Silk peptide production from whole silkworm cocoon using ultrasound and enzymatic treatment and its suppression of solar ultraviolet-induced skin inflammation.

Silk fibroin, which is derived from sericin through degumming, is mainly used as a biomaterial. However, interest in functional verification and industrial applications of sericin has been growing for several years. We used ultrasonication to simplify the extraction process of the silk peptide under low salt conditions at 20 °C, instead of using the conventional conditions of high salt and temperature. The concentration of the silk peptide was measured to determine the optimized extraction time and solvent, which were 4 h and 0.1 N NaOH, respectively. The molecular weight of the enzyme-treated silk peptide was measured using SDS-PAGE and GPC. Silk peptide treated with papain after ultrasound had a molecular weight of less than 5 kDa, and the papain treated-silk peptide reduced solar ultraviolet-induced COX-2 expression through inhibition of ERK phosphorylation. This is the first study investigating simultaneous extraction of fibroin and sericin, which can be used for mass production of food materials.

The use of papain gel cream and sunflower oil in promoting healing in a wound in dogs: three case reports / Uso de gel creme de papaína na cicatrização de feridas em cães: relato de três casos

Papain is a proteolytic enzyme removed from the leaves of green papaya and/or latex. This enzyme is widely known as a medicinal fruit used extensively in human medicine for the treatment of wounds of various etiologies. However, studies and reports in veterinary medicine are scarce. Another herbal drug widely used in wound healing is Sunflower oil (Helianthus annus). It has inflammatory and antimicrobial properties which stimulate the local neovascularization, promoting tissue granulation, cell migration, fibroblast proliferation, and differentiation. Three dogs were treated with infected necrosis wounds, considered large, extent, and severe, with varied etiology. All cases were treated with papain gel with the exception of one dog, which was given the sunflower oil at the end of the treatment. Papain gel shows effectiveness in the treatment of wounds especially with wound debridement and removal of necrotic tissue. In addition, the healing time was shorter when compared to the treatment with sunflower oil. Finally, the herbal drugs have a low cost and high accessibility. This study contributes to create a new research regarding the use of this drug in animal wound healing.(AU)

A papaína é uma enzima proteolítica retirada do mamão-papaia verde e/ou do látex das folhas do mamoeiro, tendo propriedades medicinais conhecidas na medicina humana para tratamento de feridas de diversas etiologias. Estudos e/ou relatos na medicina veterinária são escassos. Nesse sentido, objetivou-se descrever três casos de cães, que foram atendidos no Hospital Veterinário da Universidade Federal de Lavras, Brasil, todos com feridas infectadas, necrosadas, com etiologia variada e consideradas de grande extensão e gravidade, sendo tratados com gel de papaína. O tratamento demonstrou efetividade na recuperação das feridas, com a formação de grande quantidade de tecido de granulação, em um período menor que os tratamentos convencionais. Por se tratar de um fitoterápico, de baixo custo e alta acessibilidade, o gel de papaína pode ser utilizado no tratamento de feridas de grande extensão em cães e, assim como em humanos, parece ter um efeito benéfico no processo de cicatrização. Pesquisas devem ser conduzidas para elucidar a ação desse produto nos tecidos, bem como as diferentes concentrações a serem administradas.(AU)

Assistência de enfermagem a um paciente com integridade da pele prejudicada relacionada à erisipela: relato de experiência / Nursing assistance to a patient with impaired skin integrity related to erysipelas: experience reporting

Erisipela é um processo infeccioso cutâneo causado por uma bactéria que se propaga pelos vasos linfáticos. Há a veemência em realizar uma orientação adequada quanto ao reconhecimento do problema, ao seguimento do tratamento e aos cuidados com a prevenção das complicações. Este é um relato de experiência de Enfermeiras residentes em Alta Complexidade de um Hospital Universitário do Nordeste do Brasil, na assistência a um paciente com integridade da pele prejudicada relacionada à erisipela. Foi realizado acompanhamento do paciente no período de maio a agosto de 2015, em que foi utilizado diferentes técnicas para tratamento e o mesmo evoluiu com cicatrização e cura da lesão. Possibilitou o crescimento técnico-científico dos profissionais assim como da abordagem da experiência para demais equipes promotoras de cuidado com o paciente. Descritores: Cuidado de Enfermagem; Erisipela; Lesão de Pele.

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Un proceso de la erisipela de Ia piei y infecciosa causada por una bacteria se propaga cola para los vasos linfáticos. Hay una vehemencia de conducta orientación adecuada para el reconocimiento por hacer problema, ao seguimiento de tratamiento y atención a la prevención de complicaciones. Esto y a enfermeras relato de experiencia residentes de alta dei hospital dei noreste de Brasil, mantenimiento universidad complejidad zumbido y zumbido con el paciente integridad de la piei relacionados con la erisipela con discapacidad. Se Ilevó a cabo la monitorización dei paciente cualquier período de mayo a agosto, 2015, estábamos en que diferentes técnicas utilizadas tratamiento párrafo e incluso evolucionamos con la formación de cicatrices y la curación de la lesión. El posible crecimiento de los profesionales científicos técnicos, así como enfoque experiencia párrafo también equipos que promueven el cuidado dei paciente.

Effectiveness of papain gel in venous ulcer treatment: randomized clinical trial / Efetividade do gel de papaína no tratamento de úlceras venosas: ensaio clínico randomizado / Efectividad del gel de papaína en el tratamiento de úlceras venosas: ensayo clínico aleatorio

to assess the effectiveness of 2% papain gel compared to 2% carboxymethyl cellulose in the treatment of chronic venous ulcer patients.

avaliar a efetividade do gel de papaína a 2% comparado ao gel de carboximetilcelulose a 2% no tratamento de pacientes com úlceras venosas crônicas.

evaluar la efectividad del gel de papaína a 2% comparado con el gel de carboximetilcelulosa a 2% en el tratamiento de pacientes con úlceras venosas crónicas.

Análise do atendimento clínico de portadores de úlceras crônicas em membros inferiores / Analysis of the clinical care of patients with chronic ulcers of the lower limbs

Introdução: Úlceras crônicas em membros inferiores podem apresentar diferentes etiologias, sendo as mais frequentes: venosa, arterial, traumática, infecciosa e diabética. O tratamento dessas feridas é dinâmico e depende da evolução da reparação tecidual. Esse tratamento inclui métodos clínicos e cirúrgicos, sendo o curativo o método não cirúrgico mais frequentemente utilizado. Curativos podem ser desde de coberturas inertes até veículos para atuação de princípios ativos no leito da ferida. A principal indicação de ativos está relacionada a efeitos de desbridamento e controle da população bacteriana, possibilitando o preparo desses leitos para resolução cirúrgica ou espontânea. Método: Esse estudo é observacional, longitudinal, retrospectivo, de amostra randomizada no qual pretendemos analisar o atendimento prestado aos portadores de úlceras crônicas em membros inferiores no Ambulatório de Feridas Crônicas da Divisão de Cirurgia Plástica do HCFMUSP entre 2011 e 2013. Resultados: Foram analisados prontuários de indivíduos de ambos os gêneros, idade média 60 anos, portadores de úlceras crônicas em diferentes estágios evolutivos. Foram pesquisadas comorbidades, doença de base, tamanho da lesão, tratamentos utilizados e evolução das feridas. Notouse predomínio das causas vasculares (69,2%) como doenças de base. Todos os pacientes foram primeiramente tratados com curativos contendo princípios ativos, para preparo do leito das feridas. Desses, 84% foram encaminhados para resolução cirúrgica das feridas. Houve fechamento espontâneo em 1,5% dos casos. Os demais pacientes (14,5%) apresentaram piora das lesões com tratamento tópico, necessitando outras formas de preparo desse leito. Conclusão: Agentes tópicos podem ser uma forma ambulatorial/domiciliar efetiva de preparo do leito de úlceras crônicas para resolução cirúrgica.

Introduction: Chronic ulcers of the lower limbs may have different etiologies, with the most frequent being venous, arterial, traumatic, infectious, and diabetic. The treatment of these wounds is dynamic and depends on the evolution of tissue repair. This treatment includes clinical and surgical methods, and dressings are the most frequently used. Dressings can range from inert covers to vehicles for actuation of active substances in the wound bed. The main indication for these substances is related to the effects of debridement and control of the bacterial population, enabling the preparation of wound beds for surgical or spontaneous resolution. Method: This study is an observational, cross-sectional, retrospective study, with random sampling, aimed at assessing the care provided to patients with chronic ulcers of the lower limbs in the Outpatient Clinic for chronic wounds of the Plastic Surgery Division, HCFMUSP, between 2011 and 2013. Results: The clinical charts of 481 patients of both sexes, with a mean age 60 years, were analyzed; all had chronic ulcers in different stages of evolution. Comorbidities, underlying disease, size of the lesion, treatments, and evolution of wounds were evaluated. A predominance of vascular disease (69.2%) was the underlying cause. All patients were initially treated with dressings containing active agents, for preparation of the wound bed. Of these, 84% were referred for surgical management of wounds. There was no spontaneous closure in 1.5% of cases. The remaining patients (14.5%) showed worsening of lesions with topical treatment, and required other forms of preparation of the wound bed. Conclusion: Topical agents may be an effective outpatient/home method to prepare the wound bed of chronic ulcers for surgical management.

Chemomechanical versus drilling methods for caries removal: an in vitro study

The purpose of this study was to compare the performance of chemomechanical caries removal (CMCR) with that of conventional drilling for efficacy of caries removal, time spent, morphological changes and microhardness of surface dentin, and microleakage of subsequent restorations. Forty-six carious deciduous molars were randomly divided into two groups: one each for caries removal by (1) CMCR and by (2) drilling. The completeness of caries removal was evaluated by visual and tactile criteria and a caries detector device. Twenty teeth in each group were restored with glass ionomer (GI) and subjected to thermocycling before undergoing microleakage and microhardness tests. In each group, three restored teeth were used for polarized light microscopic analysis, and three unrestored teeth for scanning electron microscopy (SEM). There was no significant difference in the completeness of caries removal between groups. However, time spent for caries removal by CMCR was significantly longer than that required for drilling. Restorations in the CMCR group had significantly more microleakage than those in the drilling group. Dentin hardness of the cavity floor after CMCR was also significantly lower. Microscopic analyses showed roughened and irregular dentin surfaces in the CMCR group, unlike the smooth surfaces observed in the drilling group. In conclusion, CMCR was as efficacious as drilling in term of completeness of caries removal, but required longer excavation times and resulted in lower microhardness of residual dentin as well as more microleakage after restorations with GI. Further laboratory and clinical evaluations on the efficiency and performance of CMCR for the durability of subsequent restorations are required.

Randomized controlled clinical trial of long-term chemo-mechanical caries removal using PapacarieTM gel

Objectives: Compare the effectiveness of PapacarieTM gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings. Material and Methods: A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with PapacarieTM and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations. Results: No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment. Conclusion: PapacarieTM is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia. .

Efficacy of Papacarie¯ in reduction of residual bacteria in deciduous teeth: a randomized, controlled clinical trial

OBJECTIVES: The aim of the present study was to analyze the efficacy of Papacarie¯ gel compared with the traditional method (low-speed bur) in reducing the counts of total bacteria, Lactobacillus, total Streptococcus and Streptococcus mutans group. METHODS: A randomized, controlled clinical trial with a split-mouth design was performed. The sample comprised 40 deciduous teeth in 20 children (10 males and 10 females) aged four to seven years. The teeth were randomly allocated to two groups: G1, or chemomechanical caries removal with Papacarie Duo¯, and G2, or the removal of carious dentin tissue with a low-speed bur. Infected dentin was collected prior to the procedure, and the remaining dentin was collected immediately following the removal of the carious tissue. Initial and final counts of bacterial colonies were performed to determine whether there was a reduction in the number of colony-forming units (CFUs) of each microorganism studied. ClinicalTrials.gov: NCT01811420. RESULTS: Reductions were found in the numbers of total bacteria, total Streptococcus and Streptococcus mutans group following either of the caries removal methods (p<0.05). A reduction was also noted in the number of Lactobacillus CFUs; however, this difference did not achieve statistical significance (p>0.05). CONCLUSION: Papacarie¯ is an excellent option for the minimally invasive removal of carious tissue, achieving significant reductions in total bacteria, total Streptococcus and S. mutans with the same effectiveness as the traditional caries removal method. .

Remoción quimico-mecánica de lesión de caries en diente permanente con Papacárie Duo(TM): reporte de un caso / Chemomechanical removal of carious lesion in a permanent tooth with Papacárie Duo(TM): report of a case

Este trabajo tiene como objetivo presentar el protocolo clínico de Papacárie Duo(TM), desde el diagnóstico de la lesión de caries hasta el procedimiento restaurador. Una paciente femenina de 12 años de edad se presentó a la consulta odontopediátrica por dolor al frío y durante la ingesta de alimentos dulces. El examen clínico y radiográfico reveló caries en la pieza 46, clasificada como score 6, según el sistema ICDAS (cavidad extensa con exposición de la dentina). La conducta clínica consistió en la eliminación del tejido infectado por medio de la remoción quimico-mecánica de la caries utilizando el gel a base de papaína y restauración con ionómero vítreo. Se concluye, a partir de este protocolo, que la eliminación quimico-mecánica de la lesión de caries es un método de fácil aplicación basdado en la odontología mínimamente invasiva.

Uso e efetividade da papaína no processo de cicatrização de feridas: uma revisão sistemática / Uso y efectividad de la papaína en la cicatrización de heridas: una revisión sistemática / Use and effectiveness of papain in the wound healing process: a systematic review

Trata-se de uma revisão sistemática, cujo objetivo é analisar as evidências sobre o uso da papaína na cicatrização de feridas. Foi realizado levantamento bibliográfico manual e eletrônico nas bases de dados: LILACS; COCHRANE; IBECS; MEDLINE via Pubmed e CINAHL, utilizando os seguintes termos como descritores e como palavras: Carica; Papaína; e Cicatrização, período de 1987 a 2010. Os resultados apontaram predomínio de estudos descritivos, exploratórios, estudos de caso e relatos de caso, apenas um ensaio clínico randomizado e controlado. Os resultados também evidenciaram que a papaína é usada em feridas de diversas etiologias e em todas as fases da cicatrização, sem contraindicações específicas, sendo efetiva e segura, embora haja relatos de ardência e dor. Conclui-se que este estudo contribuiu para demonstrar o uso da papaína nesse período, como fonte de consulta, além de apontar para necessidade de pesquisas com maior rigor metodológico, que proporcionem evidências fortes do seu uso e recomendação.

Se trata de revisión sistemática, cuyo objetivo es analizar evidencias sobre la papaína en la cicatrización de heridas. Se realizó un levantamiento bibliográfico manual y electrónico en la siguientes bases de datos: LILACS, Cochrane, IBECS, MEDLINE vía PubMed y CINAHL, utilizando los términos como descriptores y también como palabra: Carica (Carica), Papaína (Papain) y Cicatrización de Heridas (Wound Healing), desde 1987 hasta 2010. Los resultados mostraron predominio de estudios descriptivos, exploratorios, estudio de caso e informes de caso, y solamente un ensayo clínico aleatorio y controlado. Los artículos mostraron que la papaína se utiliza en heridas de diversas etiologías y en todas las etapas de la cicatrización; sin contraindicaciones específicas; es efectiva y segura, aunque haya informes de ardor y dolor. Se concluye que este estudio demostró cómo se utiliza la papaína desde 1987 hasta hoy, convirtiéndose en una fuente de consulta y aprendizaje, apuntando la necesidad de búsquedas con más rigor metodológico.

This systematic review is aimed at analyzing the evidences about the use of papain in wound healing. A manual and electronic bibliographic research was performed in the following databases: LILACS, Cochrane, IBECS, MEDLINE via Pubmed and CINAHL, using the following terms as descriptors and as word: Carica, Papain and Wound Healing, from 1987 to 2010. The types of studies that predominated were descriptive, exploratory, case studies, case reports and only one randomized controlled clinical trial. The articles showed that papain can be used in wounds of many etiologies and in various healing stages without any specific contraindications, proving to be effective and safe; although there were reports of burning and pain. We conclude that this review contributes to the demonstration of how papain has been used in this period, becoming a learning source, besides pointing to the need of further studies conducted with greater methodological rigor.

Clinical evaluation of caries removal in primary teeth using conventional, chemomechanical and laser technique: an in vivo study.

AIM: To evaluate four different techniques of caries excavation in primary teeth in terms of efficacy, efficiency and pain experienced during the procedure. MATERIALS AND METHODS: Sample of 120 teeth from children aged 5 to 9 years were equally divided into 4 groups - Air rotor (group A), Carisolv (group B), Papacarie (group C) and Er:YAG laser (group D). Visual and tactile criteria along with DIAGNOdent pen value was used to evaluate efficacy. Time was recorded to determine efficiency and FLACC scale was used to assess the pain experienced. RESULTS: Air rotor and laser were more effective and efficient method whereas laser and CMCR methods were more comfortable methods. CONCLUSION: Laser irradiation and CMCR methods are comparable to conventional methods in terms of effectiveness and are less painful methods. CLINICAL SIGNIFICANCE: Newer techniques of CMCR and laser irradiation of dentinal caries are minimally invasive methods and are less painful and thus should be more frequently employed in pediatric dentistry.

Métodos químico-mecânicos para a remoção do tecido cariado / Chemical-mechanical methods for the removal of caries

Há algumas décadas, o tratamento da cárie preconizava a remoção dos tecidos cariados baseados em princípios de extensão para prevenção por meio de instrumentos rotatórios de corte e desgaste. Atualmente, novos materiais foram introduzidos no mercado com a utilização de produtos a base de aminoácidos com hidróxido de sódio ou papaína, os quais são indicados para remoção química - mecânica da cárie sem a necessidade de anestesia e equipamentos rotatórios. Esses materiais possibilitam preparos ultraconservadores. Portanto, o objetivo deste trabalho foi discutir, por meio de uma revisão de literatura, a efetividade dos métodos químico-mecânicos para remoção do tecido cariado.

Stain removal efficacy of a novel dentifrice containing papain and Bromelain extracts--an in vitro study.

OBJECTIVE: To assess the in vitro stain removal efficacy of a novel commercially available dentifrice. MATERIALS AND METHODS: Twenty four human molar teeth (12 in test and 12 in control group) were cut to obtain enamel specimens approximately 9 mm(2) and placed on a microscopic slide using mounting adhesive. They were cycled in human saliva, staining model and dried for brushing regimen using a customized brushing apparatus. Lightness values were recorded at baseline, after staining and after brushing regimen using Adobe Photoshop software. Stain removal efficacy was tested using the either of the two dentifrice slurries for 2 one minute brushing cycles. RESULTS: The mean lightness increment for test and control after brushing regimen was 13.7 ± 6.35 and 3.16 ± 1.29 respectively. There was statistically significant difference in percentage removal of stains for test and control groups (66.99 ± 9.57 and 25.89 ± 16.2 P < 0.001). CONCLUSION: There was significant stain removal with new whitening dentifrice when compared with control. Further clinical trials are recommended to evaluate this significant difference.

A papaína no tratamento da periodontite crônica / Papain in the treatment of chronic periodontitis

A raspagem subgengival e o alisamento radicular constituem o "padrão ouro" e o tratamento de eleição para a periodontite; porém, é um procedimento difícil de ser executado, que requer um intenso treinamento e que pode expor a dentina, causando hipersensibilidade dentinária pela remoção excessiva de cemento, ou produzir defeitos, como sulcos e ranhuras, além de deixar cálculo residual e não conseguir atingir toda as superfície radicular. Recentemente, um gel a base de papaína e cloramina foi introduzido no mercado (Papacárie®), utilizado no tratamento da remoção de dentina cariada. Este gel poderia auxiliar na remoção do cálculo subgengival com menor desgaste do cemento. O objetivo deste trabalho foi comparar a eficácia e analisar a superfície radicular na utilização de um gel à base de papaína e cloramina, associado ao alisamento radicular, na região subgengival. Após receberem instruções de higiene oral, raspagem supragengival e polimento coronário, 18 pacientes com periodontite crônica, 6 mulheres e 12 homens, com idade média de 51 anos (±8) foram tratados num modelo de boca dividida. O tratamento-teste foi constituído pela aplicação do gel na área subgengival por 1 min., seguida pelo alisamento radicular; o tratamento-controle foi constituído pela raspagem subgengival e alisamento radiculares. A terapia foi executada por 3 operadoras e os exames inicial, de 28 dias e 3 meses, foram realizados por um único examinador. Quatro dentes nunca tratados de dois outros pacientes (2 incisivos centrais inferiores e 2 premolares), com indicação para extração, foram submetidos ao tratamento teste e controle e, após a exodontia, analisados em microscopia eletrônica de varredura (MEV). Ao longo dos 3 meses, os resultados demonstraram significativa melhora nos parâmetros clínicos: sangramento à sondagem, profundidade de bolsa e ganho de inserção, tanto no lado-teste, como no lado-controle, principalmente aos 28 dias; mas não foi observada significância estatística ...

Although subgingival scaling and root planing are the “gold standard” for elective treatment of periodontitis, they are difficult procedures to perform. As well as requiring intensive training, they can expose the dentin, causing dentin hypersensitivity by excessive removal of cement, or produce defects such as ridges and grooves, leaving residual calculus, whilst the whole root surface cannot be reached. A papain- and chloramine-based gel (Papacárie®) has recently been introduced to remove carious dentin. This gel may help in the removal of subgingival calculus with reduced consumption of cement. The objective of this study was to compare the effectiveness of a papain- and chloramine-based gel and analyze the root surface in the region associated with subgingival root planing. After receiving oral hygiene instructions, supragingival scaling and coronary polishing, 18 chronic periodontitis patients (6 women and 12 men with a mean age of 51 years ± 8) were treated using a split-mouth model. The test treatment was established by applying the gel to the subgingival area for 1 minute, followed by root planing; whilst the control treatment was established by subgingival scaling and root planing. The therapy was performed by 3 operators, examinations initially and after 28 days and 3 months being performed by a single examiner. Four previously untreated teeth (2 lower central incisors and 2 premolars) with indication for extraction in two other patients were treated as test and control and analyzed by scanning electron microscopy (SEM) following extraction. Although over the 3 months the results showed marked improvement in clinical parameters: bleeding on probing, pocket depth and attachment gain on both test and control sides, especially after 28 days; the difference between the two forms of therapy was not found to be statistically significant. The mean plaque index remained high throughout the study. The SEM analysis showed that the test treatment left ...

A papaína no tratamento da periodontite crônica / Papain in the treatment of chronic periodontitis

A raspagem subgengival e o alisamento radicular constituem o "padrão ouro" e o tratamento de eleição para a periodontite; porém, é um procedimento difícil de ser executado, que requer um intenso treinamento e que pode expor a dentina, causando hipersensibilidade dentinária pela remoção excessiva de cemento, ou produzir defeitos, como sulcos e ranhuras, além de deixar cálculo residual e não conseguir atingir toda as superfície radicular. Recentemente, um gel a base de papaína e cloramina foi introduzido no mercado (Papacárie®), utilizado no tratamento da remoção de dentina cariada. Este gel poderia auxiliar na remoção do cálculo subgengival com menor desgaste do cemento. O objetivo deste trabalho foi comparar a eficácia e analisar a superfície radicular na utilização de um gel à base de papaína e cloramina, associado ao alisamento radicular, na região subgengival. Após receberem instruções de higiene oral, raspagem supragengival e polimento coronário, 18 pacientes com periodontite crônica, 6 mulheres e 12 homens, com idade média de 51 anos (±8) foram tratados num modelo de boca dividida. O tratamento-teste foi constituído pela aplicação do gel na área subgengival por 1 min., seguida pelo alisamento radicular; o tratamento-controle foi constituído pela raspagem subgengival e alisamento radiculares. A terapia foi executada por 3 operadoras e os exames inicial, de 28 dias e 3 meses, foram realizados por um único examinador. Quatro dentes nunca tratados de dois outros pacientes (2 incisivos centrais inferiores e 2 premolares), com indicação para extração, foram submetidos ao tratamento teste e controle e, após a exodontia, analisados em microscopia eletrônica de varredura (MEV). Ao longo dos 3 meses, os resultados demonstraram significativa melhora nos parâmetros clínicos: sangramento à sondagem, profundidade de bolsa e ganho de inserção, tanto no lado-teste, como no lado-controle, principalmente aos 28 dias; mas não foi observada significância estatística...

Although subgingival scaling and root planing are the “gold standard” for elective treatment of periodontitis, they are difficult procedures to perform. As well as requiring intensive training, they can expose the dentin, causing dentin hypersensitivity by excessive removal of cement, or produce defects such as ridges and grooves, leaving residual calculus, whilst the whole root surface cannot be reached. A papain- and chloramine-based gel (Papacárie®) has recently been introduced to remove carious dentin. This gel may help in the removal of subgingival calculus with reduced consumption of cement. The objective of this study was to compare the effectiveness of a papain- and chloramine-based gel and analyze the root surface in the region associated with subgingival root planing. After receiving oral hygiene instructions, supragingival scaling and coronary polishing, 18 chronic periodontitis patients (6 women and 12 men with a mean age of 51 years ± 8) were treated using a split-mouth model. The test treatment was established by applying the gel to the subgingival area for 1 minute, followed by root planing; whilst the control treatment was established by subgingival scaling and root planing. The therapy was performed by 3 operators, examinations initially and after 28 days and 3 months being performed by a single examiner. Four previously untreated teeth (2 lower central incisors and 2 premolars) with indication for extraction in two other patients were treated as test and control and analyzed by scanning electron microscopy (SEM) following extraction. Although over the 3 months the results showed marked improvement in clinical parameters: bleeding on probing, pocket depth and attachment gain on both test and control sides, especially after 28 days; the difference between the two forms of therapy was not found to be statistically significant. The mean plaque index remained high throughout the study. The SEM analysis showed that the test treatment left...

Comparación entre la utilización de elementos rotatorios de baja velocidad y tratamiento químico mecánico de caries dentinal en dentición decidua / Comparison between the use of low speed rotary elements and chemical mechanical treatment of dentinal caries in deciduous dentition

Uno de los principales objetivos en el manejo del paciente pediátrico con caries es la utilización de técnicas no invasivas, que permitan el tratamiento de la patología dentaria sin afectar el comportamiento del niño. El propósito de este estudio fue evaluar la reacción de niños y registrar su sensación mientras recibían tratamiento de caries dentinal utilizando elementos rotatorios de baja velocidad, en comparación al tratamiento químico mecánico de caries dentinal en dentición decidua. Participaron en el estudio 36 niños, entre 4 y 8 años de edad. Se utilizó un diseño de estudio al azar de sección cruzada de manera tal que cada niño sirviera como su propio control, recibiendo cada tratamiento en cada lado de la misma arcada. Cada paciente era asignado al azar para recibir el tratamiento con elementos rotatorios o tratamiento químico mecánico en la primera visita, administrándosele el restante en la segunda visita. Luego de su tratamiento, todos los dientes fueron obturados con ionómero de vidrio fotopolimerizable. Para la evaluación objetiva de la reacción de los niños se aplicó la Escala de Comportamiento ante el Dolor Modificada. Inmediatamente después de realizado el tratamiento, se solicitaba a los niños que llenaran el formulario que contenía la Escala Facial para Registro del Dolor de Wong-Baker (Facial Pain Scale) para la evaluación subjetiva. El tratamiento químico mecánico demostró ser un procedimiento mejor aceptado por los pacientes pediátricos que el tratamiento con elementos rotatorios de baja velocidad.

One of the main objectives during the pedodontics assistance is the use of noninvasive techniques, that allow the treatment of the dental caries without affecting the behavior of the child. The aim of this study was to evaluate the reaction of children and to register its sensations during the treatment of dental caries in deciduous teeth, using low speed cutting rotatory instruments in comparison to the chemical and mechanical caries removal treatment. 36 children participated in the study, between 4 and 8 years of age. A cross section study design was used and each child served like his own control, receiving the two treatment in teeth of the same arches. Each patient one was selected randomly to receive the treatment with rotatory instruments or the chemical and mechanical treatment in the first visit, administered him to it the rest treatment in the second visit. After their treatment, all the teeth were restorated with light-curing glass ionomer. For the objective evaluation of the reaction of the children the Behavior Scale in the Modified Pain was applied. Immediately after the treatment, one asked for the children who filled the form that contained the Wong-Baker’s Face Scale for Registry of the Pain (Face Pain Scale) for the subjective evaluation. The chemical-mechanical treatment demostrated to be more accepted for the children in comparasion to the treatment with cutting rotatory istruments.

Remoção química-mecânica da cárie dentária com o gel Papacárie®: relato de caso clínico / Chemomechanical caries removal with Papacárie® gel: case report

A Odontologia contemporânea visa desenvolver novos materiais e aprimorar as técnicas restauradoras para restabelecer a estética e a função, preservando o máximo de estrutura dentária. O uso extensivo de alta e baixa rotação deixou de ser técnica única de preparos cavitários, passando a contar com um aliado importante nessa etapa operatória, a remoção química-mecânica da cárie. Vários agentes foram testados, entre eles o gel Papacárie®, material de origem brasileira que em relação aos pesquisados anteriormente, acrescentou a vantagem do baixo custo, tornando-o compatível com a realidade nacional. O uso de curetas e produtos químicos permite a seleção do tecido necrótico que deve ser eliminado, mantendo o restante da dentina desorganizada, mas com capacidade de regeneração. Pelo fato da dentina necrótica ser morta, a remoção seletiva desse tecido torna a remoção de cárie indolor, dispensando o uso de anestesia. Estas qualidades são atraentes, especialmente no atendimento infantil por reduzir as freqüentes fobias ao tratamento odontológico. Objetiva-se descrever, nesse trabalho, o protocolo de aplicação do gel Papacárie® em criança portadora de lesões agudas de cárie.

New materials and techniques, aiming to reestablish esthetics and function, and to preserve the maximum of healthy structure, plow of major concern in dentistry today. The Papacarie® gel is a material developed to removes carious tissue, (and to further denaturation) of the infected and necrotic dentin, without removing its capacity of regeneration. The vantage of being the method performed without pain, with the uses of scarves, and without anesthetics and the uses of drills. It goes these reasons, this study have the objective presents the clinical marries using Papacarie® gel,with the presentation of his application protocol in sharp decay lesion. The pediatric patient, feminine gender, with 5 years of acts, leukoderma, presents lesion of sharp decays in the deciduous teeth 74 and 75 without pulp involvement. This technique was indicated due to its easy utilization, since it donate not require the uses of rubber dam, anesthetics and drills. Like this, that material an alternative in daily clinical treatment in lesion of sharp decays without pulp involvement, mainly in pediatric dentistry.

A aplicabilidade da papaína no tratamento de úlcera por pressão de calcâneo: relato de experiência / The aplicability of papain in the treatment of ankle pression ulcer: an experience report

A pesquisa foi desenvolvida no Hospital Geral de Vila Nova Cachoeirinha, localizado na cidade de São Paulo. Relata um estudo de um caso, como forma de descrever o planejamento e as ações da enfermagem no cuidado ao paciente com úlcera por pressão em região calcânea utilizando papaína em pó a 100 por cento e 2 por cento. Pode-se concluir que o emprego da papaína em pó, a 100 por cento em tecido necrótico realiza o debridamento autolítico, sem necessidade de debridamento cirúrgico e 2 por cento em tecido de granulação acelera a epitelização, podendo ser um método facilitador no processo de cicatrização da ferida. Em função desses achados, a rotina institucional foi alterada, preconizando-se esses produtos.

Tratamento de lesão por piomiosite tropical: relato de caso / Treatment of lesion by tropical pyomyositis: case report

A Piomiosite Tropical consiste na infecção primária de um agrupamento muscular, principalmente dos membros inferiores e tronco. O objetivo deste trabalho é relatar um caso de lesão por Piomiosite Tropical em região glútea, tratado com papaína gel 3 por cento, e posteriormente, óleo de girassol in natura, associado à Câmara Hiperbárica. Trata-se de um estudo de caso com abordagem qualitativa realizado no Hospital de Base de São José do Rio Preto. Concluiu-se que o uso da papaína, do óleo de girassol in natura associados à Câmara Hiperbárica contribuíram para a aceleração do processo cicatricial, tendo a cicatrização da ferida ocorrido em aproximadamente quatro meses. Observou-se ainda, a importância do papel do enfermeiro para a condução do caso.

Enzymes, trophoblasts, and cancer: the afterlife of an idea (1924-2008).

In the early 20th century, advocacy of the enzyme therapy of cancer was primarily the work of one man, John Beard, DSc (1858-1924). He and his collaborators made a determined effort to establish this mode of therapy, especially in the years 1905 to 1911. Despite a brief flowering of international interest, Beard's efforts came to naught. During the 20th century, there was a succession of American researchers who continued to investigate this topic. This included Marshall William McDuffie, MD (1882-1945), Frank LeForest Morse, MD (1876-1953), Franklin Lloyd Shively, MD (1887-1971), and William Donald Kelley (1926-2005). In central Europe, India, and other parts of the globe, the use of pancreatic enzymes as an adjuvant treatment for cancer has become a fairly routine practice, at least among those doctors who utilize complementary and alternative medicine (CAM). It is also a well-established method for reducing inflammation and mitigating the adverse effects of cytotoxic treatment.