Does the Application of Additional Hydrophobic Resin to Universal Adhesives Increase Bonding Longevity of Eroded Dentin?

This paper evaluates the effect of an additional hydrophobic resin coat (extra HL) associated with universal adhesives on sound and eroded dentin and evaluated immediately or after 2 years of water storage to improve the microtensile bond strength (µTBS) and nanoleakage (NL) when compared to the use of universal adhesives only. Sixty-four molars were assigned to eight groups using the following combinations: 1. dentin substrate, including sound and eroded dentin; 2. treatment, including the control and extra HL and storage time (immediately and after two-years of storage). Two universal adhesives (Prime & Bond Active or Scotchbond Universal) were evaluated. Before restoration, half of the teeth were subjected to soft-drink erosion. Composite buildups were bonded; specimens were stored (37 °C/24 h), sectioned into resin−dentin bonded sticks and tested for microtensile bond strength and nanoleakage using SEM (immediately and after two-years of storage). Three-way ANOVA and Tukey's test (α = 0.05%) were used. In the immediate testing, the application of extra HL did not increase microtensile bond strength values compared with the control group in either substrate (p > 0.05). However, extra HL significantly decreased nanoleakage values when applied to eroded and sound dentin (p = 0.0001). After two years, the application of extra HL produced significantly higher microtensile bond strength and lower nanoleakage values than the control group for both adhesives (p = 0.0001). In all cases, sound dentin showed higher microtensile bond strength and lower nanoleakage values than eroded dentin (p = 0.000001). An extra HL increased the bond strength and reduced nanoleakage in eroded dentin after two-years of storage.

Oral Pentoxifylline Associated with Pentavalent Antimony: A Randomized Trial for Cutaneous Leishmaniasis.

AbstractCutaneous leishmaniasis (CL) by Leishmania braziliensis is associated with decreasing cure rates in Brazil. Standard treatment with pentavalent antimony (Sbv) cures only 50-60% of the cases. The immunopathogenesis of CL ulcer is associated with high interferon-γ and tumor necrosis factor (TNF) production. Pentoxifylline, a TNF inhibitor, has been successfully used in association with Sbv in mucosal and cutaneous leishmaniasis. This randomized, double-blind, and placebo-controlled trial aimed to evaluate the efficacy and safety of oral pentoxifylline plus Sbv versus placebo plus Sbv in patients with CL in Bahia, Brazil. A total of 164 patients were randomized in two groups to receive the combination or the monotherapy. Cure rate 6 months after treatment was 45% in the pentoxifylline group and 43% in the control group. There was also no difference between the groups regarding the healing time (99.7 ± 66.2 days and 98.1 ± 72.7 days, respectively). Adverse events were more common in the pentoxifylline group (37.8%), versus 23% in the placebo group. This trial shows that Sbv combined therapy with pentoxifylline is not more effective than Sbv monotherapy in the treatment of CL caused by L. braziliensis.

Clinical and immunological outcome in cutaneous leishmaniasis patients treated with pentoxifylline.

Pentoxifylline is a tumor necrosis factor-α (TNF-α) inhibitor that also attenuates the immune response and decreases tissue inflammation. The association of pentoxifylline with antimony improves the cure rate of mucosal and cutaneous leishmaniasis. In this randomized and double blind pilot trial, cure rate was higher, although not significant, in patients who received antimony plus pentoxifylline than in those patients receiving antimony plus placebo. A significant decrease in TNF-α and interferon-γ (IFN-γ) levels during therapy was more pronounced in the antimony plus pentoxifylline group, whereas CCL-3 (Chemokine [C-C motif] ligand 3) decreased similarly in both groups. The increased levels of CXCL-9 (Chemokine [C-X-C motif] ligand 9) during therapy were lower in the antimony plus pentoxifylline group. Therapy with pentoxifylline modifies cytokines and chemokines production, which may be associated with therapeutic outcome.

Influência da idade na morbidade e mortalidade da cirurgia arterial coronária / Influence of age on the morbidity and mortality of the coronary artery surgery

Para estudar os efeitos da idade nos resultados da cirurgia coronária, 250 pacientes, operados entre 1986 e 1989, foram divididos em dois grupos: 1) doentes apresentando menos de 65 anos de idade; 2) pacientes com idade igual ou superior a 65 anos. Os dados analisados no pré, trans e pós-operatório incluíram: sexo, tipo e classe de angina, doenças associadas, infarto do miocárdio prévio, cirurgia coronária prévia, aneurisma do ventrículo esquerdo, tempos de perfusäo e de clampeamento aórtico, número de artérias revascularizadas, necessidade de suporte inotrópico prolongado, complicaçöes pós-operatórias e mortalidade. Observou-se nos pacientes idosos uma maior incidência de angina instável (20,3% x 6,2%), angina pós-infarto (10,1% x 7,8%), angina em repouso (10,1 x 3,6%), doença vascular periférica (8,4% x 2,6%), necessidade de suporte inotrópico prolongado (18,6% x 3,1%), complicaçöes neurológicas (8,4% x 0,5%) e, por fim, infarto do miocárdio trans ou pós-operatório (5,0% x 0,5%). A mortalidade global foi de 3,6%, sendo, contudo, significativamente maior nos pacientes idosos (11,8% x 1,0%). Estes dados sugerem que os pacientes idosos apresentam um risco maior de complicaçöes neurológicas, cardíacas e de mortalidade, o que provavelmente deve-se a uma maior susceptibilidade desses doentes a complicaçöes pós-operatórias graves