The aim of this retrospective study was to evaluate implant survival rates (ISRs) for implants placed in grafted sinuses where a membrane perforation occurred during augmentation using exclusively ...anorganic bovine bone (ABB) by means of clinical and radiographic examinations. Histologic information of five biopsy specimens taken from large membrane perforations is also presented.
Consecutive patients who underwent sinus augmentation procedures at a private practice Dental Institute between 2004 and 2013 were collected from a computer database. The following profiles were selected for data analysis: computed tomography prior to treatment; perforated membrane information according to size: not perforated, small (≤ 5 mm), medium (> 5 and < 10 mm), or large (≥ 10 mm); sinuses grafted exclusively with ABB and lateral window covered with a collagen membrane (CM); and implant survival after at least 2 years of functional loading placed in augmented sinuses. Implants were considered survivals in the absence of infection, mobility, or pain.
The sample in this retrospective study comprised 531 patients; 214 required bilateral sinus augmentation, and 317 required unilateral sinus augmentation (total = 745 sinuses). A total of 1,588 implants were placed. From 745 augmented sinuses, 237 (31.8%; 523 implants) were perforated during the procedure. Among these, 48 perforations were large (20.2%; 107 implants), 67 (28.3%; 150 implants) were medium, and 122 were small (51.5%; 266 implants). Of 523 implants placed in perforated sinuses, 15 were lost (ISR = 97.1%). Comparison of the ISRs for small (97.7%), medium (97.3%), and large (95.3%) perforations with 1,065 implants placed in nonperforated sinuses (ISR = 97.7%) was not statistically significant. The histomorphometric analysis of the five biopsy specimens showed 24.52% ± 6.99% of new bone, 24.32% ± 6.42% of marrow space, and 51.2% ± 3.75% of the remaining ABB.
The difference in ISR for implants placed in perforated and nonperforated sinuses was not statistically significant. Within the limits of the histologic data, histomorphometric results with 24.52% ± 6.99% of new bone formation in sinuses with large perforations showed similar bone formation compatible with nonperforated sinuses described in the literature. The authors attributed the high ISR shown in perforated sinuses in this study to the proper management of the perforations.
The use of medicinal plants and their derivatives is increasing, and approximately one-third of all traditional herbal medicines are intended for wound treatment. Natural products used in these ...treatments include vegetable oils, which are rich in essential fatty acids. Once in contact with an ulcerative surface, the oil reaches the blood and lymphatic vessels, thus eliciting systemic effects.
This study evaluated the local and possible systemic effects of essential fatty acids (sunflower oil) applied topically to rat wounds.
Cutaneous punch wounds (6 mm) were produced on the dorsa of 30 rats. Saline (SS), mineral oil (MO) or essential fatty acid (EFA) solutions were applied topically. Healing was evaluated after 2, 4 and 10 days (n = 5 per group) by visual and histological/morphometric examination, second harmonic generation (SHG) microscopy, and cytokine and growth factor quantification in the scar tissue (real-time PCR) and in serum (ELISA).
MO/EFA-treated animals had higher IGF-1, leptin, IL-6 and IFN-γ mRNA expression and lower serum IL-6 levels than the control (SS/MO) animals. SHG analysis showed no difference in collagen density between the animals treated with MO and EFA.
EFA treatment induces topical (observed by local IGF-1, leptin, IL-6 and IFN-γ production) and systemic effects, lowering IL-6 levels in the serum. As the oil is widely used to shorten ulcer healing time, studies are needed to evaluate the treatment safety and possible undesired effects.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objectives
To evaluate graft remodelling according to the distance from the native bone in maxillary sinuses grafted with anorganic bovine bone (ABB).
Material and methods
Bilateral sinus grafting ...was performed in twenty patients with residual bone height <5 mm before implant placement. After 8 months, biopsy samples were harvested, and histomorphometric analysis was performed to examine bone formation according to the distance (in mm) from the native bone (sinus floor). In the grafted area, the percentages of new bone (NB), residual graft material (rABB), and soft tissue (ST) were evaluated.
Results
A total of 103 biopsy samples were evaluated, and the percentages of NB, rABB, and ST were 31.62 ± 9.85%, 18.94 ± 7.88%, and 49.41 ± 9.52%, respectively, in the 1st mm; 27.15 ± 9.83%, 23.33 ± 9.45%, and 49.53 ± 11.73%, respectively, in the 2nd mm; 23.61 ± 13.02%, 21.35 ± 11.08%, and 55.03 ± 16.14%, respectively, in the 3rd mm; and 21.67 ± 12.29%, 19.67 ± 10.28%, and 58.66 ± 12.46%, respectively, in the 4th mm. The 1st millimetre of the grafted area (closer to the native bone) presented a larger amount of NB than the other portions of the grafted areas and a smaller amount of rABB than the 2nd mm of the grafted area (p < .05). The amount of ST was larger in the 3rd and 4th mm of the grafted area than in the first 2 millimetres (p < .05).
Conclusion
The distance from the native bone influences bone formation following maxillary sinus augmentation
Copernicia prunifera (Miller) H. E. Moore is a palm tree native to Brazil. The products obtained from its leaf extracts are a source of income for local families and the agroindustry. Owing to the ...reduction of natural habitats and the absence of a sustainable management plan, the maintenance of the natural populations of this palm tree has been compromised. Therefore, this study aimed to evaluate the diversity and genetic structure of 14 C. prunifera populations using single nucleotide polymorphisms (SNPs) identified through genotyping-by-sequencing (GBS) to provide information that contributes to the conservation of this species. A total of 1,013 SNP markers were identified, of which 84 loci showed outlier behavior and may reflect responses to natural selection. Overall, the level of genomic diversity was compatible with the biological aspects of this species. The inbreeding coefficient (f) was negative for all populations, indicating excess heterozygotes. Most genetic variations occurred within populations (77.26%), and a positive correlation existed between genetic and geographic distances. The population structure evaluated through discriminant analysis of principal components (DAPC) revealed low genetic differentiation between populations. The results highlight the need for efforts to conserve C. prunifera as well as its distribution range to preserve its global genetic diversity and evolutionary potential.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Implant-retained custom-milled framework enhances the stability of palatal obturator prostheses. Therefore, to evaluate the mechanical response of implant-retained obturator prostheses with bar-clip ...attachment and milled bars, in three different materials under two load incidences were simulated. A maxilla model which Type IIb maxillary defect received five external hexagon implants (4.1 x 10 mm). An implant-supported palatal obturator prosthesis was simulated in three different materials: polyetheretherketone (PEEK), titanium (Ti:90%, Al:6%, V:4%) and Co-Cr (Co:60.6%, Cr:31.5%, Mo:6%) alloys. The model was imported into the analysis software and divided into a mesh composed of nodes and tetrahedral elements. Each material was assumed isotropic, elastic and homogeneous and all contacts were considered ideal. The bone was fixed and the load was applied in two different regions for each material: at the palatal face (cingulum area) of the central incisors (100 N magnitude at 45°); and at the occlusal surface of the first left molar (150 N magnitude normal to the surface). The microstrain and von-Mises stress were selected as criteria for analysis. The posterior load showed a higher strain concentration in the posterior peri-implant tissue, near the load application side for cortical and cancellous bone, regardless the simulated material. The anterior load showed a lower strain concentration with reduced magnitude and more implants involving in the load dissipation. The stress peak was calculated during posterior loading, which 77.7 MPa in the prosthetic screws and 2,686 με microstrain in the cortical bone. For bone tissue and bar, the material stiffness was inversely proportional to the calculated microstrain and stress. However, for the prosthetic screws and implants the PEEK showed higher stress concentration than the other materials. PEEK showed a promising behavior for the bone tissue and for the integrity of the bar and bar-clip attachments. However, the stress concentration in the prosthetic screws may represent an increase in failure risk. The use of Co-Cr alloy can reduce the stress in the prosthetic screw; however, it increases the bone strain; while the Titanium showed an intermediate behavior.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
It is estimated that atrial fibrillation (AF) affects approximately 1.5 million people in Brazil; however, epidemiological data are limited. We sought to evaluate the characteristics, treatment ...patterns, and clinical outcomes in patients with AF in Brazil by creating the first nationwide prospective registry.
RECALL was a multicenter, prospective registry that included and followed for 1 year 4,585 patients with AF at 89 sites across Brazil from April 2012 to August 2019. Patient characteristics, concomitant medication use, and clinical outcomes were analyzed using descriptive statistics and multivariable models.
Of 4,585 patients enrolled, the median age was 70 (61, 78) years, 46% were women, and 53.8% had permanent AF. Only 4.4% of patients had a history of previous AF ablation and 25.2% had a previous cardioversion. The mean (SD) CHA2DS2-VASc score was 3.2 (1.6); median HAS-BLED score was 2 (2, 3). At baseline, 22% were not on anticoagulants. Of those taking anticoagulants, 62.6% were taking vitamin K antagonists and 37.4% were taking direct oral anticoagulants. The primary reasons for not using an oral anticoagulant were physician judgment (24.6%) and difficulty in controlling (14.7%) or performing (9.9%) INR. Mean (SD) TTR for the study period was 49.5% (27.5). During follow-up, the use of anticoagulants and INR in the therapeutic range increased to 87.1% and 59.1%, respectively. The rates/100 patient-years of death, hospitalization due to AF, AF ablation, cardioversion, stroke, systemic embolism, and major bleeding were 5.76 (5.12-6.47), 15.8 (14.6-17.0), 5.0 (4.4-5.7), 1.8 (1.4-2.2), 2.77 (2.32-3.32), 1.01 (0.75-1.36), and 2.21 (1.81-2.70). Older age, permanent AF, New York Heart Association class III/IV, chronic kidney disease, peripheral arterial disease, stroke, chronic obstructive pulmonary disease, and dementia were independently associated with increased mortality while the use of anticoagulant was associated with lower risk of death.
RECALL represents the largest prospective registry of patients with AF in Latin America. Our findings highlight important gaps in treatment, which can inform clinical practice and guide future interventions to improve the care of these patients.
O abortamento é definido, pela Organização Mundial da Saúde, como a interrupção da gravidez antes da viabilidade fetal. Apesar de uma definição clara, o abortamento ou aborto aparece como uma questão ...de relevância bioética com diversas controvérsias muito discutida na “bioética de situações persistentes”. Este artigo tem por objetivo avaliar a opinião de acadêmicos de medicina de universidades públicas e privadas a respeito do abortamento, descriminalização e dos deveres do médico diante de uma situação de aborto provocado. Foram incluídas nesta pesquisa respostas de acadêmicos de Medicina (n=110) a questionário estruturado autoaplicado a respeito da descriminalização do abortamento. Os resultados demonstraram que a maioria dos alunos (89%) é favorável à descriminalização do aborto em várias situações, incluindo casos em que a lei brasileira ainda não permite o abortamento, como em caso de malformações compatíveis com a vida e alterações cromossômicas. Além disso, os alunos defendem que os principais responsáveis pela decisão sobre a realização do aborto sejam os dois progenitores. Discussões a respeito das implicações bioéticas do aborto e os direitos e deveres do médico nesse contexto são fundamentais, haja vista a ignorância que ainda existe sobre esse assunto.
Objective
To evaluate the influence of the posterior residual bone height and sinus width on the outcome of maxillary sinus bone augmentation using anorganic bovine bone.
Material and methods
...Bilateral sinus bone augmentation was performed using anorganic bovine bone in 20 patients with residual bone height <2 mm in at least one site on each side. Trephine samples were removed at the implant insertion site 8 months after the grafting procedure, and histological and histomorphometric analyses were performed to examine the relative amount (%) of new bone, anorganic bovine bone, and soft tissue in the grafted area. Based on cone beam computed tomography evaluation, the sites of implant insertion were classified according to sinus width into narrow, average, and wide, and according to residual bone height into ≤2 and >2 mm.
Results
A total of 146 implants were installed and 103 biopsies were evaluated. New bone formation in sites classified as narrow (69 sites), average (19 sites), and wide (15 sites) was 28.5% ± 9.24, 28.9% ± 8.61, and 30.3% ± 7.80, respectively. The mean posterior maxillary residual bone height was 4.0 ± 2.43 mm, and 26 and 77 sites were classified as ≤2 and >2 mm, respectively. New bone formation was 26.2% ± 9.10 and 29.8% ± 8.67 for residual bone height ≤2 and >2 mm, respectively. The differences were non‐significant.
Conclusions
Within the limitations of the present study, posterior residual bone height and sinus width were not factors with influence on new bone formation in sinuses grafted exclusively with anorganic bovine bone after 8 months of healing.
Although cancer patients experience distressing symptoms and health-related changes in their quality of life, they may report positive emotional states. The lives of informal caregivers of cancer ...patients may also be affected by the patient's cancer diagnosis; however, they may also find benefits in their experiences. Noticeable changes are reported in personal priorities after an oncologic diagnosis that can lead individuals to restructure their values and the way they perceive life. This study aims to assess happiness/satisfaction with life and positive and negative affect in cancer patients and informal caregivers compared with healthy people in the general population.
A cross-sectional study with participants recruited online in five regions of Brazil through the social network site Facebook® and the application WhatsApp®. Surveys were completed using the SurveyMonkey® platform. A different sample of cancer patients and informal caregivers that was personally interviewed with the same forms was also grouped in the present analysis. Variables with p-values < 0.05 in the univariate analysis were included in linear regression models (stepwise, backward).
A total of 2580 participants were included, of whom 2112 were healthy representatives of the general population, 342 were cancer patients, and 126 were informal caregivers of cancer patients. In the multivariate analysis, the cancer patients and informal caregivers were happier than the healthy people in the general population, even after controlling for age, sex, educational level, and income. The patients and caregivers had lower scores for positive affect and higher scores for negative affect.
Overall, the conditions related to happiness, satisfaction with life and positive affect are similar for all groups. However, cancer patients and informal caregivers report increased rates of happiness and satisfaction with life compared with theoretically healthy people, although they have lower positive affect scores and higher negative affect scores. It is suggested that cancer patients and caregivers of cancer patients experience more difficulties (suffering) on a daily basis. However, given the increased difficulties, they perceive life differently, reporting that they are happier.
Background
The novel coronavirus disease 2019 (COVID-19) presents with complex pathophysiological effects in various organ systems. Following the COVID-19, there are shifts in biomarker and cytokine ...equilibrium associated with altered physiological processes arising from viral damage or aggressive immunological response. We hypothesized that high daily dose methylprednisolone improved the injury biomarkers and serum cytokine profiles in COVID-19 patients.
Methods
Injury biomarker and cytokine analysis was performed on 50 SARS-Cov-2 negative controls and 101 hospitalized severe COVID-19 patients: 49 methylprednisolone-treated (MP group) and 52 placebo-treated serum samples. Samples from the treated groups collected on days D1 (pre-treatment) all the groups, D7 (2 days after ending therapy) and D14 were analyzed. Luminex assay quantified the biomarkers HMGB1, FABP3, myoglobin, troponin I and NTproBNP. Immune mediators (CXCL8, CCL2, CXCL9, CXCL10, TNF, IFN-γ, IL-17A, IL-12p70, IL-10, IL-6, IL-4, IL-2, and IL-1β) were quantified using cytometric bead array.
Results
At pretreatment, the two treatment groups were comparable demographically. At pre-treatment (D1), injury biomarkers (HMGB1, TnI, myoglobin and FABP3) were distinctly elevated. At D7, HMGB1 was significantly higher in the MP group (p=0.0448) compared to the placebo group, while HMGB1 in the placebo group diminished significantly by D14 (p=0.0115). Compared to healthy control samples, several immune mediators (IL-17A, IL-6, IL-10, MIG, MCP-1, and IP-10) were considerably elevated at baseline (all p≤0.05). At D7, MIG and IP-10 of the MP-group were significantly lower than in the placebo-group (p=0.0431, p=0.0069, respectively). Longitudinally, IL-2 (MP-group) and IL-17A (placebo-group) had increased significantly by D14. In placebo group, IL-2 and IL-17A continuously increased, as IL-12p70, IL-10 and IP-10 steadily decreased during follow-up. The MP treated group had IL-2, IFN-γ, IL-17A and IL-12p70 progressively increase while IL-1β and IL-10 gradually decreased towards D14. Moderate to strong positive correlations between chemokines and cytokines were observed on D7 and D14.
Conclusion
These findings suggest MP treatment could ameliorate levels of myoglobin and FABP3, but appeared to have no impact on HMGB1, TnI and NTproBNP. In addition, methylprednisolone relieves the COVID-19 induced inflammatory response by diminishing MIG and IP-10 levels. Overall, corticosteroid (methylprednisolone) use in COVID-19 management influences the immunological molecule and injury biomarker profile in COVID-19 patients.
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