RESUMO
PURPOSE: The aim of this study was to evaluate the effects of a new irrigant solution on the post space cleaning and the adhesive resistance of fiber posts. METHODS AND MATERIALS: Eighty roots of bovine teeth were randomly allocated into eight groups (n=10 for each group). Evaluations were performed in two different time points for each irrigant. The irrigants included a control group with distilled water (DW), 2.5% NaOCl and 17% EDTA (SH), 1% peracetic acid (PA), and 5% boric acid and 1% citric acid (EX). The time points were 24 hours (I-immediate) and 6 months (D-delayed). The push-out test was performed using a universal testing machine with a 5 kN load cell operating at a crosshead speed of 0.5 mm/minute. The dentinal cementation system was analyzed using a laser confocal microscope (LSM5, Zeiss, Jena, Germany), and incidence of residue on radicular dentin was evaluated by scanning electron microscopy (SEM). The incidence of residue was evaluated by the Kruskal-Wallis test and push-out bond strength and dentin penetrability were evaluated via a one-way analysis of variance (ANOVA) and Tukey tests (α=0.05). RESULTS: The EX irrigation protocol demonstrated the lowest incidence of residue on the dentin surface (p<0.05), independently of the evaluated third. In the cervical and the middle post thirds, EXI, EXD, SHI, and SHD groups exhibited similar push-out bond strength values (p>0.05). EXI, EXD, PAI, and PAD exhibited the greatest dentinal penetrability of the cementation system in all the post thirds (p<0.05). CONCLUSIONS: A solution containing 5% boric acid and 1% citric acid can be a promising irrigant for radicular post space cleaning. It has adequate potential for cleaning the dentin surface without interfering with the adhesive interface between the dentin and the cementation system.
Assuntos
Colagem Dentária , Técnica para Retentor Intrarradicular , Animais , Ácidos Bóricos , Bovinos , Ácido Cítrico/análise , Ácido Cítrico/farmacologia , Colagem Dentária/métodos , Cimentos Dentários/uso terapêutico , Cavidade Pulpar , Dentina , Dissulfetos , Ácido Edético/química , Teste de Materiais , Ácido Peracético/análise , Ácido Peracético/farmacologia , Cimentos de Resina/química , Cimentos de Resina/uso terapêutico , Irrigantes do Canal Radicular/análise , Irrigantes do Canal Radicular/química , Irrigantes do Canal Radicular/uso terapêutico , Tionas , ÁguaRESUMO
INTRODUCTION AND AIM: Anastomosis leak occurs in 1-19% of colorrectal surgeries. Our objective was to present the first Mexican case series on colorrectal surgery using indocyanine green fluorescence angiography to evaluate perfusion prior to carrying out the anastomosis. MATERIALS AND METHODS: A retrospective, analytic, descriptive study was conducted. We studied the case records of consecutive patients that underwent colorrectal surgery with indocyanine green angiography performed by the same group of colorrectal surgeons. RESULTS: Twenty-one case records were reviewed. Eleven (52.3%) of the patients were women, mean patient age was 57 years (38-82), and mean body mass index was 25 kg/m2 (17-34). Fifteen (71.4%) patients were diagnosed with malignant disease. Indocyanine green angiography changed our therapeutic decision in three (14.2%) patients. Two colorrectal anastomoses (14.2%) were performed at fewer than 5 cm from the anal verge and 13 (61.9%) were performed at more than 5 cm from the anal verge. Three of the anastomoses were ileocolic (14.2%), two were coloanal (9.5%), and one was ileoanal (4.7%). There were six (28.5%) complications, no cases of anastomotic leak, and no complications associated with the use of indocyanine green. The mortality rate was 0%. CONCLUSION: The present case series is the first on colorrectal surgery conducted in Mexico using indocyanine green fluorescence angiography, with excellent results.
Assuntos
Cirurgia Colorretal , Verde de Indocianina , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Angiofluoresceinografia , Humanos , México , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
PURPOSE: SBRT (stereotactic body radiation therapy) is widely used as a curative treatment in tumoral lesions and has become a fundamental tool for the treatment of spine metastasis. In this study, we present survival and toxicity outcomes of spine SBRT after a 2-year follow-up. METHODS/PATIENTS: Data from spine SBRT treatments performed at our institution between March 2012 and February 2020 was collected. Medical records, including demographic, primary tumor, and treatment characteristics were reviewed. Patient follow-up included clinical evaluation, imaging, and blood tests. Toxicity was recorded according to CTCAE v4.0. RESULTS: We analyzed 73 consecutive spine SBRT treatments in 60 patients. 39.7% of the cases had primary breast cancer and 23.3% had prostate cancer. Most cases (87.7%) were treated with a single SBRT fraction of 16 Gy. Median follow-up was 26.1 months (range 1.7-78.6), and 1- and 2-year overall survival (OS) rates were 96.9% and 84.2%, respectively. Local control (LC) rates at 1- and 2-years were 76.3% and 70.6%, respectively. Multivariate analysis identified histology as a prognostic factor for both OS and LC. Patients who underwent spine SBRT 6 months after the spinal lesion diagnosis had LC at 2 years of 88%, vs 61.7% for those who underwent SBRT before this period. No grade III or higher toxicity was reported. The vertebral compression fracture (VCF) rate was 4.1%. CONCLUSION: Spine SBRT at our institution showed a 2-year LC of 70.6%, without G3 toxicities. Delaying SBRT at least 6 months to administer systemic treatment was related to an improvement in local control.
Assuntos
Radiocirurgia , Neoplasias da Coluna Vertebral/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiocirurgia/efeitos adversos , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/mortalidade , Neoplasias da Coluna Vertebral/secundário , Taxa de Sobrevida , Fatores de Tempo , Tempo para o Tratamento , Resultado do TratamentoRESUMO
OBJECTIVE: This study aimed to evaluate the effect of fiber post customization on the bond strength (24 hours and 6 months), resin cement thickness, and dentinal penetrability of Adper Scotchbond Multi-Purpose - RelyX ARC (AS-RA), RelyX U200 (R2), and Scotchbond Universal - RelyX Ultimate (SU-RU) cementation systems to root dentin from the cervical-, middle-, and apical-thirds of the post space. METHODS: One hundred twenty bovine incisors were endodontically treated. After post space preparation, the roots were divided into six groups, according to the luting protocols (AS-RA, R2, SU-RU) and the type of fiber post [noncustomized post (NC) and customized post (C)]. Customization procedures were peformed using a resin composite (Z350 XT). 24 hours (n=60) or 6 months later (n=60), specimens from the cervical-, middle-, and apical-thirds of the post space were submitted to cementation system thickness measurement, bond strength evaluation, and dentinal penetrability analysis with Confocal Laser Scanning Microscopy (CLSM). Failure mode was classified as adhesive, cohesive, or mixed. Data were submitted to ANOVA and Tukey tests (α=0.05). RESULTS: Cementation protocols with customized fiber posts presented the lowest cementation system thickness, regardless of the cementation system or post space-third (p<0.05), and the highest bond strength values (p<0.05), regardless of the third space (p>0.05), for both periods (24 hours or 6 months). The comparison of push-out bond strength values between 24 hours and 6 months showed a reduction in all groups for the cervical-third (p<0.05). For the middle-third, only noncustomized groups showed reduction (p<0.05). For the apical-third, no reduction was observed (p>0.05). CONCLUSIONS: Anatomical customization favored both the bond strength of cements to dentin and the dentinal penetrability, but with lower cementation system thickness, regardless of cement composition and adhesive strategy.
Assuntos
Colagem Dentária , Técnica para Retentor Intrarradicular , Animais , Bovinos , Cimentação/métodos , Cimentos Dentários/química , Dentina , Vidro , Teste de Materiais , Cimentos de Resina/química , Raiz DentáriaRESUMO
PURPOSE: The following PICO (Patient/Population, Intervention, Comparison, and Outcomes) question was proposed: "Are retention rates of composite resin restorations in noncarious cervical lesions (NCCLs) when using adhesives considered "gold standard" (OptiBond FL and Clearfil SE Bond) higher than those obtained with other adhesives brands"? METHODS: A search was performed in February 2019 (updated in November 2019) in the PubMed/MEDLINE, EMBASE, LILACS, BBO, Web of Science, Cochrane Library, Grey Literature, and IADR abstracts (1990-2018); unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (RCTs) conducted in NCCLs that compared either OptiBond FL or Clearfil SE Bond adhesive with other commercially available adhesives were included. The risk of bias (RoB) was applied by using the Cochrane Collaboration tool. A meta-analysis was performed for retention rates at different follow-up times using a random effects model for both the adhesives. Heterogeneity was assessed with the Cochran Q test and I2 statistics. Grading of Recommendations: Assessment, Development and Evaluation (GRADE) assessed the quality of evidence. RESULTS: After removal of duplicates and noneligible articles, 25 studies remained for qualitative synthesis, as one study was common to the two adhesives, of which 9 studies were used for the OptiBond FL meta-analysis and 14 for the Clearfil SE Bond meta-analysis. No significant differences were observed for retention rates in follow-up periods of 12-24 months (p=0.97), 36-48 months (p=0.72), or 108-156 months (p=0.73) for OptiBond FL; and for 12-24 months (p=0.10) and 36-48 months (p=0.17) for Clearfil SE Bond. A significant difference was only found for OptiBond FL at 60-96 months (p=0.02), but only three studies were included in this meta-analysis. CONCLUSIONS: The evidence from available RCTs conducted in NCCLs that compared OptiBond FL or Clearfil SE Bond does not support the widespread concept that these adhesives are better than any other competitive brands available in the dental market.
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Colagem Dentária , Restauração Dentária Permanente , Resinas Compostas/uso terapêutico , Cimentos Dentários/uso terapêutico , Adesivos Dentinários/uso terapêutico , Humanos , Cimentos de ResinaRESUMO
The contamination of estuaries by heavy metals from anthropogenic activities in the industrial, domestic, and agricultural sectors is a global concern. In this study, the Cr, Fe, and Mn levels in the suspended particulate matter (SPM) were analyzed in estuarine waters from Bahia Blanca Estuary, during 2014-2015. The values of particulate Cr ranged from 7.33 to 35.20 µg g-1, which could be associated to several anthropogenic sources. The positive correlations found between Cr and Chlorophyll-a, and Cr and particulate organic carbon (POC) suggest the strong influence of phytoplankton on the adsorption of this metal and on the increase of particulate Cr. Negative correlations were found between Cr and DO and between Cr and pH, which could indicate an increasing trend in the dissolved form of Cr. This study suggests that the physical-chemical characteristics of the water column as well as phytoplankton and POC dynamics influence the behavior of Cr in this estuary.
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Metais Pesados , Poluentes Químicos da Água , Argentina , Brasil , Cromo , Monitoramento Ambiental , Estuários , Sedimentos Geológicos , Metais Pesados/análise , Poluentes Químicos da Água/análiseRESUMO
Colorectal cancer is the second leading cause of cancer-related death worldwide. For metastatic colorectal cancer (mCRC) patients, it is recommended, as first-line treatment, chemotherapy (CT) based on doublet cytotoxic combinations of fluorouracil, leucovorin, and irinotecan (FOLFIRI) and fluorouracil, leucovorin, and oxaliplatin (FOLFOX). In addition to CT, biological (targeted agents) are indicated in the first-line treatment, unless contraindicated. In this context, most of mCRC patients are likely to progress and to change from first line to second line treatment when they develop resistance to first-line treatment options. It is in this second line setting where Aflibercept offers an alternative and effective therapeutic option, thought its specific mechanism of action for different patient's profile: RAS mutant, RAS wild-type (wt), BRAF mutant, potentially resectable and elderly patients. In this paper, a panel of experienced oncologists specialized in the management of mCRC experts have reviewed and selected scientific evidence focused on Aflibercept as an alternative treatment.