Antibody-based assay discriminates Zika virus infection from other flaviviruses.

Zika virus (ZIKV) is a mosquito-borne flavivirus that emerged recently as a global health threat, causing a pandemic in the Americas. ZIKV infection mostly causes mild disease, but is linked to devastating congenital birth defects and Guillain-Barré syndrome in adults. The high level of cross-reactivity among flaviviruses and their cocirculation has complicated serological approaches to differentially detect ZIKV and dengue virus (DENV) infections, accentuating the urgent need for a specific and sensitive serological test. We previously generated a ZIKV nonstructural protein 1 (NS1)-specific human monoclonal antibody, which we used to develop an NS1-based competition ELISA. Well-characterized samples from RT-PCR-confirmed patients with Zika and individuals exposed to other flavivirus infections or vaccination were used in a comprehensive analysis to determine the sensitivity and specificity of the NS1 blockade-of-binding (BOB) assay, which was established in laboratories in five countries (Nicaragua, Brazil, Italy, United Kingdom, and Switzerland). Of 158 sera/plasma from RT-PCR-confirmed ZIKV infections, 145 (91.8%) yielded greater than 50% inhibition. Of 171 patients with primary or secondary DENV infections, 152 (88.9%) scored negative. When the control group was extended to patients infected by other flaviviruses, other viruses, or healthy donors (n = 540), the specificity was 95.9%. We also analyzed longitudinal samples from DENV-immune and DENV-naive ZIKV infections and found inhibition was achieved within 10 d postonset of illness and maintained over time. Thus, the Zika NS1 BOB assay is sensitive, specific, robust, simple, low-cost, and accessible, and can detect recent and past ZIKV infections for surveillance, seroprevalence studies, and intervention trials.

Novel Decision Tool for More Severe α-Thalassemia Genotypes Screening with Functional Loss of Two or More α-Globin Genes: A Diagnostic Test Study.

After the exclusion of iron deficiency and ß-thalassemia, molecular research for α-thalassemia is recommended to investigate microcytic anemia. Aiming to suggest more efficiently the molecular analysis for individuals with a greater chance of having a symptomatic form of the disease, we have developed and validated a new decision tool to predict the presence of two or more deletions of α-thalassemia, increasing considerably the pre-test probability. The model was created using the variables: the percentage of HbA2, serum ferritin and mean corpuscular volume standardized by age. The model was trained in 134 patients and validated in 160 randomly selected patients from the total sample. We used Youden's index applied to the ROC curve methodology to establish the optimal odds ratio (OR) cut-off for the presence of two or more α-globin gene deletions. Using the OR cut-off of 0.4, the model's negative predictive value (NPV) was 96.8%; the cut-off point accuracy was 85.4%; and the molecular analysis pre-test probability increased from 25.9% to 65.4% after the use of the proposed model. This tool aims to assist the physician in deciding when to perform molecular studies for the diagnosis of α-thalassemia. The model is useful in places with few financial health resources.

Cyclic Fatigue and Torsional Strength of a New Thermally Treated Reciprocating System.

OBJECTIVE: This study evaluated the resistance to cyclic fatigue and the torsional strength of Prima One Gold® and WaveOne Gold® reciprocating systems. METHODS: Cyclic fatigue was tested in an artificial canal with 60º curvature, a 5 mm radius of curvature at 22°C (n=10) and 36.5°C (n=10). The torsional strength test followed ISO 3630-1, measuring torque and deflection angle until fracture (n=10). The t-test was used to compare the two groups, and the significance level was set at 5%. RESULTS: The Prima One Gold group presented greater resistance to cyclic fatigue at room temperature (P=0.001) and body temperature (P<0.001). For the torsional resistance test, the Prima One Gold group had a lower maximum torque value (P=0.029), despite having a greater deflection angle (P<0.001). CONCLUSION: The Prima One Gold group showed greater resistance to cyclic fatigue regardless of temperature and a greater deflection angle. The WaveOne Gold group showed a greater maximum torque value than the Prima One Gold group.

Bone Marrow Stromal Cell Regeneration Profile in Treated B-Cell Precursor Acute Lymphoblastic Leukemia Patients: Association with MRD Status and Patient Outcome.

For the last two decades, measurable residual disease (MRD) has become one of the most powerful independent prognostic factors in B-cell precursor acute lymphoblastic leukemia (BCP-ALL). However, the effect of therapy on the bone marrow (BM) microenvironment and its potential relationship with the MRD status and disease free survival (DFS) still remain to be investigated. Here we analyzed the distribution of mesenchymal stem cells (MSC) and endothelial cells (EC) in the BM of treated BCP-ALL patients, and its relationship with the BM MRD status and patient outcome. For this purpose, the BM MRD status and EC/MSC regeneration profile were analyzed by multiparameter flow cytometry (MFC) in 16 control BM (10 children; 6 adults) and 1204 BM samples from 347 children and 100 adult BCP-ALL patients studied at diagnosis (129 children; 100 adults) and follow-up (824 childhood samples; 151 adult samples). Patients were grouped into a discovery cohort (116 pediatric BCP-ALL patients; 338 samples) and two validation cohorts (74 pediatric BCP-ALL, 211 samples; and 74 adult BCP-ALL patients; 134 samples). Stromal cells (i.e., EC and MSC) were detected at relatively low frequencies in all control BM (16/16; 100%) and in most BCP-ALL follow-up samples (874/975; 90%), while they were undetected in BCP-ALL BM at diagnosis. In control BM samples, the overall percentage of EC plus MSC was higher in children than adults (p = 0.011), but with a similar EC/MSC ratio in both groups. According to the MRD status similar frequencies of both types of BM stromal cells were detected in BCP-ALL BM studied at different time points during the follow-up. Univariate analysis (including all relevant prognostic factors together with the percentage of stromal cells) performed in the discovery cohort was used to select covariates for a multivariate Cox regression model for predicting patient DFS. Of note, an increased percentage of EC (>32%) within the BCP-ALL BM stromal cell compartment at day +78 of therapy emerged as an independent unfavorable prognostic factor for DFS in childhood BCP-ALL in the discovery cohort­hazard ratio (95% confidence interval) of 2.50 (1−9.66); p = 0.05­together with the BM MRD status (p = 0.031). Further investigation of the predictive value of the combination of these two variables (%EC within stromal cells and MRD status at day +78) allowed classification of BCP-ALL into three risk groups with median DFS of: 3.9, 3.1 and 1.1 years, respectively (p = 0.001). These results were confirmed in two validation cohorts of childhood BCP-ALL (n = 74) (p = 0.001) and adult BCP-ALL (n = 40) (p = 0.004) treated at different centers. In summary, our findings suggest that an imbalanced EC/MSC ratio in BM at day +78 of therapy is associated with a shorter DFS of BCP-ALL patients, independently of their MRD status. Further prospective studies are needed to better understand the pathogenic mechanisms involved.

Comparative analysis of bond strength to root dentin and compression of bioceramic cements used in regenerative endodontic procedures.

OBJECTIVES: This study compared the Biodentine, MTA Repair HP, and Bio-C Repair bioceramics in terms of bond strength to dentin, failure mode, and compression. MATERIALS AND METHODS: Fifty-four slices obtained from the cervical third of 18 single-rooted human mandibular premolars were randomly distributed (n = 18). After insertion of the bioceramic materials, the push-out test was performed. The failure mode was analyzed using stereomicroscopy. Another set of cylindrically-shaped bioceramic samples (n = 10) was prepared for compressive strength testing. The normality of data distribution was analyzed using the Shapiro-Wilk test. The Kruskal-Wallis and Friedman tests were used for the push-out test data, while compressive strength was analyzed with analysis of variance and the Tukey test, considering a significance level of 0.05. RESULTS: Biodentine presented a higher median bond strength value (14.79 MPa) than MTA Repair HP (8.84 MPa) and Bio-C Repair (3.48 MPa), with a significant difference only between Biodentine and Bio-C Repair. In the Biodentine group, the most frequent failure mode was mixed (61%), while in the MTA Repair HP and Bio-C Repair groups, it was adhesive (94% and 72%, respectively). Biodentine showed greater resistance to compression (29.59 ± 8.47 MPa) than MTA Repair HP (18.68 ± 7.40 MPa) and Bio-C Repair (19.96 ± 3.96 MPa) (p < 0.05). CONCLUSIONS: Biodentine showed greater compressive strength than MTA Repair HP and Bio-C Repair, and greater bond strength than Bio-C Repair. The most frequent failure mode of Biodentine was mixed, while that of MTA Repair HP and Bio-C Repair was adhesive.

Flow Cytometry Immunophenotyping for Diagnostic Orientation and Classification of Pediatric Cancer Based on the EuroFlow Solid Tumor Orientation Tube (STOT).

Early diagnosis of pediatric cancer is key for adequate patient management and improved outcome. Although multiparameter flow cytometry (MFC) has proven of great utility in the diagnosis and classification of hematologic malignancies, its application to non-hematopoietic pediatric tumors remains limited. Here we designed and prospectively validated a new single eight-color antibody combination-solid tumor orientation tube, STOT-for diagnostic screening of pediatric cancer by MFC. A total of 476 samples (139 tumor mass, 138 bone marrow, 86 lymph node, 58 peripheral blood, and 55 other body fluid samples) from 296 patients with diagnostic suspicion of pediatric cancer were analyzed by MFC vs. conventional diagnostic procedures. STOT was designed after several design-test-evaluate-redesign cycles based on a large panel of monoclonal antibody combinations tested on 301 samples. In its final version, STOT consists of a single 8-color/12-marker antibody combination (CD99-CD8/numyogenin/CD4-EpCAM/CD56/GD2/smCD3-CD19/cyCD3-CD271/CD45). Prospective validation of STOT in 149 samples showed concordant results with the patient WHO/ICCC-3 diagnosis in 138/149 cases (92.6%). These included: 63/63 (100%) reactive/disease-free samples, 43/44 (98%) malignant and 4/4 (100%) benign non-hematopoietic tumors together with 28/38 (74%) leukemia/lymphoma cases; the only exception was Hodgkin lymphoma that required additional markers to be stained. In addition, STOT allowed accurate discrimination among the four most common subtypes of malignant CD45- CD56++ non-hematopoietic solid tumors: 13/13 (GD2++ numyogenin- CD271-/+ nuMyoD1- CD99- EpCAM-) neuroblastoma samples, 5/5 (GD2- numyogenin++ CD271++ nuMyoD1++ CD99-/+ EpCAM-) rhabdomyosarcomas, 2/2 (GD2-/+ numyogenin- CD271+ nuMyoD1- CD99+ EpCAM-) Ewing sarcoma family of tumors, and 7/7 (GD2- numyogenin- CD271+ nuMyoD1- CD99- EpCAM+) Wilms tumors. In summary, here we designed and validated a new standardized antibody combination and MFC assay for diagnostic screening of pediatric solid tumors that might contribute to fast and accurate diagnostic orientation and classification of pediatric cancer in routine clinical practice.

Guided Endodontics: Volume of Dental Tissue Removed by Guided Access Cavity Preparation-An Ex Vivo Study.

INTRODUCTION: Guided endodontics emerged as an alternative method capable of providing greater precision and accuracy to endodontic treatments. The aim of the present study was to compare the volume of dental tissue removed after guided endodontic access (GEA) and conventional endodontic access (CEA) to mandibular incisors and upper molars. METHODS: Twenty extracted human mandibular incisors and upper molars were selected and submitted to cone-beam computed tomographic (CBCT) examination. They were divided into 2 groups, G1 (mandibular incisors) and G2 (maxillary molars), and subdivided into G1a (CEA), G1b (GEA), G2a (CEA), and G2b (GEA). The Digital Imaging and Communications in Medicine files obtained by examining the CBCT scans were transferred to InVesalius software (Renato Archer Information Technology Center, Campinas, SP, Brazil) to calculate the initial volume of each tooth. G1b and G2b teeth were scanned with a device to plan and print the guides. After gaining endodontic access, new CBCT examinations were performed to calculate the final volume of each sample unit. The Student t test for independent samples compared the volumes among the groups. RESULTS: G1 group had an average volume reduction of 31.667 mm3 (10.62%) using CEA and 26.523 mm3 (10.65%) using GEA with no significant difference among the groups (P = .960). There was an average volume reduction of 62.526 mm3 (5.86%) in the G2 group using CEA and 45.677 mm3 (4.11%) using GEA with a significant difference among the groups (P = .004). CONCLUSIONS: GEA preserved a greater volume of dental tissue in extracted upper human molars than CEA; however, there was no significant difference between CEA and GEA in the volume of dental tissue removed from mandibular incisors.

Interference of coronal enamel and dentin thickness and ambient light on pulse oximetry interpretation.

This study evaluated the interference of enamel and coronal dentin thickness and ambient light in pulse oximetry interpretation, using SaO2the human finger as a reference. Forty-two intact human permanent mandibular molars were sectioned mesiodistally in the central portion. Buccal and lingual dentin surfaces were drilled, and 4 mm, 3 mm and 2 mm enamel/dentin thicknesses were interposed between finger and device, after which SaO2 levels were measured by finger pulse oximetry. A reference device was designed to align pulse oximeter light-emitting diode, buccal surface of tooth, little finger, lingual surface of tooth and photodiode. Variables were described as means and standard deviation, and the confidence interval was reported. Repeated measures analysis of variance (ANOVA) was used to compare the groups, followed by Bonferroni correction. Student t test for paired samples was used to determine presence of ambient light (α = 0.05). Mean SaO2 level was lower at 4.0 ± 0.2 mm thickness, regardless of presence or absence of ambient light (92.7% and 89.3%). The other thicknesses yielded values of 95.5% and 94.5% at 3.0 ± 0.2 mm, and 96.4% and 96.0% at 2.0 ± 0.2 mm (p < 0.001). There were significant differences between SaO2 values at 4.0 ± 0.2 mm, 3.0 ± 0.2 mm and 2.0 ± 0.2 mm thicknesses, in the presence of ambient light. Mean SaO2 level in positive control was 96.3%, and mean pulse rate was 69.5 bpm in presence of ambient light; in the absence of light, these values were 96% and 70.5 bpm. Enamel and dentin thickness interfere with SaO2, regardless of presence or absence of ambient light. The lowest SaO2 levels were found for the thickest tooth samples.

Protector effect of α-thalassaemia on cholecystitis and cholecystectomy in sickle cell disease.

OBJECTIVES: Cholecystitis is one of the complications of symptomatic cholelithiasis responsible for high levels of morbidity of sickle cell disease (SCD) patients. Here, we investigated the possible protective role of single gene deletions of α-thalassaemia in the occurrence of cholelithiasis and cholecystitis in SCD patients, as well as the cholecystectomy requirements. METHODS: The α-globin genotype was determined in 83 SCD patients using the multiplex-polymerase chain reaction and compared with clinical events. RESULTS: Overall, in 23% of patients, -α3.7 deletion was found. α-Thalassaemia concomitant to SCD was an independent protective factor to cholecystitis (OR = 0.07; 95% CI: 0.01-0.66; p = 0.020) and cholecystectomy requirement (OR = 0.14; 95% CI: 0.03-0.60; p = 0.008). The risk of cholelithiasis was not affected by the α-thalassaemia concomitance. CONCLUSIONS: To the best our knowledge, our study is the first to show the protective effect of α-thalassaemia on cholecystitis and cholecystectomy requirements in SCD, which may be due to an improved splenic function.

Interference of coronal enamel and dentin thickness and ambient light on pulse oximetry interpretation

Abstract This study evaluated the interference of enamel and coronal dentin thickness and ambient light in pulse oximetry interpretation, using SaO2the human finger as a reference. Forty-two intact human permanent mandibular molars were sectioned mesiodistally in the central portion. Buccal and lingual dentin surfaces were drilled, and 4 mm, 3 mm and 2 mm enamel/dentin thicknesses were interposed between finger and device, after which SaO2 levels were measured by finger pulse oximetry. A reference device was designed to align pulse oximeter light-emitting diode, buccal surface of tooth, little finger, lingual surface of tooth and photodiode. Variables were described as means and standard deviation, and the confidence interval was reported. Repeated measures analysis of variance (ANOVA) was used to compare the groups, followed by Bonferroni correction. Student t test for paired samples was used to determine presence of ambient light (α = 0.05). Mean SaO2 level was lower at 4.0 ± 0.2 mm thickness, regardless of presence or absence of ambient light (92.7% and 89.3%). The other thicknesses yielded values of 95.5% and 94.5% at 3.0 ± 0.2 mm, and 96.4% and 96.0% at 2.0 ± 0.2 mm (p < 0.001). There were significant differences between SaO2 values at 4.0 ± 0.2 mm, 3.0 ± 0.2 mm and 2.0 ± 0.2 mm thicknesses, in the presence of ambient light. Mean SaO2 level in positive control was 96.3%, and mean pulse rate was 69.5 bpm in presence of ambient light; in the absence of light, these values were 96% and 70.5 bpm. Enamel and dentin thickness interfere with SaO2, regardless of presence or absence of ambient light. The lowest SaO2 levels were found for the thickest tooth samples.

Cytotoxicity of glass ionomer cements containing silver nanoparticles.

BACKGROUND: Some studies have investigated the possibility of incorporating silver nanoparticles (NAg) into dental materials to improve their antibacterial properties. However, the potential toxic effect of this material on pulp cells should be investigated in order to avoid additional damage to the pulp tissue. This study evaluated the cytotoxicity of conventional and resin-modified glass ionomer cements (GIC) with and without addition of NAg. MATERIAL AND METHODS: NAg were added to the materials at two different concentrations by weight: 0.1% and 0.2%. Specimens with standardized dimensions were prepared, immersed in 400 µL of culture medium and incubated at 37°C and 5% CO2 for 48 h to prepare GIC liquid extracts, which were then incubated in contact with cells for 48 h. Culture medium and 0.78% NAg solution were used as negative and positive controls, respectively. Cell viability was determined by MTT and Trypan Blue assays. ANOVA and the Tukey test (α=0.05) were used for statistical analyses. RESULTS: Both tests revealed a significant decrease in cell viability in all groups of resin modified cements (p<0.001). There were no statistically significant differences between groups with and without NAg (p>0.05). The differences in cell viability between any group of conventional GIC and the negative control were not statistically significant (p>0.05). CONCLUSIONS: NAg did not affect the cytotoxicity of the GIC under evaluation. KEY WORDS: Glass ionomer cements, totoxicity, cell culture techniques, nanotechnology, metal nanoparticles.

Estudo Comparativo do Preparo Transversal Produzido pelo Emprego de Instrumentos de NiTi e Manual em Molares Inferiores / Comparative Study of the Transversal Preparation Carried Out by NiTi and Manual Instruments in Lower Molars

Objetivo: avaliar o desgaste dentinário promovido por instrumentação rotatória com diferentes sistemas de NiTi e instrumentação manual em raízes mesiais de molares inferiores. Material e Métodos: Foram selecionados 60 molares inferiores extraídos que foram divididos em 6 grupos (n=10). Nos grupos A, B, C e D os canais radiculares foram preparados utilizando-se os sistemas de NiTi ProFile®, ProTaper Universal®, K3® e Race®, respectivamente. No grupo E, os canais radiculares foram preparados com limas manuais do tipo K Flexofile®, e no grupo F os canais radiculares não foram preparados (controle). Após os preparos, foram realizados dois cortes perpendiculares ao longo eixo da raiz mesial, sendo um no terço cervical e outro no terço apical. As imagens dos cortes foram capturadas por meio de microscópio e analisadas através de software. Para cada corte, foram realizadas três medidas correspondentes à menor espessura da parede dentinária, sendo obtida uma média de cada espécime. As comparações entre os grupos das medidas obtidas foram realizadas pelo teste t, com nível de significância de 5%. Resultados: Tanto no terço cervical quanto apical houve diferença significante entre o grupo E (Flexofile) e os grupos de sistemas de NiTi, bem como entre o grupo controle. No terço apical foi observada diferença significante entre o grupo A (Profile®) e o grupo D (Race®) em comparação ao grupo controle. Conclusões: Pôde-se concluir que as técnicas que utilizaram instrumentos de NiTi preservaram mais estrutura dentinária quando comparados à técnica que se utilizou de limas manuais.

Objective: to evaluate dentinal wear promoted by rotary instrumentation with different NiTi systems and manual instrumentation in mesial roots of lower molars. Material and Methods: Sixty extracted lower molars were selected and divided into 6 groups (n = 10). In groups A, B, C and D the root canals were prepared using the NiTi ProFile®, ProTaper Universal®, K3® and Race® systems, respectively. In group E, the root canals were prepared with manual files of type K Flexofile®, and in group F the root canals were not prepared (control). After the preparation, two perpendicular cuts were made along the axis of the mesial root, one in the cervical third and the other in the apical third. The images of the cuts were captured by means of a microscope and analyzed through software. For each cut, three measurements were made corresponding to the lowest thickness of the dentin wall, obtaining an average of each specimen. The comparisons between the groups of measures obtained were performed by the t test, with a significance level of 5%. Results: In both the cervical and apical thirds there was a significant difference between the group E (Flexofile) and the groups of NiTi systems, as well as between the control group. In the apical third, a significant difference was observed between group A (Profile®) and group D (Race®) compared to the control group. Conclusions: It could be concluded that the techniques that used NiTi instruments preserved more dentin structure when compared to the technique used of manual files.

Avaliação da composição química e radiopacidade de diferentes pastas de hidróxido de cálcio / Evaluation of chemical composition and radiopacity of different calcium hydroxide pastes

Objetivo: Avaliar a composição química e a radiopacidade de diferentes pastas de hidróxido de cálcio. Material e métodos: Foram avaliadas três pastas comerciais: Ultracal XS®; Hydropast® e Callen®. O hidróxido de cálcio P.A. foi utilizado como controle. Para avaliar a composição química dos materiais, uma amostra de cada pasta foi avaliada por análise termogravimétrica, e a massa de hidróxido de cálcio presente foi obtida por meio de cálculos estequiométricos a partir da decomposição térmica de suas moléculas. Para avaliar a radiopacidade, foram analisadas 03 amostras para cada grupo. A radiopacidade foi avaliada com um sistema de radiografia digital indireta Express™ e equipamento de raios X Focus™. As imagens obtidas foram analisadas quanto aos padrões do valor de cinza por meio do software ImageJ. Resultados: Os percentuais de massa de hidróxido de cálcio obtidos para cada material foram: hidróxido de cálcio P.A.: 87,12%; Ultracal XS®: 36,38%; Hydropast®: 30,66%; Callen®: 50,54%. Os valores de cinza das pastas foram de: 63,41 para o hidróxido de cálcio P.A.; 126,35 para Ultracal XS®; 106,73 para Hydropast®, e 72,23 para Callen®. Na mesma análise, a escala de alumínio apresentou os valores: Al 1mm: 53,50; Al 4 mm: 98,06; Al 8mm: 162,14; Al 12mm: 205,4. Conclusões: Houve diferenças em todas as pastas entre a quantidade de hidróxido de cálcio informada pelo fabricante e a quantidade encontrada nas análises termogravimétricas. As pastas comerciais testadas apresentaram maior radiopacidade que o grupo controle. A Ultracal XS® foi o material com maior radiopacidade, seguido da Hydropast e Callen.

Objective: To evaluate and compare the chemical composition and radiopacity of different calcium hydroxide pastes. Material and methods: Three commercial pastes were evaluated: Ultracal XS®; Hydropast® and Callen®. Calcium hydroxide P.A. was used as control. To evaluate the chemical composition of the materials, a sample of each paste was evaluated by thermogravimetric analysis and the mass of calcium hydroxide presented was obtained through stoichiometric calculations from the thermal decomposition of its molecules. To evaluate the radiopacity were analyzed 03 samples for each group. Radiopacity was evaluated with an Express™ indirect digital radiography system and Focus™ X-ray equipment. The images were analyzed as gray value standards using ImageJ software. Results: The percentages of mass of calcium hydroxide obtained for each material were: calcium hydroxide P.A.: 87.12%; Ultracal XS®: 36.38%; Hydropast ®: 30.66%; Callen®: 50.54%. The gray values of the pastes were: 63.41 for the calcium hydroxide P.A.; 126.35 for Ultracal®; 106.73 for Hydropast®, and 72.23 for Callen®. In the same analysis, the aluminum scale presented in values: Al 1mm: 53,50; Al 4 mm: 98.06; Al 8mm: 162.14; Al 12mm: 205.4. Conclusions: There were differences in all pastes between the amount of calcium hydroxide reported by the manufacturer and the amount found in the thermogravimetric analyzes. The commercial pastes tested showed higher radiopacity than the control group. Ultracal XS® was the material with the highest radiopacity, followed by Hydropast ® and Callen®.

Oximetria de pulso na avaliação da vitalidade pulpar: análise crítica / Pulse oximetry in evaluation of pulp vitality: critical analysis

O diagnóstico da condição pulpar é essencial para o estabelecimento do tratamento adequado, e continua sendo um desafio na prática clínica atual. Os testes pulpares térmicos e elétrico são os mais comumente utilizados, porém apresentam as limitações inerentes por avaliarem apenas a sensibilidade pulpar, através da aplicação de estímulos na superfície dentária. A vitalidade da polpa dentária está relacionada à sua vascularização, e testes que avaliam o fluxo sanguíneo pulpar têm sido desenvolvidos e estudados. A oximetria de pulso é amplamente utilizada na medicina para determinação dos níveis de saturação de oxigênio sanguíneos, e tem apresentado-se como recurso para determinação da vitalidade pulpar. Com a utilização de adaptadores, os níveis de saturação de oxigênio da polpa dentária têm sido determinados em diferentes condições clínicas, direcionando para um diagnóstico mais preciso. Resultados promissores obtidos em diversos estudos reforçam as vantagens do oxímetro de pulso em comparação aos testes de sensibilidade, por se tratar de um método mais acurado, objetivo, não invasivo e que não provoca dor e desconforto ao paciente. Nesta perspectiva, os avanços científicos e tecnológicos têm aprimorado o uso de métodos de diagnóstico pulpar inovadores, e o oxímetro de pulso é um potencial recurso para aplicação na rotina clínica dos cirurgiões-dentistas.

Dental pulp diagnosis is essential for the establishment of appropriate treatment and remains a challenge in current clinical practice. Thermal and electrical pulp tests are the most commonly used, but they have the inherent limitations of only evaluating the pulp sensitivity through the application of stimuli on the dental surface. The vitality of the dental pulp is related to its vascularization, and tests that evaluate pulp blood flow have been developed and studied. Pulse oximetry is widely used in medicine for determination of blood oxygen saturation levels and has been presented as a resource for pulp vitality determination. With use of adapters, the levels of oxygen saturation of the dental pulp have been determined in different clinical conditions, leading to a more accurate diagnosis. Promising results obtained in several studies reinforce the advantages of the pulse oximeter in comparison to the sensitivity tests, because it is a more accurate, objective, non-invasive method that does not cause pain and discomfort to the patient. In this perspective, scientific and technological advances have improved the use of innovative pulp diagnostic methods, and the pulse Oximeter is a potential resource for application in the clinical routine of dentists.

Análise da erosão da dentina radicular após irrigação com hipoclorito de sódio em diferentes concentrações por meio de microscopia eletrônica de varredura / Analysis of radicular dentin erosion after sodium hypochlorite irrigation at different concentrations by scanning electron microscopy

Objetivo: Avaliar a erosão dentinária após a irrigação com hipoclorito de sódio (NaOCl) em diferentes concentrações por meio de microscopia eletrônica de varredura (MEV). Material e método: Foram utilizados doze dentes humanos unirradiculares divididos em 4 grupos (n=3) conforme solução utilizada: NaOCl 1%, NaOCl 2,5%, NaOCl 5,0% e água destilada (controle). Todos os canais radiculares foram preparados utilizando o sistema BioRace, irrigados com a solução do grupo correspondente e EDTA 17%. Ranhuras longitudinais foram preparadas para clivar as raízes. Os espécimes foram avaliados em MEV. A erosão dentinária foi analisada e registrada considerando os seguintes scores: Score 1 - não houve erosão na dentina; score 2 - erosão moderada e score 3 - erosão severa. Resultado: Praticamente não observou-se erosão (score 1) no grupo preparado com água destilada, em contrapartida, o grupo de dentes que foram irrigados com NaOCl 5%, obteve a maior prevalência de erosão severa (score 3). No grupo irrigado com NaOCl 1% houve prevalência de score 1 no terço cervical e de score 2 no terço médio, já no terço apical os 3 scores foram observados. No grupo irrigado com a solução de hipoclorito de sódio a 2,5% houve erosão dentinária predominantemente moderada (score 2) em todos os terços. Conclusão: A erosão dentinária foi diretamente proporcional à concentração de hipoclorito de sódio.

Objective: To evaluate the dentin erosion after sodium hypochlorite irrigation in different concentrations by scanning electron microscopy (SEM). Methods: It was used twelve singlerooted teeth divided into 4 groups (n = 3) according to the used solution: 1% NaOCl, 2.5% NaOCl, 5% NaOCl and distilled water (control). All root canals were prepared using BioRace system, irrigated with the solution of the corresponding group and 17% EDTA. Longitudinal grooves were made to cleave the roots. The specimens were evaluated in scanning electron microscopy. The dentin erosion level was recorded considering the following criteria: Score 1 - there was no erosion on dentin; score 2 - moderate erosion and score 3 - Severe erosion. Result: The dentin erosion was proportional to the concentration of sodium hypochlorite. Practically, there was no erosion (score 1) in the group prepared with distilled water, on the other hand, the group irrigated with 5% NaOCl had the highest percentage of severe erosion, score 3. The group irrigated with 1% NaOCl had the prevalence of score 1 in cervical third and score 2 in the middle third, however all the scores were observed in apical third. In group irrigated with 2,5% sodium hypochlorite there was, predominantly, moderate dentin erosion (score 2) in all thirds. Conclusion: Dentin erosion was directly proportional to the concentration of sodium hypochlorite

Coherencia cortical interhemisférica de ninãs en el periodos pre y pos menarquia / Cortical interhemisferic coherence periods of girls in pre and pos menarche

Objetivo: el presente estudio tuvo como objetivo observar la coherencia cortical interhemisférica en niñas el períodos pre y pos menarquia. Materiales y métodos: una muestra de 45 niñas de 10 a 15 años fue compuesta y dividida en dos grupos: pre menarquia (G1) y pos menarquia (G2) compuestos por 21 y 24 niñas, respectivamente.Las participantes en el estudio se sometieron a captar la señal electroencefalográfico en reposo. Después de la recogida de datos, fue realizado el cálculo de la variable dependiente extraída del eletroencefalograma quantitativo. Para el análisis del índice de coherencia se rotaron las pruebas de Mann-Whitney para cada par de electrodos (frontales: F3-F4; central C3-C4 y parietal: P3-P4), específicamente en la banda de frecuencia beta (13-35 Hz). Resultados: fueron observadas diferencias estadísticamente significativas en las tres áreas corticales (F3-F4: p = 0,001; C3-C4: p = 0,002 y P3-P4: p = 0,003). Específicamente, el grupo pos menarquia mostraron valores de coherencia significativamente más altos en los tres pares de electrodos analizados, o sea, en las tres regiones corticales; en comparación con el grupo pre menarquia. Esto significa decir que cuanto mayor el grado de maduración del grupo, mayores son las posibilidades de los valores de coherencia interhemisférica presentarse más elevados. Conclusiones: se observó que, con relación a las características electroencefalográficas, los grupos se mostrarón distintos, siendo mayor la atictividad cerebral relacionada a la coherencia interhemisférica del grupo pos menarquia...(AU)

Objective: this study aimed to observe the cortical interhemispheric coherence in girls in the pre and post-menarche. Materials and methods: a sample was composed of 45 girls between 10 and 15 years divided into two groups: pre-menarche (G1) and post-menarche (G2) composed of 21:24 girls, respectively. The participants of the study were submitted to the electroencephalographic signal at rest. After data collection, we performed the calculation of the dependent variable extracted from the quantitative electroencephalogram.For the analysis of interhemispheric coherence index Mann-Whitney tests were run for each pair of electrodes (front F3-F4; core: C3 -C4 and P3-P4), in particular en el beta frequency rate (13 -35 Hz). Results: there were statistically significant differences in the three cortical regions (F3-F4: p = 0.001, C3- C4: p = 0.002 and P3-P4: p = 0.003). Specifically, the post-menarche group presented significantly higher coherence values in the three pairs of electrodes analyzed, that is, in the three cortical regions when compared to the pre-menarche group. This means that the higher the degree of maturation of the group, the greater the possibilities of inter-hemispheric coherence values present higher. Conclusion: it was observed that, in relation to the electroencephalographic characteristics, the groups were different and the cerebral activity related to interhemispheric coherence of the post-menarche group was higher...(AU)

Influence of the resin cement color on the shade of porcelain veneers after accelerated artificial aging / Influence of the resin cement color on the shade of porcelain veneers after accelerated artificial aging / Influência da cor do cimento resinoso na tonalidade de facetas de porcelana após envelhecimento artificial acelerado

Objectives: The aim of this study was to evaluate the influence of the color of the resin luting cement in the final shade of minimally invasive porcelain veneers after accelerated artificial aging (AAA). Material and methods: 20 bovine teeth were collected, prepared and divided into two groups. The roots were removed and the buccal surfaces were polished to obtain a flat surface. Porcelain discs (IPS Empress Esthetic) were produced to a standardized shade (ET1) and thickness (0.6mm). The teeth and the veneers surfaces were prepared according to manufacturer recommendations. For group I (n=10), the White-Opaque (WO) base-paste was used and for group II (n=10) the Yellow (Y) base-paste. Each specimen was photocured for 60 s. The specimens were next subjected to AAA. They were submitted to color readings with a spectrophotometer in three moments: after the preparation (only the substrate), after the cementation and polymerization of the veneers and after the AAA. Were obtained values of L*, a* and b* and the total color change was calculated (?E*). Values obtained were subjected to statistical analysis in SPSS 17.0 for Windows with a significance of 0.05. Results: When comparing the cements, the Y cement showed higher ?E*, lower L* and higher b* after AAA than the WO. Conclusion: Both cements could mask the substrate color. With AAA, only the Y shade showed a ?E* clinically unacceptable, becoming more yellow (higher b*) and losing lightness (lower L*).

Objetivos: O objetivo do presente estudo foi avaliar a influência da cor do cimento resinoso na tonalidade final de facetas de porcelana minimamente invasivas, após envelhecimento artificial acelerado (EAA). Material e Métodos: 20 dentes bovinos foram coletados, preparados e divididos em dois grupos. As raízes foram removidas e a face vestibular foi polida para obter uma superfície plana. Discos de porcelana (IPS Empress Esthetic) foram confeccionados na cor ET1 e espessura de 0,6 mm. Os dentes e as superfícies dos discos foram preparados de acordo com as recomendações do fabricante. Para o grupo I (n=10) foi usado o cimento resinoso White-Opaque (WO) pasta-base, e para o grupo II (n-10) utilizou-se o Yellow (Y) pasta-base. Cada espécime foi fotopolimerizado por 60 s. Os espécimes foram então submetidos ao EAA. Eles foram submetidos a leituras de cor com auxílio de um espectro fotômetro em três momentos: após o preparo (apenas o substrato), após a cimentação e polimerização das facetas e após o EAA. Foram obtios valores de L*, a* e b* e o total da variação de cor foi calculado (?E*). Os valores obtidos foram submetidos à análise estatística no SPSS 17.0 para Windows, com nível de significância de 0,05. Resultados: O cimento Y apresentou maior ?E*, menor L* e maior b* após o EAA em comparação com o WO. Conclusão: Ambos os cimentos têm capacidade de mascarar a cor do substrato. Com o EAA, apenas o Y apresentou um valor de ?E* inaceitável clinicamente, se tornando mais amarelo (maior b*) e perdendo luminosidade (menor L*).

Fratura mandibular após injúria por projétil de arma de fogo: relato de caso clínico / Mandibular fracture after gunshot injury: a case report

As fraturas mandibulares correspondem ao segundo tipo mais comum dentre as fraturas do esqueleto facial. Atualmente, com o incremento da violência nos grandes centros urbanos, houve também um aumento de fraturas decorrentes de armas de fogo em civis, tornando-se necessário o seu estudo para elaboração de protocolos de diagnóstico e tratamento desses pacientes. O presente trabalho visa apresentar um caso clínico de fratura de mandíbula por arma de fogo.

The mandibular fractures represent the second type most common among all fractures of the facial skeleton. Currently, with the increase of violence in big cities, there was also an increase in fractures caused by gunshots wounds in citizens, making it necessary to study their development of protocols for diagnosis and treatment of these patients. The present paper presents a case of mandibular fractures by firearms.

A enfermagem e a saúde da mulher: questöes de gênero e sociopolíticas / Nursing and women's health: social, political and gender issues / La Enfermería y la Salud de la mujer: cuestiones de género y sociopolíticas

O estudo apresenta uma reflexão sobre a evolução da mulher e suas conquistas na dimensão sociopolítica através de um breve recorte histórico, evidenciando sua inserção no mercado de trabalho e as modificações acarretadas para sua vida no núcleo familiar e na sociedade. Avalia a política de atenção à saúde da mulher discutindo os avanços e limites que apresenta, como também a questão da violência e a repercussão na saúde dessa parcela da população. Faze-se uma contextualização da mulher brasileira, destacando-se o compromisso da enfermagem como uma profissão da área de saúde essencialmente e majoritariamente feminina, valorizando-se as orientações, o encaminhamento aos demais profissionais e, sobretudo, a escuta, o olhar atentivo e a solidariedade.