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BACKGROUND AND OBJECTIVE: The introduction of the single-port (SP) robotic system has led to new approaches in robot-assisted radical prostatectomy (RARP), such as the transvesical (TV) approach, offering high rates of early urinary continence. While previous studies of SP TV RARP have identified perioperative factors influencing continence outcomes, the impact of anatomical factors remains unexplored. This study aims to assess magnetic resonance imaging (MRI)-based anatomical predictors of urinary continence after SP TV RARP. METHODS: A retrospective analysis of consecutive SP TV RARP cases (November 2020 to June 2023) with preoperative prostate MRI was performed. Two urogenital radiologists independently evaluated ten anatomical parameters to distinguish patients achieving urinary continence within 1 wk and 3 mo. Nonparametric methods estimated receiver operating characteristic curves (area under the curve [AUC]) and inter-reader agreement. KEY FINDINGS AND LIMITATIONS: In 120 cases, 40% achieved continence within 1 wk, rising to 71.7% by 3 mo. Membranous urethra length (MUL) alone was significantly associated with continence at 3 mo (AUC: 0.67, p = 0.003). At 1 wk, several parameters, including anteroposterior diameter of the prostate, coronal membranous urethra length, prostate volume, and transverse diameter of the prostate, showed promise in predicting continence. CONCLUSIONS AND CLINICAL IMPLICATIONS: A longer preoperative MUL was significantly associated with better odds of an early return to urinary continence after SP TV RARP. Each 1-mm increase in coronal MUL was associated with a 27% increase in the odds of continence at 3 mo. This information can aid in patient counseling and expectations preoperatively. PATIENT SUMMARY: Urinary incontinence is a common outcome after prostate cancer surgery, particularly in the early months. Recently, the single-port (SP) robotic system has emerged, localizing surgery to the diseased area. With the SP robot, accessing the prostate via the bladder leads to high rates of early continence. Our study reveals that the longer the urethral portion beneath the prostate, the higher the likelihood of regaining continence within 3 mo after surgery.
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PURPOSE: This study aims to describe the surgical steps for the single-port low anterolateral extraperitoneal approach to pyeloplasty, report its feasibility, and share the initial outcomes of our experience. METHODS: We analyzed all consecutive patients who underwent single-port low anterolateral extraperitoneal pyeloplasty due to ureteropelvic junction obstruction (UPJO). The surgical steps included a pure single-port approach through a 3.5 cm low anterolateral incision two fingerbreadths above the superior pubic ramus. The ureter was localized and followed cranially, a dismembered pyeloplasty was performed, and a running ureteropelvic anastomosis was completed. No drains were placed. The urinary catheter was removed upon discharge, and the ureteral stent after 3-5 weeks. RESULTS: A total of eight cases (two adults and six children) were completed successfully, without complications or conversions. Median operative time, console time, and estimated blood loss were 208.5 min, 114.5 min, and 10.0 ml, respectively. All patients were discharged within 24 h, except for one that required urinary output observation due to retention. There were no major postoperative complications. The median pain score at discharge was 0/10. Only one patient was prescribed PRN opioids at discharge. The readmission rate was 0.0%. All patients were asymptomatic on their last follow-up with no definitive obstruction on imaging, and no requirement for additional procedures or stents. CONCLUSION: Single-port low anterolateral extraperitoneal pyeloplasty is a feasible alternative for surgical treatment of UPJO in adult and pediatric patients with improved recovery outcomes.
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Pelve Renal , Procedimentos Cirúrgicos Robóticos , Obstrução Ureteral , Procedimentos Cirúrgicos Urológicos , Humanos , Obstrução Ureteral/cirurgia , Masculino , Feminino , Pelve Renal/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Criança , Adulto , Procedimentos Cirúrgicos Urológicos/métodos , Adolescente , Estudos de Viabilidade , Estudos Retrospectivos , Adulto Jovem , Pré-Escolar , Pessoa de Meia-Idade , Duração da Cirurgia , Resultado do TratamentoRESUMO
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Single-port (SP) robotic surgery is a relatively new technology that is expected to become available on the European market within a year. We investigated the current expectations of robotic surgery experts and opinion leaders practicing in Europe. A 17-item online questionnaire was sent to 120 participants identified as "experts" on the basis of their general contributions to the field of robotic surgery. Overall, 90 responses were registered, with a response rate of 75%. Italy (30%), France (15%), and the UK (12%) provided the most participants, who worked mainly in academic-either public (60%) or private (20%)-hospitals. Most respondents (79%) had no previous experience with "single site" surgery, and attendance at scientific meetings (79%) and perusal of the literature (65%) were the sources of SP knowledge most frequently reported. The perceived advantages of SP robotic surgery included lower invasiveness (61%), easier access to the retroperitoneal or extraperitoneal space (53%), better cosmetic results (44%), and lower postoperative pain (44%). The most "appealing" SP procedures were retroperitoneal partial nephrectomy via an anterior approach (43%) and transvesical simple prostatectomy (43%). Within the limitations of this type of analysis, our findings suggest high interest and a positive attitude towards SP technology overall. Patient summary: Technology for single-port (SP) robotic surgery, in which just one skin incision is made in the abdomen to perform the operation, will soon be available in Europe. We conducted a survey on SP surgery among European experts in urological robotic surgery. The results show that there is high interest in and a positive attitude to SP surgery. The SP approach could result in better cosmetic results and lower postoperative pain for patients.
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INTRODUCTION: We aim to report our surgical technique, functional and radiological outcomes of single port (SP) extraperitoneal robotic pediatric pyeloplasty through a low anterior (3 cm) access using a da-Vinci single-port (SP) robotic surgical system in the pediatric population. MATERIAL AND METHODS: We present our initial series of 6 pediatric patients that underwent robotic SP extraperitoneal pyeloplasty between 2022 and 2023. Patient clinicopathologic variables and perioperative outcomes were collected prospectively. RESULTS: All cases of SP extraperitoneal pyeloplasty were completed without any intraoperative complications or conversion to an open, laparoscopic, or multi-port robotic pyeloplasty. Total operative times including cystoscopy ranged from 178 min to 240 min. All patients tolerated the surgery with minimal postsurgical pain and no narcotic requirement. No intraoperative or immediate postoperative complications were recorded in the cohort. There were no readmissions after discharge at a median follow-up of 12 months (6-18 months) in our series. CONCLUSIONS: Single port extraperitoneal pyeloplasty is a safe and feasible option for upper tract reconstruction in pediatric patients. All patients had complete resolution of symptoms and improvement of hydronephrosis on follow-up imaging.
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Pelve Renal , Procedimentos Cirúrgicos Robóticos , Obstrução Ureteral , Procedimentos Cirúrgicos Urológicos , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Pelve Renal/cirurgia , Criança , Masculino , Feminino , Procedimentos Cirúrgicos Urológicos/métodos , Obstrução Ureteral/cirurgia , Pré-Escolar , Adolescente , Resultado do Tratamento , Laparoscopia/métodos , Estudos Prospectivos , Procedimentos de Cirurgia Plástica/métodosRESUMO
BACKGROUND: Surgical management of large prostatic adenomas can be performed via open, endoscopic, or robotic approaches. A low-profile single-port (SP) robot was built to work in confined areas (ie, the bladder) and regionalize surgery. OBJECTIVE: To describe the novel SP transvesical (TV) robot-assisted simple prostatectomy (RASP) and report clinical outcomes. DESIGN, SETTING, AND PARTICIPANTS: SP TV RASP cases were performed in an academic hospital by two surgeons from 2019 to 2023. A total of 117 cases were performed, and data from patients with at least 12 mo of follow-up were analyzed. The inclusion criterion was severe obstructive urinary symptoms or catheter-dependent urinary retention due to large prostates with volume >80 ml. SURGICAL PROCEDURE: The procedure consisted of two main steps through a single 3-cm suprapubic incision: first, enucleation of the adenoma, and second, a 360° bladder mucosal flap reconstruction. No drains or continuous bladder irrigation was used routinely. MEASUREMENTS: Intraoperative parameters, pre- and postoperative uroflowmetry, and 1-yr clinical outcomes were assessed. We used descriptive statistics to analyze the data. RESULTS AND LIMITATIONS: All procedures were completed successfully without additional ports or conversions. The median console time and estimated blood loss were 107 min and 100 ml, respectively. Transfusion rate was 0%. Intraoperative complications included two suspected air emboli attributed to high insufflation pressures. There were no major postoperative complications. In total, 95.8% were discharged within the first 24 h, with a median length of stay and pain score of 5 h and 3/10, respectively. There was persistent improvement in the median International Prostate Symptom Score and flow rate after 1 yr. The median Sexual Score Inventory for Men score was 20 at 12 mo. Our study is limited by its retrospective nature and cohort size. CONCLUSIONS: SP TV RASP is a feasible alternative for the management of severe benign prostatic hyperplasia that promotes fast recovery and demonstrates 1-yr improvement in urinary function. PATIENT SUMMARY: Single-port transvesical robot-assisted simple prostatectomy is a minimally invasive alternative for the treatment of large benign prostatic growth. A single robotic arm goes through a small incision in the skin and bladder to extract the obstructive prostatic tissue. Afterward, reconstruction of the area is done to decrease bleeding and improve postoperative symptoms. We found that patients recover quickly and have excellent clinical results with a low risk of complications.
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Hiperplasia Prostática , Procedimentos Cirúrgicos Robóticos , Robótica , Masculino , Humanos , Robótica/métodos , Estudos Retrospectivos , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Bexiga Urinária/cirurgia , Hiperplasia Prostática/complicações , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do TratamentoRESUMO
Drinking water treatment residuals (WTR), a waste-derived product, are often recommended to use as an amendment in stormwater biofilters to enhance their capacity to remove phosphate and microbial pollutants. However, their efficacy has been assumed to remain high in the presence of compost, one of the most common amendments used in biofilters. This study tests the validity of that assumption by comparing the removal capacities of WTR-amended biofilters with and without the presence of compost. Our results show that amending sand with WTR increased E. coli removal by at least 1-log, but the addition of compost in the sand-WTR media lowered the removal capacity by 13 %. Similarly, the addition of WTR to sand improved phosphate removal to nearly 1177 %, but the removal decreased slightly by 8 % when adding compost to the media. The results confirmed that dissolved organic carbon (DOC) leached from the compost could compete for adsorption sites for bacteria and phosphate, thereby lowering WTR's adsorption capacity based on the amount of DOC adsorbed on WTR. Collectively, these results indicate that the stormwater treatment industry should avoid mixing compost with WTR to get the maximum benefits of WTR for bacterial removal and improve the performance lifetime of WTR-amended biofilters.
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Compostagem , Água Potável , Purificação da Água , Purificação da Água/métodos , Abastecimento de Água , Areia , Escherichia coli , Chuva , Fosfatos , ResíduosRESUMO
OBJECTIVE: To compare robot-assisted simple prostatectomy intraoperative and postoperative.ßoutcomes between single-port (SP) and multiport (MP) robotic systems in a multi-institutional setting. METHODS: We analyzed all-consecutive robot-assisted simple prostatectomy cases done in 5 centers from January 2017 to October 2022. Data were analyzed with descriptive statistics and compared with appropriate tests depending on the type of variable and distribution. Statistical significance was considered when P.ß<.05. RESULTS: A total of 405 cases were analyzed:.ß249 and 156 were MP and SP, respectively. Operative times were similar between groups (P.ß=.ß.62). Estimated blood loss during surgery was significantly lower with the SP robot (P.ß<.001). Postoperatively, the SP approach required a significantly shorter hospital stay, less use of opioids, and a shorter duration of Foley catheter (P.ß<.001). There was no significant difference between the post-operative Clavien-Dindo ...3 complication rate (P.ß=.ß.30). The 30-day readmission rate of MP (10.8%) was significantly higher than for SP (0%) (P.ß<.001). De novo urge incontinence was more common in the MP group (P.ß=.ß.02). CONCLUSION: The SP robotic approach to simple prostatectomy is advantageous when it comes to postoperative comfort for patients. Specifically, it requires a shorter hospital stay, less use of opioids, and a shorter Foley catheter duration.
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Procedimentos Cirúrgicos Robóticos , Robótica , Masculino , Humanos , Analgésicos Opioides , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Prostatectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento , OsteonectinaRESUMO
Some evidence supports the fact that chronic low-grade inflammation contributes to the physiopathology of type 2 diabetes mellitus (T2DM), and circulating markers of inflammation (e.g., C-reactive protein (CRP), pro- and anti-inflammatory biomarkers (e.g., adiponectin), and endothelial function markers could indicate an ongoing pathology. Following certain dietary patterns (DPs) may result in favorable changes in inflammatory biomarkers. The overarching aim of this systematic review and meta-analysis is to explore the inflammatory effect of healthy DPs on inflammatory biomarkers in adults with T2DM. A systematic search of the literature was conducted using the electronic databases MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trials. A total of 10 randomized controlled clinical trials (RCTs) were analyzed. In our linear meta-analysis, the random-effects model was applied to estimate standardized mean differences (SMD) to associate the effect of the interventions. Dietary Approaches to Stop Hypertension (DASH), Diabetes UK healthy eating, Mediterranean Diet (MD), Diabetes Prevention Program (DPP), and the American Heart Association's Therapeutic Lifestyle Changes diet were associated with a significant reduction in CRP (SMD: −0.83, 99% CI −1.49, −0.17, p < 0.001; I2 94%), while plasma levels of adiponectin were significantly higher with the intake of MD, DPP, and Diabetes UK healthy eating (SMD: 0.81, 99% CI 0.06,1.56, p < 0.005; I2 96%), both of which indicate less inflammation. Sensitivity analyses were carried out, and potential publication bias was examined. In conclusion, low- moderate-quality evidence from RCTs suggests that, for the DPs evaluated, there are favorable changes in CRP and adiponectin.
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Adiponectina , Diabetes Mellitus Tipo 2 , Adulto , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Biomarcadores , Proteína C-Reativa/metabolismo , InflamaçãoRESUMO
INTRODUCTION: The effects of fatty acids on health vary and depend on the type, amount, and route of consumption. EPA and DHA have a defined role in health, unlike coconut oil. OBJECTIVE: The aim was to investigate the changes in metabolic regulation and the composition of the culture-dependent microbiota after supplementation with different fatty acids in db/db mice. Material and Methods. We were using 32 8-week-old db/db mice, supplemented for eight weeks with EPA/DHA derived from microalgae as well as coconut oil. The lipid, hormonal profiles, and composition of the culture-dependent microbiota and the phylogenetic analysis based on the 16S rRNA gene sequencing were determined for identification of the intestinal microbiota. RESULTS: Enriched diet with EPA/DHA reduced TNF-α, C-peptide, insulin resistance, resistin, and the plasma atherogenic index, but increased TC, LDL-c, VLDL-c, and TG without changes in HDL-c. Coconut oil raised the HDL-c, GIP, and TNF-α, with TG, insulin resistance, adiponectin, and C-peptide reduced. CONCLUSION: The most abundant microbial populations were Firmicutes and the least Proteobacteria. EPA/DHA derived from microalgae contributes to improving the systemic inflammatory status, but depressed the diversity of the small intestine microbiota. Coconut oil only decreased the C-peptide, raising TNF-α, with an unfavorable hormonal and lipid profile.
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BACKGROUND: Wolff-Parkinson-White syndrome is a congenital abnormality of the heart. Patients with this syndrome and multiple dental caries with pulp exposure may require comprehensive dental treatment under general anesthesia. Pulpectomy is performed in primary teeth with pulp expose. This treatment in anterior teeth requires palatal access and the majority there is no good visibility, requiring more time to perform. Therefore, this case aimed to demonstrate a pulp chamber opening alternative in pulpectomies in a child with Wolff-Parkinson-White syndrome. CASE PRESENTATION: A 3-year-old female patient with Wolff-Parkinson-White syndrome and multiple dental caries with reversible pulpitis in anterior upper teeth. The dental treatment was performed under general anesthesia. Due to abundant hemorrhage in anterior upper teeth, pulpectomies were performed, which pulp chamber openings were modified by labial and the treatment itself was completed. After, these teeth were rehabilitated with direct restorative veneers using light-curing composite resin. The follow-up at 12 months showed an absence of evidence clinic and radiographic. CONCLUSION: This case demonstrated the pulp chamber opening performed by labial in pulpectomy is an effective and viable alternative to reduce operative time and improve visibility in pulpotomies in a child with Wolff-Parkinson-White syndrome.
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Cárie Dentária , Síndrome de Wolff-Parkinson-White , Criança , Pré-Escolar , Cárie Dentária/cirurgia , Cavidade Pulpar , Feminino , Humanos , Pulpectomia , Dente Decíduo , Resultado do Tratamento , Síndrome de Wolff-Parkinson-White/cirurgiaRESUMO
OBJECTIVE: To assess oral health-related quality of life (OHRQoL) changes before and after the primary surgical treatment in infants with cleft lip and/or palate (CL/P). DESIGN: Quasi-experimental study. METHODS: A total of 106 infants with CL/P younger than 2 years undergoing primary surgical treatment in the Plastic Surgery Service of the Instituto Nacional de Salud del Niño in Peru. The parent/caregiver answered a questionnaire about OHRQoL named the Peruvian version of the Early Childhood Oral Health Impact Scale (P-ECOHIS) in the pretreatment (baseline) and follow-up post-treatment. The total score of P-ECOHIS and their 2 sections (child impact and family impact) in the baseline and each follow-up period post-treatment scores were assessed. As well as, the type of the CL/P on OHRQoL, standardized effect sizes (ES) based on mean total change scores (difference between baseline and 12th month) were analyzed. RESULTS: Improvements in infant's OHRQoL after treatment were reflected in each follow-up period P-ECOHIS score compared to the baseline score. The total P-ECOHIS scores decreased significantly from 28.07 (baseline) to 7.7 (12th month; P < .0001), as did the individual domain scores (P < .0001). There were significant differences in the baseline and follow-up post-treatment scores of infants who reported improvement of the OHRQoL (P < .0001). The ES was large (3.79). The cleft lip had an improvement in the OHRQoL at 12th month post-treatment (P < .0001). CONCLUSIONS: Primary surgical post-treatment resulted in significant improvement of the infant's OHRQoL with CL/P.
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Fenda Labial , Fissura Palatina , Criança , Pré-Escolar , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Saúde Bucal , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
Beneficial effects of n-3 fatty acids on metabolic biomarkers in patients with type 2 diabetes (T2DM) has been reported. The objectives of this current research were to investigate the effects of n-3 supplementation on metabolic factors, weight, and body mass index (BMI) in patients with type 2 diabetes mellitus (T2DM), using a meta-analysis of randomized, controlled trials (RCTs). Online databases PubMed, Embase, Web of Science, and Science Direct were searched until 2021 to identify eligible articles. Thirty trials were included. The results showed that n-3 consumption can significantly reduce glycemic factors including fasting blood sugar (FBS) (-0.36 (-0.71 to -0.01)), glycated hemoglobulin (HbA1c) (-0.74 (-1.13 to -0.35)), and homeostatic model assessment of insulin resistance (HOMA.IR) (-0.58 (-1.13 to -0.03)). Furthermore, significant improvement in lipid profile including triglycerides (TG) (-0.27 (-0.37 to -0.18)), total cholesterol (-0.60 (-0.88 to -0.32)), low density lipoprotein (LDL) (-0.54 (-0.85 to -0.23)), and high-density lipoprotein (HDL) (0.60 (0.23 to 0.96)) levels were found in the present meta-analysis. The reduction in the inflammatory marker's tumor necrosis factor-alpha (TNF-α) (-0.13 (-0.75 to 0.48)) and c-reactive protein (CRP) (-0.72 (-1.70 to 0.27)), as well as weight (-0.09 (-0.24 to 0.07)) and BMI (-0.13 (-0.29 to 0.02)) were not statistically significant. Furthermore, the findings revealed that the optimal dose and duration of n-3 consumption for patients with T2DM is 1000-2000 mg/d for more than 8 weeks. The present meta-analysis and review reveals that n-3 supplementation can improve glycemic factors and lipid profile in patients with T2DM. Furthermore, n-3 supplementation may provide beneficial effects on inflammatory markers and body weight if used at the appropriate dose and duration.
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Introduction: Sweeteners are additives used in different foods. They can be natural (sucrose and stevia) or artificial (sucralose). Currently, they are routinely consumed in multiple products and their effects on the mucosa of the small intestine and its microbiota are still controversial. Objective: To relate the consumption of sweeteners and their effect on the immune system and the microbiota of the small intestine in CD1 mice. Materials and methods: We used 54 three-week-old CD1 mice divided into three groups in the experiments: 1) A group of three weeks without treatment, 2) a group treated for six weeks, and 3) a group treated for 12 weeks using sucrose, sucralose, and stevia. We obtained CD19+ B lymphocytes, IgA+ antibodies, transforming growth factor-beta (TGF-b), and interleukins 12 and 17 (IL-12 and -17) from Peyer's patches and lamina propria cells while DNA was obtained from intestinal solids to identify bacterial species. Results: After 12 weeks, sucrose and sucralose consumption caused a reduction in bacterial communities with an increase in CD19+, a decrease in IgA+ and TGF-b, and an increase in IL-12 and -17 in the Peyer's patches while in the lamina propria there was an increase in all parameters. In contrast, stevia led to an improvement in bacterial diversity and percentage of CD19+ lymphocytes with minimal increase in IgA+, TGF-b, and IL-12, and a decrease in IL-17. Conclusion: Sucrose and sucralose caused negative alterations in bacterial diversity and immune parameters after 12 weeks; in contrast, stevia was beneficial for the intestinal mucosa.
Introducción. Los edulcorantes son aditivos que se consumen en los alimentos. Pueden ser naturales (sacarosa y estevia) o artificiales (sucralosa). Actualmente, se consumen rutinariamente en múltiples productos, y sus efectos en la mucosa y la microbiota del intestino delgado aún son controversiales Objetivo. Relacionar el consumo de edulcorantes y su efecto en el sistema inmunitario y la microbiota del intestino delgado en ratones CD1. Materiales y métodos. Se utilizaron 54 ratones CD1 de tres semanas de edad divididos en tres grupos: un grupo de tres semanas sin tratamiento, un grupo tratado durante seis semanas y un grupo tratado durante 12 semanas. Se les administró sacarosa, sucralosa y estevia. A partir del intestino delgado, se obtuvieron linfocitos B CD19+ y células IgA+, TGF-ß (Transforming Growth Factor-beta) o el factor de crecimiento transformador beta (TGF-beta), IL-12 e IL-17 de las placas de Peyer y de la lámina propia. De los sólidos intestinales se obtuvo el ADN para identificar las especies bacterianas. Resultados. Después del consumo de sacarosa y sucralosa durante 12 semanas, se redujeron las comunidades bacterianas, la IgA+ y el TGF-beta, se aumentó el CD19+, y además, se incrementaron la IL-12 y la IL-17 en las placas de Peyer; en la lámina propia, aumentaron todos estos valores. En cambio, con la estevia mejoraron la diversidad bacteriana y el porcentaje de linfocitos CD19+, y hubo poco incremento de IgA+, TGF-b e IL-17, pero con disminución de la IL-17. Conclusión. La sacarosa y la sucralosa alteraron negativamente la diversidad bacteriana y los parámetros inmunitarios después de 12 semanas, en contraste con la estevia que resultó benéfica para la mucosa intestinal.
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Microbiota , Edulcorantes , Animais , Linfócitos B , Mucosa Intestinal , Intestino Delgado , CamundongosRESUMO
Resumen Introducción. Los edulcorantes son aditivos que se consumen en los alimentos. Pueden ser naturales (sacarosa y estevia) o artificiales (sucralosa). Actualmente, se consumen rutinariamente en múltiples productos, y sus efectos en la mucosa y la microbiota del intestino delgado aún son controversiales. Objetivo. Relacionar el consumo de edulcorantes y su efecto en el sistema inmunitario y la microbiota del intestino delgado en ratones CD1. Materiales y métodos. Se utilizaron 54 ratones CD1 de tres semanas de edad divididos en tres grupos: un grupo de tres semanas sin tratamiento, un grupo tratado durante seis semanas y un grupo tratado durante 12 semanas. Se les administró sacarosa, sucralosa y estevia. A partir del intestino delgado, se obtuvieron linfocitos B CD19+ y células IgA+, TGF-ß (Transforming Growth Factor-beta) o el factor de crecimiento transformador beta (TGF-beta), IL-12 e IL-17 de las placas de Peyer y de la lámina propia. De los sólidos intestinales se obtuvo el ADN para identificar las especies bacterianas. Resultados. Después del consumo de sacarosa y sucralosa durante 12 semanas, se redujeron las comunidades bacterianas, la IgA+ y el TGF-beta, se aumentó el CD19+, y además, se incrementaron la IL-12 y la IL-17 en las placas de Peyer; en la lámina propia, aumentaron todos estos valores. En cambio, con la estevia mejoraron la diversidad bacteriana y el porcentaje de linfocitos CD19+, y hubo poco incremento de IgA+, TGF-ß e IL-17, pero con disminución de la IL-17. Conclusión. La sacarosa y la sucralosa alteraron negativamente la diversidad bacteriana y los parámetros inmunitarios después de 12 semanas, en contraste con la estevia que resultó benéfica para la mucosa intestinal.
Abstract Introduction: Sweeteners are additives used in different foods. They can be natural (sucrose and stevia) or artificial (sucralose). Currently, they are routinely consumed in multiple products and their effects on the mucosa of the small intestine and its microbiota are still controversial. Objective: To relate the consumption of sweeteners and their effect on the immune system and the microbiota of the small intestine in CD1 mice. Materials and methods: We used 54 three-week-old CD1 mice divided into three groups in the experiments: 1) A group of three weeks without treatment, 2) a group treated for six weeks, and 3) a group treated for 12 weeks using sucrose, sucralose, and stevia. We obtained CD19+ B lymphocytes, IgA+ antibodies, transforming growth factor-beta (TGF-b), and interleukins 12 and 17 (IL-12 and -17) from Peyer's patches and lamina propria cells while DNA was obtained from intestinal solids to identify bacterial species. Results: After 12 weeks, sucrose and sucralose consumption caused a reduction in bacterial communities with an increase in CD19+, a decrease in IgA+ and TGF-b, and an increase in IL-12 and -17 in the Peyer's patches while in the lamina propria there was an increase in all parameters. In contrast, stevia led to an improvement in bacterial diversity and percentage of CD19+ lymphocytes with minimal increase in IgA+, TGF-b, and IL-12, and a decrease in IL-17. Conclusion: Sucrose and sucralose caused negative alterations in bacterial diversity and immune parameters after 12 weeks; in contrast, stevia was beneficial for the intestinal mucosa.
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Edulcorantes , Microbioma Gastrointestinal , Sacarose , Stevia , Intestino DelgadoRESUMO
El citomegalovirus congénita es un virus ADN de doble cadena que pertenece a la familia Herpesviridae y causa infección intrauterina, puede ser asintomático o sintomático desde el nacimiento. El objetivo del presente reporte de caso es mostrar la eficacia antimicrobiana de la pasta 3Mix modificada en el tratamiento de periodontitis apical aguda, en una paciente niña con infección congénita por citomegalovirus. Paciente de sexo femenino de 2 años y 3 meses, sintomática a la infección congénita por citomegalovirus. con secuelas permanentes. A nivel estomatológico presenta múltiples lesiones cariosas, pulpitis reversible, periodontitis apical aguda, se realizó tratamientos pulpares en las piezas 61,62,51,52,81,71,54,64 en una sola sesión, bajo anestesia general. En la pulpectomía de la pieza 61 se aplicó el material obturador intraconducto en el tercio apical con pasta 3Mix modificada con una composición (ciprofloxacino, metronidazol, cefalexina) y como vehículo el macrogol y el propilenglicol, y en el tercio medio y cervical con óxido de zinc y eugenol. Se determinó realizar su reconstrucción con poste de fibra de vidrio y restauraciones con resina a partir de matrices de silicona de adición. Conclusión: A los 30 días y 6 meses posterior al tratamiento, se observó ausencia de dolor, hinchazón/absceso o fistula, sin movilidad patológica del diente.
RESUMO
El síndrome Muenke se caracteriza por retraso del desarrollo y pérdida auditiva neurosensorial. Personas que presentan síndromes podrían presentar defectos del desarrollo del esmalte. Sin embargo, en personas con síndrome Muenke no existe evidencia sobre la presencia y el manejo de las secuelas de estos defectos. Objetivo: Describir el manejo de secuelas de los defectos del desarrollo del esmalte en dientes primarios con un procedimiento odontológico integral en sala de operaciones de paciente con síndrome Muenke. Caso Clínico: Paciente de 2 años de edad, sexo masculino, con diagnóstico sistémico de Síndrome Muenke y diagnóstico odontológico: fracturas post eruptivas del defecto del esmalte extensión I (< 1/3 del diente) y II (de 1/3 a 2/3 del diente) en los dientes anteroinferiores y fracturas post eruptivas del defecto del esmalte extensión III (> 2/3 del diente) de los dientes 62 y 52. El manejo clínico de estas secuelas, realizadas en sala de operaciones, consistió en: carillas de resina compuestas fotopolimerizable que permitieron restaurar las fracturas post eruptivas de los dientes antero inferiores; y los dientes 62 y 52 fueron rehabilitadas con coronas de resina compuesta fotopolimerizable a mano alzada. Conclusión: El manejo de las secuelas de los defectos de desarrollo del esmalte, en paciente con Síndrome Muenke, se consideró clínicamente positivo; pues después de 6 meses los dientes tratados no presentaron dolor espontáneo, ni se observó fistulas o absceso, ni movilidad dentaria.
O síndrome Muenke é caracterizado por atraso no desenvolvimento e perda auditiva neurossensorial. Pessoas com síndrome podem ter defeitos de desenvolvimento do esmalte. No entanto, em pessoas com síndrome Muenke não há evidências sobre o manejo das sequelas desses defeitos. Objetivo: Descrever o manejo das sequelas de defeitos de desenvolvimento do esmalte em dentes decíduos com um procedimento odontológico abrangente na sala de cirurgia de um paciente com síndrome Muenke. Caso Clínico: Paciente masculino de 2 anos com diagnóstico sistêmico de Síndrome Muenke e diagnóstico dentário: Fraturas pós-eruptivas da extensão do defeito de esmalte I (< 1/3 do dente) e II (1 / 3 - 2/3 do dente) nos dentes anteriores inferiores. e fraturas pós-eruptivas da extensão do defeito de esmalte III (> 2/3 do dente) dos dentes 62 e 52. Os tratamentos realizados foram com resina compostas fotopolimerizáveis que permitiu restaurar as fraturas pós-eruptivas da extensão I e II do defeito do esmalte dos dentes anteriores inferiores. Nos dentes 62 e 52 com fraturas pós-eruptivas do defeito de esmalte de extensão III. foram restauradas com coroas de resina compostas fotopolimerizáveis à mão libre. Conclusão: Os tratamentos foi considerado clinicamente positivo em paciente com Síndrome de Muenke; porque após 6 meses os dentes tratados não apresentavam dor espontânea, nem fístulas ou abscessos, nem mobilidade dentária
Muenke syndrome is characterized by developmental delay and sensorineural hearing loss. People with a syndrome may have enamel development defects. However, in people with Muenke syndrome, there is no evidence on the management of the sequelae of these defects. Objective: To describe the management of sequelae of enamel development defects in the operating room with a comprehensive dental procedure in primary teeth in a single sesión. Clinical case: 2 -year -old, male patient with medical diagnosis: Muenke Syndrome and dental diagnosis: Post eruptive fractures of the enamel defect extensión I (< 1/3 of the tooth) and II (at least 1/3 but less than 2/3 of the affected tooth) in teeth 63, 73, 72,71, 81, 82, 83 and post- eruptive of the extensión III (more than 2/3 of the tooth is affected) enamel defect of teeth 62 and 52, treatment consisted in: veneers that allowed to restore the post eruptive fractures of lower anterior teeth and composite
Assuntos
Humanos , Masculino , Pré-Escolar , Craniossinostoses , Esmalte Dentário , Síndrome , Defeitos de Desenvolvimento do Esmalte DentárioRESUMO
El tratamiento de endodoncia en dientes permanentes jóvenes que han sufrido un episodio de trauma dental era desalentador hasta hace unas épocas. La revascularización, se ha posicionado como una opción de tratamiento que tienen aquellos dientes con raíces inmaduras porque favorece el desarrollo radicular y el posterior cierre apical. El objetivo fue describir el tratamiento de revascularización en un incisivo central permanente no vital post traumatismo dental. Se presenta el caso de un paciente de sexo femenino, de 08 años de edad, con antecedentes de traumatismo dental, en sector antero superior, incisivo central permanente con formación radicular incompleta y con ausencia de vitalidad pulpar; se realizó el tratamiento de revascularización pulpar utilizando pasta antibiótica 3Mix MP para la desinfección del conducto radicular. Se realizaron controles clínicos y radiográficos para evaluar la ausencia de sintomatología y el desarrollo radicular, a los 14 meses se observó aumento del grosor y longitud radicular y cierre apical. Se concluyó que la revascularización es una opción de tratamiento que permite un desarrollo radicular en sentido longitudinal y un engrosamiento de las paredes del conducto radicular con un posterior cierre apical, disminuyendo el riesgo de fractura que pudiera sufrir
O tratamento endodôntico de dentes permanentes jovens que sofreram um episódio de trauma dentário foi desencorajador até algumas vezes atrás. A revascularização foi posicionada como uma opção de tratamento para os dentes com raízes imaturas, pois favorece o desenvolvimento radicular e o fechamento apical subsequente. O objetivo foi descrever o tratamento de revascularização em um incisivo central permanente não vital após traumatismo dentário. Apresentamos o caso de uma paciente do sexo feminino, 8 anos, com história de traumatismo dentário, no setor antero superior, incisivo central permanente com formação radicular incompleta e ausência de vitalidade pulpar; O tratamento de revascularização da polpa foi realizado com pasta antibiótica 3Mix-MP para desinfecção do canal radicular. Controles clínicos e radiográficos foram realizados para avaliar ausência de sintomas e o desenvolvimento radicular, aos 14 meses foi observado um aumento na espessura e comprimento da raiz e no fechamento apical. Concluiu-se que a revascularização é uma opção de tratamento que permite o desenvolvimento radicular na direção longitudinal e o espessamento das paredes do canal radicular com posterior fechamento apical, reduzindo o risco de fratura que poderia ser sofrida
Endodontic treatment of immature permanent teeth that have had an episode of dental trauma was discouraging until a recently. Revascularization has been positioned as a treatment option because it promotes root development and subsequent apical closure. The aim is of this report is to describe revascularization treatment performed in a non-vital permanent central incisor with history of dental trauma. We present the case of an 8 year-old female patient of with history of dental trauma, in the upper anterior section, The permanent central incisor presented with incomplete root formation and absence of pulpal vitality. Pulp revascularization treatment was performed using 3Mix - MP paste for disinfection of the root canal. Clinical and radiographic controls were performed to evaluate the absence of symptomatology and root development. After 14 months the thickness and root length and the apical closure were increased. It was
Assuntos
Humanos , Feminino , Criança , Traumatismos Dentários , Dentição Permanente , Endodontia , Terapêutica , Cavidade PulparRESUMO
BACKGROUND: Breast cancer (BC) is the first cause of cancer morbidity and mortality in women. This disease has been linked to obesity; however, it is not clear how fat accumulation affects women who survive breast cancer. Although the visceral adiposity index (VAI) is a marker of cardiometabolic risk and adipose tissue dysfunction, it is not clear how it changes in breast cancer survivors. The aim of this investigation was to compare VAI in women with and without breast cancer. METHODS: A case-control cross-sectional study was conducted on women who were BC survivors and women without the history of BC (control group). Body composition was assessed using electrical bioimpedance while VAI by means of waist circumference (WC), body mass index (BMI), triacylglycerols (TG), and high-density lipoprotein cholesterol (HDL-C). RESULTS: 49 women in the BC survivor group and 50 in the control group. WC was wider in the survivor group as regards control (93.65 ± 10.48 vs. 88.52 ± 9.61 cm) (p=0.025); at once, TG and VAI were significantly higher for the survivor group (243.55 ± 199.84 vs. 159.84 ± 75.77) (p=0.007) and (11.03 ± 11.15 vs. 6.41 ± 3.66) (p < 0.005), respectively. Body composition parameters were similar in both groups. CONCLUSIONS: VAI is higher in women who are BC survivors in comparison with controls matched by age and bodyweight.