RESUMO
BACKGROUND: A systematic review with meta-analysis was conducted to assess the effect of adding potassium nitrate to carbamide peroxide gels on bleaching efficacy and on reducing the risk and intensity of tooth sensitivity. METHODS: PubMed, Scopus, Web of Science, LILACS, BBO, and Cochrane Library databases and the gray literature were searched. IADR abstracts, records of trials, dissertations and theses were also searched. The Cochrane Collaboration risk of bias tool was used to assess the quality of the studies. RESULTS: Six studies were included in the systematic review and most of them had unclear risk of bias for the key domains, and of these only five were included in the meta-analysis. The risk ratio (RR) for sensitivity was 0.93 (95% CI = 0.73 to 1.19, P = 0.56). The standardized mean difference for pain intensity was -0.10 (95% CI = -0.36 to 0.16, P = 0.45), and for colour change was 0.12 (95% CI = -0.22 to 0.46; P = 0.49). CONCLUSIONS: No significant differences were observed between the groups with and without addition of the desensitizer in the gel. The addition of potassium nitrate to carbamide peroxide gel did not reduce the risk and intensity of tooth sensitivity during at-home bleaching. Colour change was not influenced by the addition of potassium nitrate to the gel.
Assuntos
Sensibilidade da Dentina , Clareadores Dentários/efeitos adversos , Clareamento Dental/efeitos adversos , Peróxido de Carbamida , Géis , Humanos , Peróxido de Hidrogênio , Nitratos , Peróxidos , Compostos de Potássio , UreiaRESUMO
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial (hypopnea) or complete interruption (apnea) in breathing during sleep due to airway collapse in the pharyngeal region. OSA and its cardiovascular consequences have been widely explored in observational and prospective studies. Most evidence verifies the positive relationship between OSA and hypertension, coronary artery disease, atrial fibrillation, stroke and heart failure. However, more studies are needed to better assess the impact of OSA, and possible benefit of treatment with continuous positive airway pressure (CPAP) on dyslipidemia, type 2 diabetes, insulin resistance and cardiovascular mortality. The leading pathophysiological mechanisms involved in the changes triggered by OSA, include intermittent hypoxemia and re-oxygenation, arousals and changes in intrathoracic pressure. Hypertension is strongly related with activation of the sympathetic nervous system, stimulation of the renin-angiotensin-aldosterone system and impairment of endothelial function. The high prevalence of OSA in the general population, hypertensive patients and especially obese individuals and patients resistant to antihypertensive therapy, highlights the need for effective screening, diagnosis and treatment of OSA to decrease cardiovascular risk.
Assuntos
Hipertensão/etiologia , Apneia Obstrutiva do Sono/complicações , Humanos , Hipertensão/epidemiologia , Respiração com Pressão Positiva , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/terapiaRESUMO
Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial (hypopnea) or complete interruption (apnea) in breathing during sleep due to airway collapse in the pharyngeal region. OSA and its cardiovascular consequences have been widely explored in observational and prospective studies. Most evidence verifies the positive relationship between OSA and hypertension, coronary artery disease, atrial fibrillation, stroke and heart failure. However, more studies are needed to better assess the impact of OSA, and possible benefit of treatment with continuous positive airway pressure (CPAP) on dyslipidemia, type 2 diabetes, insulin resistance and cardiovascular mortality. The leading pathophysiological mechanisms involved in the changes triggered by OSA, include intermittent hypoxemia and re-oxygenation, arousals and changes in intrathoracic pressure. Hypertension is strongly related with activation of the sympathetic nervous system, stimulation of the reninangiotensinaldosterone system and impairment of endothelial function. The high prevalence of OSA in the general population, hypertensive patients and especially obese individuals and patients resistant to antihypertensive therapy, highlights the need for effective screening, diagnosis and treatment of OSA to decrease cardiovascular risk.
Assuntos
Apneia Obstrutiva do Sono , Doença da Artéria Coronariana , Doença das Coronárias , HipertensãoRESUMO
Leucocyte- and platelet-rich plasma (L-PRP) is an autogenous platelet concentrate enriched with leukocytes that releases various growth factors responsible for the proliferation, regulation, and differentiation of mesenchymal cells during wound healing. Since the bone and medullary tissue are contiguous and share the same origin, this study evaluated the effect of L-PRP on the repair of calvaria bone using histomorphometric analysis of the newly formed bone, and compared the results in the presence of osteocalcin (OC) and peroxisome proliferator-activated receptor gamma (PPAR-γ) detected by immunohistochemistry. Artificial circular bone defects (5mm diameter) were produced in the calvaria of 42 rats. The defects were treated with autograft, autograft combined with L-PRP, or without grafting material (sham). The animals were euthanized at 15 or 40 days postsurgery (n=7 in each group). Data obtained were analyzed by Student-Newman-Keuls test for histomorphometric and immunohistochemical interpretation. The development of bone matrix was significantly less in the defects treated with L-PRP, while the medullary area composed of fatty cells was larger. This coincided with the minor expression of OC and expressive presence of PPAR-γ. These results suggest that L-PRP may impair osteoneogenesis and alter the ratio of differentiation between bone matrix and fatty cells, increasing the medullary tissue.
Assuntos
Transplante Ósseo/métodos , Osteocalcina/metabolismo , Osteogênese/efeitos dos fármacos , PPAR gama/metabolismo , Plasma Rico em Plaquetas , Crânio/cirurgia , Animais , Matriz Óssea/transplante , Processamento de Imagem Assistida por Computador , Técnicas Imunoenzimáticas , Masculino , Ratos , Ratos Wistar , Transplante AutólogoRESUMO
Paradoxo da realidade econômica mundial, no qual a fome é um flagelo da sociedade, a obesidade ganha espaço na humanidade, atingindo cerca de 300 milhões de pessoas, sendo que cerca de 10% expressem a variedade mórbida (IMC > 40 kg/m²), tendo na cirurgia seu único tratamento efetivo. Os autores relatam a experiência e dificuldades na implantação do Serviço de Cirurgia Bariátrica da Faculdade de Medicina do ABC, bem como os resultados alcançados em 312 obesos mórbidos tratados. A opção cirúrgica foi a Gastroplastia Vertical com Banda e Reconstrução Intestinal em Y de Roux (GVYR) em 273 pacientes; colocação endoscópica de BIB em 33; derivação bileopancreática em 4 e banda gástrica ajustável em 2 pacientes. Cinco pacientes apresentaram obstrução anastomótica sendo reoperadas. Foram observados 7 casos de fístula no pósoperatório, sendo que três pacientes foram reoperados. Houve 4 óbitos (1,3%): uma paciente por infarto agudo do miocárdio; duas pacientes por tromboembolismo pulmonar e um óbito devido a sepsis por deiscência da linha de grampos, sendo a paciente idosa, diabética, hipertensa e cardiopata. Dentre os 308 pacientes restantes, a resposta a um questionário sobre a qualidade de vida, 293 afirmaram terem uma qualidade ótima/boa (95,1%) e 15 pacientes qualidade regular (4,9%). Após um ano de pós-operatório, 98,5% dos pacientes tiveram redução de peso superior a 40%. Destarte, conclui-se que, sendo a obesidade doença complexa e multifatorial, os serviços universitários, públicos e particulares devem compor equipe multidisciplinar que agirá integradamente na atenção ao obeso, individualizando suas características, tratamento e acompanhamento, ciente de suas particularidades e riscos.
Assuntos
Humanos , Obesidade Mórbida/cirurgiaRESUMO
Dual-cured cements have been studied in terms of the hardness or degree of conversion achieved with different curing modes. However, little emphasis is given to the influence of the curing method on other mechanical properties. This study investigated the flexural strength, flexural modulus and hardness of four proprietary resin cements. Materials tested were: Enforce and Variolink II (light-, self- and dual-cured), RelyX ARC (self- and dual-cured) and C & B (self-cured). Specimens were fractured using a three-point bending test. Pre-failure loads corresponding to specific displacements of the cross-head were used for flexural modulus calculation. Knoop hardness (KHN) was measured on fragments obtained after the flexural test. Tests were performed after 24 h storage at 37 degrees C. RelyX ARC dual-cured showed higher flexural strength than the other groups. RelyX ARC and Variolink II depended upon photo-activation to achieve higher hardness values. Enforce showed similar hardness for dual- and self-curing modes. No correlation was found between flexural strength and hardness, indicating that other factors besides the degree of cure (e.g. filler content and monomer type) affect the flexural strength of composites. No statistical difference was detected in the flexural modulus among the different groups.
Assuntos
Cimentos de Resina/química , Análise de Variância , Bis-Fenol A-Glicidil Metacrilato/química , Compostos de Boro/química , Resinas Compostas/química , Elasticidade , Dureza , Humanos , Luz , Teste de Materiais , Metacrilatos/química , Metilmetacrilatos/química , Maleabilidade , Polietilenoglicóis/química , Ácidos Polimetacrílicos/química , Estatística como Assunto , Estresse Mecânico , Propriedades de Superfície , Temperatura , Fatores de TempoRESUMO
PURPOSE: To determine the tensile bond strength of three filled and two unfilled adhesives applied to bovine dentin. MATERIALS AND METHODS: Fragments of the labial dentin of bovine incisors were embedded in PVC cylinders with self-cure acrylic resin, and ground flat using 200 grit and 600 grit sandpaper. The following adhesive systems were tested (n=10): Prime & Bond NT, Prime & Bond NT dual cure, Prime & Bond 2.1, OptiBond Solo and Single Bond. A 3 mm-diameter bonding surface was delimited using a perforated adhesive tape. After etching with 37% phosphoric acid and adhesive application, a resin-based composite truncated cone (TPH, shade A3) was built. Tensile test was performed after 24 hrs storage in distilled water at 37 degrees C. Failure mode was accessed using a x10 magnification stereomicroscope. RESULTS: Weibull statistical analysis revealed significant differences in the characteristic strength between Single Bond and Prime & Bond NT dual cure, and between Single Bond and Prime & Bond 2.1. The Weibull parameter (m) was statistically similar among the five groups. Single Bond and Prime & Bond NT showed areas of dentin cohesive failure in most of the specimens. For OptiBond Solo, Prime & Bond NT dual cure and Prime & Bond 2.1 failure was predominantly adhesive.
Assuntos
Colagem Dentária , Adesivos Dentinários/química , Dentina/ultraestrutura , Condicionamento Ácido do Dente , Adesividade , Animais , Bis-Fenol A-Glicidil Metacrilato/química , Bovinos , Resinas Compostas/química , Intervalos de Confiança , Adesivos Dentinários/classificação , Ácidos Fosfóricos/química , Ácidos Polimetacrílicos/química , Cimentos de Resina/química , Estatística como Assunto , Propriedades de Superfície , Temperatura , Resistência à Tração , Fatores de Tempo , Água/químicaRESUMO
The molecular weight and the electrofocusing profile of human amniotic membrane interferon (IFN-AM) were determined. When submitted to gel filtration, IFN-AM showed a single 26-28 kDa component; in polyacrylamide gel electrophoresis one component of 19,500. In electrofocusing, IFN-AM displayed a terogeneity was reduced by previous treatment of IFN-AM with neuraminidase. IFN-AMis a siaglycoprotein similarto human beta IFN in terms of antigenicity but different from it in electrofocusing profile
Assuntos
Humanos , Membranas Extraembrionárias/metabolismo , Interferons/química , Placenta/análise , Cromatografia em Gel , Eletroforese em Gel de Poliacrilamida , Focalização Isoelétrica , Peso MolecularRESUMO
1. The molecular weight and the electrofocusing profile of human amniotic membrane interferon (IFN-AM) were determined. 2. When submitted to gel filtration, IFN-AM showed a single 26-28 kDa component; in polyacrylamide gel electrophoresis one component of 19,500. 3. In electrofocusing, IFN-AM displayed a heterogeneous profile with 5 to 7 peaks, but different from human alpha or beta IFNs. This heterogeneity was reduced by previous treatment of IFN-AM with neuraminidase. 4. IFN-AM is a sialoglycoprotein similar to human beta IFN in terms of antigenicity but different from it in electrofocusing profile.