1
|
Tripto-Shkolnik L, Szalat A, Tsvetov G, Rouach V, Sternberg C, Hoppe A, Burshtein G, Galitzer H, Toledano M, Harari G, Santora AC, Cosman F. Oral daily PTH(1-34) tablets (EB613) in postmenopausal women with low BMD or osteoporosis: a randomized, placebo-controlled, six-month, phase 2 study. J Bone Miner Res 2024:zjae057. [PMID: 38578978 DOI: 10.1093/jbmr/zjae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 02/21/2024] [Accepted: 04/03/2024] [Indexed: 04/07/2024]
Abstract
Anabolic treatment is indicated for high and very-high risk patients with osteoporosis, but acceptance is limited because current anabolic medications require subcutaneous injections. The purpose of this study was to assess the effects of a novel orally administered parathyroid hormone (PTH) tablet on serum markers of bone formation [N-terminal propeptide of Type I procollagen (PINP) and osteocalcin (OC)] and bone resorption [crosslinked C-telopeptide (CTX)], bone mineral density (BMD) and safety in postmenopausal women with low BMD or osteoporosis. In this 6-month, double-blind, placebo-controlled study, 161 patients were randomized to oral PTH tablets containing 0.5, 1.0, 1.5, or 2.5 mg or placebo daily. Biochemical markers were assessed at 1, 2, 3 and 6 months and BMD of lumbar spine, total hip and femoral neck was measured at 6 months. Biochemical marker changes were dose dependent with minimal or no effect at the two lowest doses. At the highest dose (2.5 mg once daily), serum PINP and OC levels increased 30% within 1 month after oral PTH initiation (p < 0.0001), remained elevated through 3 months and were back to baseline at 6 months. In contrast, serum CTX levels declined 16% and 21% below baseline at 3 and 6 months respectively (both p ≤ 0.02). At 6 months, 2.5 mg tablets increased mean BMD vs placebo of the lumbar spine by 2.7%, total hip by 1.8%, and femoral neck by 2.8% (all p ≤ 0.01). There were no drug-related serious adverse events. The most common adverse events were headache, nausea, and dizziness. In contrast to subcutaneous PTH, the oral PTH tablet appears to increase BMD rapidly by the dual mechanism of stimulating formation and inhibiting bone resorption. This might be the first effective oral anabolic alternative to subcutaneous administration for the treatment of low BMD or osteoporosis.
Collapse
|
2
|
Álvarez-Fuente M, Toledano M, Garrido-Lestache E, Sánchez I, Molina I, Rivero N, García-Ormazábal I, Del Cerro MJ. Balloon-Expandable Pulmonary Valves for Patched or Native Right Ventricular Outflow Tracts. Pediatr Cardiol 2023:10.1007/s00246-023-03173-2. [PMID: 37147525 DOI: 10.1007/s00246-023-03173-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/19/2023] [Indexed: 05/07/2023]
Abstract
The implantation of percutaneous balloon expandable valves in native or patched right ventricular outflow tracts (nRVOT) is a challenging technique due to the diversity of anatomies and shapes, the large sizes, and the distensibility of the nRVOT, for which specific techniques have been developed. We present a single center experience with balloon expandable percutaneous pulmonary valves in nRVOT, describing the techniques used, complications observed, and a short-mid term follow-up.. This is a single center descriptive study of patients who underwent a percutaneous pulmonary valve implantation in a nRVOT with a balloon expandable pulmonary valve in our center between September 2012 and June 2022.. We implanted successfully 45 valves in 46 patients (20 Sapien and 25 Melody). Tetralogy of Fallot or pulmonary atresia with VSD were the main congenital heart disease (n = 32). All were pre-stented, 18 in a one step procedure. We used a Dryseal sheath in 13/21 Sapien. In 6 patients we used the anchoring technique, 5 with a very large nRVOT and one pyramidal nRVOT. In the 3.5 year follow-up 7 patients developed endocarditis and 3 required a valve redilation, no fractures were observed. PPVI of native RVOT with balloon expandable valves is feasible in a number of selected anatomies, including large or pyramidal nRVOT, using specific techniques, (presenting, LPA anchoring).
Collapse
Affiliation(s)
- M Álvarez-Fuente
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain.
| | - M Toledano
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - E Garrido-Lestache
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - I Sánchez
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - I Molina
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - N Rivero
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - I García-Ormazábal
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - M J Del Cerro
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| |
Collapse
|
3
|
Marschall A, Alvarez-Fuente M, Garrido-Lestache E, Tellez L, Sanchez I, Toledano M, Molina I, Rivero N, Garcia-Ormazabal I, Tamariz R, Del Cerro MJ. Percutaneous interventions in Fontan circulation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In light of increased survival of patients with Fontan circulation, percutaneous interventions in these patients have become growingly significant in the recent years. Percutaneous treatments in patients with univentricular physiology can optimize the short term hemodynamics in these patients. However, information on long term outcomes is scarce.
Purpose
To present the cumulative work experience in percutaneous interventions of a tertiary center in the past 12 years in patients that have undergone total cavopulmonary deviation (TCD) and to investigate long term outcomes.
Methods
In this retrospective study, all patients with TCD that underwent follow-up in our specialized department of congenital heart disease in the past 12 years, were eligible for chart-review. Cardiac catheterization was performed by experienced interventional cardiologists, specialized in structural interventions in congenital heart disease. All catheterizations were performed under general anesthesia and mechanical ventilation. All patients underwent Fontan pressure measurements and cardiac output estimation with Fick method.
Results
A total of 80 patients, with a mean follow-up time of 24 (±7.1) years, were included in the study. Details on baseline characteristics are depicted in Table 1. Fifty-two (65%) patients underwent percutaneous intervention during follow-up, and 33% (n=17) of these patients required multiple interventions. Angioplasty with stent implantation of the Fontan conduit or the pulmonary arteries was the most common intervention (30 (58%) and 8 (15%) patients, respectively), followed by embolization of collaterals (11 (21%) patients). Patients with right systemic ventricle physiology needed more interventions and had a shorter time-to-first-intervention period. (Figure 1) Pacemaker implantation was required in a total of 15 patients, being significantly more frequent in patients with atriopulmonary connection than in patients with lateral tunnel or extracardiac conduit (11 (36%) vs 4 (11%), p<0.01). Overall long-term outcome (with regards to mortality) was good (4 (0.5%) patients). Patients that required percutaneous structural interventions showed a tendency towards a higher mortality than those not in need of intervention (4 (8%) vs 0 (0%), respectively, p=0.14).
Conclusions
During long-term follow-up of patients with Fontan circulation, almost two thirds of the patients required percutaneous intervention. Patients with right systemic ventricle physiology were in greater need of intervention. Patients that required intervention had a tendency towards a worse clinical outcome.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A Marschall
- Gomez Ulla Central Defense Hospital, Department of Cardiology , Madrid , Spain
| | - M Alvarez-Fuente
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - E Garrido-Lestache
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - L Tellez
- Ramon and Cajal University Hospital, Hepatic Hemodynamics & Vascular Liver Diseases Unit , Madrid , Spain
| | - I Sanchez
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - M Toledano
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - I Molina
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - N Rivero
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - I Garcia-Ormazabal
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - R Tamariz
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| | - M J Del Cerro
- Ramon and Cajal University Hospital, Paediatric and Adult Congenital Heart Disease , Madrid , Spain
| |
Collapse
|
4
|
Altes A, Levy F, Iacuzio L, Dumortier H, Toledano M, Tartar J, Tribouilloy C, Marechaux S. Comparison of mitral regurgitant volume assessment between proximal flow convergence and volumetric methods in patients with significant primary mitral regurgitation. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background. Discrepancies have been observed between transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (MRI) severity grading in primary mitral regurgitation (MR).
Purpose. To compare mitral regurgitant volume (RV) obtained by the proximal flow convergence method (PISA) method by TTE and by volumetric methods (TTE and MRI), and study the relationship between LV size and RV obtained by either the PISA or volumetric methods.
Methods and results. 188 patients from 2 heart valve clinics with at least moderate-to-severe primary MR due to prolapse in sinus rhythm who underwent evaluation with TTE and MRI were included. RV was estimated by either PISA or volumetric methods (Left ventricular [LV] stroke volume minus systolic aortic outflow volume)) by either MRI (MRI-RV) or TTE (TTE-RV)). PISA-RV and either MRI-RV or TTE-RV weakly correlated (r = 0.29 and 0.30,p < 0.001). On multivariable analysis, LV end-diastolic volume (LVEDV) and bileaflet prolapse independently correlated with the magnitude of the difference between PISA and volumetric methods. While PISA-RV and LVEDV were unrelated, MRI-RV and TTE-RV strongly correlated with LVEDV (r = 0.66 and 0.68,p < 0.001). In contrast, LVEDV and regurgitant fraction (RF = RV/LVEDV) either with TTE or MRI were poorly related (r = 0.17,p = 0.02 and r = 0.12,p = 0.10).
Conclusion. RV estimated by the PISA and volumetric methods are not comparable. The expected proportional relationship between volumetric RV and LV size, which is not observed with PISA-RV suggests the inaccuracy of PISA-RV. Given that RV by volumetric methods depends on LV size, determination of a unique RV threshold for severe MR is challenging. Calculation of RF may overcome this limitation. Abstract Figure. RV assessed by PISA or volumetric method Abstract Figure. Illustrative example
Collapse
Affiliation(s)
- A Altes
- Lille Catholic University, Lille, France
| | - F Levy
- Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | - L Iacuzio
- Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | | | - M Toledano
- Lille Catholic University, Lille, France
| | - J Tartar
- Lille Catholic University, Lille, France
| | | | | |
Collapse
|
5
|
Arias-Moliz MT, Baca P, Solana C, Toledano M, Medina-Castillo AL, Toledano-Osorio M, Osorio R. Doxycycline-functionalized polymeric nanoparticles inhibit Enterococcus faecalis biofilm formation on dentine. Int Endod J 2020; 54:413-426. [PMID: 33107032 DOI: 10.1111/iej.13436] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 12/24/2022]
Abstract
AIM To evaluate in a laboratory setting the antimicrobial properties and the potential to inhibit biofilm formation of novel remineralizing polymeric nanoparticles (NPs) when applied to dentine surfaces and to ascertain the effect of the functionalization of these NPs with zinc, calcium or doxycycline. METHODOLOGY The antimicrobial activity and inhibition of biofilm formation of polymeric NPs were analysed on human dentine blocks that were infected with Enterococcus faecalis before or after application of NPs. LIVE/DEAD ® testing under Confocal Laser Scanning Microscopy and bacterial culturing were employed to analyse biofilm biovolume and bacterial viability. Field Emission Scanning Electron Microscopy was also employed to assess biofilm morphology. One-way anova with Welch's correction and post hoc comparison by the Games-Howell test were performed for comparisons between groups. RESULTS The un-functionalized NPs displayed the greatest antimicrobial activity against E. faecalis biofilms as they provided the lowest biovolume (3865.7 ± 2926.97 µm3 ; P < 0.001) and the highest dead/injured cells percentage (79.93 ± 18.40%; P < 0.001), followed by Dox-NPs (biovolume: 19,041.55 ± 17,638.23 µm3 , dead/injured cells: 45.53 ± 26.50%; P < 0.001). Doxycycline-loaded NPs had the largest values of inhibition of biofilm formation with the lowest biofilm biovolume (8517.65 ± 7055.81 µm3 ; P < 0.001) and a high dead/injured bacterial percentage (68.68 ± 12.50%; P < 0.001). Un-functionalized NPs did not reduce biomass growth (P > 0.05), but attained the largest percentage of compromised cells (93 ± 8.23%; P < 0.001), being able to disrupt biofilm formation. It also produced occlusion of dentinal tubules, potentially interfering with bacterial tubule penetration. CONCLUSIONS A new generation of bioactive nano-fillers (doxycycline-functionalized polymeric NPs) had antibacterial activity and occluded dentinal tubules. Incorporating these NPs into endodontic sealers may have the potential to enhance the outcome of root canal treatment.
Collapse
Affiliation(s)
| | - P Baca
- Faculty of Dentistry, University of Granada, Granada, Spain
| | - C Solana
- Faculty of Dentistry, University of Granada, Granada, Spain
| | - M Toledano
- Faculty of Dentistry, University of Granada, Granada, Spain
| | | | | | - R Osorio
- Faculty of Dentistry, University of Granada, Granada, Spain
| |
Collapse
|
6
|
Bueno J, Sánchez MC, Toledano-Osorio M, Figuero E, Toledano M, Medina-Castillo AL, Osorio R, Herrera D, Sanz M. Antimicrobial effect of nanostructured membranes for guided tissue regeneration: an in vitro study. Dent Mater 2020; 36:1566-1577. [PMID: 33010943 DOI: 10.1016/j.dental.2020.09.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/26/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The purpose of this in vitro study was to evaluate the antibacterial effect of a novel non-resorbable, bioactive polymeric nanostructured membrane (NMs), when doped with zinc, calcium and doxycycline. METHODS A validated in vitro subgingival biofilm model with six bacterial species (Streptococcus oralis, Actinomyces naeslundii, Veillonela parvula, Fusobacterium nucleatum, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans) was used. The experimental NMs, with and without being doped with doxycycline, calcium and zinc, were placed on hydroxyapatite (HA) discs. As positive control membranes, commercially available dense polytetrafluoroethylene (d-PTFE) membranes were used and, as negative controls, the HA discs without any membrane. The experimental, positive and negative control discs were exposed to a mixed bacterial suspension, at 37 °C under anaerobic conditions, during 12, 24, 48 and 72 h. The resulting biofilms were analyzed through scanning electron microscopy (SEM), to study their structure, and by quantitative polymerase chain reaction (qPCR), to assess the bacterial load, expressed as colony forming units (CFU) per mL. Differences between experimental and control groups were evaluated with the general linear model and the Bonferroni adjustment. RESULTS As shown by SEM, all membrane groups, except the NMs with doxycycline, resulted in structured biofilms from 12-72 hours. Similarly, only the membranes loaded with doxycycline demonstrated a significant reduction in bacterial load during biofilm development, when compared with the control groups (p < 0.001). SIGNIFICANCE Doxycycline-doped nanostructured membranes have an impact on biofilm growth dynamics by significant reducing the bacterial load.
Collapse
Affiliation(s)
- J Bueno
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - M C Sánchez
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - M Toledano-Osorio
- Biomaterials in Dentistry Research Group, University of Granada, Spain
| | - E Figuero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - M Toledano
- Biomaterials in Dentistry Research Group, University of Granada, Spain
| | - A L Medina-Castillo
- NanoMyP. Spin-Off Enterprise from University of Granada, Edificio BIC-Granada, Av. Innovación 1. 18016 Armilla, Granada, Spain
| | - R Osorio
- Biomaterials in Dentistry Research Group, University of Granada, Spain.
| | - D Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - M Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| |
Collapse
|
7
|
Piel FB, Fecht D, Hodgson S, Blangiardo M, Toledano M, Hansell AL, Elliott P. Small-area methods for investigation of environment and health. Int J Epidemiol 2020; 49:686-699. [PMID: 32182344 PMCID: PMC7266556 DOI: 10.1093/ije/dyaa006] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 01/10/2020] [Indexed: 11/30/2022] Open
Abstract
Small-area studies offer a powerful epidemiological approach to study disease patterns at the population level and assess health risks posed by environmental pollutants. They involve a public health investigation on a geographical scale (e.g. neighbourhood) with overlay of health, environmental, demographic and potential confounder data. Recent methodological advances, including Bayesian approaches, combined with fast-growing computational capabilities, permit more informative analyses than previously possible, including the incorporation of data at different scales, from satellites to individual-level survey information. Better data availability has widened the scope and utility of small-area studies, but has also led to greater complexity, including choice of optimal study area size and extent, duration of study periods, range of covariates and confounders to be considered and dealing with uncertainty. The availability of data from large, well-phenotyped cohorts such as UK Biobank enables the use of mixed-level study designs and the triangulation of evidence on environmental risks from small-area and individual-level studies, therefore improving causal inference, including use of linked biomarker and -omics data. As a result, there are now improved opportunities to investigate the impacts of environmental risk factors on human health, particularly for the surveillance and prevention of non-communicable diseases.
Collapse
Affiliation(s)
- Frédéric B Piel
- UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Imperial College London, UK
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Susan Hodgson
- UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Marta Blangiardo
- UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
| | - M Toledano
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
| | - A L Hansell
- UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- Centre for Environmental Health and Sustainability, Medical School, University of Leicester, Leicester, UK
| | - Paul Elliott
- UK Small Area Health Statistics Unit, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment & Health, Department of Epidemiology & Biostatistics, School of Public Health, Imperial College London, London, UK
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Imperial College London, UK
| |
Collapse
|
8
|
Altes A, Sochala M, Attias D, Dreyfus J, Bohbot Y, Toledano M, Macron L, Renard C, Chadha G, Truffier A, Guerbaai R, Ennezat P, Graux P, Tribouilloy C, Maréchaux S. Correlates of the ratio of acceleration time to ejection time in patients with aortic stenosis: An echocardiographic and computed tomography study. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
9
|
Altes A, Sochala M, Attias D, Dreyfus J, Toledano M, Macron L, Renard C, Truffier A, Guerbaai RA, Ennezat PV, Graux P, Tribouilloy C, Marechaux S. P3696Correlates of the ratio of acceleration time to ejection time in patients with aortic stenosis: an echocardiographic and computed tomography study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Acceleration time to ejection time ratio (AT/ET) prolongation is associated with increased mortality in patients with aortic stenosis (AS).
Purpose
To identify the determinants associated with increased AT/ET.
Methods
The relationships between AT/ET ratio, clinical and Doppler echocardiographic variables of interest in the setting of AS were studied in 1107 patients with AS and preserved left ventricular (LV) ejection fraction (EF), with Computed Tomography – Aortic Valve Calcium (CT-AVC) score studied in a subgroup of 342 patients.
Results
In univariate analysis, AT/ET ratio did correlate with aortic peak velocity (Vmax, r=0.57, p<0.0001), mean pressure gradient (MPG, r=0.60, p<0.0001), aortic valve area (AVA, r=−0.50, p<0.0001) and CT-AVC score (r=0.24, p<0.0001). An AT/ET ratio had a good accuracy to predict an aortic peak velocity ≥4 m/s, a MPG≥40 mmHg, or an AVA≤1.0 cm2, with an optimal cut-off value of 0.34. By multivariate linear regression analysis, presence of AS-related symptoms, decreased LV stroke volume index, LVEF, systolic blood pressure (SBP), absence of diabetes mellitus, and increased LV mass index, relative wall thickness, and Vmax were independently associated with increased AT/ET ratio (all P<0.05). In the subgroup of patients who underwent CT-AVC, CT-AVC score was independently associated with increased AT/ET ratio (P<0.05).
Conclusion
AT/ET ratio is related to echocardiographic and CT-AVC indices of AS severity. However, multiple intricate factors beyond hemodynamic and anatomic severity of AS influence AT/ET ratio including LV geometry, function and SBP. These findings should be considered when assessing AT/ET in patients with AS and preserved LVEF.
Acknowledgement/Funding
Local funding
Collapse
Affiliation(s)
- A Altes
- Lille Catholic University, Lille, France
| | - M Sochala
- Centre Cardiologique du Nord (CCN), Saint Denis, France
| | - D Attias
- Centre Cardiologique du Nord (CCN), Saint Denis, France
| | - J Dreyfus
- Centre Cardiologique du Nord (CCN), Saint Denis, France
| | - M Toledano
- Lille Catholic University, Lille, France
| | - L Macron
- Centre Cardiologique du Nord (CCN), Saint Denis, France
| | | | - A Truffier
- Lille Catholic University, Lille, France
| | | | - P V Ennezat
- University Hospital of Grenoble, Grenoble, France
| | - P Graux
- Lille Catholic University, Lille, France
| | | | | |
Collapse
|
10
|
Fernandez MEE, Gómez-España M, Grávalos C, García-Alfonso P, Rodríguez B, Losa F, Ales-Diaz I, Suarez BG, Toledano M, Valladares-Ayerbes M, Marques EP, Fernandez MS, de Castro EM, Raga MG, Salvia MAS, Ruiz-Casado A, Rodríguez-Ariza A, Aguilar EA. POLAF study: Efficacy and safety of FOLFIRI/aflibercept in a phase II trial in patients with metastatic colorectal cancer: Results of plasmatic prognostic and predictive markers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
11
|
Toledano M, Aguilera FS, Cabello I, Toledano-Osorio M, Osorio E, López-López MT, García-Godoy F, Lynch CD, Osorio R. Silver-loaded nanoparticles affect ex-vivo mechanical behavior and mineralization of dentin. Med Oral Patol Oral Cir Bucal 2019; 24:e156-e164. [PMID: 30818307 PMCID: PMC6441607 DOI: 10.4317/medoral.22885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/22/2019] [Indexed: 12/04/2022] Open
Abstract
Background The aim was to evaluate the effect of silver loaded nanoparticles (NPs) application on the triboscopic, crystallographic and viscoelastic properties of demineralized dentin. Polymethylmetacrylate-based NPs and Ag loaded NPs were applied on demineralized dentin. Material and Methods Treated and untreated surfaces were probed by a nanoindenter to test viscoelasticity, and by atomic force microscopy to test nanoroughness and collagen fibril diameter. X-ray diffraction and transmission electron microscopy through selected area diffraction and bright-field imaging were also used. Results Dentin treated with Ag-NPs attained the lowest complex modulus, and the highest tan delta values after 7 days of storage. Dentin treated with undoped-NPs achieved the lowest nanoroughness and the greatest collagen bandwidths among groups. Crystals were identified as hydroxyapatite with the highest crystallographic maturity and crystallite size in dentin treated with undoped-NPs. Texture increased in all samples from 24 h to 7 d, except in dentin surfaces treated with Ag-NPs at 310 plane. Polyhedral, block-like, hexagonal or plate-like shaped apatite crystals constituted the bulk of minerals in dentin treated with Ag-NPs, after 7 d. Polyhedral or rounded/drop-like, and polymorphic in strata crystal apatite characterized the minerals when undoped-NPs were used, with more crystalline characteristics after 7 d than that found when Ag-NPs were applied. Ag-NPs application did not improve the mechanical performance of dentin and did not produce dentin remineralization. However, energy was dissipated through the dentin without showing stress concentration; contrary was occurring at dentin treated with undoped-NPs, that provoked bridge-like mineral deposits at the dentin surface. Conclusions Ag-NPs application did not enhance the mechanical properties of cervical dentin, though the energy dissipation did not damage the dentin structure. Remineralization at dentin was not produced after Ag-NPs application, though improved crystallinity may lead to increase stability of the apatite that was generated at the dentin surface. Key words:Dentin, mechanical, mineralization, roughness, silver, viscoelastic.
Collapse
Affiliation(s)
- M Toledano
- University of Granada, Faculty of Dentistry, Colegio Máximo de Cartuja s/n, 18071, Granada, Spain,
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Colas L, Budzik JF, Toledano M, Norberciak L, Verclytte S. Etude TC3A : Évaluation de l’intérêt des scanners cérébraux pour traumatisme crânien léger chez les patients sous anti-agrégants plaquettaires, anticoagulants et anticoagulants oraux directs : Étude prospective chez 847 patients. J Neuroradiol 2019. [DOI: 10.1016/j.neurad.2019.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
13
|
Sánchez MC, Toledano-Osorio M, Bueno J, Figuero E, Toledano M, Medina-Castillo AL, Osorio R, Herrera D, Sanz M. Antibacterial effects of polymeric PolymP-n Active nanoparticles. An in vitro biofilm study. Dent Mater 2018; 35:156-168. [PMID: 30502966 DOI: 10.1016/j.dental.2018.11.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE to study the antibacterial effect of polymeric PolymP-n Active nanoparticles using an in vitro subgingival biofilm model. METHODS Hydroxyapatite discs coated with five modalities of nanoparticles (NPs): NPs, NPs doped with zinc, calcium, silver and doxycycline, PBS as control, and Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were studied in a static in vitro biofilm model (12, 24, 48, and 72h). Nano-roughness of the different disc surfaces (SRa, in nm) and morphological characteristic of the biofilms (thickness (μm) and bacterial viability) were studied by different microscopy modalities. Quantitative Polymerase Chain Reaction was used to assess the effect of the nanoparticles on the bacterial load (colony forming unit per milliliter) (CFUmL-1). Analysis of variance and post-hoc testing with T3 Dunnett́s, and Student Newman Keuls correction was used. Results were considered statistically significant at p<0.05. RESULTS Surfaces containing the different nanoparticles showed significant increments in roughness when compared to controls (p<0.05). A similar biofilm formation and dynamics was observed, although reductions in bacterial viability were detected in biofilms in contact with the different nanoparticles, more pronounced with silver and doxycycline NPs. Doxycycline-NPs biofilms resulted in unstructured biofilm formation and significantly lower number of the six species when compared with the other nanoparticles specimens and controls (p<0.001 in all cases). SIGNIFICANCE Polymeric PolymP-n Active nanoparticles when combined with silver and doxycycline showed a significant antibacterial effect when tested in an in vitro subgingival biofilm model.
Collapse
Affiliation(s)
- M C Sánchez
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - M Toledano-Osorio
- Biomaterials in Dentistry Research Group, University of Granada, Spain
| | - J Bueno
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - E Figuero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - M Toledano
- Biomaterials in Dentistry Research Group, University of Granada, Spain
| | - A L Medina-Castillo
- NanoMyP. Spin-Off Enterprise from University of Granada, Edificio BIC-Granada, Av. Innovación 1, 18016 Armilla, Granada, Spain
| | - R Osorio
- Biomaterials in Dentistry Research Group, University of Granada, Spain.
| | - D Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - M Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| |
Collapse
|
14
|
Toledano M, Osorio R, Pérez-Álvarez MC, Osorio E, Lynch CD, Toledano-Osorio M. A zinc-doped endodontic cement facilitates functional mineralization and stress dissipation at the dentin surface. Med Oral Patol Oral Cir Bucal 2018; 23:e646-e655. [PMID: 30341273 PMCID: PMC6260998 DOI: 10.4317/medoral.22751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/07/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate nanohardness and viscoelastic behavior of dentin surfaces treated with two canal sealer cements for dentin remineralization. MATERIAL AND METHODS Dentin surfaces were subjected to: i) 37% phosphoric acid (PA) or ii) 0.5 M ethylenediaminetetraacetic acid (EDTA) conditioning prior to the application of two experimental hydroxyapatite-based cements, containing sodium hydroxide (calcypatite) or zinc oxide (oxipatite), respectively. Samples were stored in simulated body fluid during 24 h or 21 d. The intertubular and peritubular dentin were evaluated using a nanoindenter to assess nanohardness (Hi). The load/displacement responses were used for the nano-dynamic mechanical analysis to estimate complex modulus (E*) and tan delta (δ). The modulus mapping was obtained by imposing a quasistatic force setpoint to which a sinusoidal force was superimposed. AFM imaging and FESEM analysis were performed. RESULTS After 21 d of storage, dentin surfaces treated with EDTA+calcypatite, PA+calcypatite and EDTA+oxipatite showed viscoelastic discrepancies between peritubular and intertubular dentin, meaning a risk for cracking and breakdown of the surface. At both 24 h and 21 d, tan δ values at intertubular dentin treated with the four treatments performed similar. At 21 d time point, intertubular dentin treated with PA+oxipatite achieved the highest complex modulus and nanohardness, i.e., highest resistance to deformation and functional mineralization, among groups. CONCLUSIONS Intertubular and peritubular dentin treated with PA+oxipatite showed similar values of tan δ after 21 d of storage. This produced a favorable dissipation of energy with minimal energy concentration, preserving the structural integrity at the dentin surface.
Collapse
Affiliation(s)
- M Toledano
- University of Granada, Faculty of Dentistry, Dental Materials Section, Colegio Máximo de Cartuja s/n, 18071 - Granada - Spain,
| | | | | | | | | | | |
Collapse
|
15
|
Vivancos A, Aranda Aguilar E, Benavides M, Elez Fernandez E, Toledano M, Alvarez M, Diaz Rubio E, Gómez-España A, Garcia-Barberan V, Chica-Parrao M. Evaluation of the sensitivity of RAS mutation detection of the Idylla platform in comparison to the OncoBEAM RAS CRC assay. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
16
|
Martín Del Olmo JC, Toledano M, Martín Esteban ML, Montenegro MA, Gómez JR, Concejo P, Rodríguez de Castro M, Del Rio F. Outcomes of laparoscopic management of multicompartmental pelvic organ prolapse. Surg Endosc 2018; 33:1075-1079. [PMID: 29998390 DOI: 10.1007/s00464-018-6357-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 07/06/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Pelvic organ prolapse (POP) is an increasing medical problem with complex diagnostics and controversial surgical management. It causes a series of dysfunctions in the gynecological, urinary, and anorectal organs. Numerous procedures have been proposed to treat these conditions, but in recent years, ventral mesh rectocolposacropexy (VMRCS) has emerged as the procedure of choice for the surgical treatment of POP, especially by a laparoscopic approach. This surgical technique limits the risk of autonomic nerve damage, and the colpopexy allows the correction of concomitant prolapse of the middle compartment. However, symptoms derived from anterior compartment prolapse remain a major morbidity and sometimes require an additional procedure. The aim of this study is to evaluate the results of laparoscopic prosthetic rectocolposacropexy (LRCS) and colposacropexy (LCS) procedures performed to manage combined multicompartmental POP. METHODS Between November 2008 and December 2017, 38 patients with symptomatic POP underwent rectocolposacropexy (RCS) or colposacropexy (CS) by a laparoscopic approach. Demographics, mortality, morbidity, hospital stay, and functional outcomes were retrospectively analyzed. RESULTS The median operating time was 200 min (IQR 160-220). Additional simultaneous surgery for POP was performed in nine cases: five suburethral slings and four hysterectomies were performed. No mortality was recorded. The conversion rate was 7.89%. There were two intraoperative complications (5.26%): one enterotomy and one urinary bladder tear. Late complications occurred in 5.26% of cases. After a mean follow-up of 20 months, constipation was completely resolved or improved in 83.33% of patients, urinary stress incontinence was resolved or improved in 52.94%, and gynecological symptomatology was resolved or improved in 93.75%. The recurrence rate was 5.26%. CONCLUSIONS Laparoscopic mesh rectocolposacropexy and colposacropexy are safe and effective techniques associated with very low morbidity. In the medium term, they provide good results for POP and associated symptoms, but urinary symptomology has a worse outcome.
Collapse
Affiliation(s)
- J C Martín Del Olmo
- Department of General Surgery, Medina del Campo Hospital, Valladolid, Spain. .,, Madrid, Spain.
| | - M Toledano
- Department of General Surgery, Medina del Campo Hospital, Valladolid, Spain
| | - M L Martín Esteban
- Department of General Surgery, Medina del Campo Hospital, Valladolid, Spain
| | - M A Montenegro
- Department of General Surgery, Medina del Campo Hospital, Valladolid, Spain
| | - J R Gómez
- Department of General Surgery, Medina del Campo Hospital, Valladolid, Spain
| | - P Concejo
- Department of General Surgery, Medina del Campo Hospital, Valladolid, Spain
| | - M Rodríguez de Castro
- Department of Obstetrics and Gynecology, Medina del Campo Hospital, Valladolid, Spain
| | - F Del Rio
- Department of Urology, Medina del Campo Hospital, Valladolid, Spain
| |
Collapse
|
17
|
Toledano M, Toledano-Osorio M, Medina-Castillo AL, López-López MT, Aguilera FS, Osorio R. Ion-modified nanoparticles induce different apatite formation in cervical dentine. Int Endod J 2018; 51:1019-1029. [PMID: 29489013 DOI: 10.1111/iej.12918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/23/2018] [Indexed: 12/24/2022]
Abstract
AIM To investigate if crystallinity and ultrastructure are modified when cervical dentine is treated with four different nanogels-based solutions for remineralizing purposes. METHODOLOGY Experimental nanogels based on polymeric nanoparticles (NPs) and zinc, calcium or doxycycline-loaded NPs were applied to citric acid etched dentine to facilitate the occlusion of tubules and the mineralization of the dentine surface. Dentine surfaces were studied by X-ray diffraction and transmission electron microscopy through selected area diffraction and bright-field imaging. RESULTS Crystals at the dentine surface were identified as hydroxyapatite with the highest crystallographic maturity and crystallite size in dentine treated with Zn-NPs-based gel. Texture increased in all samples from 24 h to 7 days, except in dentine surfaces treated with Zn-NPs gel. Polyhedral, plate-like and drop-like shaped apatite crystals constituted the bulk of minerals in dentine treated with Zn-NPs gel, after 7 days. Polymorphic, cubic and needle-like shaped crystals distinguished minerals, with more amorphous characteristics in dentine treated with Ca-NPs gel after 7 days than that found when Zn-NPs were applied. Doxycycline-NPs produced the smallest crystallites with poor crystallinity, maturity and chemical stability. CONCLUSIONS Crystalline and amorphous phases of newly formed hydroxyapatite were described in both types of dentine treated with Zn-NPs as well as Ca-NPs gels with multiple shapes of crystallites. Crystal shapes ranged from rounded/drop-like or plate-like crystals to needle-like or polyhedral and cubic apatite appearance.
Collapse
Affiliation(s)
- M Toledano
- Dental Materials Section, Faculty of Dentistry, Granada, Spain
| | | | | | - M T López-López
- Applied Physics Department, Faculty of Science, University of Granada, Granada, Spain
| | - F S Aguilera
- Dental Materials Section, Faculty of Dentistry, Granada, Spain
| | - R Osorio
- Dental Materials Section, Faculty of Dentistry, Granada, Spain
| |
Collapse
|
18
|
Crawshaw A, Toledano M, Pozniak A, Kennedy A, Davies N. Parkinsonism in HIV patients: A descriptive case series. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
19
|
Toledano M, Pérez-Álvarez MC, Aguilera FS, Osorio E, Cabello I, Toledano-Osorio M, Osorio R. A zinc oxide-modified hydroxyapatite-based cement facilitated new crystalline-stoichiometric and amorphous apatite precipitation on dentine. Int Endod J 2017; 50 Suppl 2:e109-e119. [DOI: 10.1111/iej.12807] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/23/2017] [Indexed: 11/26/2022]
Affiliation(s)
- M. Toledano
- Department of Stomatology; Dental Materials Section; Faculty of Dentistry; University of Granada; Granada Spain
| | | | - F. S. Aguilera
- Department of Stomatology; Dental Materials Section; Faculty of Dentistry; University of Granada; Granada Spain
| | - E. Osorio
- Department of Stomatology; Dental Materials Section; Faculty of Dentistry; University of Granada; Granada Spain
| | - I. Cabello
- Department of Stomatology; Dental Materials Section; Faculty of Dentistry; University of Granada; Granada Spain
| | - M. Toledano-Osorio
- Department of Stomatology; Dental Materials Section; Faculty of Dentistry; University of Granada; Granada Spain
| | - R. Osorio
- Department of Stomatology; Dental Materials Section; Faculty of Dentistry; University of Granada; Granada Spain
| |
Collapse
|
20
|
Abstract
Er-YAG laser irradiation has been claimed to improve the adhesive properties of dentin. We tested the hypothesis that dentin adhesion is affected by Er-YAG laser conditioning. Superficial or deep dentin from human molars was: (a) acid-etched with 35% H3PO4; (b) irradiated with an Er-YAG laser (KaVo) at 2 Hz and 180 mJ, with water-cooling; and (c) laser- and acid-etched. Single Bond (3M ESPE) and Z100 composite (3M ESPE) were bonded to the prepared surfaces. After storage, specimens were tested in shear to failure. Bonded interfaces were demineralized in EDTA and processed for transmission electron microscopy. Two-way ANOVA revealed that conditioning treatment and interaction between treatment and dentin depth significantly influenced shear bond strength results. Acid-etching alone yielded shear bond strength values that were significantly higher than those achieved with laser ablation alone, or in combination with acid-etching. The Er-YAG laser created a laser-modified layer that adversely affects adhesion to dentin, so it does not constitute an alternative bonding strategy to conventional acid etching.
Collapse
Affiliation(s)
- L. Ceballos
- Department of Dental Materials, University of Granada, Granada, Spain
- Conservative Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China; and
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA, USA
| | - M. Toledano
- Department of Dental Materials, University of Granada, Granada, Spain
- Conservative Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China; and
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA, USA
| | - R. Osorio
- Department of Dental Materials, University of Granada, Granada, Spain
- Conservative Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China; and
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA, USA
| | - F.R. Tay
- Department of Dental Materials, University of Granada, Granada, Spain
- Conservative Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China; and
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA, USA
| | - G.W. Marshall
- Department of Dental Materials, University of Granada, Granada, Spain
- Conservative Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China; and
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA, USA
| |
Collapse
|
21
|
Abstract
Posterior reversible encephalopathy syndrome (PRES) is increasingly diagnosed in the emergency department, and medical and surgical intensive care units. PRES is characterized by acute onset of neurologic symptoms in the setting of blood pressure fluctuations, eclampsia, autoimmune disease, transplantation, renal failure, or exposure to immunosuppressive or cytotoxic drugs, triggers known to admit patients to the intensive care unit (ICU). Although the exact pathophysiology remains unknown, there is growing consensus that PRES results from endothelial dysfunction. Because of the heterogeneous nature of the disorder, it is probable that different mechanisms of endothelial injury are etiologically important in different clinical situations. The presence of bilateral vasogenic edema on brain imaging, particularly in parieto-occipital regions, is of great diagnostic utility but PRES remains a clinical diagnosis. Although largely reversible, PRES can result in irreversible neurologic injury and even death. The range of clinical and radiographic manifestations of the syndrome is probably broader than previously thought, and it is imperative that clinicians become familiar with the full spectrum of the disorder, as prompt recognition and elimination of an inciting factor improve outcome. PRES may be the most frequent toxic-metabolic encephalopathy seen in the ICU.
Collapse
Affiliation(s)
- M Toledano
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - J E Fugate
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
22
|
Osorio R, Sauro S, Watson TF, Toledano M. Polyaspartic acid enhances dentine remineralization bonded with a zinc-doped Portland-based resin cement. Int Endod J 2015; 49:874-883. [DOI: 10.1111/iej.12518] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/08/2015] [Indexed: 11/29/2022]
Affiliation(s)
- R. Osorio
- Dental Materials; School of Dentistry; University of Granada; Granada Spain
| | - S. Sauro
- Dental Biomaterials and Minimally Invasive Dentistry; Departamento de Odontología; Facultad de Ciencias de la Salud; CEU-Cardenal Herrera University; Valencia Spain
| | - T. F. Watson
- Biomaterials; Biomimetics & Biophotonics; King's College London Dental Institute at Guy's Hospital; London UK
| | - M. Toledano
- Dental Materials; School of Dentistry; University of Granada; Granada Spain
| |
Collapse
|
23
|
Osorio R, Osorio E, Medina-Castillo AL, Toledano M. Polymer nanocarriers for dentin adhesion. J Dent Res 2014; 93:1258-63. [PMID: 25227634 PMCID: PMC4462807 DOI: 10.1177/0022034514551608] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 07/23/2014] [Accepted: 08/22/2014] [Indexed: 01/07/2023] Open
Abstract
To obtain more durable adhesion to dentin, and to protect collagen fibrils of the dentin matrix from degradation, calcium- and phosphate-releasing particles have been incorporated into the dental adhesive procedure. The aim of the present study was to incorporate zinc-loaded polymeric nanocarriers into a dental adhesive system to facilitate inhibition of matrix metalloproteinases (MMPs)-mediated collagen degradation and to provide calcium ions for mineral deposition within the resin-dentin bonded interface. PolymP- N : Active nanoparticles (nanoMyP) were zinc-loaded through 30-minute ZnCl2 immersion and tested for bioactivity by means of 7 days' immersion in simulated body fluid solution (the Kokubo test). Zinc-loading and calcium phosphate depositions were examined by scanning and transmission electron microscopy, elemental analysis, and x-ray diffraction. Nanoparticles in ethanol solution infiltrated into phosphoric-acid-etched human dentin and Single Bond (3M/ESPE) were applied to determine whether the nanoparticles interfered with bonding. Debonded sticks were analyzed by scanning electron microscopy. A metalloproteinase collagen degradation assay was also performed in resin-infiltrated dentin with and without nanoparticles, measuring C-terminal telopeptide of type I collagen (ICTP) concentration in supernatants, after 4 wk of immersion in artificial saliva. Numerical data were analyzed by analysis of variance (ANOVA) and Student-Newman-Keuls multiple comparisons tests (p < .05). Nanoparticles were effectively zinc-loaded and were shown to have a chelating effect, retaining calcium regardless of zinc incorporation. Nanoparticles failed to infiltrate demineralized intertubular dentin and remained on top of the hybrid layer, without altering bond strength. Calcium and phosphorus were found covering nanoparticles at the hybrid layer, after 24 h. Nanoparticle application in etched dentin also reduced MMP-mediated collagen degradation. Tested nanoparticles may be incorporated into dental adhesive systems to provide the appropriate environment in which dentin MMP collagen degradation is inhibited and mineral growth can occur.
Collapse
Affiliation(s)
- R Osorio
- Dental School, University of Granada, Colegio Maximo, Campus de Cartuja s/n, 18017 Granada, Spain
| | - E Osorio
- Dental School, University of Granada, Colegio Maximo, Campus de Cartuja s/n, 18017 Granada, Spain
| | - A L Medina-Castillo
- NanoMyP, Spin-Off Enterprise from University of Granada, Edificio BIC-Granada, Av. Innovación 1, 18016 Armilla, Granada, Spain
| | - M Toledano
- Dental School, University of Granada, Colegio Maximo, Campus de Cartuja s/n, 18017 Granada, Spain
| |
Collapse
|
24
|
Canché-Escamilla G, Duarte-Aranda S, Toledano M. Synthesis and characterization of hybrid silica/PMMA nanoparticles and their use as filler in dental composites. Materials Science and Engineering: C 2014; 42:161-7. [DOI: 10.1016/j.msec.2014.05.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 04/23/2014] [Accepted: 05/13/2014] [Indexed: 10/25/2022]
|
25
|
Toledano M, Britton JW, McKeon A, Shin C, Lennon VA, Quek AML, So E, Worrell GA, Cascino GD, Klein CJ, Lagerlund TD, Wirrell EC, Nickels KC, Pittock SJ. Utility of an immunotherapy trial in evaluating patients with presumed autoimmune epilepsy. Neurology 2014; 82:1578-86. [PMID: 24706013 DOI: 10.1212/wnl.0000000000000383] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To evaluate a trial of immunotherapy as an aid to diagnosis in suspected autoimmune epilepsy. METHOD We reviewed the charts of 110 patients seen at our autoimmune neurology clinic with seizures as a chief complaint. Twenty-nine patients met the following inclusion criteria: (1) autoimmune epilepsy suspected based on the presence of ≥ 1 neural autoantibody (n = 23), personal or family history or physical stigmata of autoimmunity, and frequent or medically intractable seizures; and (2) initiated a 6- to 12-week trial of IV methylprednisolone (IVMP), IV immune globulin (IVIg), or both. Patients were defined as responders if there was a 50% or greater reduction in seizure frequency. RESULTS Eighteen patients (62%) responded, of whom 10 (34%) became seizure-free; 52% improved with the first agent. Of those receiving a second agent after not responding to the first, 43% improved. A favorable response correlated with shorter interval between symptom onset and treatment initiation (median 9.5 vs 22 months; p = 0.048). Responders included 14/16 (87.5%) patients with antibodies to plasma membrane antigens, 2/6 (33%) patients seropositive for glutamic acid decarboxylase 65 antibodies, and 2/6 (33%) patients without detectable antibodies. Of 13 responders followed for more than 6 months after initiating long-term oral immunosuppression, response was sustained in 11 (85%). CONCLUSIONS These retrospective findings justify consideration of a trial of immunotherapy in patients with suspected autoimmune epilepsy. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that in patients with suspected autoimmune epilepsy, IVMP, IVIg, or both improve seizure control.
Collapse
Affiliation(s)
- M Toledano
- From the Departments of Neurology (M.T., J.W.B., A.M., C.S., V.A.L., E.S., G.A.W., G.D.C., C.J.K., T.D.L., E.C.W., K.C.N., S.J.P.), Laboratory Medicine and Pathology (A.M., V.A.L., A.M.L.Q., C.J.K., S.J.P.), and Immunology (V.A.L.), Mayo Clinic, College of Medicine, Rochester, MN
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Osorio R, Osorio E, Cabello I, Toledano M. Zinc Induces Apatite and Scholzite Formation during Dentin Remineralization. Caries Res 2014; 48:276-90. [DOI: 10.1159/000356873] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 10/28/2013] [Indexed: 01/01/2023] Open
|
27
|
Toledano M, Aguilera F, Cabello I, Osorio R. Masticatory function induced subnanostructural changes at the resin–dentin interface. Dent Mater 2014. [DOI: 10.1016/j.dental.2014.08.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
28
|
Osorio R, Osorio E, Medina-Castillo A, Toledano M. Polymer nanocarriers as new fillers for dental adhesives. Dent Mater 2014. [DOI: 10.1016/j.dental.2014.08.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
29
|
Mestres G, Aguilera FS, Manzanares N, Sauro S, Osorio R, Toledano M, Ginebra MP. Magnesium phosphate cements for endodontic applications with improved long-term sealing ability. Int Endod J 2013; 47:127-39. [DOI: 10.1111/iej.12123] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 04/03/2013] [Indexed: 11/30/2022]
Affiliation(s)
- G. Mestres
- Biomaterials; Biomechanics and Tissue Engineering Group; Department of Materials Science and Metallurgy; Technical University of Catalonia; Barcelona Spain
- Biomedical Research Networking Center in Bioengineering; Biomaterials and Nanomedicine (CIBER-BBN); Barcelona Spain
| | - F. S. Aguilera
- Department of Dental Materials; School of Dentistry; University of Granada; Granada Spain
| | - N. Manzanares
- School of Dentistry; University of Barcelona; Barcelona Spain
| | - S. Sauro
- Department of Dental Materials; School of Dentistry; University of Granada; Granada Spain
- Biomaterials; Biomimetics and Biophotonics (B ); King's College London Dental Institute; Guy's Dental Hospital; London UK
| | - R. Osorio
- Department of Dental Materials; School of Dentistry; University of Granada; Granada Spain
| | - M. Toledano
- Department of Dental Materials; School of Dentistry; University of Granada; Granada Spain
| | - M. P. Ginebra
- Biomaterials; Biomechanics and Tissue Engineering Group; Department of Materials Science and Metallurgy; Technical University of Catalonia; Barcelona Spain
- Biomedical Research Networking Center in Bioengineering; Biomaterials and Nanomedicine (CIBER-BBN); Barcelona Spain
| |
Collapse
|
30
|
Darchis C, Caron S, Lacour A, Toledano M, Boulanger T, Tempremant F. Hirayama disease: An uncommon cause of distal upper extremity deficit. J Neuroradiol 2012; 39:176-80. [DOI: 10.1016/j.neurad.2011.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 04/22/2011] [Accepted: 05/02/2011] [Indexed: 11/25/2022]
|
31
|
Marmin C, Toledano M, Lemaire S, Boury S, Mordon S, Ernst O. Computed tomography of the parathyroids: the value of density measurements to distinguish between parathyroid adenomas of the lymph nodes and the thyroid parenchyma. Diagn Interv Imaging 2012; 93:597-603. [PMID: 22749201 DOI: 10.1016/j.diii.2012.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare the densities of parathyroid adenomas, lymph nodes and the thyroid parenchyma during multi-phase cervico-thoracic computed tomography to determine the differentiating threshold values. MATERIALS AND METHODS This study comprises 30 patients operated for a parathyroid adenoma after computed tomography without injection and then 45 and 70 seconds after the injection of an iodine based contrast product (350 mgI/mL, 150 mL, 3 mL/s). The density of the adenomas, lymph nodes and thyroid was measured during the three phases (D0, D45, D70). The relative enhancement (RE) at 45 seconds was calculated: RE=(D45-D0)/D0. RESULTS A significant difference was found in the spontaneous density of the parathyroid adenomas of the thyroid (P<0.01) with a threshold value of 75 HU. A significant difference is found in the enhancement after injection of the adenomas and lymph nodes (P<0.01). The adenomas present an enhancement peak at 45 seconds while the maximum enhancement of the lymph nodes is at 70 seconds. At 45 seconds, a threshold value of 114 HU and an RE 125% allows them to be distinguished (sensitivity and specificity 0.96). CONCLUSION Measurement of the densities can differentiate between the parathyroid adenomas, lymph nodes and thyroid.
Collapse
Affiliation(s)
- C Marmin
- Department of radiology, Hôpital Huriez, CHRU de Lille, 1 rue Polonovski, Lille, France
| | | | | | | | | | | |
Collapse
|
32
|
Grynberg M, Even M, Berwanger da Silva AL, Gallot V, Toledano M, Frydman R, Fanchin R. [Cancer, fertility preservation and gonadotropins]. ACTA ACUST UNITED AC 2012; 41:512-8. [PMID: 22633037 DOI: 10.1016/j.jgyn.2012.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 04/13/2012] [Accepted: 04/18/2012] [Indexed: 01/19/2023]
Abstract
The recent emergence of oncofertility raises the question of ovarian stimulation and its risks when performed for oocyte or/and embryo cryopreservation in a fertility preservation program. The relation between ovarian stimulation and cancer has been marked by the possible direct or indirect tumorigenic role for pituitary gonadotrophins in the tumorogenesis. Although the growth of many gonadal and extragonadal tumors is stimulated by gonadal sex hormones, whose production is regulated by gonadotrophins, there is still a lack of data to consider FSH and LH as tumor promoters. The purpose of this brief review is to present on one hand, the questions raised by the administration of exogenous gonadotrophins in cancer patients and on the other, to evaluate both experimental and clinical data about the possible relation between gonadotrophins and tumorogenesis.
Collapse
Affiliation(s)
- M Grynberg
- Université Paris-Sud, 92140 Clamart, France.
| | | | | | | | | | | | | |
Collapse
|
33
|
Huang J, Toledano M, Katz B, Lanzino G, Moseley B. Seeing Double: Intercavernous Sinus Dural Arteriovenous Fistula as a Rare Cause of Bilateral Abducens Palsy (P07.019). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
34
|
Toledano M, Smith J, Dhamija R, Jones L, Moseley B. Primary Angiitis of the Central Nervous System Presenting with Microhemorrhages on Gradient Echo Imaging (P07.042). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
35
|
Huang JF, Toledano M, Katz BS, Lanzino G, Moseley BD. Teaching neuroImages: Seeing double: intercavernous sinus dural arteriovenous fistula causing bilateral abducens palsy. Neurology 2012; 78:e95-6. [PMID: 22496395 DOI: 10.1212/wnl.0b013e31824f80a5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- J F Huang
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | |
Collapse
|
36
|
Badillo K, Prieto L, Toledano M, Guillen S, Alvarez A, García Bermejo I, Ramos Amador JT. [Characteristics of human immunodeficiency virus-1 infected children receiving highly active antiretroviral therapy: a cross-sectional study]. An Pediatr (Barc) 2012; 76:317-23. [PMID: 22326511 DOI: 10.1016/j.anpedi.2011.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 12/19/2011] [Accepted: 12/21/2011] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Since 1996, when HAART became available, there has been a change in the course of HIV-infection, leading it to become a chronic disease. Our aim was to describe the characteristics of the children followed up in our hospital. PATIENTS AND METHODS A cross-sectional study was conducted on 32 HIV-infected children followed up until December-2010, at the University-Hospital de Getafe. Clinical and laboratory information from the last visit was collected for the evaluation of patients. RESULTS Thirty-two children with HIV-1 were evaluated, 29 infected through vertical-transmission. The median age was 14 years. According to the CDC classification, 56% (18/32) of children were in category A, 28% (9/32) B and 16% (5/32) C. Immunological class was 3 in 75% of children, class 2 in 9% and class 1 in 16%. The median nadir of CD4 was 337 cells/ml (12%). The median current CD4 was 749 (31%). Only one adolescent had a CD4% below 200 cells/ml due to lack of adherence. Twenty-eight patients (87%) were receiving HAART, and 4 patients were off antiretroviral treatment. Among the patients treated, 26 (93%) had viral loads <200 copies/ml. The median viral-load was<20 copies/ml. Median time on antiretroviral treatment was 10 years. The combination more frequently used was two nucleoside reverse transcriptase inhibitors (NRTI) and one protease inhibitor (PI), that was given to 15 patients (47%), followed by 2 NRTI, and one non-nucleoside reverse transcriptase inhibitor (NNRTI) in 8 patients (29%). Two children received rescue therapy including raltegravir, one with tipranavir and the other with darunavir. A total of 12 patients (43%) received medication once a day, 7 of them with fixed-dose combinations in a single tablet (25%). There were metabolic complications, including hyperlipidaemia or lipodystrophy were observed in 17 children (53%). CONCLUSIONS Most of our patients are receiving HAART, with good virological and immunological control. The prevalence of metabolic abnormalities was high. Strategies to improve adherence and decrease toxicities are needed in perinatally-acquired HIV-infected children.
Collapse
Affiliation(s)
- K Badillo
- Servicio de Pediatría, Hospital Universitario de Getafe, Madrid, Spain.
| | | | | | | | | | | | | |
Collapse
|
37
|
Toledano M, Lamazou F, Gallot V, Frydman R, Fanchin R, Grynberg M. Les stimulations ovariennes modérées pour fécondation in vitro constituent-elles un réel progrès en assistance médicale à la procréation ? ACTA ACUST UNITED AC 2012; 41:6-13. [DOI: 10.1016/j.jgyn.2011.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2011] [Revised: 07/03/2011] [Accepted: 08/22/2011] [Indexed: 10/16/2022]
|
38
|
Toledano M, Yamauti M, Osorio E, Osorio R. Zinc-Inhibited MMP-Mediated Collagen Degradation after Different Dentine Demineralization Procedures. Caries Res 2012; 46:201-7. [DOI: 10.1159/000337315] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 02/01/2012] [Indexed: 12/25/2022] Open
|
39
|
Wang Z, Jiang T, Sauro S, Pashley DH, Toledano M, Osorio R, Liang S, Xing W, Sa Y, Wang Y. The dentine remineralization activity of a desensitizing bioactive glass-containing toothpaste: an in vitro study. Aust Dent J 2011; 56:372-81. [DOI: 10.1111/j.1834-7819.2011.01361.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
40
|
Toledano M, Mazzoni A, Monticelli F, Breschi L, Osorio E, Osorio R. ElectroBond application may improve wetting characteristics of etched dentine. J Dent 2011; 39:180-6. [DOI: 10.1016/j.jdent.2010.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 11/22/2010] [Accepted: 11/23/2010] [Indexed: 11/25/2022] Open
|
41
|
Toledano M, Yamauti M, Osorio E, Quintana M, Osorio R. Bleaching agents increase metalloproteinases mediated collagen degradation in dentin. Dent Mater 2011. [DOI: 10.1016/j.dental.2011.08.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
42
|
Castillo-de Oyague R, Osorio R, Lynch C, Gilmour A, Toledano M. Effect of alloy type and casting technique on the fracture strength of implant-cemented structures. Med Oral Patol Oral Cir Bucal 2011; 16:e619-25. [DOI: 10.4317/medoral.16.e619] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 07/05/2010] [Indexed: 11/05/2022] Open
|
43
|
Aguilera FS, Osorio E, Toledano M, Osorio R. Ultra-structure characterization of self-etching treated cementum surfaces. Med Oral Patol Oral Cir Bucal 2011; 16:e265-70. [DOI: 10.4317/medoral.16.e265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 06/25/2010] [Indexed: 11/05/2022] Open
|
44
|
Osorio R, Yamauti M, San Roman J, Osorio E, Toledano M. Zinc-doped dentin adhesives for collagen protection at the hybrid layer. Dent Mater 2011. [DOI: 10.1016/j.dental.2011.08.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
45
|
Osorio R, Yamauti M, Osorio E, Ruiz-Requena ME, Pashley DH, Tay FR, Toledano M. Zinc reduces collagen degradation in demineralized human dentin explants. J Dent 2010; 39:148-53. [PMID: 21108986 DOI: 10.1016/j.jdent.2010.11.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 10/22/2010] [Accepted: 11/16/2010] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Dentin matrix metalloproteinases are implicated in the pathogenesis of caries and contribute to collagen degradation in resin-dentin interfaces. The objective was to determine if collagen degradation may be modulated by an excess of zinc or zinc chelators. METHODS Mineralized and phosphoric acid demineralized human dentin specimens were tested. Chlorhexidine digluconate, doxycycline or ZnCl₂ were added to the media. In half of the groups, active exogenous metalloproteinase-2 was incorporated into the solution. C-terminal telopeptide determinations (radioimmunoassay) were performed after 24 h, 1 and 3 weeks. RESULTS Collagen degradation was prominent in demineralized dentin. Doxycycline fully blocked dentin proteolysis. Chlorhexidine digluconate reduced the degradation at the 24-h period. Zinc in excess strongly inhibits hydrolysis of collagen and its effect was maintained for 3 weeks. CONCLUSIONS Zinc in excess reduces MMP-mediated collagen degradation. The hypothesis that binding of zinc to collagen results in protection of sensitive cleavage sites of metalloproteinases requires further validation.
Collapse
Affiliation(s)
- R Osorio
- Department of Dental Materials, School of Dentistry, Campus de Cartuja s/n, University of Granada, E-18071 Granada, Spain.
| | | | | | | | | | | | | |
Collapse
|
46
|
Abstract
In ethanol wet bonding, water is replaced by ethanol to maintain dehydrated collagen matrices in an extended state to facilitate resin infiltration. Since short ethanol dehydration protocols may be ineffective, this study tested the null hypothesis that there are no differences in ethanol dehydration protocols for maintaining the surface roughness, fibril diameter, and interfibrillar spaces of acid-etched dentin. Polished human dentin surfaces were etched with phosphoric acid and water-rinsed. Tested protocols were: (1) water-rinse (control); (2) 100% ethanol-rinse (1-min); (3) 100% ethanol-rinse (5-min); and (4) progressive ethanol replacement (50-100%). Surface roughness, fibril diameter, and interfibrillar spaces were determined with atomic force microscopy and analyzed by one-way analysis of variance and the Student-Newman-Keuls test (α = 0.05). Dentin roughness and fibril diameter significantly decreased when 100% ethanol (1-5 min) was used for rinsing (p < 0.001). Absolute ethanol produced collapse and shrinkage of collagen fibrils. Ascending ethanol concentrations did not collapse the matrix and shrank the fibrils less than absolute ethanol-rinses.
Collapse
Affiliation(s)
- E Osorio
- Department of Dental Materials, School of Dentistry, University of Granada, Spain.
| | | | | | | | | |
Collapse
|
47
|
Toledano M, Osorio E, Aguilera FS, Gomes G, Perdigão J, Osorio R. Bond strength and nanoroughness assessment on human pretreated cementum surfaces. J Dent 2010; 38:678-85. [PMID: 20546826 DOI: 10.1016/j.jdent.2010.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 05/13/2010] [Accepted: 05/13/2010] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To determine the bond strength of seven adhesive systems to human cementum, and to assess the promoted surface roughness. METHODS Extracted human canines were used for the present study. The mesial surface from the cervical third of the roots were ground flat with wet 600-grit silicon carbide paper and bonded. Seven adhesive systems were employed: an etch-and-rinse adhesive (Single Bond), two two-step self-etching (Clearfil SE Bond and Resulcin Aquaprime) and four one-step self-etching (One-up Bond F, Prompt-L-Pop, Etch and Prime 3.0 and NRC+Prime&Bond NT). Composite build-ups were constructed and stored in a humid environment for 24h at 37 degrees C. Specimens were sectioned into 1mm(2) beams and tested for microtensile bond strength (MTBS). Additional surfaces were conditioned for atomic force microscopy (AFM) analysis. Results were analyzed with ANOVA and Student-Newman-Keuls tests (P<0.05). RESULTS Single Bond showed the highest MTBS values. No differences were found between Resulcin Aquaprime, One-up Bond and Prompt-L-Pop. Clearfil SE Bond, Etch and Prime and NRC+Prime&Bond NT obtained the lowest bond strength values. H(3)PO(4) acid treatment of cementum and Resulcin Aquaprime showed the highest nanoroughness parameters and One-up Bond the lowest. CONCLUSION The etch-and-rinse adhesive and the two-step self-etching adhesive with the lowest pH value promoted the highest bond strength to human cementum surfaces.
Collapse
Affiliation(s)
- M Toledano
- Department of Dental Materials, School of Dentistry, University of Granada, Avda Fuerzas Armadas 1, 1B, 18014 Granada, Spain.
| | | | | | | | | | | |
Collapse
|
48
|
Erhardt MC, Osorio R, Pisani-Proenca J, Aguilera FS, Osorio E, Breschi L, Toledano M. Effect of Double Layering and Prolonged Application Time on MTBS of Water/Ethanol-based Self-etch Adhesives to Dentin. Oper Dent 2009; 34:571-7. [DOI: 10.2341/08-060-l] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Problems related to the chemical formulation and/or chemical dispersion of hydrophilic/hydrophobic components in one-step self-etch adhesives limit their efficacy and are not easily solved by changing the different bonding application parameters.
Collapse
|
49
|
Casucci A, Mazzitelli C, Monticelli F, Osorio R, Toledano M, Ferrari M. Retention of self-adhesive cements on pre-treated epoxy-based fiber posts. Dent Mater 2009. [DOI: 10.1016/j.dental.2009.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
50
|
Monticelli F, Mazzitelli C, Casucci A, Osorio R, Toledano M, Ferrari M. Bond strengths of self-adhesive cements to fiber-reinforced posts. Dent Mater 2009. [DOI: 10.1016/j.dental.2009.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|