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This study aimed to characterize the epidemiological aspects of PrEP use and barriers to accessing this prophylaxis. This cross-sectional study was conducted between January 2021 and April 2022, encompassing 140 PrEP users treated at the Testing and Counseling Center (CTA) in Campo Grande, Mato Grosso do Sul. Data on sociodemographic characteristics and factors associated with PrEP discontinuation were obtained using a standardized questionnaire. Most PrEP users were cisgender men (92.00%), predominantly white (51.00%), over 30 years of age (56.50%), homosexual-oriented (76.50%), and had a minimum of 12 years of education (77.50%). Approximately 60.00% admitted to inconsistent condom use in recent sexual encounters, primarily involving anal intercourse. Approximately 88.00% perceived themselves as at risk of contracting STIs in the upcoming year. Regarding new presentation forms, 54.00% indicated a willingness to use "on-demand PrEP," and 92.00% expressed interest in using "injectable PrEP." After 6 months of follow-up, 43.60% (95.00% CI: 35.50-52.00) discontinued PrEP use, primarily due to changes in sexual behavior (38.30%) and difficulties accessing healthcare services (21.28%). This study underscores the need to involve diverse key populations and highlights the significance of PrEP as an ongoing monitoring strategy for HIV/STI prevention in addition to the importance of incorporating new formulations such as daily oral PrEP into the Brazilian National Health System (SUS).
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Preoperative localization of parathyroid pathology, generally a parathyroid adenoma, can be difficult in some cases due to the anatomical variants that these glands present. The objective of this review is to analyse the different imaging techniques used for preoperative localization of parathyroid pathology (scintigraphy, ultrasound, CT, MRI and PET). There is great variability between the different tests for the preoperative localization of parathyroid pathology. The importance of knowing the different diagnostic options lies in the need to choose the most suitable test at each moment and for each patient for an adequate management of primary hyperparathyroidism (PHP) with surgical criteria.
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Neoplasias de las Paratiroides , Humanos , Neoplasias de las Paratiroides/diagnóstico por imagen , Ultrasonografía/métodos , Diagnóstico por Imagen/métodos , Hiperparatiroidismo Primario/diagnóstico por imagen , Glándulas Paratiroides/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Enfermedades de las Paratiroides/diagnóstico por imagenRESUMEN
PURPOSE: Nutritional ketosis synergistically with body-weight loss induced by a very-low-calorie ketogenic diet (VLCKD) has proven to be effective in improving obesity-related pathophysiology. Recently, growing attention has been focused on the relation between erythropoietin (EPO) and obesity. Thus, this study aims to investigate whether nutritional ketosis and weight loss induced by a VLCKD modify the circulating levels of EPO in patients with obesity in comparison with the effect of low-calorie diet (LCD) or bariatric surgery (BS). METHODS: EPO levels, iron status and body composition parameters were evaluated in 72 patients with overweight or obesity and 27 normal-weight subjects at baseline and after the three different weight-reduction therapies (VLCKD, LCD and BS) in 69 patients with excess body weight. ß-hydroxybutyrate levels were also measured in the VLCKD group. The follow-up was established at 2-3 months and 4-6 months. RESULTS: It was found that EPO levels were higher in morbid obesity and correlated with higher basal weight, fat mass (FM) and fat-free mass (FFM) in the overall sample. High baseline EPO levels were also correlated with higher impact on the course of weight loss and changes in FM and FFM induced by the three weight-loss interventions. Furthermore, the VLCKD induced a decrease in EPO levels coinciding with maximum ketosis, which was maintained over time, while statistically significant changes were not observed after LCD and BS. CONCLUSION: The obesity-related increased EPO levels are restored after VLCKD intervention at the time of maximum ketosis, suggesting a potential role of the nutritional ketosis induced by the VLCKD. Baseline EPO levels could be a biomarker of response to a weight-loss therapy.
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Autologous platelet concentrates (APCs) have demonstrated clear benefits across various clinical applications, including alveolar ridge preservation, guided tissue regeneration, guided bone regeneration, sinus floor elevation (both lateral window approach and transcrestal technique), endodontic surgery, the treatment of medication-related osteonecrosis of the jaw bones, and periodontal plastic surgery. To ensure an optimal clinical outcome, clinicians must adhere strictly to the protocol to prepare the APCs and, especially follow evidence-based surgical guidelines, often simple but crucial, to minimize the likelihood of errors. The majority of clinical trials reported on second-generation APCs [the leukocyte- and platelet-rich fibrin (L-PRF) family, including its modifications (A-PRF, A-PRF+, CGF, T-PRF, H-PRF, etc.)]. These second-generation APCs offer additional benefits compared to the first-generation APCs, making them the preferred choice for the development of clinical recommendations. These recommendations have been formulated through a meticulous examination of the available clinical data and the clinical experience of the authors of this paper.
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Marine organisms are often subject to numerous anthropogenic stressors, resulting in widespread ecosystem degradation. Physiological responses to these stressors, however, are complicated by high biological variability, species-specific sensitivities, nonlinear relationships, and countless permutations of stressor combinations. Nevertheless, quantification of these relationships is paramount for parameterizing predictive tools and ultimately for effective management of marine resources. Multi-level, multi-stressor experimentation is therefore key, yet the high replication required has remained a logistical challenge and a financial barrier. To overcome these issues, we created an automated system for experimentation on marine organisms, the Sequential Treatment Application Robot (STAR). The system consists of a track-mounted robotic arm that sequentially applies precision treatments to independent aquaria via syringe and peristaltic pumps. The accuracy and precision were validated with dye and spectrophotometry, and stability was demonstrated by maintaining corals under treatment conditions for more than a month. The system is open source and scalable in that additional treatments and replicates may be added without incurring multiplicative costs. While STAR was designed for investigating the combined impacts of nutrients, warming, and disease on reef-building corals, it is highly customizable and may be used for experimentation involving a diverse array of treatments and species.
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Ferroic orders and their associated structural phase transitions are paramount in the understanding of a multitude of unconventional condensed matter phenomena. On this note, our investigation focuses on the polymorphic ferroelectric (FE) phase transitions of Copper(II) hydroxide, Cu(OH)2, considering an antiferromagnetic ground state. By employing the first-principles studies and group theory analysis, we have provided a systematic theoretical investigation of vibrational properties in the hypotheticalCmcmhigh-symmetry phase to unveil the symmetry-allowed ferroic phases. We identified a non-polar to polar (Cmc21) phase transition, in which the displacive transformation is primarily responsible for the phase change induced by twoB1u(i.e.Γ2-) phonon modes within the centrosymmetric phase. We also observed the existence of two polar structures with the same space group and different degrees of polarization (i.e.Ps= 3.06µC·cm-2andPs= 42.41µC·cm-2), emerging from the high symmetry non-polar structure. According to the structural analysis the FE order, of a geometric nature, is driven by theΓ2-mode in which the O- and H-sites displacements lead the polar distortion with a minor contribution from the Cu-sites. Interestingly, the 3d9:Cu2+Jahn-Teller distortion coupled with the orientational shifts of O-H atoms enhances the polarization.
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(In, Ga) alloy droplets are used to catalyse the growth of (In, Ga)As nanowires by molecular beam epitaxy on Si(111) substrates. The composition, morphology and optical properties of these nanowires can be tuned by the employed elemental fluxes. To incorporate more than 10% of In, a high In/(In+Ga) flux ratio above 0.7 is required. We report a maximum In content of almost 30% in bulk (In, Ga)As nanowires for an In/(In+Ga) flux ratio of 0.8. However, with increasing In/(In+Ga) flux ratio, the nanowire length and diameter are notably reduced. Using photoluminescence and cathodoluminescence spectroscopy on nanowires covered by a passivating (In, Al)As shell, two luminescence bands are observed. A significant segment of the nanowires shows homogeneous emission, with a wavelength corresponding to the In content in this segment, while the consumption of the catalyst droplet leads to a spectrally-shifted emission band at the top of the nanowires. The (In,Ga)As nanowires studied in this work provide a new approach for the integration of infrared emitters on Si platforms.
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Spalt-like proteins are Zinc finger transcription factors from Caenorhabditis elegans to vertebrates, with critical roles in development. In vertebrates, four paralogues have been identified (SALL1-4), and SALL2 is the family's most dissimilar member. SALL2 is required during brain and eye development. It is downregulated in cancer and acts as a tumor suppressor, promoting cell cycle arrest and cell death. Despite its critical functions, information about SALL2 regulation is scarce. Public data indicate that SALL2 is ubiquitinated and phosphorylated in several residues along the protein, but the mechanisms, biological consequences, and enzymes responsible for these modifications remain unknown. Bioinformatic analyses identified several putative phosphorylation sites for Casein Kinase II (CK2) located within a highly conserved C-terminal PEST degradation motif of SALL2. CK2 is a serine/threonine kinase that promotes cell proliferation and survival and is often hyperactivated in cancer. We demonstrated that CK2 phosphorylates SALL2 residues S763, T778, S802, and S806 and promotes SALL2 degradation by the proteasome. Accordingly, pharmacological inhibition of CK2 with Silmitasertib (CX-4945) restored endogenous SALL2 protein levels in SALL2-deficient breast MDA-MB-231, lung H1299, and colon SW480 cancer cells. Silmitasertib induced a methuosis-like phenotype and cell death in SW480 cells. However, the phenotype was significantly attenuated in CRISPr/Cas9-mediated SALL2 knockout SW480 cells. Similarly, Sall2-deficient tumor organoids were more resistant to Silmitasertib-induced cell death, confirming that SALL2 sensitizes cancer cells to CK2 inhibition. We identified a novel CK2-dependent mechanism for SALL2 regulation and provided new insights into the interplay between these two proteins and their role in cell survival and proliferation.
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Quinasa de la Caseína II , Neoplasias del Colon , Animales , Humanos , Proteínas de Unión al ADN/metabolismo , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Neoplasias del Colon/genética , Línea Celular TumoralRESUMEN
OBJECTIVE: There are limited studies on urogenital symptoms in women who experience menopause before the age of 40 years due to primary ovarian insufficiency (POI) or bilateral oophorectomy (surgical POI). This study aimed to compare the urogenital symptoms, including sexuality, of women with POI to those without the condition. METHODS: This cross-sectional study conducted was in seven Latin American countries, in which postmenopausal women (with POI and non-POI) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS) and the six-item Female Sexual Function Index (FSFI-6). The association of premature menopause with more urogenital symptoms and lower sexual function was evaluated with logistic regression analysis. RESULTS: Women with POI experience more urogenital symptoms (MRS urogenital score: 3.54 ± 3.16 vs. 3.15 ± 2.89, p < 0.05) and have lower sexual function (total FSFI-6 score: 13.71 ± 7.55 vs. 14.77 ± 7.57 p < 0.05) than women who experience menopause at a normal age range. There were no significant differences in symptoms when comparing women based on the type of POI (idiopathic or surgical). After adjusting for covariates, our logistic regression model determined that POI is associated with more urogenital symptoms (odds ratio [OR]: 1.38, 95% confidence interval [CI] 1.06-1.80) and lower sexual function (OR: 1.67, 95% CI 1.25-2.25). CONCLUSION: POI, whether idiopathic or secondary to bilateral oophorectomy, is associated with symptoms that affect vaginal and sexual health.
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Menopausia Prematura , Insuficiencia Ovárica Primaria , Disfunciones Sexuales Fisiológicas , Humanos , Femenino , Estudios Transversales , Insuficiencia Ovárica Primaria/complicaciones , Persona de Mediana Edad , Disfunciones Sexuales Fisiológicas/etiología , Adulto , Encuestas y Cuestionarios , Ovariectomía/efectos adversos , Enfermedades Urogenitales Femeninas , América Latina , Modelos Logísticos , Menopausia/fisiologíaRESUMEN
INTRODUCTION: Total hip arthroplasty is one of the most frequent surgical interventions in the hospital setting. Nonetheless, the ideal method to manage post-operative pain is still unknown. Multimodal analgesia techniques based on regional anaesthesia are amongst the most promising solutions. OBJECTIVES: The aim of this study was to evaluate postoperative pain after total hip arthroplasty according to whether peripheral nerve block was performed (femoral block, fascia iliaca block and pericapsular nerve group block). Intravenous morphine consumption during the patient's stay in the post-anaesthesia care unit was measured, as well as the number of opioid rescues at 24 and 48â¯h post intervention. As secondary objectives, the prevalence of nerve injury, prolonged quadricipital block, and morphine consumption were established according to other variables of interest. MATERIALS AND METHODS: In this observational retrospective study, data was collected from the electronic medical record of 656 traumatological surgery patients from April 2018 to August 2020, with the following inclusion criteria: over 18 years old, ASA I-III, primary total hip arthroplasty under general anaesthesia or subarachnoid anaesthesia (only with hyperbaric bupivacaine) and use of levobupivacaine for peripheral nerve block. RESULTS: A total of 362 patients were selected. The main surgical indication was coxarthrosis (61.3%), followed by hip fracture (22.6%). Peripheral nerve blocks were performed on 169 patients (66.3% femoral, 27.7% PENG, and 6.0% fascia iliaca). Mean postoperative opioid consumption in PACU was lower in patients in who received a PENG (2.2â¯mg) or a femoral (3.27â¯mg) block, compared to those who received neither (6.69â¯mg). There were no differences in opioid rescues at 24 and 48â¯h after the procedure. Nerve injury incidence was low (.8%), and not associated with nerve blocks. The incidence of prolonged quadricipital paralysis was also low (1.3%), and was mainly associated with femoral nerve block (75% of cases). CONCLUSIONS: This retrospective study supports the use of regional blocks as opioid-sparing techniques, highlighting their role in rapid functional recovery with no motor impairment.
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Analgésicos Opioides , Artroplastia de Reemplazo de Cadera , Bloqueo Nervioso , Dolor Postoperatorio , Humanos , Estudios Retrospectivos , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/epidemiología , Dolor Postoperatorio/tratamiento farmacológico , Masculino , Femenino , Bloqueo Nervioso/métodos , Anciano , Analgésicos Opioides/administración & dosificación , Analgésicos Opioides/uso terapéutico , Persona de Mediana Edad , Anestesia de Conducción/métodos , Morfina/administración & dosificación , Morfina/uso terapéutico , Auditoría Clínica , Nervio Femoral , Anestésicos Locales/administración & dosificación , Anciano de 80 o más Años , Fracturas de Cadera/cirugíaRESUMEN
INTRODUCTION: During the SARS-CoV-2 pandemic, several corticosteroid regimens have been used in the treatment of the disease, with disparate results according to drug and regimen used. For this reason, we wanted to analyze differences in early mortality derived from the use of different regimens of dexamethasone and methylprednisolone in SARS-CoV-2 infection in critically ill patients requiring admission to an ICU. METHOD: Observational, analytical and retrospective study, in an intensive care unit of a third-level university hospital, (March 2020 and June 2021). Adult patients (>18 years old) who were admitted consecutively for proven SARS-CoV-2 infection were included. The association with mortality in ICU at 28 days, different corticosteroid regimens used, was analyzed using a Cox proportional risk regression model. RESULTS: Data from a cohort of 539 patients were studied. Patient age (RR: 1.06; 95% CI: 1.02-1.10; P=<0.01) showed a significant association with 28-day mortality in the ICU. In the comparison of the different corticosteroid regimens analyzed, taking as a reference those patients who did not receive corticosteroid treatment, the dose of dexamethasone of 6mg/day showed a clear trend towards statistical significance as a protector of mortality at 28 days in the ICU (RR: 0.40, 95% CI: 0.15-1.02, p=0.05). The dose of dexamethasone of 6mg/day and low doses of methylprednisolone show a similar association with survival at 28 days (OR: 1.19; 95% CI: 0.63-2.26). CONCLUSIONS: The use of corticosteroids has been associated with better mortality outcomes in severe cases of SARS-CoV-2 infection. However, the therapeutic benefits of corticosteroids are not limited to dexamethasone alone.
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Tratamiento Farmacológico de COVID-19 , COVID-19 , Dexametasona , Unidades de Cuidados Intensivos , Metilprednisolona , Humanos , Estudios Retrospectivos , Metilprednisolona/uso terapéutico , Metilprednisolona/administración & dosificación , Masculino , Dexametasona/uso terapéutico , Dexametasona/administración & dosificación , Femenino , Persona de Mediana Edad , Anciano , COVID-19/mortalidad , Unidades de Cuidados Intensivos/estadística & datos numéricos , Enfermedad Crítica , Glucocorticoides/uso terapéutico , Glucocorticoides/administración & dosificación , Corticoesteroides/uso terapéutico , Adulto , Estudios de Cohortes , Mortalidad HospitalariaRESUMEN
INTRODUCTION: Developmental dysplasia of the hip is the cause of approximately one third of secondary coxarthrosis. Anatomy alterations make it difficult to place a total hip prosthesis in its anatomical position and for it to be stable in the long term; there are several techniques to achieve this goal. In the present work, we used autograft of the femoral head (shelf graft or reinforced roof), to improve the coverage of the acetabular component with favourable results. MATERIALS AND METHODS: Sixteen cases were included in 14 patients with a diagnosis of developmental dysplasia of the hip (13 women and one man), the mean age was 44.3 years (range 35-68 years), with a mean follow-up of 7 years (range 1-15 years). All the cases were evaluated clinically and radiographically, to demonstrate the osseointegration of the graft and the functional results in the medium term. RESULTS: All the acetabular components were placed in anatomical position (Ranawat technique), the mean percentage of host bone coverage was 54.53% (range 43.28-79.05%), obtaining additional coverage with the bone graft of 45.13%. Osseointegration of the graft of 100% at 12 weeks, resorption of the graft from the sixth month, stabilising in the third postoperative year. Only one case of dislocation is reported, no cases of infection, loosening, heterotopic ossification or revision. CONCLUSION: This procedure has shown good functional results in the medium term with 100% osseointegration, despite cases of severe bone resorption of the graft that does not compromise the stability of the prosthesis.
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BACKROUND: Dermatofibrosarcoma protuberans (DFSP) is a low-grade spindle cell sarcoma of fibroblastic origin. This tumor originates in the dermis and infiltrates the subcutaneous tissue. The highest incidence occurs in the third and fourth decades of life, affecting most frequently the trunk and proximal extremities. Ultrasound is performed in those cases where the clinical appearance of the lesion is not typical and when the physician wants to determine the extent and depth of the lesion. MATERIAL AND METHODS: Retrospective analysis of the ultrasound and demographic findings of thirteen patients with DFSP. RESULTS: 13 patients, 8 females and 5 males, aged from 2 months to 58 years old. One patient with two different separated synchronous tumors. On ultrasonography they compromised the dermal hypodermal layers in 93% of the cases and 1 dermal lesion. The compromise reached the aponeurotic plane in two cases. The sized varied from 5 to 38 mm. They presented as a well-defined hypoechogenic nodule in seven cases (50%). In three cases (21%) they presented as a hypoechogenic infiltrate ill-defined border solid lesion; in two cases as a plaque ill-defined lesion, and two cases as a pseudonodular inflammatory lesion with irregular borders. All lesions appeared vascularized on color Doppler imaging. CONCLUSION: DFSP is a low grade sarcoma of fibroblastic origin, that usually arises in the dermis and infiltrates the subcutaneous tissue. The clinical presentations are variable. On ultrasound we found different patterns: well-defined hypoechogenic solid nodule, hypoechogenic infiltrate ill-defined border solid lesion, plaque ill-defined lesion, and pseudonodular inflammatory lesion. It is important to know and recognize this suspicious different ultrasound presentations in order to recommend a histological study.
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Dermatofibrosarcoma , Neoplasias Cutáneas , Femenino , Masculino , Humanos , Dermatofibrosarcoma/diagnóstico por imagen , Estudios Retrospectivos , Grasa Subcutánea , Ultrasonografía , Neoplasias Cutáneas/diagnóstico por imagenRESUMEN
BACKGROUND: Sacituzumab govitecan (SG), a novel antibody-drug conjugate (ADC) targeting TROP2, is approved for pre-treated metastatic triple-negative breast cancer (mTNBC). We conducted an investigator-initiated clinical trial evaluating neoadjuvant (NA) SG (NCT04230109), and report primary results. PATIENTS AND METHODS: Participants with early-stage TNBC received NA SG for four cycles. The primary objective was to assess pathological complete response (pCR) rate in breast and lymph nodes (ypT0/isN0) to SG. Secondary objectives included overall response rate (ORR), safety, event-free survival (EFS), and predictive biomarkers. A response-guided approach was utilized, and subsequent systemic therapy decisions were at the discretion of the treating physician. RESULTS: From July 2020 to August 2021, 50 participants were enrolled (median age = 48.5 years; 13 clinical stage I disease, 26 stage II, 11 stage III). Forty-nine (98%) completed four cycles of SG. Overall, the pCR rate with SG alone was 30% [n = 15, 95% confidence interval (CI) 18% to 45%]. The ORR per RECIST V1.1 after SG alone was 64% (n = 32/50, 95% CI 77% to 98%). Higher Ki-67 and tumor-infiltrating lymphocytes (TILs) were predictive of pCR to SG (P = 0.007 for Ki-67 and 0.002 for TILs), while baseline TROP2 expression was not (P = 0.440). Common adverse events were nausea (82%), fatigue (76%), alopecia (76%), neutropenia (44%), and rash (48%). With a median follow-up time of 18.9 months (95% CI 16.3-21.9 months), the 2-year EFS for all participants was 95%. Among participants with a pCR with SG (n = 15), the 2-year EFS was 100%. CONCLUSIONS: In the first NA trial with an ADC in localized TNBC, SG demonstrated single-agent efficacy and feasibility of response-guided escalation/de-escalation. Further research on optimal duration of SG as well as NA combination strategies, including immunotherapy, are needed.
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Anticuerpos Monoclonales Humanizados , Camptotecina/análogos & derivados , Inmunoconjugados , Neoplasias de la Mama Triple Negativas , Humanos , Persona de Mediana Edad , Neoplasias de la Mama Triple Negativas/tratamiento farmacológico , Neoplasias de la Mama Triple Negativas/patología , Terapia Neoadyuvante , Antígeno Ki-67 , Antígenos de Neoplasias/genética , Inmunoconjugados/efectos adversosRESUMEN
INTRODUCTION: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications. OBJECTIVE: The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain. METHODS: We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 10 Spanish centres. RESULTS: We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3 to 6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score ≤ 2), with papilloedema (Pâ¯=⯠.03), focal deficits (Pâ¯=â¯.001), and encephalopathy (Pâ¯<â¯.001) showing a statistically significant association with poor prognosis (mRS > 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%. CONCLUSION: The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity.
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Trombosis Intracraneal , Accidente Cerebrovascular , Trombosis de la Vena , Adulto Joven , Humanos , Femenino , Persona de Mediana Edad , Masculino , Estudios Retrospectivos , España , Trombosis de la Vena/terapia , Trombosis de la Vena/tratamiento farmacológico , Trombosis Intracraneal/terapia , Trombosis Intracraneal/tratamiento farmacológicoRESUMEN
PURPOSE: The objective of this double-blind, split-mouth, randomized clinical trial was to evaluate the color match of a single-shade composite resin Admira Fusion X-tra in comparison with a multi-shade composite resin Admira Fusion in non-carious cervical lesion restorations (NCCLs). METHODS AND MATERIALS: One hundred and twenty restorations were performed on NCCLs with two restorative materials (n=60). After prophylaxis, the teeth were isolated with a rubber dam, and one universal adhesive was applied in the selective enamel etching strategy. For both groups, the restorations were inserted incrementally and light-cured. The values of the coordinates L*, a*, and b* in the cervical third before vs after the restorations and cervical vs middle third after the restorations were evaluated using a digital spectrophotometer after the coordinate values were used to calculate the CIEDE (ΔE00). The restorations were evaluated at baseline and after 7 days of clinical performance according to the FDI criteria. Statistical analysis was performed using the Chi-square test for all parameters. Color change was analyzed by Student t-test for paired samples (α=0.05). RESULTS: All restorations were evaluated after 7 days. Regarding the color measurement, no significant difference was observed when Admira Fusion was compared to Admira Fusion X-tra for any of the comparisons performed (p>0.05). However, the values of ΔE00 in the cervical third before vs after the restorations were higher when compared with ΔE00 observed when the cervical vs middle third after restorations were compared. All restorations received the score "clinically very good" after 7 days for all outcomes, including the subjective color match, when evaluated for FDI criterion. CONCLUSIONS: The single-shade composite resin used achieves the same color match when compared to a multi-shade composite resin after 7 days in NCCLs.
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Resinas Compuestas , Restauración Dental Permanente , Resinas Compuestas/uso terapéutico , Restauración Dental Permanente/métodos , Estudios de Seguimiento , Materiales Dentales , Cementos de Resina , Color , Adaptación Marginal DentalRESUMEN
We report the results of the first six years of measurements of the energetic particle radiation environment on the International Space Station (ISS) with the Radiation Assessment Detector (ISS-RAD), spanning the period from February 2016 to February 2022. The first RAD was designed and built for MSL, the Mars Science Laboratory rover, also known as Curiosity; it has been operating on Mars since 2012 and is referred to here as MSL-RAD. ISS-RAD combines two sensor heads, one nearly identical to the single MSL-RAD sensor head, the other with greatly enhanced sensitivity to fast neutrons. These two sensor heads are referred to as the Charged Particle Detector (CPD) and Fast Neutron Detector (FND), respectively. Despite its name, the CPD is also capable of measuring high-energy neutrons and γ-rays, as is MSL-RAD. ISS-RAD was flown to the ISS in December 2015 and was deployed in February 2016, initially in the USLab module. RAD was used as a survey instrument from January 2017 through May 2020, when the instrument was positioned in the USLab and set to a zenith-pointing orientation. The energetic particle environment on the ISS is complex and varies on short time scales owing to the orbit, which has a 51.6∘ inclination with respect to the equator and has had an altitude in the 400-440 km range in this time period. The ISS moves continuously through the geomagnetic field, the strength of which varies with latitude, longitude, and altitude. The orbit passes through the South Atlantic Anomaly (SAA) several times a day, where magnetically trapped protons and electrons produce large but transient increases in observed fluxes and absorbed dose rates. The environment inside the ISS is affected by the solar cycle, altitude, and the local shielding, which varies between different ISS modules. We report results for charged particle absorbed dose and dose equivalent rates in various positions in the ISS. In an accompanying paper, we report similar results for neutron dose equivalent rates obtained with the ISS-RAD Fast Neutron Detector.