Effect of Repeated Intravitreal Injections in Glaucoma Spectrum Diseases.

Purpose: To evaluate whether repeated intravitreal injections (IVI) with an anti-vascular endothelial growth factor (anti-VEGF) agent are associated with glaucomatous progression in eyes with glaucoma spectrum diseases (GSD). Methods: Single-center, retrospective, longitudinal study of patients with bilateral and similar GSD who: (1) received ≥8 IVI in only one eye during the study period; (2) had ≥2 retinal nerve fiber layer thickness (RNFL) measurements obtained by spectral-domain optical coherence tomography (SD-OCT) at least 12 months apart. The primary outcome was the absolute RNFL thickness change, comparing injected and fellow uninjected eyes. Linear mixed effects models were constructed, including a multivariable model. Results: Sixty-eight eyes from 34 patients were included, 34 injected and 34 fellow uninjected eyes. Average baseline age was 67.68±21.77 years with a follow-up of 3.66±1.89 years and 25.12±14.49 IVI. RNFL thickness decreased significantly from 80.92±15.78 to 77.20±17.35 µm (p<0.001; -1.18±1.93 µm/year) in injected eyes and from 79.95±17.91 to 76.61±17.97 µm (p<0.001; -1.07±0.98 µm/year) in uninjected eyes. In a multivariable linear mixed model of injected eyes, only higher baseline RNFL thickness (p < 0.001) significantly predicted higher absolute RNFL thickness loss. Neither absolute RNFL thickness variation (p=0.716) nor RNFL rate (p=0.779) was significantly different between paired injected and uninjected eyes. Absolute IOP variation was not significantly different between groups (16.62±4.77 to 15.09±4.34 mmHg in injected eyes and 17.68±5.01 to 14.50±3.39 mmHg in fellow uninjected eyes; p=0.248). The proportion of eyes receiving glaucoma medical treatment increased significantly in both groups (55.9% to 76.5% in injected eyes; p=0.039; 58.8% to 76.5% in uninjected eyes; p = 0.031). The number of glaucoma medications also increased significantly in both groups (1.03±1.11 to 1.59±1.18 glaucoma medications in injected eyes; p=0.003; 1.09±1.11 to 1.56±1.19 glaucoma medications in uninjected eyes; p=0.003). Conclusion: Repeated IVI do not seem to accelerate glaucomatous progression. Future studies with a longer follow-up are needed.

Cytotoxicity evaluation of sodium alendronate on cultured human periodontal ligament fibroblasts.

External root resorption processes are usually associated with dental trauma, mainly avulsion and intrusion. In such cases endodontic therapy aims to prevent this process by using medications that can inhibit osteoclastic activity, such as bisphosphonates. However, these drugs must be biocompatible to the periapical tissues. The aim of this study was to analyze the cytotoxicity of a bisphosphonate (sodium alendronate) on human periodontal ligament fibroblasts (PDL cells). Cells were plated in a density of 1 x 10(3) cells per dish. The experimental groups were GI (control) no sodium alendronate, and GII, GIII, and GIV with sodium alendronate at the concentrations of 10(-5), 10(-6), and 10(-7) M, respectively. The experimental times were 1, 6, 12, and 24 h (short-term) for viability and 2, 4, 6, and 8 days (long-term) for cell survival. Data in triplicate were statistically analyzed. Cultures treated with the highest alendronate concentration (GII) showed cell viability percentages significantly lower (P < 0.01) than those of the other groups (GI, GIII, and GIV), at 12 and 24 h. Cell growth on GII and GIII groups was similar. GII presented smaller growth than the other groups (P < 0.05). We concluded that sodium alendronate, on direct contact with human periodontal ligament fibroblasts, is cytotoxic in concentrations higher than of 10(-6) M.

Report: Valorsul integrated waste management: waste incineration plant.

Valorsul, SA, is responsible for the management of waste produced in 5 municipalities in the area of Lisbon. Due to the high density production, a multi-municipal waste management was implemented in which the primary unit is an incineration plant, built in 1999, that produces almost 2% of the national energy demand. This paper describes the main characteristics of this plant, in particular the treatment of gases and waste management. Apart from that, and because of environmental concern of this type of unit, the monitoring program established one year before the start of the operation is described.

Perfuraçöes iatrogênicas: Super-Eba e MTA: uma revisäo de novos cimentos / Iatrogenic perforations: Super-Eba and MTA: a review of new cements

Perfuraçöes iatrogênicas podem ocorrer durante a manobra de cirurgia de acesso, instrumentaçäo de canais radiculares ou até durante a manobra de preparo para retentor intra-radicular. A inflamaçäo nos tecidos subjacentes, causada pelas perfuraçöes, torna duvidoso o prognóstico do dente envolvido. Nessa revisäo, analisamos alguns materiais, além do Super-Elba, o MTA para o reparo imediato de perfuraçöes iatrogênicas. O uso do MTA mostrou ser o material mais promissor, porém necessitando de novos estudos clínicos para uma melhor avaliaçäo

O fenômeno "flare-up" em endodontia: fatores etiológicos e associados / The flare-up phenomenon in endodontics: etiologics and associated factors

Muitas vezes as urgências em endodontia podem ser apresentadas em três momentos distintos: antes, durante e após a intervençäo endodôntica. Essas urgências säo denominadas flare-ups, onde se faz necessário um atendimento em caráter emergencial, em virtude da presença de edema, ou dor e edema combinados. As razöes pelas quais os flare-ups ocorrem nem sempre säo claras. Nesse trabalho, discorreremos sobre as hipóteses de sua ocorrência e prevençäo