RESUMO
In recent years the traditional treatment spectrum of tumors--chemotherapy or radiotherapy--has been extended with immune-modulating strategies. For some tumors, clinical responses have been observed but for numerous others no satisfactory approach has been established. Many new agents have been developed; the targeted or smart drugs modulate a constantly growing list of tumor-specific signal pathways and represent an enormous hope for cancer patients. The clinical evaluation of these targeted drugs alone or in combination also presents an enormous challenge. Since the number of possible combinations of targeted drugs seems almost limitless, an accurate strategy for determination of success-promising combination patterns for the individual cancer patient is of special importance.
Assuntos
Antineoplásicos/uso terapêutico , Sistemas de Liberação de Medicamentos/métodos , Neoplasias/tratamento farmacológico , Neoplasias/genética , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Transformação Celular Neoplásica/efeitos dos fármacos , Transformação Celular Neoplásica/genética , Ensaios Clínicos como Assunto , Avaliação Pré-Clínica de Medicamentos , Sinergismo Farmacológico , Gefitinibe , Inativação Gênica/efeitos dos fármacos , Humanos , Prognóstico , Quinazolinas/administração & dosagemRESUMO
BACKGROUND: Regenerative periodontal therapy with an enamel matrix protein derivative (EMD) has been shown to promote regeneration in intrabony periodontal defects. However, in most clinical studies, root surface conditioning with EDTA was performed in conjunction with the application of EMD, and, therefore, it cannot be excluded that the results may also be attributable to the effect of the root conditioning procedure. The purpose of this study was to determine the effect of root conditioning on the healing of intrabony defects treated with EMD. METHODS: Twenty-four patients, each of whom exhibited one deep intrabony defect, were randomly treated with either open flap debridement (OFD) followed by root surface conditioning with EDTA and application of EMD (OFD+EDTA+EMD) or with OFD and application of EMD only (OFD+EMD). The following parameters were recorded at baseline and at 1 year: plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 year after therapy, the OFD+EDTA+EMD group showed a reduction in mean PD from 9.3+/-1.3 mm to 4.0+/-0.9 mm (P<0.001), and mean CAL changed from 10.8+/-2.2 mm to 7.1+/-2.8 mm (P<0.001). In the OFD+EMD group, mean PD was reduced from 9.3+/-1.2 mm to 4.2+/-0.9 mm (P<0.001), and a change in mean CAL from 11.0+/-1.7 mm to 7.3+/-1.6 mm (P<0.001). There were no significant differences in any of the investigated parameters between the two groups. CONCLUSION: In intrabony defects, regenerative surgery including OFD+EDTA+EMD failed to show statistically significant differences in terms of PD reduction and CAL gain compared to treatment with OFD+EMD.
Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Regeneração Óssea/efeitos dos fármacos , Quelantes/uso terapêutico , Proteínas do Esmalte Dentário/uso terapêutico , Ácido Edético/uso terapêutico , Raiz Dentária/efeitos dos fármacos , Adulto , Perda do Osso Alveolar/cirurgia , Quelantes/farmacologia , Proteínas do Esmalte Dentário/farmacologia , Método Duplo-Cego , Ácido Edético/farmacologia , Feminino , Humanos , Masculino , Procedimentos Cirúrgicos Bucais/métodos , Índice Periodontal , Estudos ProspectivosRESUMO
The aim of the present study was to evaluate histologically in dogs the effect of treating intrabony defects with an oily calcium hydroxide suspension (OCHS). Intrabony defects were surgically created bilaterally at the distal aspects of the maxillary first premolars and at the mesial aspects of the third premolars in two mongrel dogs. Subsequently, the defects were randomly treated with (a) access flap surgery followed by the application of an OCHS or (b) access flap surgery alone. After 8 weeks of healing, the animals were killed. Dissected blocks containing the experimental specimens were fixed in formalin, decalcified in EDTA, and embedded in paraffin. The formation of new cementum and bone was assessed histomorphometrically. In the control group, healing was predominantly characterized by the formation of a long junctional epithelium along the root surface and limited periodontal regeneration at the most apical part of the defect. The OCHS-treated defects consistently revealed periodontal regeneration (i.e., new periodontal ligament, new cementum with inserting collagen fibers, and new bone). Within the limits of the present study, it can be concluded that OCHS may favor periodontal regeneration in acute-type intrabony periodontal defects.
Assuntos
Perda do Osso Alveolar/cirurgia , Substitutos Ósseos/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Perda do Osso Alveolar/patologia , Processo Alveolar/efeitos dos fármacos , Processo Alveolar/patologia , Animais , Dente Pré-Molar/patologia , Regeneração Óssea/efeitos dos fármacos , Regeneração Óssea/fisiologia , Cementogênese/efeitos dos fármacos , Cementogênese/fisiologia , Colágeno/efeitos dos fármacos , Cemento Dentário/efeitos dos fármacos , Cemento Dentário/patologia , Cães , Inserção Epitelial/efeitos dos fármacos , Inserção Epitelial/patologia , Masculino , Osteogênese/efeitos dos fármacos , Osteogênese/fisiologia , Ligamento Periodontal/efeitos dos fármacos , Ligamento Periodontal/patologia , Projetos Piloto , Distribuição Aleatória , Regeneração/efeitos dos fármacos , Regeneração/fisiologia , Retalhos Cirúrgicos , Raiz Dentária/efeitos dos fármacos , Raiz Dentária/patologia , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologiaRESUMO
In addition to conventional treatment modalities (mechanical and chemical), the use of lasers has been increasingly proposed for the treatment of periodontal and peri-implant infections (i.e., cleaning and detoxification of implant surfaces). Preliminary results from basic studies have pointed to the high potential of the Erbium-doped: Yttrium, Aluminum and Garnet (Er:YAG) laser. Furthermore, preliminary clinical data indicate that treatment with this kind of laser may positively influence peri-implant healing. The aim of this research update is to evaluate, based on the currently available evidence, the use of an Er:YAG laser for the treatment of peri-implant infections and to indicate its potential as a new treatment modality.
Assuntos
Implantes Dentários/efeitos adversos , Terapia com Luz de Baixa Intensidade/instrumentação , Periodontite/etiologia , Periodontite/prevenção & controle , Infecções Relacionadas à Prótese/etiologia , Infecções Relacionadas à Prótese/prevenção & controle , Cicatrização/efeitos da radiação , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Terapia a Laser , Terapia com Luz de Baixa Intensidade/métodos , Avaliação da Tecnologia Biomédica , Resultado do TratamentoRESUMO
Alterations of skin and hair pigmentation are important features that have warranted treatment from ancient history on up to modern time. In some cultures, even today patients with vitiligo are regarded as social outcasts and are affected considerably both emotionally and physically. This article presents current options and future directions for the treatment of hypopigmentary disorders. Whereas with congenital disorders, such as albinism and phenylketonuria, no causal therapy has been established up to now, several treatment options for acquired hypopigmentary disorders have been investigated. In particular, in vitiligo, one of the most prevalent hypopigmentary disorders, a number of treatment modalities have been employed in the past 30 years. However, most of them are only able to palliate, not cure, the disease. Depending on the distribution of the hypopigmented lesions (localised or generalised) and the state of the disease (active or stable), several therapeutic options, for example phototherapy, surgical skin grafts, autologous melanocyte transplantation and immunomodulators, can be applied alone or in combination. For phototherapy, because of unfavourable results and adverse effects, ultraviolet (UV) A has been largely replaced by narrow-band UVB for repigmentation of generalised vitiligo. Although immunomodulators, such as corticosteroids, have been used both topically and systemically over the past 3 decades for the treatment of disseminated vitiligo, they are only suitable for the treatment of acrofacial and localised forms because of adverse effects. Hence, new immunomodulatory agents, such as calcineurin antagonists, have recently been introduced as new promising tools to treat acquired hypopigmentary disorders. However, all therapeutic approaches are hampered by the fact that the pathophysiology of hypopigmentary disorders is still poorly understood.
Assuntos
Hipopigmentação/terapia , Adjuvantes Imunológicos/uso terapêutico , Ensaios Clínicos como Assunto , Terapia Genética , Humanos , Hipopigmentação/tratamento farmacológico , Fototerapia , Piebaldismo/tratamento farmacológico , Piebaldismo/terapia , Vitiligo/tratamento farmacológico , Vitiligo/terapiaRESUMO
OBJECTIVES: The aim of the present study was to compare the combination therapy of deep intrabony periodontal defects using an Er:YAG laser (ERL) and enamel matrix protein derivative (EMD) to scaling and root planing+ ethylenediaminetetraacetic acid (EDTA)+EMD. MATERIAL AND METHODS: Twenty-two patients with chronic periodontitis, each of whom displayed 1 intrabony defect, were randomly treated with access flap surgery and defect debridement with an Er:YAG (160 mJ/pulse, 10 Hz) plus EMD (test) or with access flap surgery followed by scaling and root planing (SRP) with hand instruments plus EDTA and EMD (control). The following clinical parameters were recorded at baseline and at 6 months: plaque index, gingival index, bleeding on probing (BOP), probing depth (PD), gingival recession, and clinical attachment level (CAL). No differences in any of the investigated parameters were observed at baseline between the two groups. RESULTS: Healing was uneventful in all patients. At 6 months after therapy, the sites treated with ERL and EMD showed a reduction in mean PD from 8.6 +/- 1.2 mm to 4.6 +/- 0.8 mm and a change in mean CAL from 10.7 +/- 1.3 mm to 7.5 +/- 1.4 mm (p < 0.001). In the group treated with SRP+EDTA+EMD, the mean PD was reduced from 8.1 +/- 0.8 mm to 4.0 +/- 0.5 mm and the mean CAL changed from 10.4 +/- 1.1 mm to 7.1 +/- 1.2 mm (p < 0.001). No statistically significant differences in any of the investigated parameters were observed between the test and control group. CONCLUSION: Within the limits of the present study, it may be concluded that both therapies led to short-term improvements of the investigated clinical parameters, and the combination of ERL and EMD does not seem to improve the clinical outcome of the therapy additionally compared to SRP+EDTA+EMD.
Assuntos
Perda do Osso Alveolar/terapia , Substitutos Ósseos/uso terapêutico , Proteínas do Esmalte Dentário/uso terapêutico , Raspagem Dentária , Terapia a Laser , Periodontite/terapia , Perda do Osso Alveolar/etiologia , Quelantes/uso terapêutico , Doença Crônica , Desbridamento/instrumentação , Índice de Placa Dentária , Ácido Edético/uso terapêutico , Érbio , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Ligamento Periodontal/cirurgia , Periodontite/complicações , Projetos Piloto , Aplainamento Radicular , Retalhos Cirúrgicos , Resultado do Tratamento , ÍtrioRESUMO
Ferrum phosphoricum is a remedy poorly known in homoeopathy. Except for the indication 'ffever with no or little other symptoms' it is rarely prescribed (or only used as Schussler salt). The results of this proving offer new moalities as well as a mental picture and may open new application for this interesting remedy. The method of proving itself is unconventional and deserves to be evaluated
Assuntos
Ferrum Phosphoricum , Patogenesia Homeopática , Alemanha , SonhosRESUMO
How many opportunities have been missed to pick the brains of experienced homoeopaths when they are gathered together at a congress? Rajan Sankaran suggested to take such an opportunity during the Liga-Congress in Cologne this year. A special session was organised in order to exchange some cases of small remedies and to make it available to the readers of Links. The topic attracted quite a few participants which made this meeting to a real sharing of knowledge. Please note that the speakers were not prepared for this ad lib presentation of cases, and were not able therefore, to refer to the cases themselves. However, they presented those features which stuck in their mind as representing the most essential characteristics of the case. Before publishing the speakers has the chance to make corrections or additions to the original presentation