or ABBB, median VP at first evaluation was 13% and 11%, respectively.
Conclusion
LBBB was the most frequent de novo conduction disturbance after TAVR, with more than half of the cases resolving in the first 6 months. RBBB, on the other hand, was the major risk factor for advanced AVB and PPM implantation. Advanced AVB was associated with a high percentage of VP at 1-year follow-up, unlike pts with milder degrees of conduction delay.
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Liquid Storage of Geophagus brasiliensis semen in the Presence of Different Extenders. CRYO LETTERS 2020; 41:202-208. [PMID: 33988648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND In order to preserve the genetic diversity of cichlid fish in gene banks, it is necessary to use certain extenders to maintain the integrity of spermatozoa cells during cooling. OBJECTIVE To evaluate the effects of different extenders on the quality parameters of cooled semen of Geophagus brasiliensis. MATERIALS AND METHODS Semen samples were collected from seven adult fish and diluted with five extenders: Beltsville Thawing Solution (BTS™), Hanks' Balanced Salt Solution (HBSS), Tris-glucose, Ginsburg's Fish Ringers, and Phosphate buffered Saline. All parameters were evaluated in fresh semen samples and after cooling at 4°C at 0, 24, 48, and 96 h to evaluate cell viability (membrane integrity, DNA, and mitochondrial functionality) and motility rate and weather motility. RESULTS The BTS and Tris-glucose resulted in the best outcomes (P<0.05) in terms of membrane integrity assessments (35.1% and 30.9%, respectively), DNA integrity (71.6%; 75.7%), mitochondrial function (26.9%; 28.0%) and motility rate (8.6%; 8.6%), respectively, for semen cooled to 4°C for 96 h. However, the 48-h period motility after cooling in BTS was superior to all other treatments. CONCLUSION BTS and Tris-glucose can be considered as the best extenders for the cold storage of Geophagus brasiliensis spermatozoa.
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SCAR ASSESSMENT AFTER PIECEMEAL ENDOSCOPIC MUCOSAL RESECTION - INTEROBSERVER AGREEMENT IN HISTOLOGICAL RECURRENCE PREDICTION. ESGE DAYS 2020. [DOI: 10.1055/s-0040-1704344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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ANALYSIS OF PERFORMANCE MEASURES IN SMALL BOWEL CAPSULE ENDOSCOPY (SBCE). ESGE DAYS 2020. [DOI: 10.1055/s-0040-1704779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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IS THE ADENOMA DETECTION RATE AN IMPORTANT INDICATOR IN THE DETECTION OF OTHER NON-NEOPLASTIC FINDINGS? ESGE DAYS 2020. [DOI: 10.1055/s-0040-1704691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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STENT-ASSOCIATED CHOLANGITIS FOLLOWING ENDOSCOPIC BILIARY STENT PLACEMENT - PREDICTIVE FACTORS AND OUTCOMES. ESGE DAYS 2020. [DOI: 10.1055/s-0040-1704930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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TARGETED VERSUS STANDARD NON-TARGETED BIOPSIES IN BARRETT’S ESOPHAGUS SURVEILLANCE. ESGE DAYS 2020. [DOI: 10.1055/s-0040-1704297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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PREPARATION PROTOCOLS BEFORE CAPSULE ENDOSCOPY. ESGE DAYS 2020. [DOI: 10.1055/s-0040-1704778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Abstract
Background: A new computer algorithm called Express-View has recently been introduced by Mirocam, but data concerning its application and efficacy are scarce.Objective: To evaluate the lesion detection rate, per-patient sensitivity and the diagnostic accuracy using Express-View.Methods: All patients who performed CE between January 2018 and June 2019, whose indication was obscure gastrointestinal bleeding (OGIB) and with findings on CE, were included. Lesions identified in conventional reading were selected and considered as reference.Results: Eighty-nine patients were included, 50.6% male, with a mean age of 68.4 years-old (±12.3). The Express-View mode detected 85.5% of lesions previously detected by conventional reading (524 out of 613). There were 89 missed lesions, mainly erosions or ulcers (44.9%) and angioectasias (38.2%). The lesion detection rate was found to be lower in the jejunum and ileum compared to extra-small bowel locations and duodenum (p = .04). Although Express-View had a per-patient sensitivity for all lesions of 56.2% and a per-patient sensitivity for all clinically significant lesions of 83.1%, it achieved a diagnostic accuracy of 91%.Conclusions: The per-patient sensitivity for all lesions was shown to be below expectations, although the lesion detection rate, the per-patient sensitivity for all clinically significant lesions, and the diagnostic accuracy were shown to be higher.
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P863 Large pericardial effusion two months after transcatheter aortic valve implantation: case report of a post-cardiac injury syndrome. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
We present a case of a 87-year-old female with a symptomatic severe aortic stenosis (aortic valve area 0.9 cm2, mean transvalvular pressure gradient 44 mmHg). She was refused to surgical aortic valve replacement due to marked aortic root calcification. A transcatheter aortic valve (ACCURATE neo™ 27) was electively implanted. In immediate post-procedure, the patient presented an episode of hypotension, rapidly reverted with supportive treatment. A transthoracic echocardiogram (TTE) showed a circumferential mild pericardial effusion (PE) without prosthetic valve disfunction and with preserved biventricular systolic function. Due to paroxysmal episodes of atrial fibrillation, it was decided to withdraw anti-aggregation and to start anticoagulation. Four days after transcatheter aortic valve implantation (TAVI) the patient presented newer intraventricular and atrioventricular conduction disturbance (left bundle branch block and type-I second-degree atrioventricular block). A definitive pacemaker was implanted without complications. PE maintained stable and seven days after TAVI the patient was discharged from hospital.
Two months after TAVI, the patient was admitted to Intensive care unit (ICU) with increasing asthenia, dyspnea and pleuritic thoracic pain over the preceding two weeks. Laboratory workup exhibited elevation of inflammatory markers (leukocytosis and C-reactive protein). A TTE was performed and showed a large circumferential PE (29 mm) with signs of hemodynamic impact (swinging heart, inferior vena cava dilation with <50% inspiratory collapse, right atrial collapse >1/3 of cardiac cycle, proto-diastolic right ventricular collapse and mitral respiratory flow variation >25%). The patient started treatment with anti-inflammatory drugs (aspirin 1000mg every 8h plus colchicine 0.5mg twice daily) and pericardiocentesis was initially postponed. In spite of clinical and echocardiographic improvement, she maintained elevated inflammatory markers and a moderate PE. Prednisolone 30mg daily was added to initial therapy and serial evaluations showed a pronounced reduction of PE as well as of inflammatory markers. Two weeks after admission to ICU the patient was discharged with a residual PE measuring less than 5mm. The previous recent cardiac intervention and the effective response to anti-inflammatory treatment suggest a post-cardiac injury syndrome.
This case report wants to show that post-cardiac injury syndrome is a diagnosis that should be keep in mind after TAVI.
Abstract P863 Figure. TTE showing large pericardial effusion
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Spontaneous Resolution of Enterocutaneous Fistula After Disseminated Tuberculosis Treatment in a Patient With Crohn's Disease: Challenges in Biologic Therapy. Inflamm Bowel Dis 2020; 26:e1-e2. [PMID: 31750911 DOI: 10.1093/ibd/izz283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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1414Vasodilator challenge with levosimendan as alternative to nitric oxide in advanced heart failure heart transplant candidates. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Vasodilator challenge (VC) during right heart catheterization in heart transplant (HTx) candidates is warranted whenever pulmonary artery (PA) systolic pressure ≥50 mmHg and either transpulmonary gradient (TPG) ≥15 mmHg or pulmonary vascular resistance (PVR) >3 WU as long as systolic arterial blood pressure >85 mmHg. Nitric oxide (NO) remains the mainstay but in doubtful cases a 24–48h course of diuretics, inotropes and vasoactive agents may be required. Our aim is to report our centre's experience with levosimendan (LEVO) as alternative to NO in VC in HTx candidates due to advanced heart failure (HF).
Methods
VC records with either NO (20 ppm for 5–10 mins) or within 72h of LEVO infusion (12 mg/kg/min for 24–48h) carried out between 2009 and September 2018 were retrieved from the centre's database. Analysis was carried out with Fisher's exact test or Student's t-test for categorical and continuous variables, respectively, or the equivalent non-parametric test for non-normal distribution variables. Data are presented as counts and percentage, or mean ± standard deviation and median, percentile 25–75, for categorical and continuous variables, respectively.
Results
Baseline demographic and clinical characteristics from 26 patients (NO=13; LEVO=13) were similar between groups (12% female; 54±10 years of age; left ventricular ejection fraction 20±7%; BNP 1550±1090 pg/mL; 88% on NYHA III-IV). Although no differences were observed in baseline cardiac index (CI, 1.6±0.3 vs 1.4±0.4 L/min.m-2, in NO and LEVO, respectively), LEVO patients showed higher right ventricular systolic (70±10 vs 60±13 mmHg; p=0.036) and diastolic pressures (16±4 vs 11±5 mmHg; p=0.009) and lower PA compliance (0.9±0.2 vs 1.3±0.4 ml/mmHg; p=0.007) as well as a trend for increased PA wedge pressure (26±4 vs 21±4 mmHg; p=0.09), translating worse hemodynamics. Upon VC only LEVO decreased PA pressure and the increase in CI was higher compared with NO (2.5±0.8 vs 1.9±0.5 L/min.m-2, p=0.004) thus PVR reduction was comparable between groups (7.8±2.7 to 4.7±1.8 vs 6.3±2.3 to 3.6±2.1 WU, respectively). Also, only LEVO increased right (497, 387–837 to 791, 570–946 mmHg.mL.m-2; p=0.006) and left ventricular stroke work index (895, 807–1364 to 1257, 1107–2957 mmHg.mL.m-2; p=0.005) and cardiac power output (0.4±0.1 to 0.6±0.1 W; p<0.001). Increase in PA compliance was also higher in LEVO (89±98 vs 22±30 Δ%, p=0.04). On the other hand, NO increased wedge pressure whereas LEVO had no effect thus TPG reduction was higher with NO (42±24% vs 17±27% drops, respectively; p=0.022). After HTx (NO=4; LEVO=10) mortality was similar in both groups (25% vs 30%; p=1.00).
Conclusion
LEVO is a safe and effective alternative in PVR reduction for VC. Its positive inotropic effect and long-lasting hemodynamic improvement may improve clinical status before HTx and allow better scrutiny of suitable candidates.
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Fractions of Selaginella convoluta (Arn.) Spring (Selaginellaceae) attenuate the nociceptive behavior events in mice. BRAZ J BIOL 2019; 80:57-65. [PMID: 31017233 DOI: 10.1590/1519-6984.189761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/04/2018] [Indexed: 11/22/2022] Open
Abstract
Selaginella convoluta (Arn.) Spring is a species popularly known as "jericó", and used in folk medicine as analgesic and anti-inflammatory. This study aimed to investigate in mice the antinociceptive and anti-inflammatory activities of the hexane (Sc-Hex) and chloroform (Sc-CHCl3) fractions (100, 200 and 400 mg/kg) obtained by partition of crude ethanol extract from S. convoluta. The preliminary phytochemical analysis of the fractions was performed. Antinociceptive activity was evaluated by writhing, formalin and hot-plate tests. Anti-inflammatory activity was evaluated using carrageenan-induced pleurisy. The rota-rod test was used to evaluate motor coordination. Preliminary phytochemical screening showed that the Sc-Hex and the Sc-CHCl3 were positive for the presence of flavonoids, anthracene derivatives, quinones, triterpenes and steroids. Inhibition of writhing was observed for fractions tested. The Sc-Hex at all doses tested was effective in reducing the nociceptive behavior produced by formalin only in the second phase. However, the Sc-CHCl3 decreased the paw licking time in the first and second phases. In the hot plate no significant effect was observed for any fraction. In the rota-rod test, treated mice did not demonstrate any significant motor performance changes. In the carrageenan-induced pleurisy, Sc-CHCl3 (200 mg/kg) reduced cell migration to the pleural cavity. These results reveal the antinociceptive properties of S. convoluta , which support, in part, its traditional use, since the fractions did not presented significant activity in the inflammatory response profile. We further verify that this antinociceptive effect could be by activation of nociceptive peripheral pathway.
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DEVELOPMENT OF A MODIFIED SMSA SCORING SYSTEM WITH IMPROVED ACCURACY IN THE PREDICTION OF COMPLICATIONS OF ENDOSCOPIC MUCOSAL RESECTION IN THE COLON. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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EVALUATION OF THE SENSITIVITY OF THE EXPRESS-VIEW MODE OF THE MIROCAM CAPSULE ENDOSCOPY PLATFORM COMPARED TO CONVENTIONAL READING IN OBSCURE GASTROINTESTINAL BLEEDING. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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NEED FOR ENTEROSCOPY IN OBSCURE DIGESTIVE HAEMORRHAGE: VALIDATION OF DISCRIMINATIVE SCORE. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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HIGH REBLEEDING RATE IN PATIENTS EVALUATED FOR OBSCURE GASTROINTESTINAL BLEEDING AFTER A FALSE-NEGATIVE DEEP ENTEROSCOPY. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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CAN SERT SCORE PREDICT HISTOLOGICAL RECURRENCE IN PIECEMEAL ENDOSCOPIC MUCOSAL RESECTION? – A COMPARATIVE STUDY WITH SMSA SCORE. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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PREDICTIVE MODEL TO DETERMINE THE NEED OF REPEATING ERCP AFTER ENDOSCOPIC TREATMENT OF BILIARY LEAKS. ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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IS IT POSSIBLE TO PREDICT THE INFLAMMATORY ACTIVITY OF SMALL BOWEL CROHN'S DISEASE IN CAPSULE ENDOSCOPY USING THE ICCE CRITERIA? ESGE DAYS 2019 2019. [DOI: 10.1055/s-0039-1681750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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P4493Predictors of returning to work in the long-run after an acute coronary syndrome episode. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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EFFICACY AND SAFETY OF ENDOSCOPIC TREATMENT FOR RECURRENCE OF NON-INVASIVE COLORECTAL LESIONS AFTER PIECEMEAL ENDOSCOPIC MUCOSAL RESECTION. ESGE DAYS 2018 ACCEPTED ABSTRACTS 2018. [DOI: 10.1055/s-0038-1637224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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WHAT IMPROVED AND WHAT REMAINS TO BE ACHIEVED IN ORDER TO COMPLY WITH THE NEW RECOMMENDATIONS OF POLYPECTOMY BY THE EUROPEAN SOCIETY OF GASTROINTESTINAL ENDOSCOPY. ESGE DAYS 2018 ACCEPTED ABSTRACTS 2018. [DOI: 10.1055/s-0038-1637394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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ESGE POST-POLYPECTOMY SURVEILLANCE GUIDELINES: ADHERENCE AND RELATION WITH HIGH RISK LESIONS. ESGE DAYS 2018 ACCEPTED ABSTRACTS 2018. [DOI: 10.1055/s-0038-1637410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Agentes Inibidores da Atividade Proteolítica em Dentina: uma Revisão da Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo foi revisar a literatura acerca de alguns dos agentes capazes de regular a atividade proteolítica dentinária. Foi realizada uma busca nas bases de dados Pubmed e Bireme, através dos descritores “matrix metalloproteinases”, “dentin” e “longevity”, considerando artigos em inglês e em português, entre 2007 e 2017. Foram obtidos 38 artigos, sendo 24 in vitro, 1 ensaio pré-clínico, 12 revisões de literatura e 1 caso clínico. Através de uma leitura crítica dos títulos e dos resumos foram selecionados 10, relevantes ao tema. Artigos que não se adequavam ao objetivo do trabalho foram excluídos. A clorexidina é capaz de preservar a integridade estrutural do colágeno, inibindo MMPs dos tipos 2, 8 e 9 e CC, entretanto mostra perda da sua substantividade ao longo do tempo. A galardina é um inibidor sintético de MMPs dos tipos 1, 2, 8 e 9, e possui ação em concentrações bem menores que a clorexidina. Os compostos de amônia quaternária inibem MMPs dos tipos 2, 8 e 9, impedindo significativamente a degradação do colágeno da dentina desmineralizada. Os bisfosfonatos podem ser potenciais inibidores de MMPs devido a quelação de íons de zinco e de cálcio, porém a literatura ainda é escassa. Dado o exposto, notam-se evidências satisfatórias, contudo ainda são necessários mais estudos sobre a aplicabilidade e efetividade clínica de tais agentes reguladores.Palavras-chave: Matrix Metalloproteinases. Dentin. Longevity.
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Ácido Fítico e Ácido Metafosfórico como Agentes Alternativos para Condicionamento Dentinário: uma Revisão da Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente estudo foi realizar uma revisão de literatura sobre a ação do ácido fítico (IP6) e do ácido metafosfórico (MPA) como agentes condicionantes em dentina e avaliar seus respectivos resultados. Foi realizada uma busca nas bases de dados Pubmed, e Science Direct, entre 2013 e 2017, utilizando os descritores, separados e em combinação, “Phytic acid”, “Metaphosphoric acid” e “Dentin”. Foram obtidos 12 artigos no total, desses 3 estavam repetidos e foram excluídos. Dos demais, 8 eram estudos in vitro e 1 era revisão de literatura. Através de uma leitura crítica dos títulos e dos resumos, foram selecionados 6, relevantes ao tema. Artigos de revisão de literatura e que não se adequavam ao objetivo do trabalho foram excluídos. Muitas estratégias são testadas com a finalidade de aumentar a longevidade das interfaces adesivas, recentemente foi proposto que IP6 e MPA poderiam ser usados como agente de condicionamento dentinário. O uso do MPA, os valores de resistência de união são melhores que os obtidos com o ácido ortofosfórico (OPA), padrão-ouro odontológico, além disso, é possível observar que o MPA desmineraliza menos a dentina que o OPA, além de formar o mineral bruxita que melhora a durabilidade da interface adesiva. Os achados em relação ao IP6 também apontam para valores de resistência de união similares ao PA, além da menor susceptibilidade de degradação colagenolítica, por possuir ação biomodificadora. São necessários mais estudos que comprovem a eficiência de tais materiais como agentes condicionantes, assim como, a aplicabilidade clínica.Palavras-chave: Phytic Acid. Metaphosphoric Acid. Dentin.
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A Eficácia Clínica da Técnica Úmida Etanólica em Restaurações de Resina Composta: Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente estudo foi revisar a literatura a cerca da eficácia clínica na técnica úmida etanólica (TUE) em restaurações com resinas compostas. Foi realizada uma busca nas bases de dados PubMed, Bireme e Cochrane Library de artigos em inglês do período de 2007 a 2017, utilizando os seguintes descritores: Dentin, Dentin-Bonding Agents e Ethanol como estratégia de busca. Foram encontrados 101 artigos, dos quais apenas os ensaios clínicos foram selecionados, totalizando 6, mediante a relevância, sendo os demais artigos excluídos do presente estudo. A TUE consiste na substituição de água livre em dentina por solvente livre de água, etanol absoluto. A técnica simplificada consiste na aplicação de etanol absoluto por 1 minuto, previamente a aplicação do “Bond”, de adesivo convencional de 3 passos. A TUE tem se mostrado bastante promissora, pois vai haver a remoção de água presente na dentina, através de desidratação química e um encolhimento das fibras colágenas permitindo que os monômeros hidrofóbicos penetrem mais facilmente em dentina, sem o uso de “primers”. Dessa forma, diminuirá a sorção dos monômeros, consequentemente a hidrólise e a degradação da interface de união restauração/adesivo, aumentando a longevidade da restauração. Entretanto quando se trata de estudos clínicos a sua eficácia ainda não é bem estabelecida, acredita-se que seja por ação da pressão pulpar. Dessa forma, são necessários mais estudos clínicos e um maior período de observação para avaliar a durabilidade clínicas de restaurações com essa técnica.Palavras-chave: Dentin. Dentin-Bonding. Agents. Ethanol.
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A CUso do Glutaraldeído como Agente de Ligações Cruzadas em Restaurações Resinosas em Dentina: uma Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente estudo foi revisar a literatura para descrever a influência do glutaraldeido (GA) como agente de ligações cruzadas em restaurações em restaurações resinosas em dentina. Revisou-se a literatura no período de 2007 a 2017, nas bases de dados Pubmed, Bireme e Science Direct, no idioma Inglês, com os seguintes descritores: Glutaral, Dentin e Crosslinking Reagents. Chegando-se ao total de 12 artigos, realizou-se uma leitura crítica dos resumos e títulos. Desses, 5 são estudos in vitro, 4 estudos clínicos e 3 são revisões de literatura, foram excluídos artigos que fugiam do objetivo do estudo e revisões de literatura, sendo utilizados 9 artigos para o presente estudo. O GA é um agente biomodificador de origem sintética que forma ligações covalentes entre dois grupos aminas de hidroxilisina, presente na molécula de colágeno, com seus grupos aldeídos a fim de formar composto piridíneo estável. Conferindo uma boa biomecânica a matriz de colágeno desnudo e irá atuar inibindo colagenases, aumentando a durabilidade da interface adesiva. O GA possui um caráter citotóxico e, por isso, deve ser usado de maneira correta e cuidadosa, a fim de se conseguir o melhor resultado possível no sistema de adesão. O GA é capaz de promover um satisfatório aumento na resistência da união do material restaurador com a dentina. Em ação conjunta com outras substâncias – por exemplo, a HEMA – o GA cria uma barreira em áreas mais profundas dos túbulos dentinários, abaixo da zona de fibras colágenas expostas, ratificando, assim, a eficácia desse agente biomodificador.Palavras-chave: Glutaral. Dentin. Crosslinking Reagents.
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Influência do Uso de Diferentes Agentes Condicionantes Associados à Técnica Úmida Etanólica Sobre União à Dentina. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo foi avaliar a resistência de união (RU) à microtração (μTBS) e o grau de conversão (GC) de diferentes agentes condicionantes associados à técnica úmida etanólica (TUE) sobre a união de um sistema restaurador adesivo à superfície dentinária e comparar os resultados com a técnica convencional (TC), de acordo com os grupos: ORTO-C – TC e ácido ortofosfórico a 37% META-C – TC e ácido metafosfórico a 40% FIT-C TC e ácido fítico a 2% ORTO-E – TUE e ácido ortofosfórico a 37% META-E – TUE e ácido metafosfórico a 40% FIT-E – TUE e ácido fítico a 2%. Quarenta e oito dentes foram restaurados em dentina média. Em seguida, trinta (n5) foram cortados em espécimes em formato de palito (área de secção transversal de 1mm²). Posteriormente, foi realizado o teste de microtração em máquina de ensaio universal. Dezoito dentes (n3) foram cortados em formato de discos para avaliação do GC em espectroscopia micro-Raman. Os dados foram submetidos à ANOVA dois fatores e teste de Tukey (p<0,05). O efeito dos diferentes agentes condicionantes vai depender da técnica adesiva utilizada (p0,004). Os grupos tratados com a TC não apresentaram diferença, já na TUE o FIT-E apresentou menor RU. Quando comparados os ácidos em diferentes técnicas, observou- se que o META apresentou melhores resultados de RU na TUE (25,72 ± 6,80 MPa), já o FIT mostrou-se melhor quando utilizado sem a TUE. Em relação ao GC, não houve diferença estatística entre os grupos (p0,658). Dessa forma, agentes condicionantes alternativos têm se tornado promissores, e juntamente com a TUE podem melhorar a adesão em dentina.Palavras-chave: Adesão. Técnica Úmida Etanólica. Agentes de Ligação Cruzada.
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Agentes Naturais de Biomodificação Dentinária: uma Revisão da Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente trabalho foi revisar a literatura e avaliar os agentes naturais quanto ao seu potencial de biomodificação dentinária. Foi realizada uma busca nas bases de dados Pubmed, Bireme e Science Direct, entre 2007 e 2017, no idioma inglês, utilizando os descritores combinados “Cross-linking Reagentes”, “Dentin” e “Biological Products”. Foram obtidos 36 artigos, sendo 7 in vitro, 13 ensaios clínicos, 11 revisões de literatura e 5 casos clínicos. Artigos de revisão de literatura e caso clínico foram excluídos, através de uma leitura crítica dos títulos e dos resumos dos demais, foram selecionados 10, relevantes ao tema. Agentes naturais de biomodificação dentinária possuem baixa citotoxicidade se comparados aos sintéticos, como o glutaraldeído que é apontado como padrão ouro. A proantocianidina, proveniente da semente de uva, mostra um aumento da resistência de união e redução da atividade das metaloproteinases de matriz (MMP) e cisteína catepsinas (CC), além de baixo custo e fácil obtenção, em relação aos demais. Outros agentes estudados são a hesperidina, que apresentou evidências positivas ao diminuir a degradação da interface adesiva. Dentre as catequinas, a Epigalocatequina-3-galato apresentou-se eficaz como agente de ligação cruzada, além de diminuir a atividade colagenolítica da dentina subjacente à restauração, mostrando-se eficaz em preservar o colágeno desnudo. Apesar dos estudos apresentarem resultados promissores, são necessários mais estudos que comprovem a efetividade clínica desses agentes.Palavras-chave: Cross-Linking Reagentes. Dentin. Biological Products.
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A Influência da Carboiimida na Durabilidade de Restaurações Resinosas no Substrato Dentinário: uma Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A Carbodiimida (EDC) é um agente biomodificador que forma ligações covalentes estáveis entre aminoácidos presentes no colágeno da dentina. O objetivo do presente estudo é revisar a literatura para avaliar a influência do EDC na durabilidade de restaurações resinosas em substrato dentinário. Para isso, foi realizada uma busca bibliográfica na qual foram selecionados artigos publicados no período de 2007 a 2017 nas bases de dados PubMed, Bireme e Science Direct, no idioma Inglês, utilizando os descritores: Cross-Linking Reagents, Dentin-Bonding Agents e Carbodiimides. Chegando-se ao total de 19 artigos, realizou-se uma leitura crítica dos resumos e títulos. Desses, 10 são estudos in vitro e 9 são revisões de literatura, sendo excluídos casos clínicos e artigos que fugiam do objetivo do estudo. Selecionou-se 10 artigos mediante a relevância ao tema. O EDC mostrou-se eficaz na formação de ligações cruzadas entre fibras colágenas melhorando a biomecânica da dentina, além disso, atua inibindo enzimas como as Metaloproteinases (MMPs), levando a uma diminuição da degradação dessas fibras que não foram impregnadas por monômeros após o condicionamento ácido desse substrato, aumentando a longevidade da restauração. Entretanto, os estudos que avaliam a atuação desse agente biomodificador foram realizados em um espaço de tempo muito curto. O desenvolvimento de estudos mais longos é fundamental para que a comunidade científica obtenha resultados concretos sobre a atuação do EDC.Palavras-chave: Cross-Linking Reagents. Dentin-Bonding Agents. Carbodiimides.
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Avaliação de Propriedades Mecânicas De Resinas Microhíbridas Comerciais para Esmalte. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente estudo foi avaliar a microdureza Knoop, a resistência flexural e o módulo de elasticidade de compósitos microhíbridos para esmalte. Foram utilizadas três resinas comerciais: Empress Direct (Ivoclar Vivadent), Charisma (Kulzer) e NT Premium (Coltene). Para o teste de microdureza foram confeccionados corpos-de-prova (n6) para cada material testado, com uma matriz de silicona, medindo 5 mm de diâmetro e 2 mm de profundidade, fotopolimerizados por 40s, com o aparelho DB685 (Dabi Atlante) com irradiância de 1100 mW/cm². Foi utilizado microdurômetro Knoop com carga de 50 gf por 15 segundos em que cada corpo de prova recebeu 5 indentações, sendo calculada a média de cada espécime. Os testes de resistência flexural e módulo de elasticidade foram realizados em uma máquina de ensaio universal (Instron) com velocidade de carga de 1 mm/min com espécimes com formato de barra com dimensões 7mmx2mmx1mm. Os dados foram submetidos à ANOVA um fator e teste post-hoc de Tukey com nível de confiança de 95%. Os resultados mostraram que não houve diferença estatística significativa entre os grupos testados quanto à microdureza (p0,087) e módulo de elasticidade (p0,114). Contudo, verificou-se a existência de diferença estatisticamente significativa (p0,036) em relação à resistência flexural. A resina NT Premium apresentou maior resistência flexural, enquanto a IPS Empress Direct mostrou-se com menor valor. Em conclusão, as resinas avaliadas apresentaram propriedades mecânicas semelhantes, exceto a resistência à flexão em que a NT Premium foi melhor.Palavras-chave: Composite Resins. Microhybrid. Classification.
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Estratégias para Melhorar a Durabilidade da Interface Adesiva: uma Revisão da Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A integridade da interface adesivo-dentina constitui-se um desafio para a odontologia restauradora, sendo necessário o uso de estratégias que aumentem a longevidade das restaurações. O objetivo deste trabalho foi realizar uma revisão de literatura com artigos que abordassem estratégias para melhorar a durabilidade da interface adesiva e avaliar seus respectivos resultados. Foi realizada uma busca nas bases de dados Pubmed, Bireme e Scopus, entre 2007 e 2017, utilizando os descritores combinados dentin, collagen e longevity, considerando artigos em inglês e em português. Foram obtidos 60 artigos, sendo 45 in vitro, 10 revisões de literatura e 5 revisões sistemáticas, desses 34 estavam repetidos e foram excluídos. Através de uma leitura crítica de títulos e resumos, foram selecionados 18, relevantes ao tema. Artigos de revisão de literatura e que não se adequavam ao objetivo do trabalho foram excluídos. Os achados apontam desde técnicas aplicadas pelo operador no procedimento clínico aos novos agentes condicionantes, materiais incorporados aos sistemas adesivos ou utilizados como pré-tratamentos às restaurações. São relatados principalmente os testes envolvendo inibidores de metaloproteinases de matriz, remineralização biomimética, adesão através da técnica úmida etanólica, o uso de substâncias que formam ligações cruzadas entre o colágeno dentinário e/ou com propriedades anticolagenolíticas. As pesquisas têm se mostrado promissoras, entretanto, são necessários mais estudos que comprovem a efetividade e viabilidade clínica de tais estratégias.Palavras-chave: Dentin. Collagen. Longevity.
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Uso dos Oxalatos no Tratamento da Hipersensibilidade Dentinária: uma Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo deste estudo é avaliar a eficácia dos Oxalatos (OX) de cálcio e potássio no tratamento da hipersensibilidade dentinária. Revisou-se a literatura de artigos publicados no período de 2007 a 2017 nas bases de dados PubMed, Bireme e Science Direct, no idioma Inglês, utilizando os seguintes descritores: Calcium Oxalate, Hypersensitivy e Dentin. Foram encontrados 16 artigos, realizou-se uma leitura crítica dos resumos e títulos. Desses, 14 são estudos in vitro, 1 estudo clínico e 1 revisão de literatura, sendo excluídos artigos que fugiam do objetivo do estudo. Selecionou-se 9 artigos mediante a relevância ao tema. A hipersensibilidade dentinária (HD) é caracterizada por uma dor transitória ocasionada quando dente é submetido a estímulos químicos, térmicos, tácteis e osmóticos. O oxalato de cálcio ou de potássio irá agir na terapêutica da HD, através da oclusão desses túbulos dentinários expostos, formando cristais insolúveis provenientes da reação do ácido oxálico com o cálcio ou potássio, podendo ligar-se a ânions presentes nas proteínas em dentina, dessa forma irá diminuir o fluxo dos fluidos entre o dente e o meio oral reduzindo a sintomatologia dolorosa. Porém as condições do meio oral influenciam na durabilidade, já que há uma penetrabilidade de apenas 2 a 3 micrômetros sendo resistentes ao desafio ácido. A dentina tratada com OX podem apresentar alterações na sua estrutura. Não há avaliações suficientes ao longo prazo, necessitando-se de mais investigações sobre novas formulações de pastas e géis a base de OX, além de mais estudos clínicos.Palavras-chave: Calcium Oxalate. Hypersensitivy.e Dentin.
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Indicações do emprego de ultrassom durante a terapia endodôntica. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objetivou-se, por meio de uma revisão de literatura, analisar a influência do emprego da agitação ultrassônica nas pastas de Hidróxido de Cálcio (HC) e nos cimentos obturadores. Os artigos foram coletados nas bases de dados Scielo e Pubmed, utilizando os descritores Endodontics, Ultrasound, Calcium Hydroxide e/ou Root Canal Filling, entre 2007 e 2017. Encontrou-se 80 artigos, sendo selecionados 6 destes após análise de títulos e resumos. Como critérios de inclusão, selecionou-se estudos clínicos e laboratoriais utilizando dentes humanos e bovinos, sendo excluídos revisões de literatura e casos clínicos. Verificou-se que a agitação ultrassônica permite um aumento na capacidade antimicrobiana e na penetração intratubular das pastas de HC. Ainda, que o uso do aparelho favoreceu, em casos de obturação dos SCR, uma maior penetração de cimento na dentina, diminuiu a presença de espaços vazios, contudo, não promoveu melhorias no selamento apical. Pode-se concluir que o uso do ultrassom demonstra apresentar melhoras significativas durante as etapas do TE, tanto na ação das pastas de HC quanto dos cimentos obturadores.Palavras-chave: Ultrassom. Hidróxido de Cálcio. Cimentos Dentários.
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Influência do Ácido Fítico na Durabilidade de Restaurações com Resinas Compostas: uma Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente estudo é revisar a literatura acerca da influência do ácido fítico no aumento da longevidade de restaurações com resinas compostas. Dessa forma, foi realizada uma pesquisa bibliográfica no período entre 2013 e 2017, no idioma inglês nas bases de dados PubMed e Science Direct. Utilizou-se os seguintes descritores: dentin, phytic acid e dentistry. Foram encontrados um total de 14 artigos, sendo 3 desses repetidos, todos os estudos são In vitro. Desses, 4 artigos foram selecionados mediante relevância ao tema. O IP6 se mostrou eficaz como agente condicionante dentinário, apresentando maior resistência de união que o ácido convencionalmente utilizado, ácido fosfórico a 37%. Além disso, o IP6 é capaz de realizar ligações cruzadas em colágeno desnudo melhorando a biomecânica desse subtrato além de inibir atividade colagenolítica, aumentando a durabilidade de restaurações resinosas, entretanto, o mecanismo de ação ainda não foi esclarecido. Apesar da literatura mostrar vantagens do uso do IP6 com essas finalidades, mais estudos precisam ser desenvolvidos com o intuito de aumentar a consistência da fundamentação acerca da utilização desse ácido a longo prazo.Palavras-chave: Dentin. Phytic Acid. Dentistry.
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Avaliação da Adesão, Sorção de Água e Solubilidade de Resinas Compostas Autoadesivas Experimentais para Capeamento Pulpar Direto. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo foi analisar resinas compostas experimentais para capeamento pulpar direto em propriedades físico-químicas selecionadas, comparando com hidróxido de cálcio fotopolimerizável e MTA. Duas resinas compostas capeadoras foram preparadas, uma sem adição de partículas bioativas (controle) e a outra com 30% em peso (experimental) de nanopartículas de hidroxiapatita adsorvidas com sinvastatina (10%), com glutationa (10%) e de beta fosfato tricálcio (10%). Foram utilizados 36 terceiros molares hígidos extraídos, onde foi realizado preparo cavitário na região coronária até atingir a câmara pulpar para posterior restauração com um dos materiais. Os espécimes foram cortados em fatias (1mm) e essas foram submetidas ao teste de resistência de união ao push-out. Espécimes em forma de disco (n8) foram preparados e avaliados (ISO4049) quanto a sorção e solubilidade. A análise estatística foi feita com ANOVA e teste de Tukey (a5%). Os resultados de resistência de união mostraram que o MTA e o hidróxido de cálcio apresentaram pior adesão do que as resinas, e os maiores valores foram obtidos com a resina experimental (p<0,05). Maior sorção de água foi observada com o hidróxido de cálcio e os demais materiais não apresentaram diferenças estatísticas. O hidróxido de cálcio obteve maior solubilidade que a resina controle e a experimental (p<0,05). Em conclusão, a resina experimental com partículas bioativas promove maior adesão à dentina e menor sorção e solubilidade que hidróxido de cálcio e MTA, esses materiais que são tradicionalmente usados para capeamento pulpar.Palavras-chave: Dental Pulp Capping. Simvastatin Calcium Hydroxide.
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Estratégias que Promovem Acesso aos Fluoretos para as Populações Indígenas: um Panorama Mundial. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do estudo é abordar estratégias usadas em diferentes países que promovem o acesso aos fluoretos para as populações indígenas. Foi realizado um levantamento bibliográfico de artigos disponíveis nas bases de dados PubMed e Bireme, entre 2007 e 2017, em língua inglesa, com os descritores: Indigenous Population, Flourides e Dental Caries. Foram encontrados 98 artigos. Através de uma leitura crítica dos títulos e resumos foram selecionados 10 relevantes ao tema: 4 estudos observacionais, 3 ensaios clínicos e 3 ensaios comunitários. Artigos de revisão, protocolos de pesquisa e os que não estavam adequados ao objetivo do trabalho foram excluídos. Os povos indígenas estão entre os grupos mais socioeconomicamente marginalizados nos países em que ainda estão presentes. A saúde oral dessa população remete a um cenário de alta prevalência de doenças bucais, principalmente a cárie. Por ser uma doença multifatorial, a cárie requer um programa de combate que inclua diferentes estratégias. Uma das principais formas de prevenção é o uso de flúor tópico ou sistêmico. Entretanto, o acesso a esse recurso pela população indígena é, muitas vezes, dificultado. Em países como Austrália, Canadá e Estados Unidos as estratégias incluem a ampliação da fluoretação das águas (≤0.5 mg/L) para áreas remotas, múltiplas aplicações de verniz de flúor e selantes, assim como fornecimento de dentifrícios fluoretados (0,243% de fluoreto de sódio). Os estudos apontaram essas estratégias como uma opção sustentável para a redução de cáries nesse grupo e de gastos para os sistemas de saúde.Palavras-chave: População Indígena. Fluoretos. Cárie Dentária.
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Tratamentos Térmicos da Liga de NiTi na Endodontia: Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AEndodontia tem sofrido grandes transformações nos princípios físico-químicos e mecânicos que norteiam sua prática. Anecessidade de desenvolver procedimentos com maior eficiência e precisão tem feito com que pesquisadores busquem novas tecnologias a fim de tornar mais efetivo e seguro o preparo químico mecânico (PQM) dos sistemas canais radiculares. Assim, vêm sendo desenvolvidos diversos tratamentos da liga de Níquel-Titâneo (NiTi) utilizada na confecção de instrumentos endodônticos. Seu aperfeiçoamento está pautado com base em seu desempenho na tentativa de produzir ligas com maior resistência à fratura cíclica e torcional, associadas a um melhor padrão de limpeza, menor desvio de canal radicular e menor tempo de execução. O presente trabalho tem por objetivo analisar a evolução da liga de NiTi na endodontia por meio de uma revisão de literatura. Para tanto, realizou-se uma busca bibliográfica na base de dados Pubmed nos últimos cinco anos com os seguintes descritores: Nickel-titanium endodontic Nickel-titanium rotatory Nickel-titanium thermal treatments, resultando em 196 artigos encontrados e 62 artigos considerados válidos seguindo os critérios de inclusão: pesquisas de revisão, estudos laboratoriais, no idioma inglês e com disponibilidade do texto completo. A literatura mostra que os diferentes tratamentos termomecânicos aos quais a liga de NiTi tem passado foram capazes de conferir-lhe maior resistência à fratura, maior flexibilidade e melhor previsibilidade dos preparos com manutenção da morfologia original do canal.Palavras-chave: Níquel-Titânio. Preparo Químico-Mecânico. Endodontia.
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A Influência do Uso de Agentes Antioxidantes na Resistência de União em Dentes Clareados: uma Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente estudo é revisar a literatura para avaliar a influência do uso de agentes antioxidantes na resistência de união em dentes clareados e restaurados imediatamente. Realizou-se uma busca bibliográfica na qual foram selecionados artigos do período de 2012 a 2017, nas bases de dados: PubMed, Bireme e Science Direct, no idioma inglês, utilizando os seguintes descritores: Dental Whitening, Antioxidant e Ascorbate. Sendo encontrados um total de 20 artigos, 10 desses são estudos laboratoriais, 7 são estudos clínicos e 3 revisões de literatura. Através de uma leitura criteriosa de títulos e resumos selecionou-se 10 artigos, de acordo com a relevância do tema, sendo excluídas revisões de literatura, bem como os artigos que fugiam da temática. No clareamento dental ocorrem reações de oxidação, os agentes clareadores liberam oxigênio e radicais com função oxidativa e é essa forte liberação de oxigênio que prejudica a resistência das ligações adesivas estabelecidas na interface dente/material restaurador. Esse oxigênio irá interferir a polimerização do adesivo e da resina, impossibilitando a restauração imediata. Uma variedade de antioxidantes é pesquisada com finalidade de aumentar a resistência de união de dentes clareados, dentre eles o ascorbato de sódio, destacou- se por se mostrar capaz de remover o peróxido de oxigênio residual, de modo a neutralizar os radicais livres remanescentes e possibilitar restituição da capacidade adesiva e de polimerização. A continuidade e o aprofundamento dos estudos sobre a eficácia e aplicabilidade dos antioxidantes são de suma importância para a comunidade científica e cirurgiões-dentistas em geral para que obtenha-se resultados cada vez mais satisfatórios.Palavras-chave: PubMed. Bireme. Science Direct.
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Uso das Proantocianidinas como Agente Biomodificador de Dentina: uma Revisão de Literatura. JOURNAL OF HEALTH SCIENCES 2018. [DOI: 10.17921/2447-8938.2017v19n5p137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
O objetivo do presente estudo é revisar a literatura para avaliar o uso das proantocianidinas como agente biomodificador da dentina. Para isso, foi realizada uma pesquisa bibliográfica na qual foram selecionados artigos publicados no período de 2007 a 2017 nas bases de dados PubMed, Cochrane e SciElo no idioma Inglês, utilizando os descritores: Cross-Linking Reagents, Dentin e Proanthocyanidins. Chegando-se ao total de 35 artigos, realizou-se uma leitura crítica dos resumos e títulos. Desses, 23 são estudos in vitro, 1 caso clínico e 3 revisões de literatura sendo excluídos os artigos que fugiam do objetivo do estudo e as revisões de literatura. Após uma leitura crítica de títulos e resumos, selecionou-se 10 artigos mediante a relevância ao tema. As PACs atuam como agente de ligações cruzadas, podendo aumentar a durabilidade das restaurações resinosas, pois têm o potencial de melhorar a dentina propriedades mecânicas e reduzir a sua degradação enzimática do colágeno tipo I, presente em dentina. Entretanto, estudos que avaliam a ação das PACs são muito recentes, não tendo trabalhos clínicos que comprovem sua efetividade ao longo dos anos. O desenvolvimento de artigos com um maior período de acompanhamento é fundamental para que a comunidade científica obtenha resultados sobre a ação das PACs, na durabilidade de restaurações resinosas. Ainda assim, esse agente biomodificador é bastante promissor na odontologia restauradora.Palavras-chave: Cross-Linking Reagents. Dentin. Proanthocyanidins.
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