Pseudotrombocitopenia dependiente de EDTA en un niño de 5 años: Reporte de caso

Introducción: La pseudotrombocitopenia dependiente del ácido etilendiaminotetraacético (PTCP-EDTA) es un fenómeno de laboratorio con una prevalencia estimada del 0,1-2% entre los pacientes hospitalizados y entre el 15-17% en los pacientes ambulatorios evaluados por trombocitopenia aislada. Se produce por cambios conformacionales a nivel de las glicoproteínas de la superficie plaquetaria que inducen la agregación de plaquetas tras la exposición al EDTA. Esta agregación da lugar a una falsa disminución del conteo de unidades totales de plaquetas al utilizar analizadores automatizados.  Presentación del caso: Presentamos el caso de un paciente de 5 años que presentaba niveles bajos de plaquetas sin signos de hemorragia activa. El paciente fue ingresado en el hospital mientras se estudiaba la causa de su bajo conteo plaquetario. Para el diagnóstico de PTCP-EDTA, se realizó un frotis de sangre periférica y se compararon los niveles plaquetarios utilizando el tubo con anticoagulante de citrato. Conclusión: La PTCP-EDTA suele ser un diagnóstico que se pasa por alto y que puede dar lugar a procedimientos innecesarios y gastos adicionales para los pacientes que presentan este fenómeno in vitro. (provisto por Infomedic International)

Introduction: Ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia (PTCP-EDTA) is a laboratory phenomenon with an estimated prevalence of 0.1-2% among hospitalized patients and between 15-17% in outpatients evaluated for isolated thrombocytopenia. It is caused by conformational changes at the level of platelet surface glycoproteins that induce platelet aggregation following EDTA exposure. This aggregation results in a false decrease in total platelet unit count when using automated analyzers. Case presentation: We present the case of a 5-year-old patient who presented with low platelet levels without signs of active bleeding. The patient was admitted to the hospital while the cause of his low platelet count was being studied. For the diagnosis of PTCP-EDTA, a peripheral blood smear was performed and platelet levels were compared using the tube with citrate anticoagulant. Conclusion: PTCP-EDTA is often an overlooked diagnosis that may result in unnecessary procedures and additional expense for patients presenting with this phenomenon in vitro. (provided by Infomedic International)

Irrigation protocols effects on radicular dentin: Cleaning, disinfection and remaining ultrastructure / Efecto del protocolo de irrigación en la dentina radicular: limpieza, desinfección y ultraestructura remanente

A successful endodontic treatment requires a combination of satisfactory mechanical instrumentation, adequate irrigation protocols, and three-dimensional obturation of the canal system. Irrigation is considered the most critical procedure to ensure cleaning and disinfection. To date, a large variety of irrigants has been proposed. However, sodium hypochlorite (NaOCl) remains the gold standard. In order to achieve complete cleaning and disinfection, final irrigation with EDTA and ultrasonic devices has been used as an ideal protocol. Most endodontic research focuses on the cleaning and antibacterial properties of the irrigant solutions. Recent evidence demonstrated that the irrigation protocols cause erosion, affecting the radicular dentin ultrastructure. This article aims to describe the clinical features of the present knowledge concerning the effect of irrigation protocols on radicular dentin.

Un tratamiento de endodoncia exitoso requiere de una satisfactoria instrumentación mecánica, protocolos de irrigación adecuados y obturación tridimensional del sistema de conductos radiculares. La irrigación se considera el procedimiento más crítico para garantizar la limpieza y desinfección. Hasta la fecha, se ha propuesto una gran variedad de irrigantes. Sin embargo, el hipoclorito de sodio (NaOCl) sigue siendo el estándar de oro. Para lograr una limpieza y desinfección completa, se ha utilizado como protocolo ideal la irrigación final con EDTA y dispositivos ultrasónicos. La mayor parte de la investigación en endodoncia se enfoca en las propiedades antibacterianas y de limpieza de las soluciones de irrigación. Reciente evidencia demostró que los protocolos de irrigación provocan erosión, afectando la ultraestructura de la dentina radicular. Este artículo tiene como objetivo describir algunas consideraciones clínicas del conocimiento actual sobre el efecto de los protocolos de irrigación en la dentina radicular.

The effect of sonic activated device used for different time on intracanal smear layer removal: An SEM analysis / 口腔医学

Objective @#To observe the clearance of smear layer on the root canal wall in different action time by scanning electron microscope (SEM), and to determine the optimal amount of time using sonically activated irrigation to wash root canal in clinic. @*Methods@# Fifty-six ex vivo human anterior teeth with single straight root canal were selected. After routine mechanical preparation, they were divided into two experimental groups according to different irrigating agents: saline group and EDTA group. Each group was assisted by VDW sonic activation EDDY. The saline group was divided into three subgroups according to the irrigating time: 5 s, 30 s and 50 s; EDTA group was divided into six subgroups according to the irrigating time: 5 s, 10 s, 20 s, 30 s, 40 s and 50 s. The control group did not undergo root canal irrigation. After irrigation, the root was cut longitudinally. The smear layer of crown, middle and apical of root canal wall was observed by SEM.@* Results@# After irrigating for 30 seconds, there was a significant difference between the normal saline group and the control group and the 5 second group (P<0.05), and there was no difference in the middle and apical part (P>0.05). After 50 seconds, there was a significant difference in the score of the smear layer between the apical area and the other groups (P<0.05). After irrigating for 5 seconds or 10 seconds in EDTA group, there was a significant difference between the scores of the crown and middle area of the root canal and the control group (P<0.05), and there was no significant difference in the apical area (P>0.05). There was a significant difference between the 20-40 second group and the first two groups (P<0.05). There was a significant difference between the 50 second group and the other groups (P<0.05). Comparing the cleaning effect on the smear layer after 50 seconds of irrigating between the two experimental groups, the whole root canal showed significant statistical difference (P<0.05). @*Conclusion @#The EDTA-assisted sonic activated device used for 50 seconds has the best cleaning effect.

Effectiveness of ultrasonic activation associated to glycolic acid on smear layer removal, dentin structure and bond strength to root dentin

This study evaluated the effects of ultrasonic activation (US) associated to glycolic acid (GA) on smear layer, dentin structure and bond strength (BS) of filling/restorative material to root dentin. The roots were used for antimicrobial activity, dentin structure and BS evaluation, being distributed into seven groups, according to irrigation protocols: G1:DW+US; G2:17% EDTA; G3:QMix; G4:17% GA; G5:17% EDTA+US; G6:QMix+US; G7:17% GA+US. Scanning electronic microscopy, transmission electronic microscopy and push-out were performed, with specific statistical analysis for each evaluation. The highest smear layer removal occured in Groups 6 and 7 (p<0.05), and the largest collagen dispersion in Group 7, being similar to Group 2 and 5 (p>0.05). The highest BS of filling and restorative material occurred in Groups 6 and 7, and Groups 5, 6 and 7, respectively, being similars between them (p>0.05). The use of GA+US promoted effective smear layer removal and dentin structure preservation, improving the BS of filling/restorative material to root dentin.

Development and verification of high performance liquidchromatography for determination of ethylenediaminetetraacetic acid disodium salt residue in NMM tumor DNA vaccine / 中国生物制品学杂志

@#Objective To develop and verify a high performance liquid chromatography(HPLC) method for the determination of ethylenediaminetetraacetic acid disodium salt(EDTA-2Na) residues in the bulk of NMM tumor DNA vaccine for the quality control of DNA vaccine.Methods After NMM tumor DNA vaccine bulk was complexed with copper sulfate,a HPLC method for the determination of EDTA-2Na residues was developed with Agilent ZORBA XSB-C18(150 mm × 4.6 mm,5 μm) as the chromatographic column,water,tetrabutylammonium hydroxide 10% and acetonitrile solution(74.5:0.5:25)as the mobile phase.The detection method was as follows:the detection wavelength was 254 nm,the flow rate was 0.8 mL/min,the column temperature was 20 ℃ and the injection volume was 20 μL.The method was verified for the specificity,linear range,limit of detection(LOD),limit of quantification(LOQ),solution stability,durability,accuracy and precision,and used to detect the EDTA-2Na residues in several batches of DNA vaccine bulk.Results When EDTA-2Na control and DNA vaccine bulk with EDTA-2Na reacted with copper sulfate,the absorption peak appeared at around 5.3 min,while no absorption peak was observed when DNA vaccine bulk reacted with copper sulfate;In the range of 4～400 μg/mL,the control solution concentration showed a good linear relationship with the peak area,R~2=0.999 9;The LOD of the method was 10 ng/mL,and the LOQ was 40 ng/mL;The solution of control and sample was stable after placed for 12 h;When the detection conditions changed slightly(different mobile phase ratio,flow rate and column temperature),the influence on the detection results was within acceptable range;The average recovery rate of EDTA-2Na in low,medium and high concentration standard added samples was 101.38% with the RSD of 0.39%;0.1 mg/mL control solution was injected continuously for 6 times,and the peak area RSD was 0.04%.EDTA-2Na was not detected in 6 sample solution,and the peak area RSD of DNA vaccine bulk with EDTA-2Na solution was 0.02%,indicating a good intermediate precision.EDTA-2Na residue was not detected in these batches of DNA vaccine bulk.Conclusion The developed method is simple,accurate,reliable with good specificity,which can be used for the determi-nation of EDTA-2Na residues in DNA vaccine bulk.

Establishment and evaluation of an autoverification scheme for hematology analysis in cancer patients / 中华检验医学杂志

Objective:According to the characteristics and common problems of hematology analysis in cancer patients, an autoverification scheme for cancer patients was formed, and the effectiveness and efficiency of the autoverification scheme were verified.Methods:The hematology review of international consensus and ourselves were respectively combined with Chinese multicenter autoverification rules to form two autoverification schemes. 10 063 blood samples (460 cases reviewed by microscope) were selected as the establishment group. Retrospective judgment was made in the instrument middleware, and various indexes such as autoverification pass rate and missed detection rate of different schemes were compared. By analyzing the data of missed cases one by one, the autoverification rules are adjusted according to the characteristics of diagnosis and treatment of cancer patients. By analyzing the platelet count variation range within 7 days in 19 300 cases, the Delta rules of platelet count were established. The platelet count Delta rules and the adjusted autoverification rules were combined to form the autoverification rules of our hospital and then combined with our hematology review rules to form the autoverification scheme of our hospital. The establishment group and verification group (10 876 cases, including 1 740 cases of microscopic examination) of the autoverification schemes were judged. The recognition function of Ethylenediaminetetraacetic acid-dependent pseudo thrombocytopenia (EDTA-PTCP) and PLT Delta check were programmed in the laboratory information system (LIS), and other rule judgment functions are performed in middleware. After four months of clinical trial application of 61 602 specimens, the effectiveness of our autoverification scheme was comprehensively evaluated.Results:The autoverification pass rates of international hematology review rules, our review rules, and Chinese multicenter autoverification rules are 46.36%, 52.26%, and the missed detection rates are 2.02%, 1.06%, respectively. The autoverification pass rates of our hospital autoverification scheme in the establishment group and the verification group are 51.19% and 52.78%, the missed detection rates are 0% and 0.03%, and the true positive rate are 100% and 99.95%, respectively. 56.06% of cases were passed automatically during the clinical trial application, and there were no missing cases, the true positive rate is 100%. The performance of our autoverification scheme is superior to the current autoverification schemes combined with mainstream hematology review rules and autoverification rules. The median time of TAT by autoverification was shortened by 15 minutes, and the 90th percentile time was shortened by 58 minutes, which was significantly lower than that of the same period last year. The marker function of "EDTA-PTCP" identified 31 special patients and 68 samples had been analyzed in total. After correction, the median increase of PLT was 76.5×10 9/L ( Z=-7.17, P<0.001). Conclusions:This study has established an autoverification scheme that combined by rules of hematology review and autoverification rules. It is suitable for cancer patients with high pass rate and very low rate of missed detection. This autoverification scheme can ensure the accuracy of the hematology analysis of cancer patients in our hospital and improve work efficiency.

Evaluation of The Cleaning Protocol of Post Space on Bond Strength of Glass Fiber Posts

ABSTRACT: This study aimed to compare the effect of four irrigation solutions for post space cleaning on the bond strength between glass fiber post and root dentine. Forty bovine roots were root-filled and randomly divided into four groups (n=10), according to the irrigation solution: CG (Control Group): saline solution; SH (Sodium Hypochlorite Group); CLX (Chlorhexidine group) and EDTA (ethylenediaminetetraacetic acid group). Specimens were submitted to mechanical aging and push-out test. Statistical analysis (ANOVA two-way and Tukey test; p<0.05) was performed. A stereomicroscope was used for failure mode classification. EDTA showed higher bond strength values, differing statistically from SH and CG (p<0.05). Adhesive failure between dentin and resinous cement was predominant, followed by mixed failures. SEM images showed pronounced smear layer removal in the EDTA group. 17 % EDTA was better than other solutions for cleaning of post space when using glass fiber posts.

RESUMEN: Este estudio tuvo como objetivo comparar el efecto de cuatro soluciones de irrigación para la limpieza del espacio del poste sobre la fuerza de unión entre el poste de fibra de vidrio y la dentina radicular. Se rellenaron cuarenta raíces bovinas y se dividieron aleatoriamente en cuatro grupos (n = 10), según la solu- ción de riego: CG (Grupo Control): solución salina; SH (Gru- po de hipoclorito de sodio); CLX (grupo clorhexidina) y EDTA (grupo ácido etilendiaminotetraacético). Las muestras se sometieron a una prueba de envejecimiento mecánico y de expulsión. Se realizó análisis estadístico (ANOVA bidireccional y prueba de Tukey; p <0,05). Se utilizó un microscopio estereoscópico para la clasificación del modo de falla. EDTA mostró valores de fuerza de unión más altos, difiriendo estadísticamente de SH y CG (p <0,05). Pre-dominó la falla adhesiva entre dentina y cemento resinoso, seguida de fallas mixtas. Las imágenes SEM mostraron una eliminación pronunciada de la capa de frotis en el grupo de EDTA. El EDTA al 17 % fue mejor que otras soluciones para la limpieza del espacio de los postes cuando se utilizan postes de fibra de vidrio.

Influência de substâncias irrigadoras endodônticas na microdureza da dentina radicular: revisão integrativa / Influence of endodontic irrigation substances on the microdurity of the radicular dentin: integrative review

As soluções de irrigação são essenciais como auxiliares na limpeza e desinfecção do sistema de canais radiculares (SCR). Entretanto, essas substâncias químicas podem gerar alterações na composição da dentina. Assim, o presente estudo teve como objetivo avaliar, por meio de uma revisão integrativa, os efeitos do hipoclorito de sódio (NaOCl) a 1%; 2,5%; 3%; 5%; 5,25%; 6% e 17%; digluconato de clorexidina (CHX) a 2% e EDTA 2,5%; 5%; 15% e 17% sobre a microdureza da dentina do canal radicular após sua utilização como solução irrigadora. Foi realizada uma revisão integrativa nas bases de dados: PubMed, Cochrane e Lilacs, utilizando-se os seguintes descritores em inglês: "irrigating solutions"; "chelaling agentes"; "dentin microhardness"; "EDTA"; "sodium hypochlorite"; "chlorhexidine gluconate". Foi utilizado o conector "and" associando dentin microhardness aos outros descritores. Critérios de inclusão: Artigos científicos na área da odontologia, escritos em inglês e português que aborda o tema "As soluções de hipoclorito de sódio (NaOCl), digluconato de clorexidina (CHX) e EDTA influenciam na microdureza da dentina radicular?''. Critérios de exclusão: artigos repetidos em mais de uma base de dados, livros, teses de doutorado, dissertações de mestrado, resumos e trabalhos publicados em congresso. Fortes evidências indicam que o hipoclorito de sódio, digluconato de clorexidina e EDTA influenciam na microdureza da dentina radicular, quando utilizadas como solução irrigadora durante o tratamento endodôntico... (AU)

Irrigation solutions are essential as an aid in cleaning and disinfecting the root canal system (SCR). However, these chemicals can cause changes in the composition of dentin. Thus, the present study aimed to evaluate, through an integrative review, the effects of 1% sodium hypochlorite (NaOCl); 2.5%; 3%; 5%; 5.25%; 6% and 17%; 2% chlorhexidine digluconate (CHX) and 2.5% EDTA; 5%; 15% and 17% on the microhardness of root canal dentin after its use as an irrigating solution. An integrative review was carried out in the databases: PubMed, Cochrane and Lilacs, using the following descriptors in English: "irrigating solutions"; "chelaling agents"; "dentin microhardness"; "EDTA"; "sodium hypochlorite"; "chlorhexidine gluconate". The "and" connector was used, associating dentin microhardness with other descriptors. Inclusion criteria: Scientific articles in the field of dentistry, written in English and Portuguese that address the topic "Do solutions of sodium hypochlorite (NaOCl), chlorhexidine gluconate (CHX) and EDTA influence the microhardness of root dentin?". Exclusion criteria: articles repeated in more than one database, books, doctoral theses, master's dissertations, abstracts and papers published in congress. Strong evidence indicates that sodium hypochlorite, chlorhexidine gluconate and EDTA influence the microhardness of root dentin when used as an irrigating solution during endodontic treatment... (AU)

Effect of paracellular permeation enhancers on intestinal permeability of two peptide drugs, enalaprilat and hexarelin, in rats

Transcellular permeation enhancers are known to increase the intestinal permeability of enalaprilat, a 349 Da peptide, but not hexarelin (887 Da). The primary aim of this paper was to investigate if paracellular permeability enhancers affected the intestinal permeation of the two peptides. This was investigated using the rat single-pass intestinal perfusion model with concomitant blood sampling. These luminal compositions included two paracellular permeation enhancers, chitosan (5 mg/mL) and ethylenediaminetetraacetate (EDTA, 1 and 5 mg/mL), as well as low luminal tonicity (100 mOsm) with or without lidocaine. Effects were evaluated by the change in lumen-to-blood permeability of hexarelin and enalaprilat, and the blood-to-lumen clearance of

Effects of chelating calcium in cryopreservation extender on frozen-thawed dog semen / [Efeitos da quelação de cálcio no meio de criopreservação no sêmen descongelado de cão]

We evaluated the effect of reducing free calcium in the cryopreservation medium, using the calcium chelator ethylene diamine tetracetic acid (EDTA) at 0.3% and 0.5% concentrations. Three male mixed breed dogs were subjected to semen collection by digital manipulation (n=16). Each ejaculate was divided in three aliquots, and each one was diluted in TRIS-glucose-egg yolk extender with 6% glycerol and 0.5% Equex STM Paste® (TGE, control); and added with 0.3% EDTA (EDTA 0.3) or 0.5% EDTA (EDTA 0.5). Calcium concentration reduced in EDTA 0.3 and all the calcium ions were chelated in EDTA 0.5. The EDTA addition did not affect sperm morphology or plasma membrane integrity; however, by removing all free calcium (EDTA 0.5), the sperm motility reduced (64.7% in TGE and 45% in EDTA 0.5; p<0.05). Acrosome integrity and sperm binding ability were not improved by calcium chelation. The failure to prevent the premature AR may explain why sperm longevity was not affected by calcium removal. Thus, the partial or complete calcium removal, through EDTA addition, is not able to prevent acrosomal damage or premature acrosomal reaction, and therefore does not improve the dog sperm binding ability.(AU)

Avaliou-se o efeito da redução do cálcio livre no meio de congelamento, usando-se o quelante de cálcio etilenodiaminotetracético (EDTA) a 0,3% e 0,5%. Três cães machos sem raça definida foram submetidos à coleta de sêmen por manipulação digital (n=16). Cada ejaculado foi diluído em diluidor controle com TRIS-glicose - gema de ovo (TGE, controle), ou em diluidor TGE enriquecido com 0,3% (EDTA 0,3) ou 0,5% de EDTA (EDTA 0,5). A concentração de cálcio reduziu no meio EDTA 0,3, e todos os íons de cálcio foram quelados no meio EDTA 0,5. A adição do EDTA e a consequente quelação do cálcio não afetaram a morfologia espermática ou a integridade da membrana plasmática, no entanto, ao remover todo o cálcio do meio (EDTA 0,5), a motilidade espermática se reduziu (64,7% no TGE e 45% no EDTA 0,5; P<0,05). A integridade do acrossoma e a capacidade de ligação do espermatozoide não melhoraram com a quelação do cálcio. Apesar da influência da concentração de cálcio sobre a motilidade espermática após o descongelamento, a falha em prever a reação acrossomal prematura pode explicar por que a longevidade espermática não foi afetada pela remoção do cálcio no meio. Dessa forma, a remoção parcial ou total do cálcio, por meio da adição de EDTA, não é capaz de prevenir o dano no acrossoma ou a reação acrossomal prematura e, portanto, não aumenta a capacidade do espermatozoide de se ligar ao oócito.(AU)

Evaluation of Internal bleaching with 35% hydrogen peroxide in dentin conditioned with 37% phosphoric acid and 17% EDTA / Evaluación del blanqueamiento interno con peróxido de hidrógeno al 35% en dentina acondicionada con ácido fosfórico al 37% y EDTA al 17%

Introduction: This study aimed to evaluate the effect of dentin surface treatment with 37% phosphoric acid or 17% ethylenedia-minetetraacetic acid (EDTA) before Internal Bleaching with 35% hydrogen peroxide using the walking bleach technique. Material and Methods: This experimental in vitro study used 66 human premolars extracted for orthodontic reasons, which were debrided, endodontically prepared, and pigmented with chromogens derived from blood decomposition. The samples were randomly divided into three groups (n=22). Group A: bleaching agent without dentin conditioning; group B: bleaching agent in dentin conditioned with phosphoric acid 37%; group C: bleaching agent in dentin conditioned with 17% EDTA. 4 applications of bleaching agent were used with a separation of 4 days between each session. The initial color (baseline) and after each application was determined by spectrophotometry, recording the CIE L*a*b* values and the total color variation between the initial parameters and the different evaluation times. Results: Data were statistically analyzed with the Wilcoxon test. This showed statistically significant differences for the total variation of the color between the study groups, with the control group in no case inferior to the rest. Conclusion: The application of 37% phosphoric acid increased the effectiveness of the bleaching agent when compared to 17% EDTA. However, these did not increase the effectiveness compared to the application of the bleaching agent without a previous dentin surface treatment.

Introducción: El objetivo de este estudio fue evaluar el efecto del tratamiento de superficie dentinaria con ácido fosfórico al 37% o EDTA al 17% previo al blanqueamiento Interno con peróxido de hidrógeno al 35% por medio de la técnica Walking Bleach. Material y Métodos:Para este estudio experimental in vitro, se utilizaron 66 premolares humanos extraídos por indicación ortodóncica, los cuales fueron desbridados, preparados endodónticamente, y pigmentados con cromógenos derivados de la descomposición sanguínea. Las muestras fueron divididas aleatoriamente en 3 grupos (n=22). Grupo A: agente blanqueador sin acondicionamiento dentinario, grupo B: agente blanqueador en dentina acondicionada con ácido fosfórico 37% y grupo C: agente blanqueador en dentina acondicionada con EDTA 17%. Se utilizaron 4 aplicaciones de agente blanqueador con una separación de 4 días entre cada sesión. El color inicial (baseline) y tras cada aplicación fue determinado mediante espectrofotometría, registrando los valores CIE L*a*b* y la variación total de color entre los parámetros iniciales y los diferentes tiempos de evaluación. Resultados: Los datos fueron analizados estadísticamente con la prueba de Wilcoxon, arrojando diferencias estadísticamente significativas para la variación total del color entre los grupos de estudio, siendo en ningún caso el grupo control inferior al resto. Conclusión: La aplicación de ácido fosfórico al 37% aumenta la eficacia del agente blanqueador al compararlo con el EDTA 17%, sin embargo, no aumentan la eficacia respecto a la aplicación del agente blanqueador sin un tratamiento de superficie dentinaria previo.

Post preparation: cleanness achieved by different irrigating protocols / Preparación para poste: limpieza lograda por diferentes protocolos de irrigación

ABSTRACT The aim of this study was to evaluate the ability of different irrigation protocols to remove from the walls of the root canal and entrance to dentinal tubules the smear layer produced during preparation for a fiber post. Fifty decoronated human lower premolars were treated endodontically and the apical third of the canal was filled with a single gutta-percha point using warm vertical compaction. Ten millimeters were left free for post preparation, which was done by sequential use of a Largo #1 drill and Exacto #3 pilot drill (Angelus, Brazil), with irrigation with distilled water upon each instrument change. Samples were distributed randomly into 5 groups (n=10). G 1: No irrigation after post preparation. G 2: Distilled water activated for 60 s + distilled water. G 3: 5.25% NaOCl 15 s+ distilled water. G 4: 17% EDTA (Farmadental, Argentina) 60 s + 5.25% NaOCl 15 s + distilled water. G 5: 10% polyacrylic acid (Densell) 15 s + distilled water. Irrigant was activated mechanically with a low-speed conical brush. Roots were then split longitudinally in vestibular-lingual direction. Each surface was observed under SEM in its different thirds. Microphotographs were taken at 150X and 600X magnification and results analyzed statistically using Kruskall Wallis and Friedman tests (p<0.05). The results [mean (standard deviation)] were: for 150X: G1 11.00 (1.33), G2 7.50 (3.13), G3 6.30 (2.58), G4 2.20 (2.80), G5 4.30 (1.50), and for 600X G1 11.40 (0.84), G2 10.00 (1.94), G3 7.70 (3.33), G4 5.80 (3.70), G5 7.20 (2.65). The statistical analysis showed significant differences between irrigants (p<0.05) but not between root thirds (p>>0.05). The EDTA+NaOCl combination and polyacrylic acid showed greater capacity to remove the smear layer created during post preparation.

RESUMEN El objetivo del presente trabajo fue evaluar la capacidad de diferentes protocolos de irrigación para remover el barro dentinario de las paredes del conducto y entrada de los túbulos dentinarios, producido durante la preparación para anclaje intarradicular. Se utilizaron 50 premolares inferiores humanos a los cuales se les cortó la corona clínica. Luego se les realizó tratamiento endodóntico y obturación del tercio apical con cono único de conicidad aumentada y compactación vertical caliente. Se dejaron libres 10 mm para la preparación para poste que se realizó utilizando secuencialmente fresa de Largo # 1y fresa piloto Exacto #1(Angelus, Brasil), irrigando a cada cambio de instrumento con agua destilada. Las muestras fueron distribuidas aleatoriamente en 5 grupos (n=10). G 1: No se efectuó ningún lavaje. Los irrigantes fueron activados con cepillo mecánico cónico a baja velocidad. G 2: Agua destilada activada 60 s+ agua destilada G 3: NaOCl al 5,25%, 15 s+ agua destilada. G 4: EDTA al 17% (Farmadental, Argentina) 60 s +NaOCl al 5,25% 15 s , + agua destilada. G 5 : Ácido poliacrílico al 10% ( Densell) 15 s + agua destilada. Posteriormente, las raíces fueron seccionadas longitudinalmente en sentido vestíbulo lingual. Cada superficie fue observada al MEB en sus diferentes tercios. Las micrografías se realizaron a 150 y 600 X y los resultados analizados estadísticamente mediante test de Kruskall Wallis y Friedman (p<0,05), Los resultados [Medias (desviaciones estándar)] fueron: para 150X G1 11,00(1,33), G2 7,50 (3,13), G3 6,30 (2,58), G4 2,20 (2,80), G5 4,30 (1,50) y para 600X G1 11,40 (0,84), G2 10,00 (1,94), G3 7,70 (3,33), G4 5,80 (3,70), G5 7,20 (2,65). El análisis estadístico mostró diferencia significativa entre irrigantes (p<0,05) pero no entre tercios radiculares (p>0,05). La combinación de EDTA+NaOCl y el ácido poliacrílico tendrían mayor capacidad de remoción del barro dentinario creado durante la preparación para poste.

The Effect of 17% Ethylenediaminetetraacetic Acid and 10% Citric Acid Solutions with Manual and Ultrasonic Agitation on Smear Layer Removal and Intraradicular Dentine Erosion: A Scanning Electron Microscope Evaluation

This study evaluated the ex vivo effectiveness of different final irrigation protocols in smear layer removal and intraradicular dentine erosion. Thirty five extracted human canines were instrumented and randomly divided, according to final rinse techniques used, into 7 groups: 1 (ED3M) and 3 (ED3US), 17% EDTA for 3 minutes with manual and ultrasonic agitation, respectively; 2 (CA30M) and 4 (CA30US), 10% citric acid for 30 seconds with manual and ultrasonic agitation, respectively; 5 (CA3M) and 6 (CA3US), 10% citric acid for 3 minutes with manual and ultrasonic agitation, respectively; and, 7 (Na3), 5.25% NaOCl for 3 minutes without agitation (control). All specimens then were irrigated with 5.25% NaOCl, split lengthwise, and examined under scanning electron microscopy (SEM) in apical, middle and coronal thirds. Data were analyzed with Kruskal-Wallis and Mann-Whitney tests. The effectiveness of 17% EDTA and 10% citric acid in removing smear layer was significantly greater than 5.25% NaOCl (control). There were no significant differences among final irrigation protocols in smear layer removal or erosive effects. However, when comparing the thirds in groups 1 (ED3M) and 2 (CA30M), the least smear layer removal and erosion was seen in the apical third, but the group 4 procedure (CA30US) was more effective than 1 (ED3M) (p=0.0004), 2 (CA30M) (p=0.0018) or 3 (ED3US) (p=0.0003) in smear layer removal for the apical third. It was concluded that protocols used in this study were similar in smear layer removal and erosive effects.

Use of scanning electron microscopy in the cochlea of guinea pigs / Microscopia eletrônica de varredura em cócleas de cobaias

Abstract Introduction: The use of electron microscopy in the study of the inner ear has allowed us to observe minute details of the hair cells, especially in ototoxicity studies; however, the preparation of this material is a difficult and delicate task. In an attempt to simplify the handling of these materials, two agents, toluidine blue and ethylenediamine tetra-acetic acid were tested, in addition to the elimination of osmium tetroxide during the preparation of albino guinea pig cochleae. We also tested the applicability of these methodologies in an ototoxicity protocol. Objective: To verify the quality of the images obtained with and without the use of ethylenediamine tetra-acetic acid, toluidine blue and osmium tetroxide in the preparation of cochleae of albino guinea pigs for the scanning electron microscopy. Methods: Three groups of cochleae were used. In Group 1, 10 cochleae were prepared with the usual methodology, dissecting the optical capsule without decalcification and using osmium tetroxide as a post-fixative agent. In Group 2, we prepared 10 cochleae decalcified with ethylenediamine tetra-acetic acid, injecting toluidine blue in the endolymphatic space to facilitate the identification of the organ of Corti. In Group 3, we used 4 cochleae of guinea pigs that received 3 doses of cisplatin (7.5 mg/kg, D1-D5-D6), two prepared according to the methodology used in Group 1 and two with that used in Group 2. Scanning electron microscopy images were obtained from the organ of Corti region of the basal turn of each cochlea. Results: The organ of Corti was more easily identified with the use of toluidine blue. The dissection of the cochlea was more accurate in the decalcified cochleae. The quality of the images and the preservation of the organ of Corti obtained with the two methodologies were similar. Conclusion: The proposed modifications resulted in images of similar quality as those observed using the traditional methodology.

Resumo Introdução: O emprego da microscopia eletrônica no estudo da orelha interna permitiu observar detalhes minuciosos das células ciliadas especialmente em estudos de ototoxicidade. Entretanto, o preparo desse material é trabalhoso e delicado. Para simplificar a manipulação desses materiais, testou-se o uso de dois agentes, azul de toluidina e ácido etilenodiamino tetra-acético, além da retirada do tetróxido de ósmio na preparação de cócleas de cobaias albinas. Testamos também a aplicabilidade dessas metodologias em um protocolo de ototoxicidade. Objetivo: Verificar a qualidade das imagens obtidas com e sem o uso de ácido etilenodiamino tetra-acético, azul de toluidina e tetróxido de ósmio na preparação de cócleas de cobaias albinas para a microscopia eletrônica de varredura. Método: Foram utilizados três grupos de cócleas. No Grupo 1 preparou-se 10 cócleas com a metodologia usual, dissecando a cápsula ótica sem descalcificac¸ão e utilizando tetróxido de ósmio como pós-fixador. No Grupo 2 preparamos 10 cócleas descalcificadas com ácido etilenodiamino tetra-acético, injetando azul de toluidina no espac¸o endolinfático para facilitar a identificação do órgão de Corti. No Grupo 3 utilizamos 4 cócleas de cobaias que receberam 3 doses de cisplatina (7,5 mg/kg, D1-D5-D6), duas preparadas com a metodologia do Grupo 1 e duas com a do Grupo 2. Foram obtidas imagens da microscopia eletrônica de varredura da região do órgão de Corti do giro basal de cada cóclea. Resultados: O órgão de Corti foi mais facilmente identificado com o azul de touidina. A dissecção da cóclea foi mais precisa nas cócleas descalcificadas A qualidade das imagens e a preservac¸ão do órgão de Corti obtidas com as duas metodologias foi similar. Conclusão: As modificações propostas resultaram em imagens de qualidade similar as observadas com o uso da metodologia tradicional.

Antitumor efficacy of EDTA co-treatment with cisplatin in tumor-bearing mice

Ethylenediamine tetraacetic acid (EDTA) is used in various medical applications. The aim of this study is to investigate the antitumor efficacy of EDTA alone or with cisplatin (Cis). Fifty male albino mice were used to assess the median lethal dose (LD50) of EDTA via intraperitoneal (i.p) injection. To determine the antitumor activity, fifty female albino mice were divided into five groups as the following; Group 1 (Gp1) was negative control; (Gp2-5) inoculated i.p with 2×106 Ehrlich Ascites Carcinoma (EAC) cells/mouse. After one day, Gp3, Gp4 and Gp5 injected with Cis (2 mg/kg), EDTA (25 mg/kg) and Cis (2 mg/kg)/EDTA (25 mg/kg) for six days, respectively. At day 14, all groups were sacrificed to assess the tumor profile, liver enzymes (alanine transaminases and aspartate transaminases), kidney function (urea and creatinine) and electrolytes (Na+, K+ and Ca2+). The results showed that the i.p LD50 of EDTA was 250 mg/kg. Treatment with EDTA alone did not show any antitumor activity and did not interfere with the antitumor efficacy of Cis. Biochemical findings revealed that EDTA had mild toxicity on liver and kidneys functions. In summary, EDTA had no antitumor effect and did not alter the Cis efficacy.

Comparative effects of final canal irrigation with chitosan and EDTA

Abstract Chitosan is a natural, biocompatible chelating substance with potential for dental use. This study compared the effects of final canal irrigation with chitosan and EDTA on dentin microhardness, sealer dentin tubules penetration capacity, and push-out strength. Methodology: Fifty canine roots were distributed according to the final irrigation protocol (n=10): G1- 15% EDTA with conventional irrigation; G2- 15% EDTA with Endovac; G3- 0.2% chitosan with conventional irrigation; G4- 0.2% chitosan with Endovac; and G5- without irrigation. Specimens were obturated (AH Plus) and sectioned in 3 slices per root third. The first slice was used for microhardness and sealer penetration assessments under a laser confocal microscope. The second was utilized in a push-out strength test. The third slice was discarded. Data were analyzed using 2-way ANOVA and Tukey's post hoc test (α<0.05). Failure mode was determined at x40 magnification. Results: Microhardness reduction was more significant in groups G2 and G4 (p<0.05). Sealer penetration through dentin was significantly greater in group G2 (p<0.05). There was no significant difference between groups G1, G3, and G4 (p>0.05). In general, all experimental groups presented similar bond resistance (p>0.05) that significantly differed from the control (p<0.001). Mixed type failures were predominant. Conclusions: In general, 0.2% chitosan and 15% EDTA solutions act in a similar manner with regard to the variables studied. The use of Endovac potentiates the effect of these solutions.

Comparación de parámetros hematológicos y morfología celular en muestras de sangre con EDTA K2 y EDTA K3 / Comparison of hematological parameters and cellular morphology in blood samples with EDTA K2 and EDTA K3

El EDTA es el anticoagulante de elección en los laboratorios de hematología para la conservación de la muestra de sangre total. Existen dos tipos, EDTA K2 y EDTA K3, y su diferencia radica en la cantidad de moléculas de potasio. Algunas guías sugieren que hay diferencias entre el anticoagulante EDTA K2 y el K3 para el proceso del hemograma; sin embargo, con las nuevas presentaciones de los tubos que traen las casas comerciales, no se tiene claro si en realidad aún hay diferencia entre los dos anticoagulantes, y si esto puede alterar el resultado del hemograma, tanto en el resultado cuantitativo, como en el cualitativo. Objetivo. Comparar los recuentos leucocitarios, la hemoglobina, el hematocrito, el volumen corpuscular medio, las plaquetas y la morfología celular en muestras de sangre periférica con EDTA K2 y EDTA K3, en diferentes tiempos (0, 1 y 2 horas). Materiales y métodos. Se realizó un estudio cuasi-experimental, multivariado, multifactorial, que tiene como unidad de análisis la sangre anticoagulada con EDTA K2 y EDTA K3, extraída de 53 individuos a través de un muestreo no probabilístico por conveniencia. Resultados. Al comparar los resultados del estudio morfológico por medio del extendido de sangre periférica y los datos cuantitativos del hemograma, se encontró que no hay diferencias estadísticamente significativas usando EDTA K2 o K3. Conclusión. Se evidenció que el uso del EDTA K2 o EDTA K3 como anticoagulante de elección, procesando las muestras en un tiempo adecuado después de su recolección, no afecta los parámetros cuantitativos del hemograma automatizado ni los morfológicos.

EDTA is the anticoagulant of choice in hematology laboratories for the conservation of whole blood samples. There are two types, K2 EDTA and K3 EDTA, and their difference lies in the amount of potassium molecules. Some guidelines suggest that there are differences between K2 and K3 EDTA for the blood analysis process. However, with the new collection tubes offered by the commercial suppliers, it is not clear if in fact there is a difference between the two anticoagulants that would result in changes in blood parameters and cell morphology. Objective. To compare leukocyte counts, hemoglobin, hematocrit, mean corpuscular volume, platelets and cell morphology in peripheral blood samples collected with K2 EDTA and K3 EDTA, at different times (0, 1 and 2 hours). Materials and methods. A quasi-experimental, multivariate, multifactorial study was carried out, with anticoagulated blood as the unit of analysis, either with K2 EDTA or K3 EDTA, extracted from 53 subjects through a non-probabilistic sampling for convenience. Results. There was no statistically significant difference when comparing results of the peripheral blood smear and the quantitative hematological parameters using K2 or K3 EDTA. Conclusion. The use of either K2 EDTA or K3 EDTA as the anticoagulant of choice, when processing samples within a suitable time after their collection, proved equally satisfactory for both quantitative and morphological parameters

Diving deep into chelation therapy for coronary artery disease: a review

Chelation therapy is still a mainstay therapy when it comes to dealing with heavy metal intoxication. The ability of various chelators to bind metal and other chemical molecules led to the idea whether chelation therapy can be used as an alternative therapy to enchain calcium element that is known to be present in the atherosclerotic plaque. Various studies have been conducted, one of which is a large trial to assess chelation therapy study to show in case ethylenediaminetetraacetic acid (EDTA) chelator can be proven by evidence-based in managing coronary heart disease. Despite the favorable results that were found in many literature studies, the results of the study are still under debate in various aspects. To address this issue, we conducted a review article to discuss comprehensively the general description of EDTA as chelation therapy, various mechanisms that can explain the use of EDTA in the management of coronary heart disease, the pharmacokinetic aspects of EDTA chelation therapy, as well as describing various existing studies with a good level of evidence to review the effectiveness of these therapies against coronary artery disease.

Acondicionamiento radicular en el tratamiento periodontal no quirúrgico y quirúrgico / Root conditioning in non-surgical and surgical periodontal therapy

La instrumentación mecánica durante el tratamiento periodontal trae consigo la formación de escombros microcristalinos que inhiben la adhesión tisular a la superfi cie radicular y favorece la proliferación bacteriana, lo cual perjudica los resultados del tratamiento periodontal a corto y largo plazo. Hoy en día el acondicionamiento radicular con el uso de biomodifi cadores es una opción de tratamiento adicional en el tratamiento de la periodontitis y el tratamiento de cobertura radicular. El objetivo del presente estudio es realizar una revisión de la literatura acerca de las aplicaciones y del acondicionamiento radicular con ácido cítrico, tetraciclina, EDTA y láser en el tratamiento periodontal no quirúrgico y quirúrgico (AU)

Mechanical instrumentation during periodontal treatment brings the formation of microcrystalline debris that inhibits tissue adhesion to the root surface and favors bacterial proliferation, which harms the results of the short and long term periodontal treatment. Nowadays, root conditioning with the use of biomodifi cators is an additional treatment option in the treatment of periodontitis and root coverage therapy. The aim of the present study is to conduct a literature review about the applications and the root conditioning with citric acid, tetracycline, EDTA and laser in the non surgical and surgical periodontal treatment (AU)

Evaluación in vitro de las superficies radiculares tratadas mediante terapia periodontal no quirúrgica y biomodificadores radiculares / In vitro evaluation of root surface treated with non-surgical periodontal therapy and root biomodification

Introducción: El uso de agentes químicos en la superficie radicular durante la fase higiénica periodontal tiene como ventajas eliminar factores irritantes, prevenir la acumulación bacteriana y fomentar la cicatrización de la herida. El objetivo del presente estudio fue evaluar la superficie radicular de órganos dentales con periodontitis crónica avanzada, tratados mediante terapia periodontal no quirúrgica con EDTA y láser CO2. Material y métodos: Se evaluaron 40 órganos dentarios de pacientes con periodontitis crónica avanzada indicados para extracción, a los cuales se les realizó raspado y alisado radicular, con el uso de EDTA al 24%, láser CO2 a energía de 1, 1.5 y 2 Watt, para posteriormente evaluar la superficie radicular mediante un microscopio electrónico de barrido. Resultados: El tratamiento de raspado y alisado radicular mostró una superficie regular, pero con marcas de estrías con una cubierta de escombro dentinario, las muestras tratadas con EDTA al 24% muestran apertura de los túbulos dentinarios, con bordes definidos y un diámetro aparentemente amplio y los órganos dentarios tratados con láser CO2 con diferentes poderes de energía mostraron múltiples cambios en su superficie, con una apertura de túbulos dentinarios en su mayoría. Conclusión: La apertura de los túbulos dentinarios se presentó en los grupos experimentales tratados con biomodificador radicular (AU)

Introduction: The use of chemical agents in the root surface during the periodontal hygienic phase has the advantages of eliminating irritating factors, preventing bacterial accumulation and promoting wound healing. The objective of the present study was to evaluate the radicular surface of dental organs with advanced chronic periodontitis treated by non-surgical periodontal therapy with EDTA and CO2 laser. Material and methods: Forty dental organs of patients with advanced chronic periodontitis indicated for extraction were evaluated, which were performed scraping and root planing, with the use of 24% EDTA, CO2 laser with energy of 1, 1.5 and 2 Watt, to later evaluate the radicular surface by means of a scanning electron microscope. Results: The treatment of scaling and root planing showed a regular surface, but with marks of striae with a covering of dentine rubble, the samples treated with 24% EDTA show opening of the dentinal tubules, with defined edges and a seemingly wide diameter and, the dental organs treated with CO2 laser with different power powers showed multiple changes in their surface, with an opening of dentinal tubules in their majority. Conclusion: The opening of the dentinal tubules was presented in the experimental groups treated with a root biomodifier (AU)