Navigating Neurological and Cardiac Complexities: A Case Study on Viral Meningoencephalitis in a Patient With Ischemic Heart Disease.

We present a case of viral meningoencephalitis in a 40-year-old male with ischemic heart disease, a combination that is rare and presents unique diagnostic and therapeutic challenges. The patient's symptoms included high-grade fever, severe headache, projectile vomiting, and altered consciousness. The diagnosis was supported by MRI and CSF analysis. Management, complicated by the patient's cardiac condition, required a personalized approach, including antiviral therapy, corticosteroids, and vigilant monitoring of cardiac and neurological status. Treatment adjustments were made in response to the patient's evolving condition, leading to improvement within a week. This case underscores the need for a multidisciplinary approach in such complex scenarios, highlighting the significance of tailored care for patients with neurological symptoms and concurrent cardiac comorbidities. The report contributes to the literature on managing meningoencephalitis in patients with significant cardiac histories, underscoring personalized medicine's role in successful outcomes.

Phase II study of gemcitabine plus cisplatin in metastatic breast cancer.

Our objectives were to assess the efficacy and toxicity of gemcitabine plus cisplatin as first-line therapy in metastatic breast cancer (MBC). Patients with stage IV MBC and no prior chemotherapy for metastatic disease were treated with gemcitabine 1200 mg/m on days 1 and 8, and cisplatin 75 mg/m on day 1 every 21 days. Up to 6 cycles were given. A total of 46 patients with a median age of 49 years (range 24-77) and Karnofsky performance status of 80 or above were enrolled. In total, 238 cycles were administered. Of the 42 patients evaluable for response, seven (17%) achieved a complete response and 27 (64%) a partial response, for an overall response rate of 81% [95% confidence interval (CI) 69-93%]. Median time to progression was 14.9 months (95% CI 0-30.2 months). Median duration of response was 24.2 months (95% CI 11.2-37.3 months). The median survival was 27.9 months (95% CI 23.1-32.7 months), and the 1- and 2-year survival probabilities were 71.4 and 61.4%, respectively. All patients were evaluable for toxicity, and grade 3/4 WHO toxicities included neutropenia (41.3%), anemia (8.7%), thrombocytopenia (8.7%), alopecia (26.1%) and nausea/vomiting (32.6%). We conclude that gemcitabine plus cisplatin is a highly effective and safe first-line treatment for patients with MBC. The time to progression of 14.9 months compares favorably with other standard treatments (anthracyclines, taxanes). A randomized study is required to further investigate the role of this combination as first-line treatment for MBC.

Product studies and laser flash photolysis of direct and 2,4,6-triphenylpyrylium-zeolite Y photocatalyzed degradation of fenvalerate.

Direct irradiation of fenvalerate (FV) in aqueous solution (4 x 10(-3) M) gives rise to 2,3-diarylisohexanitrile through the homolytic CO-CH(i-Pr) bond cleavage, followed by a rapid decarboxylation of the primary carbonyloxy radical, and radical recombination. The unusual exclusive formation of the cross combination product suggests that the persistent free radical effect is operative in this system and controls product formation. Spectroscopic evidence of the intermediacy of benzylic radicals decaying in microsecond time scale has been obtained by laser flash photolysis. These studies also reveal a remarkable attenuation of radical reactivity toward oxygen resulting from cyano substitution at the radical center. TPY photocatalyzed degradation of FV also leads to decarboxylation products accompanied by oxidative mineralization (38%). The TPY-photocatalyzed degradation can occur through two operating mechanisms involving the generation of OH(*) radicals and/or FV(*+) radical cations. Evidence for the latter intermediate has been obtained by laser flash photolysis in acetonitrile solution (detection of TP(*) radical) and by the quenching by FV of the emission from the TPY solid.

Evaluación del éxito clínico y radiográfico postratamiento de dientes con necrosis pulpar y lesión periapical visible radiográficamente / Evaluation of the clinical and radiographic postreatment success in teeth with pulp necrosis and radiographically visible periapical lesion

Uno de los factores imprescindibles para la obtención del éxito post-tratamiento endodóntico es el material obturador. Para verificar la influencia del tipo de material obturador en la reparación post-tratamiento endodóntico y el consecuente éxito clínico y radiográfico, nos propusimos a evaluar los tratamientos endodónticos de 55 dientes realizados en la clínica de Endodoncia de la Facultad de Odontología de Araraquara, dividiéndolos en 2 grupos, en función del cemento obturador utilizado: a base de Óxido de Zinc y Eugenol y a base de Hidróxido de Calcio. A través de los resultados observamos que los 36 dientes obturados con Sealapex, 34 presentaron éxito clínico y radiográfico. Cuando el cemento usado fue a base de Óxido de Zinc y Eugenol, de los 19 casos analizados, 3 fracasaron, representando un índice menor de éxito que el Sealapex. Concluimos que respetando las variables, el cemento Sealapex permite índice más elevado de éxito post-tratamiento endodóntico

The root canal filling is one of the most important factors for a successful endodontic treatment. The aim of this study was to evaluate the root canal sealer role in the clinic and radiographic success of teeth who received endodontic treatment. Fifty-five root canals were evaluated after endodontic treatment in the Endodontic Clinic of School Dentistry of Araraquara. There were 2 groups, according to the root canal sealer: zinc oxide and eugenol root canal sealer (Endofill) and calcium hydroxide root canal sealer (Sealapex). The results showed that 32 of 34 teeth treated with Sealapex showed clinic and radiographic success. When the sealer used was Endofill, 3 of 19 evaluated failed; a worst result than that observed in the cases filled with Sealapex. We could conclude that respecting the differences in the sample, the sealer Sealapex allows a high level of clinic and radiographic success.

Um dos fatores imprescindíveis para a obtenção do êxito pós-tratamento endodôntico é o material obturador. Para verificar a influência do tipo de material obturador na reparação pós-tratamento endodôntico, e o conseqüente sucesso clínico e radiográfico,nos propusemos a avaliar os tratamentos endoônticos de 55 dentes realizados na lcínica de Endodontia da Faculdade de Odontologia de Araraquara, dividindo-os em 2 grupos, em função do cimento obturador utilziado: à base de Óxido de Zinco e Eugenol e à base de Hidróxido de Cálcio. Através dos resultados, foi possível observar que dos 36 dentes obturados com Sealapex, 34 apresentaram sucesso clínico e radiográfico. Quando o cimento utilizado foi à base de Óxido de Zinco e eugenol, dos 19 casos analisados, 3 fracassaram, representando um índice menor de sucesso que o Sealapex. Concluimos que, respeitando as variáveis, o cimento Sealapex permitiu um índice mais elevado de sucesso pós-tratamento endodôntico.

Efectividad de las técnicas rotatoria y oscilatoria en la preparación de conductos radiculares de conformación ovalada / Efetividade das técnicas rotatória e oscilatória no preparo biomecânico de canais radiculares de conformação ovalada / Effectiveness of root canal rotary and oscillatory peraparation techniques in flattened root canals

Este trabajo evaluó la preparación biomecánica de conductos radiculares de conformación ovalada, en cuanto al área de utilización de los instrumentos, se aplicaron cuatro técnicas: instrumentación oscilatoria con instrumentos de acero inoxidable Endo-Eze; instrumentación rotatoria con instrumentos de níquel-titanio del sistema Profile, instrumentación oscilatoria utilizando o sistema Profile, e instrumentación rotatoria con sistema Profile asociada a la instrumentación oscilatoria con sistema Endo-Eze. Fueron utilizadas 40 raíces distales de molares inferiores extraídos. Los especimenes fueron incluidos en resina poliéster cristal incolora, obteniendo un bloque con marcas en la porción externa. La raíz incluida en el bloque de resina fue seccionada de forma que pudiéramos visualizar la porción media del conducto radicular. Los dos cortes del bloque de resina fueron reposicionados, posibilitando la instrumentación de los conductos radiculares. Las imágenes de la superficie inferior de la sección media de cada raíz fueron obtenidas a través de una cámara digital y las imágenes archivadas. Después de la instrumentación, fueron realizadas nuevas fotografías. Las imágenes fueron transferidas para el programa AutoCAD, para que los conductos radiculares fueran trazados y la medición de las áreas de actuación de los instrumentos fuera realizada. Los resultados demostraron que no hubo diferencia estadísticamente significativa entre los grupos, aún haya sido observado un desgaste más uniforme en las paredes dentinarias por la instrumentación con los sistemas Profile y Endo-Eze asociados

This study evaluated the biomechanical preparation of flattened root canals, considering the effective area of instrumentation, using four different techniques: oscillatory instrumentation using Endo-Eze instruments; rotary instrumentation using Profile system; oscillatory instrumentation using Profile system; and rotary instrumentation with Profile system associated to oscillatory instrumentation with Endo-Eze system. A total of 40 distal roots of lower molars were used. These teeth were included in transparent resin blocks and grooves were made in the external portion of the block. The resin block containing the teeth was cut showing the median third of the root. Using a digital camera, the lower portion from the median third of the root were photographed, and the images recorded. After instrumentation, new images were obtained. The images were transferred to AutoCAD, the root canal was demarcated and the root canal area was measured. The results showed no statistically significant difference between the groups. However, a more uniform enlargement was observed in the group where oscillatory and rotary instrumentation were associated

Este trabalho avaliou o preparo biomecânico de canais radiculares de conformação ovalada, quanto à área de atuação dos instrumentos, utilizando quatro técnicas: instrumentação oscilatória com instrumentos de aço inoxidável Endo-Eze; instrumentação rotatória com instrumentos de níquel-titânio do sistema Profile, instrumentação oscilatória utilizando o sistema Profile, e instrumentação rotatória com sistema Profile associada à instrumentação oscilatória com sistema Endo-Eze. Foram utilizadas 40 raízes distais de molares inferiores extraídos. Os espécimes foram incluídos em resina poliéster cristal incolor, obtendo-se um bloco com marcas na porção externa. A raiz incluída no bloco de reina foi seccionada de forma a visualizarmos a porção média do canal radicular. Os dois cortes do bloco de resina foram reposicionados, possibilitando a instrumentação dos canais radiculares. As imagens da superfície inferior da secção média de cada raiz foram obtidas através de uma câmera digital e as imagens arquivadas. Após a instrumentação, foram realizadas novas fotografias. As imagens foram transferidas para o programa AutoCAD, para q os canais radiculares fossem traçados e a mensuração das áreas de atuação dos instrumentos fosse realizada. Os resultados demonstraram que não houve diferença estatisticamente significante entre os grupos, embora tenha sido observado um desgaste mais uniforme nas paredes dentinárias pela instrumentação com os sistemas Profile e Endo-Eze associados