An adapted cardioprotective diet with or without phytosterol and/or krill oil supplement in familial hypercholesterolemia: A pilot study protocol

BACKGROUND AND AIMS: A healthy diet is one of the pillars of familial hypercholesterolemia (FH) treatment. However, the best dietary pattern and indication for specific supplementation have not been established. Our aim is to conduct a pilot study to assess the effect of an adapted cardioprotective diet with or without phytosterol and/or krill oil supplement in participants with a probable or definitive diagnosis of FH, treated with moderate/high potency statins. METHODS: A national, multicenter, factorial, and parallel placebocontrolled randomized clinical trial with a superiority design and 1:1:1:1 allocation rate will be conducted. The participants will undergo whole exome sequencing and be allocated into four treatment groups: 1) a cardioprotective diet adapted for FH (DICAFH) þ phytosterol placebo þ krill oil placebo; 2) DICA-FH þ phytosterol 2 g/day þ krill oil placebo; 3) DICA-FH þ phytosterol placebo þ krill oil 2 g/day; or 4) DICA-FH þ phytosterol 2 g/day þ krill oil 2 g/day. The primary outcomes will be low-density lipoprotein (LDL)-cholesterol and lipoprotein (a) levels and adherence to treatment after a 120-day follow-up. LDL- and high-density lipoprotein (HDL)-cholesterol subclasses, untargeted lipidomics analysis, adverse events, and protocol implementation components will also be assessed. RESULTS: A total of 58 participants were enrolled between May e August 2023. After the end of the follow-up period, the efficacy and feasibility results of this pilot study will form the basis of the design of a large-scale randomized clinical trial. CONCLUSIONS: This study's overall goal is to recommend dietary treatment strategies in the context of FH.

Influence of Specimen Dimension, Water Immersion Protocol, and Surface Roughness on Water Sorption and Solubility of Resin-Based Restorative Materials.

The evaluation of water sorption and solubility is pivotal for the development of new resin-based restorative materials with the potential for clinical application. The purpose of the present study was to evaluate the influence of the specimen dimension, water immersion protocol, and surface roughness on the water sorption and solubility of three resin-based restorative materials. Disk-shaped specimens of 15 mm × 1 mm, 10 mm × 1 mm, and 6 mm × 1 mm were produced with a composite resin (Z100), a resin cement (RelyX ARC), and an adhesive system (Single Bond 2-SB2). The specimens were immersed in distilled water according to four protocols: ISO (all the specimens for each group were vertically immersed in 50 mL); IV-10 (the specimens were individually and vertically immersed in 10 mL); IH-10 (the specimens were individually and horizontally immersed in 10 mL); and IH-2 (the specimens were individually and horizontally immersed in 2 mL). The surface roughness (Sa and Sp) was evaluated using an atomic force microscope, and the degree of conversion was determined using FT-IR spectrometry. The specimen dimension and water immersion protocol had no effect on water sorption and solubility. For the three resin-based restorative materials, Sp was higher than Sa. The degree of conversion was not influenced by the specimen dimension. The variations in the specimen dimension and water immersion protocol compared to those determined by ISO 4049 did not prevent the comparison between the values of water sorption and solubility obtained for a given resin-based restorative material.

Neonatal nociceptive stimulation results in pain sensitization, reduction of hippocampal 5-HT1A receptor, and p-CREB expression in adult female rats.

Painful invasive procedures are often performed on newborns admitted to intensive care units (ICU). The acute and long-term effects caused by these stimuli can be investigated in animal models, such as newborn rats. Previous studies have shown that animals subjected to nociceptive stimuli in the neonatal period show sex-specific behavioral changes such as signs of anxiety or depression. Under the same conditions, neonatal stimuli also provoke an increase in the rate of neurogenesis and cell activation in the hippocampal dentate gyrus. So, this study aims to identify the possible roles of central monoamines, receptor expression (5-HT1A), and signaling factors (p-CREB) underlying the long-term effects of neonatal nociceptive stimulation. For this, noxious stimulation was induced by intra-plantar injection of Complete Freund´s adjuvant (CFA) on the postnatal day 1 (P1) or 8 (P8). Control animals were not stimulated. On P75 the behavioral tests were conducted (hotplate and elevated plus maze), followed by sacrifice and molecular studies. Our results showed that neonatal nociceptive stimulation alters pain sensitization specially in females, while stimulation on P1 increases pain threshold, P8-stimulated animals respond with reduced pain threshold (P < 0.001). Hippocampal expression of 5-HT1A receptor and p-CREB were reduced in P8 F group (P < 0.001) in opposition to the increased utilization rate of dopamine and serotonin in this group (P < 0.05). This study shows sex- and age-specific responses of signaling pathways within the hippocampus accompanied by altered behavioral repertoire, at long-term after neonatal painful stimulation.

Utilização da bioimpedância em pacientes cardiopatas cirúrgicos / Bioimpedance usage in cardiac surgery patients

INTRODUÇÃO: Existem diversas ferramentas que podem auxiliar na avaliação e caracterização do estado nutricional. Uma delas é a bioimpedância (BIA), que fornece parâmetros como resistência (R), reactância capacitiva (Xc) e ângulo de fase (AF). Esses parâmetros podem variar, dependendo da composição celular e de seu potencial de membrana. Dessa forma, esse instrumento apresenta cada vez mais destaque no cenário clínico atual, podendo apresentar resultados promissores. Caracterizamos o sexo e estado nutricional da população estudada através do índice de massa corpórea (IMC) e identificamos elementos da BIA por meio de parâmetros da BIA (Xc, R e AF) de pacientes cardiopatas no período pré e pós-operatório. Também associou-se o AF com o tempo de permanência na unidade de terapia intensiva (UTI) e tempo de intubação orotraqueal (IOT) no período pós-operatório, além de possíveis readmissões no hospital público IDPC (Instituto Dante Pazzanese de Cardiologia), em São Paulo, Brasil. MÉTODO: Trata-se de um estudo transversal com 51 pacientes participantes do projeto Avaliação Nutricional e Terapia Nutricional em Cirurgia Cardíaca (AVANTCCA). Os pacientes foram avaliados no período pré-operatório, entre 2016 e 2017, avaliando a composição corporal e dados da BIA. Associou-se aqueles que apresentaram intercorrências clínicas no período pós-operatório. Resultados: Em mulheres, os valores de AF foram relacionados com maior tempo de hospitalização na UTI (p=0,02) e maior readmissão hospitalar (p=0,01). Não houve relação entre AF e tempo de IOT. CONCLUSÃO: A população estudada apresentou eutrofia (homens) e obesidade (mulheres). Houve uma associação entre o valor de AF em mulheres e maior tempo de permanência na UTI. O AF proporcionou uma melhor caracterização da evolução clínica dos pacientes.

Associação entre ângulo de fase e o SCORE HFA-PEFF de pacientes com ICFEP / Association between phase angle and HFA-PEFF SCORE in patients with HFpEF

INTRODUÇÃO: A insuficiência cardíaca com fração de ejeção preservada (ICFEp), já é responsável por mais da metade de todas as internações hospitalares por insuficiência cardíaca (IC). Pesquisas mostram que na população geral com idade >60 anos, 4,9% são diagnosticados com ICFEP e espera-se um aumento à medida que as pessoas vivem mais e a obesidade e diabetes tornam-se mais comuns. Heart Failure Association (HFA) da European Society of Cardiology (ESC) publicou uma recomendação para o diagnóstico da insuficiência cardíaca com fração de ejeção preservada ICFEp, trata-se do score (HFA-PEFF).A utilização de índices prognósticos no paciente com IC permite uma avaliação quanto à gravidade e ao impacto da doença na sobrevida do seu portador, além do monitoramento adequado da evolução clínica do mesmo. Nesse contexto, o exame de bioimpedância elétrica (BIA) vem sendo adotado para a avaliação de prognóstico. A partir da BIA obtém-se o ângulo de fase (AF), que expressa o equilíbrio entre os espaços intra e extracelulares, e tem sido relacionado com o sucesso, sobrevivência e evolução da doença, possibilitando não só monitorar a resposta do paciente ao tratamento em curso, mas reprogramar o cuidado prestado com a possibilidade de modificar o prognóstico. OBJETIVO: Verificar associação entre o AF a classificação dos pacientes com ICFEp, de acordo com o score HFA-PEFF. MÉTODO: Estudo transversal com 132 pacientes que foram avaliados e classificados através do score HFA-PEFF em baixa, intermediária ou alta probabilidade de ICFEp. Foram obtidos dados antropométricos e realizaram o exame de BIA para avaliação do AF. RESULTADOS: A média etária dos avaliados foi de 63±12 anos, sendo 65,15% (n= 86) do sexo feminino. Segundo a probabilidade de ICFEP pelo score HFA-PEFF, foram classificados em Baixa (n=39), Intermediário (n=57) e Alta (n=36). Em relação ao AF, houve associação entre pacientes com alta probabilidade de ICFEP e AF significativamente menores do que aqueles com probabilidades baixa e intermediária. CONCLUSÃO: O menor AF verificado foi encontrado nos pacientes com alta probabilidade de ICFEP segundo o score HFA-PEFF, sugerindo como um potencial marcador prognóstico na evolução da ICFEp.

Evolution of roughness and optical properties of resin composites submitted to whitening toothpastes-cigarette smoking cycling.

PURPOSE: To evaluate the effect of cycling whitening toothpaste with cigarette smoking (WTCS) on the evolution of roughness, color, translucency, and gloss of microfilled, microhybrid, and nanofilled resin composites. METHODS: 15 specimens of Durafill - DVS, Empress Direct - ED, and Z350 - FZ were divided into three groups according to the toothpastes:: conventional, control group, (Colgate - C) and Whitening (Colgate Luminous White - CW and Oral B 3D White - OW) and roughness, color, translucency, and gloss were evaluated before and after the specimens were submitted to WTCS for 8 weeks. Data were analyzed by two-way ANOVA, 3-way repeated measures ANOVA, and Tukey HSD post hoc test (α= 0.05). RESULTS: Only ED and FZ brushed with CW and FZ brushed with C presented an increase in roughness after WTCS. The three composites suffered a significant color alteration after WTCS. Excepting DVS brushed with CW, all the other groups presented a significant reduction in translucency after WTCS. DVS was the only resin composite that maintained its gloss stability after WTCS. Whitening toothpastes behaved similarly to conventional (control) toothpaste regarding the evolution of roughness and optical stability of the three resin composites. CLINICAL SIGNIFICANCE: Whitening toothpastes were not capable of maintaining the color stability of the three resin composites after 8 weeks of toothpastes-cigarette smoking cycling.

Characterization and Anti-Caries Effect of an Experimental Adhesive Containing Natural Antimicrobial Agents.

PURPOSE: To characterize experimental adhesives containing natural antimicrobial agents (proanthocyanidins, apigenin, tt-farnesol) in the primer and to evaluate their anti-caries effect. MATERIALS AND METHODS: Natural agents were incorporated in the primer of an experimental adhesive: 4.5% proanthocyanidins (PA), 1 mM apigenin (API), 1 mM apigenin + 5 mM tt-farnesol (API + FAR), and primer without antimicrobial agent (control). Microtensile bond strength (µTBS) to dentin and nanoleakage were measured immediately (n = 7) and after 1 year of storage (n = 7). Water sorption (WS), solubility (SO), and degree of conversion (DC%) of the adhesives were measured. The hardness loss of enamel (n = 6) and dentin (n = 6) at the restorative margin was evaluated after biofilm formation. RESULTS: DC%, nanoleakage, and immediate µTBS were similar for all groups. After 1 year, API + FAR showed higher nanoleakage and lower µTBS than the other groups, which were similar. WS and SO of API + FAR were lower than in the other groups. PA, API, and API + FAR presented less hardness loss than did the control group. At enamel, PA and API presented less hardness loss than the control and API + FAR groups at distances 50 µm and 100 µm; the hardness loss of enamel was similar for all groups 150 µm from the margin. CONCLUSION: The addition of proanthocyanidins and apigenin to the adhesives decreased the hardness loss of dentin and enamel submitted to biofilm formation, without jeopardizing the physical properties of the adhesives. The combination of apigenin + tt-farnesol decreased the hardness loss of dentin but not of enamel, and decreased the µTBS after 1 year of storage.

Effect of qualitative and quantitative nutritional plan on gene expression in obese patients in secondary prevention for cardiovascular disease

Summary Background & aims: Diet is a modifiable risk factor, which may influence the gene expression and the concentration of inflammatory biomarkers related to obesity and atherosclerosis. In this sub study from Brazilian Cardioprotective Nutritional (BALANCE) Program, we hypothesized that a nutritional intervention based on the usual Brazilian diet modulates the expression of genes involved with atherosclerosis and inflammatory biomarkers in male patients, in the secondary prevention for cardiovascular disease. Methods: Six male patients, aged 45 years or older, obese, were selected to follow a qualitative-quantitative food plan for 6 months. Glycemia, insulinemia, lipid profile, plasma concentration of inflammatory biomarkers (interleukin (IL) -1b), IL-6, IL-8, IL-10, IL-12, tumor necrosis factor alpha, C-reactive protein and adiponectin, and expression of 84 atherosclerosis-related genes in total peripheral blood cells, were measured. Results: After nutritional intervention, the participants reduced weight (p<0.04), waist circumference(p<0.04), Homeostasis Model Assessment index for insulin resistance (p»0.046) and overall leukocyte count (p»0.046) and neutrophils (p»0.028). There was no significant modification in the plasma concentration of the inflammatory biomarkers, however, there was a significant increase in the expression of Apo A1 (p»0.011), ELN (p»0.017) and IL4 (p»0.037) genes. Conclusions: The BALANCE Program, the qualitative-quantitative food plan composed of Brazilian usual foods, did not reduce the concentration of inflammatory biomarkers, but increased in total peripheral blood cells the expression of genes involved in reducing the risk of cardiometabolic in obese patients, in secondary prevention for cardiovascular disease. The clinical trial is registered athttps://clinicaltrials.gov/and the unique identifier is NCT01620398.

Effect of qualitative and quantitative nutritional plan on gene expression in obese patients in secondary prevention for cardiovascular disease.

BACKGROUND & AIMS: Diet is a modifiable risk factor, which may influence the gene expression and the concentration of inflammatory biomarkers related to obesity and atherosclerosis. In this substudy from Brazilian Cardioprotective Nutritional (BALANCE) Program, we hypothesized that a nutritional intervention based on the usual Brazilian diet modulates the expression of genes involved with atherosclerosis and inflammatory biomarkers in male patients, in the secondary prevention for cardiovascular disease. METHODS: Six male patients, aged 45 years or older, obese, were selected to follow a qualitative-quantitative food plan for 6 months. Glycemia, insulinemia, lipid profile, plasma concentration of inflammatory biomarkers (interleukin (IL) -1ß), IL-6, IL-8, IL-10, IL-12, tumor necrosis factor alpha, C-reactive protein and adiponectin, and expression of 84 atherosclerosis-related genes in total peripheral blood cells, were measured. RESULTS: After nutritional intervention, the participants reduced weight (p < 0.04), waist circumference (p < 0.04), Homeostasis Model Assessment index for insulin resistance (p = 0.046) and overall leukocyte count (p = 0.046) and neutrophils (p = 0.028). There was no significant modification in the plasma concentration of the inflammatory biomarkers, however, there was a significant increase in the expression of Apo A1 (p = 0.011), ELN (p = 0.017) and IL4 (p = 0.037) genes. CONCLUSIONS: The BALANCE Program, the qualitative-quantitative food plan composed of Brazilian usual foods, did not reduce the concentration of inflammatory biomarkers, but increased in total peripheral blood cells the expression of genes involved in reducing the risk of cardiometabolic in obese patients, in secondary prevention for cardiovascular disease. The clinical trial is registered at https://clinicaltrials.gov/ and the unique identifier is NCT01620398.

Comportamento alimentar em obesos e sua correlação com o tratamento nutricional / Eating behavior in obesity and its correlation with nutritional treatment

RESUMO Objetivo Avaliar os tipos de comportamentos alimentares em indivíduos com obesidade e correlacionar com a adesão ao tratamento proposto. Métodos Estudo transversal desenvolvido em instituição de cardiologia em indivíduos com obesidade. Os tipos de comportamentos alimentares foram analisados pela escala The Three Factor Eating Questionnaire - R21 (TFEQ-21) - versão traduzida e adaptada para brasileiros. Nela são abordadas três subescalas: restrição cognitiva (RC), alimentação emocional (AE) e descontrole alimentar (DA). A adesão ao tratamento nutricional foi verificada pelo instrumento desenvolvido pela instituição, baseado nas principais diretrizes de doenças crônicas. Resultados Analisaram-se 100 indivíduos, com maior prevalência do sexo feminino (68%). Em relação à adesão, somente 25% apresentam boa aderência (escore > 60%). Foi possível identificar a relação entre o IMC e a RC; quanto maior o IMC, menor foi a intensidade da RC (p = 0,02). Observou-se correlação positiva entre a RC e adesão ao consumo de gorduras (p = 0,02) e fibra alimentar (p = 0,004). A subescala AE apresentou correlação negativa com a adesão ao consumo de gorduras (p = 0,03) e correlação positiva com a DA (p < 0,01). Conclusões O tipo de comportamento alimentar mais frequente na amostra foi a restrição cognitiva, que não foi correlacionada com o escore total de adesão. A AE foi associada com maior consumo de gorduras, similar ao encontrado em estudos nacionais e internacionais. Nota-se uma lacuna de estudos que relacionam o comportamento alimentar com a adesão ao tratamento nutricional.

ABSTRACT Objective To analyze the types of eating behavior in individuals with obesity and correlated with adherence to the adopted treatment. Methods Cross-sectional study developed at the institution of cardiology in individuals with obesity. The types of eating behavior were analyzed using the scale The Three-Factor Eating Questionnaire - R21 (TFEQ-21) - translated and adapted for Brazilians. Three subscales are addressed: cognitive restriction (CR), emotional eating (EE), and uncontrolled eating (UE). Adherence to nutritional treatment was verified by the instrument developed by the institution, based on the main guidelines for chronic diseases. Results We analyzed 100 individuals, with a higher prevalence of females (68%). Regarding adherence, only 25% have good adherence (score > 60%). It was possible to identify the relationship between the BMI and the CR, the higher or lower the BMI was the intensity of the CR (p = 0.02) There was a positive correlation between CR and adherence to fat (p = 0.02) and dietary fiber (p = 0.004). The EE subscale showed a negative correlation with adherence to fat consumption (p = 0.03) and a positive correlation with UE (p < 0.01). Conclusions The most frequent type of eating behavior in the sample was cognitive restriction and was not correlated with the total adherence score. AE was associated with greater consumption of fats, like national and international studies. There is a gap in studies that relate to eating behavior with adherence to nutritional treatment.

Characterization and Antibacterial Effect of an Experimental Adhesive Containing Different Concentrations of Proanthocyanidin.

PURPOSE: To evaluate the degree of conversion (DC%), water sorption (Sp), solubility (Sl), dentin bond strength (µTBS) (immediate and after 12 months of storage), and the antibacterial effect of an experimental adhesive containing different concentrations (%) of proanthocyanidin (PA): 0, 1%, 2%, 4.5%, and 6% (PA0, PA1%, PA2%, PA4.5% and PA6%, respectively). MATERIALS AND METHODS: DC% was measured by FT-IR and the Sp and Sl were determined based on the ISO 4049 specification. For µTBS, resin composite buildups were constructed incrementally and specimens (n = 8) were sectioned to obtain sticks (1 mm2). The µTBS was evaluated after 24 h and 12 months of water storage at 37°C. The failure mode was analyzed. The antibacterial effects were evaluated by analyzing the bacterial growth (S. mutans) (n = 5) and antibiofilm activity (n = 5) of the adhesives by spectrophotometry. RESULTS: The incorporation of PA did not affect the Sp, Sl, or DC%. Immediate µTBS was similar for all groups. After 12 months, PA4.5% presented significantly higher µTBS than PA0, while the other groups did not differ from PA0 and PA4.5%. Groups PA0 and PA1% underwent significant reduction in µTBS. In the experimental groups PA2%, PA4.5% and PA6%, µTBS was maintained after storage. All groups showed antibacterial activity. CONCLUSION: Incorporation of 2%, 4.5%, and 6% PA maintained the dentin µTBS after 12-month storage, without affecting the Sp, Sl, or DC% of experimental adhesives. PA4.5% presented higher µTBS values than PA0 after 12 months. The adhesive presented antibacterial effect irrespective of PA concentration.

Resin-dentin bond stability of etch-and-rinse adhesive systems with different concentrations of MMP inhibitor GM1489.

Enzymatic degradation of the hybrid layer can be accelerated by the activation of dentin metalloproteinases (MMP) during the bonding procedure. MMP inhibitors may be used to contain this process. Objective To evaluate the degree of conversion (DC%), dentin bond strength (µTBS) (immediate and after 1 year of storage in water), and nanoleakage of an experimental (EXP) and a commercial (SB) adhesive system, containing different concentrations of the MMP inhibitor GM1489: 0, 1 µM, 5 µM and 10 µM. Methodology DC% was evaluated by FT-IR spectroscopy. Dentin bond strength was evaluated by µTBS test. Half of beams were submitted to the µTBS test after 24 h and the other half, after storage for 1 year. From each tooth and storage time, 2 beams were reserved for nanoleakage testing. Data were analyzed using ANOVA and Tukey's test to compare means (α=0.05). Results All adhesive systems maintained the µTBS after 1 year of storage. Groups with higher concentrations of inhibitor (5 µM and 10 µM) showed higher µTBS values than groups without inhibitor or with 1 µM. The nanoleakage values of all groups showed no increase after 1 year of storage and values were similar for SB and EXP groups, in both storage periods. The inhibitor did not affect the DC% of the EXP groups, but the SB5 and SB10 groups showed higher DC% values than those of SB0 and SB1. Conclusions The incorporation of GM1489 in the adhesive systems had no detrimental effect on DC%. The concentrations of 5 µM GM1489 for SB and 5 µM or 10 µM for EXP provided higher µTBS than groups without GM1489, in the evaluation after 1 year of storage; whereas the concentration of inhibitor did not affect adhesive systems nanoleakage.

Resin-dentin bond stability of etch-and-rinse adhesive systems with different concentrations of MMP inhibitor GM1489

Abstract Enzymatic degradation of the hybrid layer can be accelerated by the activation of dentin metalloproteinases (MMP) during the bonding procedure. MMP inhibitors may be used to contain this process. Objective To evaluate the degree of conversion (DC%), dentin bond strength (µTBS) (immediate and after 1 year of storage in water), and nanoleakage of an experimental (EXP) and a commercial (SB) adhesive system, containing different concentrations of the MMP inhibitor GM1489: 0, 1 µM, 5 µM and 10 µM. Methodology DC% was evaluated by FT-IR spectroscopy. Dentin bond strength was evaluated by µTBS test. Half of beams were submitted to the µTBS test after 24 h and the other half, after storage for 1 year. From each tooth and storage time, 2 beams were reserved for nanoleakage testing. Data were analyzed using ANOVA and Tukey's test to compare means (α=0.05). Results All adhesive systems maintained the µTBS after 1 year of storage. Groups with higher concentrations of inhibitor (5 µM and 10 µM) showed higher µTBS values than groups without inhibitor or with 1 µM. The nanoleakage values of all groups showed no increase after 1 year of storage and values were similar for SB and EXP groups, in both storage periods. The inhibitor did not affect the DC% of the EXP groups, but the SB5 and SB10 groups showed higher DC% values than those of SB0 and SB1. Conclusions The incorporation of GM1489 in the adhesive systems had no detrimental effect on DC%. The concentrations of 5 µM GM1489 for SB and 5 µM or 10 µM for EXP provided higher μTBS than groups without GM1489, in the evaluation after 1 year of storage; whereas the concentration of inhibitor did not affect adhesive systems nanoleakage.

Bond stability of conventional adhesive system with MMP inhibitors to superficial and deep dentin.

PURPOSE: To evaluate the microshear bond strength (µSBS) to deep (DD) or superficial (SD) dentin (µSBS) overtime, nanoleakage (AG%), degree of conversion (DC%), water sorption (WSp), and solubility (WSl) of an adhesive system [Adper Single Bond 2(ASB)] containing matrix metalloproteinases (MMP) inhibitors [GM1489 (ASB-GM), Batimastat (ASB-BAT), or Chlorhexidine diacetate (ASB-CHX)]. ASB without inhibitor was used as control (CONTROL). MATERIALS AND METHODS: WSp and WSL were calculated based on ISO4049. DC% was analyzed using FT-IR spectroscopy. Dentin discs were used for µSBS evaluation. For AG%, resin-dentin beams were analyzed under scanning electronic microscopy. Data were analyzed using three-way ANOVA (AG% and µSBS) or ANOVA (DC%, WSp, WSl) and Tukey's HSD test. RESULTS: ASB-CHX presented the lowest DC%, lowest WSp, and highest WSl. ASB-GM reached the highest immediate µSBS in SD, only different from ASB-CHX. In DD, ASB-BAT and ASB-GM had the highest µSBS, statistically different from ASB-CHX. After twelve months, ASB-GM and ASB-BAT presented higher µSBS in SD when compared to CONTROL and ASB-CHX. In DD, ASB-GM reached the highest value, which was statistically different from CONTROL and ASB-CHX. CONTROL at both dentin depths and ASB-CHX at DD did not maintain bond stability. In SD after 12 months, ASB-BAT and ASB-GM decreased AG%. In DD, only ASB-GM reduced AG%. CONCLUSION: The ASB containing Batimastat and GM1489 maintained resin-dentin bond stability after 12 months for both dentin depths, without jeopardizing WSp, WSl, or DC% of the adhesive system. The ASB-GM presented greater µSBS after 12 months when compared with ASB. CLINICAL SIGNIFICANCE: Batimastat and GM1489 could be suitable for inclusion as an MMP-inhibitor into Single Bond to improve the bond stability to superficial and deep dentin, without jeopardize the physic-mechanical proprieties.

Proteomic analysis of Paracoccidioides brasiliensis complex isolates: Correlation of the levels of differentially expressed proteins with in vivo virulence.

BACKGROUND: Paracoccidioidomycosis (PCM) is a systemic mycosis commonly found in Latin America that is caused by distinct species of Paracoccidioides genus: Paracoccidioides brasiliensis complex (S1, PS2, PS3 and PS4) and Paracoccidioides lutzii. Its pathobiology has been recently explored by different approaches to clarify the mechanisms of host-pathogen interactions underpinning PCM. The diversity of clinical forms of this disease has been attributed to both host- and fungus-related factors. METHODOLOGY/PRINCIPAL FINDINGS: For better understanding of the molecular underpinnings of host-fungus interactions, we evaluated in vivo virulence of nine Paracoccidioides brasiliensis complex isolates and correlated it to protein expression profiles obtained by two-dimensional gel electrophoresis. Based on the recovery of viable fungi from mouse organs, the isolates were classified as those having low, moderate, or high virulence. Highly virulent isolates overexpressed proteins related to adhesion process and stress response, probably indicating important roles of those fungal proteins in regulating the colonization capacity, survival, and ability to escape host immune system reaction. Moreover, highly virulent isolates exhibited enhanced expression of glycolytic pathway enzymes concomitantly with repressed expression of succinyl-CoA ligase beta chain, a protein related to the tricarboxylic acid cycle. CONCLUSIONS/SIGNIFICANCE: Our findings may point to the mechanisms used by highly virulent P. brasiliensis isolates to withstand host immune reactions and to adapt to transient iron availability as strategies to survive and overcome stress conditions inside the host.

Effect of Calcium Hydroxide on Bonding Performance of an Experimental Self-etch Adhesive.

PURPOSE: To investigate the effect of Ca(OH)2 concentration on pH neutralization, degree of conversion (DC%), and bonding performance of experimental self-etch adhesives (SEAs). MATERIALS AND METHODS: Four different concentrations of Ca(OH)2 (0 wt%, 1 wt%, 2 wt%, and 4 wt%) were added to the bond of an experimental two-step SEA consisting of primer (10-MDP [30 wt%], TEG-DMA [30 wt%], ethanol [35 wt%], water [5 wt%], camphorquinone [0.5 wt%], and tertiary amine [0.5 wt%]) and bond (bis-GMA [50 wt%], TEG-DMA [30 wt%], HEMA [20 wt%], camphorquinone [0.5 wt%], and tertiary amine [0.5 wt%]) to form four groups: E0, E1, E2 and E4. pH neutralization was evaluated until it reached equilibrium, and DC% within the hybrid layer was analyzed by micro-Raman spectroscopy. Human molars were wet ground until the occlusal dentin was exposed, SEAs were applied, and composite buildups were constructed. After storage in distilled water at 37°C for 24 h, the teeth were cut into composite-dentin beams. Microtensile bond strength (µTBS) was evaluated after 24 h of water storage at 37°C. Nanoleakage was evaluated by SEM. Data were analyzed using ANOVA and Tukey's HSD test (a = 0.05). RESULTS: All the SEAs reached pH equilibrium after thirteen days, with E1 and E4 presenting the highest pH (p < 0.05). E0 and E1 presented lower DC% than did E2 and E4 (p < 0.05). All the SEAs showed statistically similar mTBS and nanoleakage (p > 0.05). CONCLUSION: The incorporation of Ca(OH)2 endowed the SEAs with pH-neutralization ability and improved their DC%, without interfering with the bond strength to dentin or nanoleakage extent.