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INTRODUCTION: In cardiorenal syndrome type 1 (CRS1), vascular congestion is central to the pathophysiology of heart failure and thus a key target for management. The venous evaluation by ultrasound (VExUS) system could guide decongestion effectively and thereby improve outcomes. METHODS: In this randomized clinical trial, patients with CRS1 (i.e., increase in creatinine ≥0.3 mg/dL) were randomized to guide decongestion with VExUS compared to usual clinical evaluation. The primary endpoint was to assess kidney function recovery (KFR), and the key secondary endpoint was decongestion evaluated by physical examination and changes in brain natriuretic peptide (BNP) and CA-125. Exploratory endpoints included days of hospitalization and mortality. RESULTS: From March 2022 to February 2023, a total of 140 patients were randomized 1:1 (70 in the VExUS and 70 in the control group). KFR was not statistically different between groups. However, VExUS improved more than twice the odds to achieve decongestion (odds ratio [OR]: 2.6, 95% CI: 1.9-3.0, p = 0.01) and the odds to reach a decrease of BNP >30% (OR: 2.4, 95% CI: 1.3-4.1, p = 0.01). The survival at 90 days, recongestion, and CA-125 were similar between groups. CONCLUSION: In patients with CRS1, we observed that VExUS-guided decongestion did not improve the probability of KFR but improved the odds to achieve decongestion.
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Síndrome Cardiorrenal , Insuficiência Cardíaca , Humanos , Diuréticos , Recuperação de Função Fisiológica , Rim/diagnóstico por imagem , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/diagnóstico , Peptídeo Natriurético EncefálicoRESUMO
Activated carbon cloths (ACCs) were used as biofilms supports in the anaerobic biotransformation of 4-nitrophenol (4NP). As received ACC material (AW) was oxidized with HNO3 (OX) and then functionalized with anthraquinone-2,6-disulfonate (AQ). The three ACCs were packed in hybrid UASB reactors and seeded with anaerobic granular sludge for biotransformation experiments. The results indicated that ACC-packed bioreactors improved the biotransformation of 4NP by twofold as compared to the control reactor without support materials. However, the biotransformation effciency of AW, OX and AQ was very similar (59%), indicating the role of ACC as biofilm support and not as redox mediator. After 4NP biotransformation several physicochemical and biological changes were observed like (1) the point of zero charge (pHPZC) shift from acidic values (AW = 5.0, OX = 3.4, AQ = 3.1) to neutral values (pHPZC = 7.6 on average), (2) increase in the concentration of acidic and basic surface functional groups over ACC materials and the amount of supported biomass on ACCs due to biofilm formation, and (3) enrichment of exoelectrogenic microorganisms belonging to the genera Geobacter over carbonyl-rich ACC surface as revealed by 16S rRNA amplicon sequencing. Overall, the results suggest that chemical modifications of ACCs changed the microbial composition of the biofilm, but the higher concentration of carbonyl groups on ACC did not affect the biotransformation of 4NP.
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Reatores Biológicos , Carvão Vegetal , Biodegradação Ambiental , Biofilmes , Biotransformação , Nitrofenóis , RNA Ribossômico 16S , Esgotos , Eliminação de Resíduos LíquidosRESUMO
BACKGROUND: Neuromuscular impairment makes individuals with cerebral palsy (CP) more prone to drooling. Among the treatment options, there are procedures that interfere with saliva production. It is imperative to evaluate the effect of the different modalities since the reduction in salivary flow rate/production may exacerbate the risk of dental caries. MATERIAL AND METHODS: The aim of this study was to compare the effects of different treatments for drooling on caries risk and salivary parameters in children and adolescents with CP. STUDY DESIGN: A total of 142 children and adolescents with CP, aged 6 to 18 years, were assigned to groups based on the different treatments they had received for drooling: G1-anticholinergic drugs (n = 18), G2-botulinum toxin injection (n = 16), G3-salivary glands surgery (n = 16), G4-no treatment (n = 42), and G5-non-drooling subjects (n = 50). All participants were evaluated on the Simplified Oral Hygiene Index, and for the prevalence of dental caries (decayed, missing, and filled teeth index and white spot lesions). Unstimulated whole saliva was collected, and salivary flow rate and osmolality were measured. Chi-square, ANOVA and Poisson regression were calculated. Prevalence ratios and their respective 95 % confidence intervals were obtained. The significance level was fixed at 5%. RESULTS: No differences were found in the decayed, missing, and filled teeth index (p = 0.128) and Simplified Oral Hygiene Index (p = 0.674) among the different groups. G3 presented significantly higher percentages of WSL (p < 0.001), lower values of salivary flow rate (p < 0.001), and higher values of osmolality (p < 0.001). The white spot lesion prevalence ratio was higher only for G3 (Prevalence ratio = 14.36; IC 95% = 4.64-44.40; p < 0.001). CONCLUSIONS: Children and adolescents with CP who had received surgical treatment for drooling exhibited higher number of white spot lesions because of the reduced salivary flow rate and higher salivary osmolality.
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Paralisia Cerebral/complicações , Cárie Dentária/epidemiologia , Sialorreia/complicações , Sialorreia/terapia , Adolescente , Toxinas Botulínicas/uso terapêutico , Brasil , Criança , Antagonistas Colinérgicos/uso terapêutico , Estudos Transversais , Índice CPO , Feminino , Humanos , Masculino , Higiene Bucal , Concentração Osmolar , Prevalência , Análise de Regressão , Saliva , Glândulas Salivares/cirurgia , Sialorreia/cirurgiaRESUMO
Case Report. A nine-year-old patient with a diagnosis of tuberous sclerosis (with no pathological record) that showed calcifications at the brain level. Besides, the case showed the Vogt triad (epilepsy, mental retardation, and sebaceous adenoma). The patient clinically showed a volume increase of hard consistency, without suppuration and no sessile that included the following teeth 73, 74, and 75. Cone beam computed tomography (CBCT) was obtained, and it displayed a delimited unilocular lesion. After surgical excision, the histopathological report was desmoplastic fibroma (DF). It was observed that the patient had an aggressive recurrence of DF at four months after surgery treatment. Due to these clinical findings, resective osseous surgery and curettage were carried out. It is uncommon to find these two pathologies together (DF and tuberous sclerosis). Since DF is a benign pathology but very invasive and destructive, it is necessary a constant follow-up examination due to a high recurrence frequency.
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OBJECTIVE: The objective of this study was to determine dental caries frequency and to analyze salivary and bacterial factors associated with active and inactive systemic lupus erythematous (SLE) patients. Also, a proposal to identify dental caries by a surface, teeth, and the patient was developed. MATERIAL AND METHODS: A cross-sectional, blinded study that included 60 SLE patients divided into two groups of 30 subjects each, according to the Activity Index for Diagnosis of Systemic Lupus Erythematous (SLEDAI). The decayed, missing, and filled teeth (DMFT) index and Integrative Dental Caries Index (IDCI) were used for analyzing dental caries. The saliva variables recorded were: flow, pH, and buffer capacity. The DNA copies of Streptococcus mutans and Streptococcus sobrinus were estimated by real-time PCR. RESULTS: The caries frequency was 85% for SLE subjects (73.3% for inactive systemic lupus erythematous (ISLE) and 100% for active systemic lupus erythematous (ASLE)); DMFT for the SLE group was 12.6 ± 5.7 and the IDCI was (9.8 ± 5.9). The ASLE group showed a salivary flow of 0.65 compared with 0.97 ml/1 min from the ISLE group; all variables mentioned above showed a statistical difference (p < 0.05). The salivary pH was 4.6 (6.06 for ISLE and 3.9 for ASLE). The DNA copies of S. mutans and S. sobrinus were high; all variables mentioned above show a significant statistical difference (p < 0.05) between groups. CONCLUSION: SLE patients had high DMFT and IDCI scores that were associated with a decrease in salivary flow, pH, and buffer capacity. There were high counts of S. sobrinus and S. mutans species, and IDCI is a useful tool to provide more detail about dental caries in epidemiological studies.
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Cárie Dentária/metabolismo , Cárie Dentária/microbiologia , Lúpus Eritematoso Sistêmico/metabolismo , Lúpus Eritematoso Sistêmico/microbiologia , Saliva/metabolismo , Adolescente , Adulto , Idoso , Carga Bacteriana , Estudos Transversais , DNA Bacteriano/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saliva/microbiologia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/fisiopatologia , Streptococcus mutans/genética , Streptococcus mutans/isolamento & purificação , Streptococcus sobrinus/genética , Streptococcus sobrinus/isolamento & purificação , Adulto JovemRESUMO
El objetivo del presente estudio fue optimizar la implementación de cultivos primarios a partir de muestras de carcinoma renal de células claras (CRCC) para comprobar la conservación del fenotipo lipogénico contra cortes fijados del mismo origen. Se utilizaron muestras de pacientes con CRCC, evaluándose diversas metodologías y condiciones experimentales de digestión de muestras, adherencia y despegue celular, fenotipo lipogénico, potencial de clonación, proliferación y capacidad de migración. El mayor rendimiento y viabilidad celular se verificó mediante digestión con colagenasa. La adherencia inicial se logró a las 24 hs de incubación, utilizando placas plásticas de cultivo, recubiertas con colágeno comercial y gelatina 0,2% en la mayoría de las muestras analizadas (60% de los casos). Se obtuvieron monocapas, con potencial de migración, en un 40% de los casos, tras 5 ± 1 días de incubación. El promedio de subcultivos fue de 3 ± 1. Este estudio permitió estandarizar cultivos primarios de CRCC comprobándose la conservación de la fenotipia lipogénica, logrando de dicha manera una herramienta importante y útil para el estudio de la biología tumoral y el ensayo de nuevas terapéuticas
The aim of this study was to optimize the implementation of primary cultures from samples of renal clear cell carcinoma (CRCC) to check the conservation of the lipogenic phenotype. CRCC Patient samples were used, in order to evaluate different methodologies and the experimental conditions of sample digestion, cell adhesion and lipogenic phenotype, proliferation and migration ability. The highest yield in cell number and viability was assessed using collagenase digestion. The initial adhesion was achieved after 24 hours of incubation in plastic plates recoverd with commercial collagen or 0.2% gelatin (60% of cases). Monolayers, with migration potential, were obtained in 40% of all cases, after 5 ± 1 days of incubation. The subcultures average was 3 ± 1. This study allowed us to standardize primary cultures of CRCC and check the conservation of the lipogenic phenotyping, achieving in this way an important and useful tool to study the tumor biology.
O objetivo deste trabalho foi otimizar a implementação de culturas primárias de amostras de carcinoma de células claras renal (CRCC) para verificar conservação fenótipo lipogenic contra os cortes previstos a mesma origem. As amostras dos pacientes foram utilizados CRCC, avaliando diferentes metodologias e as condições experimentais da digestão de amostras, adesão celular e fenótipo clonagem potencial take-lipogenic, proliferação e capacidade de migração. O maior rendimento e a viabilidade celular foi avaliada por digestão com colagenase. A adesão inicial foi obtida após 24 horas de incubação com colagénio e gelatina comercial 0,2% em 60% dos casos. As monocamadas foram obtidos em 40% após 5 ± 1 dias de incubação com o potencial de migração. As subculturas média foi de 3 ± 1. Este estudo nos permitiu padronizar culturas primárias de CRCC são verificados quanto à conservação da fenotipagem lipogenic, conseguindo desta forma um importante e útil para o estudo da biologia do tumor e teste de nova ferramenta terapêutica
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Humanos , Carcinoma de Células Renais/diagnóstico , Neoplasias Renais/diagnóstico , Técnicas de Cultura/métodos , Cultura Primária de Células/métodosRESUMO
BACKGROUND: Bacterial resistance to antibiotics is a health problem in many parts of the world. The aim of this study was to identify bacteria from dental infections and determine bacterial resistance to antibiotics used in dental care in the primary dentition. METHODS: This cross-sectional study comprised 60 children who presented for dental treatment for active dental infections in the primary dentition. Samples from dental infections were collected and bacteria were identified by polymerase chain reaction (PCR) assay. Bacterial resistance to antibiotics was determined by colony forming units on agar plates containing amoxicillin, clindamycin and amoxillicin-clavulanic acid (A-CA) tested at 8 µg/ml or 16 µg/ml. RESULTS: Clindamycin in both concentrations tested (8 µg/ml and 16 µg/ml) showed the highest bacterial resistance (85.9%), followed by amoxicillin (43.7%) and A-CA (12.0%). All comparisons among the three antibiotics used in the study exhibited statistical significance (p = <0.05) in both concentrations tested (8 µg/ml and 16 µg/ml), and under aerobic and anaerobic conditions. The most prevalent resistant species identified by PCR in primary dentition infections were: Streptococcus oralis and Prevotella intermedia (75.0%); Treponema denticola and Porphyromonas gingivalis (48.3%); Streptococcus mutans (45.0%); Campylobacter rectus; and Streptococcus salivarius (40%). CONCLUSIONS: This study demonstrated that A-CA exhibited the lowest bacterial resistance for clinical isolates in primary dentition infections.
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Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Infecções Bacterianas/tratamento farmacológico , Clindamicina/administração & dosagem , Farmacorresistência Bacteriana Múltipla , Doenças Dentárias/tratamento farmacológico , Doenças Dentárias/microbiologia , Dente Decíduo/microbiologia , Biofilmes/crescimento & desenvolvimento , Criança , Pré-Escolar , Contagem de Colônia Microbiana , Estudos Transversais , Placa Dentária/microbiologia , HumanosRESUMO
UNLABELLED: The aim of this study was to characterize the main periodontal bacterial species in Down syndrome (DS) patients with and without periodontitis. METHOD: This cross-sectional study involved 75 DS patients, 45 with and 30 without periodontitis. Informed consent, health and dental questionnaires and periodontitis diagnosis were performed PCR and LAMP assays were performed on subgingival dental plaque sample. RESULTS: Tannerella forsythia was the most frequent bacteria detected in the group with and without periodontitis (95.5 and 63.3%) followed by Treponema denticola (88.8 and 50%) and Porphyromonas gingivalis (53.3 and 25% respectively). There were statistical differences between groups (p < 0.05). Pg fimA type I was the most frequent Porphyromonas gingivalis genotype. Two different sets of primers (Aa-F/Aa-R and ltx3/ltx4) were used to detect Aggregatibacter actinomycetemcomitans and different frequencies were obtained, (68% and 14.6% respectively), they had a weak correlation (Cohen Kappa = 0.16). After sequencing of PCR products, ltx3/ltx4 showed more specificity. JP2 clone of A. actinomycetemcomitans was not detected in any sample. CONCLUSIONS: The composition of oral biofilm is fundamental for the development of periodontal disease independently of immunological alterations associated with DS. The frequency of detection of A. actinomycetemcomitans reported in the literature has a wide range, because the primers and probes applied
Assuntos
Biofilmes/classificação , Placa Dentária/microbiologia , Síndrome de Down/microbiologia , Periodontite/microbiologia , Aggregatibacter actinomycetemcomitans/classificação , Aggregatibacter actinomycetemcomitans/genética , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Toxinas Bacterianas/genética , Bacteroides/isolamento & purificação , Estudos Transversais , Primers do DNA , DNA Bacteriano/análise , Exotoxinas/genética , Feminino , Proteínas de Fímbrias/análise , Genótipo , Humanos , Masculino , Consórcios Microbianos , Perda da Inserção Periodontal/classificação , Perda da Inserção Periodontal/microbiologia , Bolsa Periodontal/classificação , Bolsa Periodontal/microbiologia , Periodontite/classificação , Periodonto/microbiologia , Pili Sexual/genética , Porphyromonas gingivalis/genética , Porphyromonas gingivalis/isolamento & purificação , Perda de Dente/classificação , Treponema denticola/isolamento & purificação , Adulto JovemRESUMO
The aim of this ex vivo study was to evaluate the adherence capacity of Streptococcus mutans after being exposed to three different sizes of silver nanoparticles on healthy human dental enamel. Three different sizes of silver nanoparticles (9.3, 21.3 and 98 nm) were prepared, characterized and an adherence testing was performed to evaluate their anti-adherence activity on a reference strain of S. mutans on healthy dental enamel surfaces. Colony-Forming Unit count was made for adherence test and light microscopy, atomic force microscopy and scanning electron microscopy were used to compare qualitative characteristics of S. mutans. 9.3 nm and 21.3 nm groups did not show differences between them but statistical differences were found when 9.3 nm and 21.3 nm groups were compared with 98 nm and negative control groups (p<0.05). Microscopy analysis shows a better inhibition of S. mutans adherence in 9.3 nm and 21.3 nm groups than the 98 nm group when compared with control group. Silver nanoparticles showed an adherence inhibition on S. mutans and the anti-adherence capacity was better when silver nanoparticles were smaller.
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Aderência Bacteriana/efeitos dos fármacos , Esmalte Dentário/efeitos dos fármacos , Nanopartículas Metálicas/química , Prata/farmacologia , Streptococcus mutans/citologia , Streptococcus mutans/efeitos dos fármacos , Humanos , Luz , Nanopartículas Metálicas/ultraestrutura , Testes de Sensibilidade Microbiana , Microscopia de Força Atômica , Espalhamento de Radiação , Streptococcus mutans/ultraestrutura , Propriedades de Superfície/efeitos dos fármacosRESUMO
Cross-neutralization of Crotalus durissus terrificus venom coagulant activity was tested using bivalent horse antivenom against Bothrops alternatus and Bothrops diporus venoms. Our in vitro and in vivo experiments showed that bothropic antivenom neutralizes the thrombin-like activity of crotalic snake venom and this cross-reaction was demonstrated by immunoassays either with whole venom or a purified thrombin-like enzyme. These results suggest common antigenic properties and, consequently, similar molecular structure among venom thrombin-like enzymes. Besides, they provide information that could be further used in the development of new antivenom formulations.(AU)