RESUMO
BACKGROUND: Predictors of permanent pacemaker implantation (PPMI) after self-expanding transcatheter aortic valve implant (TAVI) were described. Is unknown if PPMI predictors remain in the era of high implants using the cusp overlap (COP). METHODS: Single-center, prospective, consecutive case series of patients undergoing self-expanding TAVI with the COP approach. The status of PPMI and other clinical events were ascertained at 30 days. RESULTS: A total of 261 patients were included (84% with Evolut, n = 219). Implant depth >4 mm was infrequent (13.8%). TAVI depth (OR 1.259; p = 0.005), first or second-degree auriculo-ventricular block (OR 3.406; p = 0.033), right-bundle (OR 15.477; p < 0.0001), and incomplete left-bundle branch block (OR 7.964; p = 0.036) were found to be independent predictors of PPMI. The risk of PPMI with deep implant and no electrical disturbances was 3%, and 0% with high implant and no prior electrical disturbances. Those who received PPMI had no statistically significant increased risk of death, myocardial infarction, stroke, bleeding events, or vascular complications at 30 days, but longer hospital stay (mean difference 1.43 days more, p = 0.003). CONCLUSIONS: Implant depth and prior conduction abnormalities remain the main predictors of PPMI using self-expanding TAVI in the COP era. Patients with high implants and no prior conduction abnormalities may be candidates for early discharge after uneventful self-expanding TAVI, while the rest may need inpatient monitoring regardless of achieving a high implant. The need for PPMI was associated with longer hospital stays.
RESUMO
Rectal and vaginal temperatures are utilised in both in vivo and in vitro models to study the effects of heat stress on oocyte competence and embryo viability in cattle. However, uterine temperature increases by only 0.5 °C in heat-stressed cows, significantly lower than simulated increases in in vitro models. Temperature variations within oviducts and ovarian follicles during heat stress are poorly understood or unavailable, and evidence is lacking that oocytes and pre-implantation embryos experience mild (40 °C) or severe (41 °C) heat stress inside the ovarian follicle and the oviduct and uterus, respectively. Gathering detailed temperature data from the reproductive tract and follicles is crucial to accurately assess oocyte competence and embryo viability under realistic heat stress conditions. Potential harm from heat stress on oocytes and embryos may result from reduced nutrient availability (e.g., diminished blood flow to the reproductive tract) or other unidentified mechanisms affecting tissue function rather than direct thermal effects. Refining in vivo stress models in cattle is essential to accurately identify animals truly experiencing heat stress, rather than assuming heat stress exposure as done in most studies. This will improve model reliability and aid in the selection of heat-tolerant animals.
RESUMO
BACKGROUND: The literature is unclear about how the different attachment systems for overdentures impact the maximum bite force, the masticatory efficiency and how this impact in the oral health self-perception in patients. OBJECTIVE: To evaluate the effect of two attachment systems (O-ring and Locator) for mandibular overdenture using single implant on quality of life, maximum bite force (BF) and masticatory efficiency (ME). METHODS: Twenty-eight completely edentulous denture wearers with a mandibular symphysis implant were randomly selected and allocated into two groups in a crossover study, considering O-ring and Locator attachment types. The quality of life and self-perception of oral health were assessed using the Oral Health Impact Profile (OHIP-Edent) and Geriatric Index of Determination of Oral Health (GOHAI) questionnaires, respectively. BF was measured using a gnathodynamometer and ME by chewing silicone cubes and almonds in different numbers of cycles. RESULTS: There was no difference between the attachment systems about self-perceived oral health and impact on quality of life (p > .05). The O-ring-type system obtained a significantly higher BF than the locator-type system (p = .04). Regardless of the food chewed, no statistically significant difference was observed with the type of attachment (p > .05). The ME was directly proportional to the masticatory cycles only for almonds (p < .01). CONCLUSIONS: Locator and O-ring inserts had a similar impact on patients' quality of life, self-perception of oral health and ME. Additionally, the O-ring system exhibited superior properties in the BF.
RESUMO
Cat-transmitted sporotrichosis is caused by the emerging fungal pathogen Sporothrix brasiliensis and constitutes a significant public health issue that affects people living in resource-poor urban centers in Brazil. The lack of knowledge about transmission dynamics makes it difficult to propose public health policies to contain the advance of sporotrichosis. We describe the recent emergence of 1,176 cases of sporotrichosis in cats (2016 to 2021) in the metropolitan region of Recife, Brazil, leading to significant zoonotic transmission and an overwhelming occurrence of S. brasiliensis as the etiological agent. Most cases were from cats in the cities of Olinda (408/1,176; 34.70%), Jaboatão dos Guararapes (332/1,176; 28.23%), and Recife (237/1,176; 20.15%). Molecular typing using amplified fragment length polymorphism (EcoRI-GA/MseI-AG) revealed low polymorphic information content (PIC = 0.2499) and heterozygosity (H = 0.2928), typical of an outbreak scenario. Dendrogram and multivariate cluster analysis revealed that isolates from Pernambuco are closely related to Rio de Janeiro isolates. We report a substantial occurrence of MAT1-2 idiomorphs in the metropolitan region of Recife (0:60 ratio; χ2 = 60.000, P < 0.0001). The limited population differentiation and genetic diversity of the isolates from Pernambuco suggest a recent introduction, possibly via a founder effect, from the parental population in Rio de Janeiro. Our findings emphasize the critical importance of molecular surveillance of S. brasiliensis for outbreak response. A comprehensive one-health strategy is mandatory to control the spread of cat-transmitted sporotrichosis driven by S. brasiliensis, encompassing sanitary barriers, quick diagnosis, and treatment.
Assuntos
Doenças do Gato , Sporothrix , Esporotricose , Esporotricose/transmissão , Esporotricose/microbiologia , Esporotricose/veterinária , Esporotricose/epidemiologia , Gatos , Brasil/epidemiologia , Sporothrix/genética , Sporothrix/isolamento & purificação , Sporothrix/classificação , Animais , Doenças do Gato/microbiologia , Doenças do Gato/transmissão , Doenças do Gato/epidemiologia , Tipagem Molecular , Zoonoses/transmissão , Zoonoses/microbiologia , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Doenças Transmissíveis Emergentes/transmissão , Doenças Transmissíveis Emergentes/microbiologia , Doenças Transmissíveis Emergentes/epidemiologia , Genótipo , FilogeniaRESUMO
The implantation of the embryo into the maternal endometrium is a complex process associated with the evolution of viviparity and placentation in mammals. In this review, we provide an overview of maternal recognition of pregnancy signals and implantation modes in eutherians, focusing on their diverse mechanisms and evolutionary patterns. Different pregnancy recognition signals and implantation modes have evolved in eutherian mammals, reflecting the remarkable diversity of specializations in mammals following the evolution of viviparity. Superficial implantation is the ancestral implantation mode in Eutheria and its major clades. The other modes, secondary, partially, and primary interstitial implantation have each independently evolved multiple times in the evolutionary history of eutherians. Although significant progress has been made in understanding pregnancy recognition signals and implantation modes, there is still much to uncover. Rodents and chiropterans (especially Phyllostomidae) offer valuable opportunities for studying the transitions among implantation modes, but data is still scarce for these diverse orders. Further research should focus on unstudied taxa so we can establish robust patterns of evolutionary changes in pregnancy recognition signaling and implantation modes.
RESUMO
Bone tissue engineering is a promising alternative to repair wounds caused by cellular or physical accidents that humans face daily. In this sense, the search for new graphene oxide (GO) nanofillers related to their degree of oxidation is born as an alternative bioactive component in forming new scaffolds. In the present study, three different GOs were synthesized with varying degrees of oxidation and studied chemically and tissue-wise. The oxidation degree was determined through infrared (FTIR), X-ray diffraction (XRD), X-ray photoelectron (XPS), and Raman spectroscopy (RS). The morphology of the samples was analyzed using scanning electron microscopy (SEM). The oxygen content was deeply described using the deconvolution of RS and XPS techniques. The latter represents the oxidation degree for each of the samples and the formation of new bonds promoted by the graphitization of the material. In the RS, two characteristic bands were observed according to the degree of oxidation and the degree of graphitization of the material represented in bands D and G with different relative intensities, suggesting that the samples have different crystallite sizes. This size was described using the Tuinstra-Koenig model, ranging between 18.7 and 25.1 nm. Finally, the bone neoformation observed in the cranial defects of critical size indicates that the F1 and F2 samples, besides being compatible and resorbable, acted as a bridge for bone healing through regeneration. This promoted healing by restoring bone and tissue structure without triggering a strong immune response.
Assuntos
Regeneração Óssea , Grafite , Engenharia Tecidual , Alicerces Teciduais , Grafite/química , Regeneração Óssea/efeitos dos fármacos , Engenharia Tecidual/métodos , Animais , Alicerces Teciduais/química , Nanoestruturas/química , Osso e Ossos/efeitos dos fármacos , Análise Espectral Raman , Oxirredução , Difração de Raios X , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Ratos , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
INTRODUCTION: Huntington's disease (HD) is a hereditary condition caused by the expansion of the CAG trinucleotide in the huntingtin gene on chromosome 4, resulting in motor, cognitive, and psychiatric disorders that significantly impact patients' quality of life. Despite the lack of effective treatments for the disease, various surgical strategies have been explored to alleviate symptoms and slow its progression. METHODOLOGY: A comprehensive systematic literature review was conducted, including MeSH terms, yielding only 38 articles that were categorized based on the surgical procedure. The study aimed to describe the types of surgeries performed and their efficacy in HD patients. RESULTS: Deep brain stimulation (DBS) involved 41 predominantly male patients with bilateral implantation in the globus pallidus, showing a preoperative Unified Huntington's Disease Rating Scale (UHDRS) score of 60.25 ± 16.13 and a marked postoperative value of 48.54 ± 13.93 with a p < 0.018 at one year and p < 0.040 at three years. Patients experienced improvement in hyperkinesia but worsening of bradykinesia. Additionally, cell transplantation in 119 patients resulted in a lower preoperative UHDRS score of 34.61 ± 14.61 and a significant postoperative difference of 32.93 ± 15.87 (p < 0.016), respectively, in the first to third years of following. Some now, less used procedures were crucial for understanding brain function, such as pallidotomies in 3 patients, showing only a 25 % difference from their baseline. CONCLUSION: Despite advancements in technology, there is still no curative treatment, only palliative options. Promising treatments like trophic factor implantation offer new prospects for the future.
Assuntos
Estimulação Encefálica Profunda , Doença de Huntington , Doença de Huntington/cirurgia , Doença de Huntington/terapia , Humanos , Procedimentos Neurocirúrgicos/métodosRESUMO
OBJECTIVE: To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up. MATERIALS AND METHODS: Sixty-five implants were placed and followed up for at least 12 months (12.3 ± 1.5), in 50 patients. The implants were installed both in fresh extraction sockets and in healed sites and received provisional restoration when the clinical insertion torque was greater than 35Ncm. The primary results describe the survival rate of these implants. Clinical performance was evaluated through the evaluation of the Pink Esthetic Score (PES) and the degree of satisfaction of the patients. Bone loss was measured through radiographic measurements of the marginal bone loss in the mesial (MBLM) and distal (MBLD) sites. RESULTS: The survival rate was 98.5%. The average MBLM was 0.24 mm (± 0.53) and the MBLD was 0.27 mm (± 0.57). A statistical difference was observed only when comparing immediate implants with delayed ones (MBLM - p = 0.046 and MBLD - p = 0.028) and when they received immediate provisionalization or not (MBLM - p = 0.009 and MBLD - p = 0.040). The PES before the intervention (T0) was 13.4 (± 0.8) and the PES at T2 (12-month follow-up) was 12.9 (± 1.5) (p = 1.14). CONCLUSION: The new two-piece ceramic implant used in the present study showed predictable and reliable results, similar to those found with titanium implants after one year of follow-up. CLINICAL RELEVANCE: These implants can be used as an alternative to titanium implants in terms of the marginal bone loss and the degree of patient satisfaction.
Assuntos
Cerâmica , Planejamento de Prótese Dentária , Humanos , Estudos Prospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Cerâmica/química , Resultado do Tratamento , Adulto , Satisfação do Paciente , Idoso , Estética Dentária , Perda do Osso Alveolar/diagnóstico por imagem , Alvéolo Dental/cirurgia , Alvéolo Dental/diagnóstico por imagem , Falha de Restauração Dentária , Implantes DentáriosRESUMO
In this study, we investigate the antibacterial effect of silver atoms implanted into a thin surface layer of titanium at low energies using an alternative ion plating technology called Diversified Ion Plating. Silver atoms were incorporated into titanium samples using reactive low-voltage ion plating at 2 keV and 4 keV. Surface modifications and morphology were evaluated using wettability, profilometry measurements, and energy-dispersive spectroscopy. For a precise determination of the quantity and depth of implanted silver atoms on titanium surfaces, a combination of experimental techniques such as Rutherford Backscattering Spectrometry along with Monte Carlo simulations were utilized. To assess the antibacterial effects of the silver atoms incorporated into pure titanium surfaces, bacterial suspension immersion tests were performed with a standard strain of Staphylococcus aureus (ATCC 12600). The outcomes indicate that titanium surfaces implanted with silver atoms were more effective in inhibiting the growth of Staphylococcus aureus than pure titanium surfaces. Better results were found when the deposition was performed at 4 keV, indicating that a deeper implantation of silver, spanning a few nanometers, can result in a longer and more effective release of silver atoms. These findings suggest the potential for the development of new, cost-effective biomaterials, paving the way for improved implant materials in various health-related applications.
RESUMO
The development of endometrial receptivity is crucial for successful embryo implantation and the initiation of pregnancy. Understanding the molecular regulatory processes that transform the endometrium into a receptive phase is essential for enhancing implantation rates in fertility treatments, such as in vitro fertilization (IVF). Long non-coding RNAs (lncRNAs) play a pivotal role as gene regulators and have been examined in the endometrium. This review offers current insights into the role of lncRNAs in regulating endometrial receptivity. Considering the significant variation in endometrial remodeling among species, we summarize the key events in the human endometrial cycle and discuss the identified lncRNAs in both humans and other species, which may play a crucial role in establishing receptivity. Notably, there are 742 lncRNAs in humans and 4438 lncRNAs that have the potential to modulate endometrial receptivity. Additionally, lncRNAs regulating matrix metalloproteinases (MMPs) and Let-7 have been observed in both species. Future investigations should explore the potential of lncRNAs as therapeutic targets and/or biomarkers for diagnosing and improving endometrial receptivity in human fertility therapy.