RESUMO
Parkinson's disease patients experience motor signs and non-motor symptoms caused by the disease. Deep brain stimulation of the Subthalamic Nucleus (STN) itself or its ventral or dorsal borders is one of the treatment options indicated to treat the refractory symptoms of this disease. However, it is still unknown which edge, when stimulated, generates more beneficial effects for these patients, which is the objective of this systematic review. To answer this question, electronic and manual searches were conducted in five databases and gray literature to identify studies that answered the question in this review. The selection of studies, data extraction, and analysis of the risk of bias of the included studies were performed. In total, seven studies were included in this systematic review. Most studies presented a minimal risk of bias, and their main methodological limitation was related to the sample inclusion criteria. Stimulation of the dorsal or ventral borders of the STN resulted in improved motor signs of Parkinson's disease, with some of the studies tending towards the choice of dorsal border stimulation for better motor effects, while the improvement in non-motor symptoms and inhibitory control was due to stimulation of the ventral border. The findings of this systematic review suggest that the improvement in the motor signs of Parkinson's disease can be brought about by stimulating the dorsal or ventral borders of the subthalamic nucleus, whereas non-motor symptoms such as anxiety improve with stimulation of the ventral border.
Pacientes com doença de Parkinson frequentemente experimentam sinais motores e sintomas não motores ocasionados pela doença. A estimulação cerebral profunda do Núcleo Subtalâmico (NST) ou de suas bordas ventral ou dorsal é uma das opções de tratamento indicada para tratar sintomas refratários dessa doença. No entanto, ainda não se sabe qual a borda que, ao ser estimulada, gera mais efeitos benéficos a esses pacientes, sendo esse o objetivo dessa revisão sistemática. Para responder essa questão foram realizadas buscas eletrônicas e manuais em cinco bancos de dados e na literatura cinzenta para identificar estudos que abordassem essa temática. Foram executados a seleção dos estudos, extração de dados e análise do risco de viés dos estudos incluídos. No total, sete artigos foram selecionados para comporem o estudo. A maioria dos estudos apresentou baixo risco de viés, sendo que a principal limitação metodológica deles se relacionou com os critérios de inclusão da amostra. A estimulação da borda dorsal ou ventral do NST resultou na melhora dos sinais motores da doença de Parkinson, com alguns dos estudos inclusos com tendência para a escolha da estimulação da borda dorsal para melhores efeitos motores, enquanto a melhora dos sintomas não motores e do controle inibitório foi devido à estimulação da borda ventral. Os achados sugerem que a melhora dos sinais motores da doença de Parkinson pode ser ocasionada ao estimular a borda dorsal ou ventral do Núcleo subtalâmico, enquanto os sintomas não motores, como a ansiedade, melhoram com a estimulação da borda ventral.
Assuntos
Doença de Parkinson/terapia , Núcleo Subtalâmico , Estimulação Encefálica Profunda , Estudos Transversais , Estudos Observacionais como AssuntoRESUMO
OBJECTIVES: The study aimed to assess the impact of diphenyliodonium hexafluorophosphate (DPI) on the physicochemical properties of experimental resin composites (ECRs) featuring reduced concentrations of camphorquinone (CQ)/amine. METHODS: Five concentrations of CQ (0.125, 0.25, 0.5, 0.75, and 1 mol%) with dimethylaminoethyl amine benzoate (EDAB) in a 1:2 mol% ratio (CQ:EDAB) were incorporated into a 50:50 mass% monomer blend of bisphenol glycidyl methacrylate (BisGMA) and triethyleneglycol dimethacrylate (TEGDMA). An additional 5 groups with the same CQ:EDAB concentrations had 0.5 mol% DPI added. Each resin group contained 60 wt% of 0.7 µm barium-alumino-silicate glass. Light transmission (n = 3), real-time degree of polymerization (n = 3), temperature change during polymerization (n = 5), polymerization shrinkage strain (n = 3), flexural strength, and modulus (n = 12), as well as water sorption and solubility (n = 5), were evaluated. Data were analyzed using two-way ANOVA and Tukey's post-hoc test (α = 0.05). RESULTS: Light transmission was reduced in groups containing 0.125 and 0.25 mol% of CQ without DPI. DPI increased temperature, degree and rate of polymerization, despite the reduction in CQ/amine concentration. Additionally, there was an increase in polymerization shrinkage strain, flexural strength and modulus, and a reduction in water sorption and solubility in ECRs with DPI, even with lower concentrations of CQ/EDAB. SIGNIFICANCE: DPI improved the assessed properties of composites across various concentrations of CQ/EDAB, showing the benefit of reducing the quantity of CQ used without compromising the properties and curing of the resin composites.
Assuntos
Resinas Compostas , Teste de Materiais , Polietilenoglicóis , Polimerização , Ácidos Polimetacrílicos , Terpenos , Resinas Compostas/química , Terpenos/química , Polietilenoglicóis/química , Ácidos Polimetacrílicos/química , Bis-Fenol A-Glicidil Metacrilato/química , Propriedades de Superfície , Oniocompostos/química , Poliuretanos/química , Resinas Acrílicas , Compostos de Bifenilo , Cânfora/análogos & derivadosRESUMO
STATEMENT OF THE PROBLEM: Biological complications of implant-supported prostheses remain a concern. Therefore, standardizing hygiene protocols to promote their maintenance is important. PURPOSE: The purpose of this scoping review was to identify available hygiene guidance for home care procedures, as well as periodicity and protocols for the professional maintenance of implant-supported prostheses. MATERIAL AND METHODS: This study was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the study protocol was made available at: https://osf.io/5jdeh/. The search was last performed in the PubMed database on March 15, 2022 and was undertaken by 2 independent researchers. Clinical studies and reviews that evaluated home care and maintenance protocols for dental implant-supported prostheses (fixed or removable), without language restriction or year of publication, were included. A descriptive analysis was performed considering study characteristics (study design, restorative assembly, maintenance strategies, eligibility criteria, number of included studies, quality/level of evidence, and main findings). RESULTS: The initial search yielded 3138 studies, of which 18 were included for descriptive analysis (6 critical reviews, 4 clinical trials, 3 systematic reviews, 2 guideline reports, 2 retrospective studies, and 1 transversal study). The main instrument recommended for home care was the use of a conventional toothbrush associated with triclosan-containing toothpaste in addition to interproximal aids (brushes or floss) for all types of restorations. The use of irrigation instruments was also frequently considered. For professional maintenance, almost all studies reported a positive effect of regular recalls every 3 months during the first year, followed by less regular recalls according to the motivation of the patient and home care efficacy. At each recall, the professional should evaluate the patient history, oral tissues, implant, abutments, and restorations, as well as perform professional cleaning of the prostheses with appropriate instruments so that the implants and abutments may be preserved. CONCLUSIONS: Establishing an adequate hygiene protocol is indispensable for implant-supported restorations. To do so, the professional must guide and support the patient's home care by taking into account the patient's motivation and efficacy during the hygiene procedures. Also, for professional maintenance, the periodicity of recalls should be constant and include an evaluation of the condition of the restoration and adjacent tissues, followed by professional cleaning of prostheses, implants, and abutments, in addition to new instructions to improve patient home care.
RESUMO
Anatomical and functional evidence suggests that the PFC is fairly unique among all cortical regions, as it not only receives input from, but also robustly projects back to mesopontine monoaminergic and cholinergic cell groups. Thus, the PFC is in position to exert a powerful top-down control over several state-setting modulatory transmitter systems that are critically involved in the domains of arousal, motivation, reward/aversion, working memory, mood regulation, and stress processing. Regarding this scenario, the origin of cortical afferents to the ventral tegmental area (VTA), laterodorsal tegmental nucleus (LDTg), and median raphe nucleus (MnR) was here compared in rats, using the retrograde tracer cholera toxin subunit b (CTb). CTb injections into VTA, LDTg, or MnR produced retrograde labeling in the cortical mantle, which was mostly confined to frontal polar, medial, orbital, and lateral PFC subdivisions, along with anterior- and mid-cingulate areas. Remarkably, in all of the three groups, retrograde labeling was densest in layer V pyramidal neurons of the infralimbic, prelimbic, medial/ventral orbital and frontal polar cortex. Moreover, a lambda-shaped region around the apex of the rostral pole of the nucleus accumbens stood out as heavily labeled, mainly after injections into the lateral VTA and LDTg. In general, retrograde PFC labeling was strongest following injections into MnR and weakest following injections into VTA. Altogether, our findings reveal a fairly similar set of prefrontal afferents to VTA, LDTg, and MnR, further supporting an eminent functional role of the PFC as a controller of major state-setting mesopontine modulatory transmitter systems.
Assuntos
Núcleos da Rafe , Área Tegmentar Ventral , Animais , Núcleo Accumbens , Córtex Pré-Frontal , Ratos , RecompensaRESUMO
OBJECTIVES: The aim of this study was to verify the match between 5 shades of composites from different manufacturers with a shade guide and among the systems using a portable spectrophotometer. MATERIALS AND METHODS: Shade measurements were performed on specimens of Z350 XT (3M ESPE), Charisma Diamond (Heraeus Kulzer GmbH), Esthet X-HD (Dentsply Caulk), and Empress Direct (Ivoclar-Vivadent) for shades A1, A2, A3, B1, and C3 using a Vita Easyshade spectrophotometer (Vita Zahnfabrik) against a white background. Corresponding shades of Vitapan Classical (Vita Zahnfabrik) guide were measured likewise and shade variation (ΔE) was calculated based on International Commission on Illumination L*a*b* parameters. The ΔE of the composites in each shade was compared by one-way analysis of variance and Tukey's post hoc test (α = 0.05). RESULTS: All composites presented ΔE > 3.7 compared with the shade guide. Variation in shades A3, B1, and C3 was significantly different for all composites. ΔE of Z350 XT was significantly lower for A1 than for the other shades, whereas ΔE of Z350 XT and Charisma Diamond were significantly lower for A2 than for the other shades. CONCLUSIONS: No composite shade matched with the shade guide. Equivalent shades of the restorative composite from different manufacturers may show clinically noticeable ΔE.
RESUMO
Objetivo: Várias fontes de luz têm sido utilizadas desde que os materiais fotoativados foram introduzidos na odontologia. Diodos emissores de luz (LEDs) se popularizaram como a principal opção para a polimerização dos materiais restauradores. O objetivo nessa revisão da literatura foi avaliar a influência das fontes de luz emitidas por diodo (LEDs) de segunda e terceira geração sobre a dureza de compósitos restauradores. Revisão de literatura: Nas bases de dados PubMed e Google Scholar foram pré-selecionados 239 artigos na língua inglesa entre os anos de 2010 e 2020, utilizando os termos: lightcuring, LED light sources, and dental LEDs. Dos 239 artigos inicialmente selecionados, 37 artigos foram avaliados devido aos critérios de inclusão/exclusão no estudo. Considerações finais: Vários estudos apontaram diferenças importantes na dureza dos compósitos restauradores testados, tanto na superfície de topo quanto na base. No entanto, essas diferenças estavam mais associadas a características como: estado de conservação do LED, irradiância, tempo de ativação, espectro de emissão dos aparelhos e sua compatibilidade ao fotoiniciador presente no compósito. Assim, podemos considerar que o monitoramento das condições do aparelho, e a escolha correta da fonte de luz de acordo com o compósito a ser utilizado são essenciais para maximizar a dureza dos compósitos restauradores, pois embora os aparelhos de terceira geração sejam preferencialmente indicados para compósitos com fotoiniciadores alternativos, os aparelhos que emitem luz azul apresentam vantagens quando o compósito é ativado apenas pela Canforoquinona.(AU)
Objective: Several light sources have been used since the light-curing materials were introduced in dentistry. Light-emitting diodes (LEDs) have become popular as the main option for the polymerization of restorative materials. This literature review aimed to evaluate the influence of second and third generation Light-emitting Diode (LEDs) sources on the hardness of restorative composites. Literature Review: In the PubMed and Google Scholar databases, 239 scientific papers in English were pre-selected between 2010 and 2020 using light-curing, LED light sources, and dental LEDs. After reading, 37 articles were selected to compose the review. Several studies have pointed out significant differences in the hardness of the tested restorative composites, both on the top and base surfaces. However, these differences were more associated with characteristics such as: LED conservation conditions, irradiance, curing time, the emission spectrum of the devices and their compatibility with the photoinitiator used in the composite. Final Considerations: Thus, it can be considered that monitoring the condition of the device and the correct choice of light sources according to the composite to be used is essential to maximize the hardness of the restorative composites, because although third-generation devices are preferably indicated for composites with alternative photoinitiators, devices that emit blue light have advantages when the composite is activated only by Camphorquinone.(AU)
Assuntos
Humanos , Resinas Compostas/química , Lâmpadas de Polimerização Dentária , Dureza , Materiais Dentários/química , Cura Luminosa de Adesivos Dentários/métodos , PolimerizaçãoRESUMO
The habenula (Hb) is a phylogenetically old epithalamic structure differentiated into two nuclear complexes, the medial (MHb) and lateral habenula (LHb). After decades of search for a great unifying function, interest in the Hb resurged when it was demonstrated that LHb plays a major role in the encoding of aversive stimuli ranging from noxious stimuli to the loss of predicted rewards. Consistent with a role as an anti-reward center, aberrant LHb activity has now been identified as a key factor in the pathogenesis of major depressive disorder. Moreover, both MHb and LHb emerged as new players in the reward circuitry by primarily mediating the aversive properties of distinct drugs of abuse. Anatomically, the Hb serves as a bridge that links basal forebrain structures with monoaminergic nuclei in the mid- and hindbrain. So far, research on Hb has focused on the role of the LHb in regulating midbrain dopamine release. However, LHb/MHb are also interconnected with the dorsal (DR) and median (MnR) raphe nucleus. Hence, it is conceivable that some of the habenular functions are at least partly mediated by the complex network that links MHb/LHb with pontomesencephalic monoaminergic nuclei. Here, we summarize research about the topography and transmitter phenotype of the reciprocal connections between the LHb and ventral tegmental area-nigra complex, as well as those between the LHb and DR/MnR. Indirect MHb outputs via interpeduncular nucleus to state-setting neuromodulatory networks will also be commented. Finally, we discuss the role of specific LHb-VTA and LHb/MHb-raphe circuits in anxiety and depression.
Assuntos
Transtorno Depressivo Maior , Habenula , Animais , Dopamina , Núcleos da Rafe , Ratos , Ratos WistarRESUMO
O objetivo do presente estudo foi revisar a literatura dos últimos cinco anos e identificar os índices de sobrevivência, principais causas de falha relatadas e verificar a confiabilidade dos laminados cerâmicos como tratamento estético e funcional em longo prazo. Métodos: foi realizada uma busca ativa na Biblioteca Nacional de Medicina dos Estados Unidos (pubmed.ncbi.nlm.nih.gov), através da base de dados Medline, dos últimos cinco anos (2015-2020) na língua inglesa, utilizando os descritores: Laminate Veneers, Porcelain Laminate Veneers e Ceramic Laminate Veneers, que resultou em 35 artigos. Após a leitura dos resumos, foram excluídos 9 estudos que utilizaram laminados cerâmicos não produzidos em cerâmicas feldspáticas, ou vidro ceramizados reforçados por cristais de leucita, ou dissilicato de lítio. Foram selecionados 26 artigos categorizados como: relatos de caso, estudos clínicos, estudos in vitro e revisões de literatura. Resultados: os estudos apontaram índices de sobrevivência de 100%, após 2 anos de cimentação, até valores superiores a 80%, após 14 anos. As três principais causas de falhas apontadas foram: desadaptação de marginal (37%), pigmentação das margens (30%) e fratura ou lascamento das restaurações (3%). Considerações finais: dentro das limitações do estudo, foi possível concluir que as principais causas de falha estão associadas às margens da restauração, no entanto, os laminados cerâmicos podem atingir índices elevados de sobrevivência mesmo 14 anos após a cimentação, mostrando um alto nível de confiabilidade. (AU)
The objective of the present study was to identify the survival rate and cause of failure of ceramic laminate veneers. Methods: An active search of the last five years (2015 2020) was carried out in the United States National Library of Medicine (pubmed.ncbi.nih.gov) the MEDLINE database, in English, using the descriptors: Laminate Veneers, Porcelain Laminate Veneers and Ceramic Laminate Veneers, which resulted in 35 papers. After reading the abstracts, 9 studies that evaluated ceramic laminates that were not produced using felspathic porcelain, leucite-reinforced glass-ceramicc, or lithium disilicate glass-ceramic were excluded. Twenty-six scientific papers were selected, categorized as: Case reports, clinical studies, in vitro studies and literature reviews. Result: The studies showed survival rates between 100% after two years of cementation up to values above 80% after 14 years. The three causes of failure identified were: marginal misfit (37%), pigmentation of the margins (30%), and fracture or chipping of the restorations (3%). Final Considerations: Within the limitations of this study, it was possible to conclude that the leading causes of failure are associated with the restoration's margins. However, ceramic laminates can achieve high survival rates even 14 years after cementation, showing a high-reliability level.(AU)
Assuntos
Humanos , Facetas Dentárias/tendências , Estética Dentária , Resultado do Tratamento , Falha de Restauração Dentária , Porcelana DentáriaRESUMO
The laterodorsal tegmental nucleus (LDTg) is a hindbrain cholinergic cell group thought to be involved in mechanisms of arousal and the control of midbrain dopamine cells. Nowadays, there is increasing evidence that LDTg is also engaged in mechanisms of anxiety/fear and promotion of emotional arousal under adverse conditions. Interestingly, LDTg appears to be connected with other regulators of aversive motivational states, including the lateral habenula (LHb), medial habenula (MHb), interpeduncular nucleus (IP), and median raphe nucleus (MnR). However, the circuitry between these structures has hitherto not been systematically investigated. Here, we placed injections of retrograde or anterograde tracers into LDTg, LHb, IP, and MnR. We also examined the transmitter phenotype of LDTg afferents to IP by combining retrograde tracing with immunofluorescence and in situ hybridization techniques. We found LHb inputs to LDTg mainly emerging from the medial division of the LHb (LHbM), which also receives axonal input from LDTg. The bidirectional connections between IP and LDTg displayed a lateralized organization, with LDTg inputs to IP being predominantly GABAergic or cholinergic and mainly directed to the contralateral IP. Moreover, we disclosed reciprocal LDTg connections with structures involved in the modulation of hippocampal theta rhythm including MnR, nucleus incertus, and supramammillary nucleus. Our findings indicate that the habenula is linked with LDTg either by direct reciprocal projections from/to LHbM or indirectly via the MHb-IP axis, supporting a functional role of LDTg in the regulation of aversive behaviors, and further characterizing LHb as a master controller of ascending brainstem state-setting modulatory projection systems.
Assuntos
Habenula/fisiologia , Núcleo Interpeduncular/fisiologia , Núcleos da Rafe/fisiologia , Rombencéfalo/fisiologia , Animais , Habenula/química , Núcleo Interpeduncular/química , Masculino , Vias Neurais/química , Vias Neurais/fisiologia , Técnicas de Rastreamento Neuroanatômico/métodos , Núcleos da Rafe/química , Ratos , Ratos Wistar , Rombencéfalo/químicaRESUMO
In the present study, a multistage route is proposed for the treatment of biodiesel industry wastewater (BWW) containing around 1000 mg L-1 of total organic carbon (TOC), 3500 mg L-1 of chemical oxygen demand (COD), and 1325 mg L-1 of oil and grease. Initially, BWW aerobic biodegradability was assessed via Zhan-Wellens biodegradability test to confirm the appropriate treatment route. Then, a hybrid moving bed bioreactor (MBBR) system was chosen as the first treatment stage. The hybrid MBBR achieved 69 and 68% removal of COD and TOC removals, respectively, and provided great conditions for biomass growth. The bacterial community present in the hybrid MBBR was investigated by PCR-DGGE and potential biodegraders were identified such as: members of Desulfuromonadales, Nocardioidaceae and Pseudomonadaceae. Since biodegradation in the hybrid MBBR alone was unable to meet quality requirements, advanced oxidation processes, such as Fenton and photo-Fenton, were optimized for application as additional treatment stages. Physicochemical properties and acute toxicity of BWW were analyzed after the multistage routes: hybrid MBBR + Fenton, hybrid MBBR + photo-Fenton and hybrid MBBR + UV-C254nm/H2O2. Hybrid MBBR + Fenton or photo-Fenton showed overall COD removal efficiencies greater than 95% and removed acute toxicity, thus being appropriate integrated routes for the treatment of real BWW. Graphical abstract á .