RESUMO
OBJECTIVE: To assess the safety and efficacy of infliximab (IFX) for the treatment of patients with Kawasaki disease (KD). STUDY DESIGN: This was a nationwide survey of 274 Japanese institutions exploring how IFX was used to treat patients with KD. The patients' sex, age, treatment course, pre- and post-IFX therapy blood test results, coronary artery lesions (CALs), and adverse events (AEs) were evaluated. RESULTS: We analyzed 434 patients with KD who received IFX between March 2005 and November 2014. The median age at onset was 33 months (range 1-138), and 66 patients (15.2%) were under 1 year old. In all cases, IFX was administered as additional treatment. The median days of illness at the initiation of IFX was 9 days. In 275 patients (63.4%), IFX was administered as third-line treatment, and in 106 patients (24.4%), IFX was administered as fourth-line treatment. Single dose IFX 5 mg/kg was administered to 412 patients (94.9%). After IFX, 363 patients (83.6%) became afebrile within 2 days, and the white blood cell count, percentage of neutrophils, and serum C-reactive protein levels significantly decreased (P < .001), although 119 patients (27.4%) received additional treatment. Before IFX, 132 patients (30.4%) had already developed CALs. In patients without CALs before IFX, 31 patients (10.3%) newly developed CAL after IFX, whereas 32 patients (24.2%) with CAL before IFX showed increased CAL severity. Eighty AEs were observed in 69 patients (15.9%); however, serious AEs were few and reversible. CONCLUSIONS: IFX might be an effective and tolerable treatment for refractory KD.
Assuntos
Antirreumáticos/administração & dosagem , Infliximab/administração & dosagem , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Japão , Masculino , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de TempoRESUMO
O Advento dos implantes integráveis promoveu uma modalidade de tratamento com alto grau de aplicabilidade em variadas situações clínicas. Entretanto, o planejamento de implantes depende,em última análise, de rebordos alveolares favoráveis para a colocação desses. Este artigo propôs relatar um caso clínico de aumento do volume osséo de uma maxila anterior por meio de osso bovino inorgânico e uma tela de titânio, com o objetivo de reter o material de preenchimento. Com base na literatura e no resultado obtido nesse trabalho, pode-se concluir que a combinação de técnicas para cirurgia óssea guiada é uma opção de tratamento para pacientes que possuem rebordo alveolar inadequado para a colocação de implantes.
The advent of integrated implants promoted a treatment modality with a highdegree of applicability to various clinical situations. However, the planning of implants depends, ultimately, on favorable alveolar ridges for itsplacement. This article purpose is to report a clinical case of anaugmentation in the bone volume of a anterior maxilla by means of inorganic bovine bone and a titanium membrane, in order to retain the filling material. Based on literature and the results obtained in this work, we can conclude that the combination of techniques for guided bone surgery is a treatment option for patients who have inadequate alveolar ridge for implant placement.
Assuntos
Humanos , Pessoa de Meia-Idade , Aumento do Rebordo Alveolar , Materiais Biocompatíveis , Regeneração Óssea , Transplante Ósseo , Brasil , Dentição Permanente , MaxilaRESUMO
Os implantes osseointegrados utilizados para reabilitação de edentulismo total mostram um elevado grau de previsibilidade terapêutica. Entretanto, surgiu a necessidade de extrapolar as alternativas de tratamento com implantes para pacientes parcialmente edêntulos. Diante disso, vários estudos têm sido direcionados para a possibilidade ou não de unir tais implantes a dentes naturais, visto que o comportamento biomecânico dessas duas estruturas apresentam peculiaridades distintas. A partir dos métodos de elementos finitos (MEF), foram modelados dois modelos visando à simulação do comportamento mecânico de uma prótese fixa de união rígida entre dente natural e implante osseointegrado. Em um modelo o implante tinha 10 mm de comprimento e em outro modelo 6 mm de comprimento. Uma carga de 100 N, distribuída uniformemente foi aplicada em todo o conjunto para simular a mastigação funcional e posterior análise das tensões principais SEQV (Von Mises). Na análise quantitativa, pode-se observar que na prótese contendo o implante de 10 mm, as tensões máximas SEQV foram menores em relação ao implante de 6 mm, porém, com localizações semelhantes. Com base nos resultados obtidos pelo programa, podemos concluir que a utilização de implante curto é mais crítica ao sistema.
Osseointegrated implants used for total rehabilitation of edentulous show a high degree of predictability therapy. However, the need to extrapolate treatment options with implants for partially edentulous patients. Given that several studies have been focused on the possibility or not to join such implants to natural teeth as the biomechanical behavior of these two structures have distinct peculiarities. Two models were constructed aiming to simulate the behavior of a fixed rigid connection between natural tooth and osseointegrated implants. In one model, the implant was 10 mm in height, whereas in the other the length was 6mm. A load of 100N was applied, evenly distributed across the assembly simulating mastication for further analysis of the principal stresses SEQV (Von Mises). Based on quantitative analysis it was seen in the first model that maximum generated stresses were slightly lower than in the second model under similar locations. Based on the results, one can conclude that the use of short implants can be more harmful to the system.