Prophylactic Anticoagulation Reduces the Risk of Kidney Graft Venous Thrombosis in Recipients From Uncontrolled Donation After Circulatory Death Donors With High Renal Resistive Index.

Background: Uncontrolled donation after circulatory death (uDCD) increases organ availability for kidney transplantation (KT) at the expense of a higher risk of primary graft nonfunction (PNF). At least half of the cases of PNF are secondary to graft venous thrombosis. The potential benefit from prophylactic anticoagulation in this scenario remains unclear. Methods: In this single-center retrospective study we compared 2 consecutive cohorts of KT from uDCD with increased (≥0.8) renal resistive index (RRI) in the Doppler ultrasound examination performed within the first 24-72 h after transplantation: 36 patients did not receive anticoagulation ("nonanticoagulation group") and 71 patients underwent prophylactic anticoagulation until normalization of RRI in follow-up Doppler examinations ("anticoagulation group"). Results: Anticoagulation was initiated at a median of 2 d (interquartile range, 2-3) after transplantation and maintained for a median of 12 d (interquartile range, 7-18). In 4 patients (5.6%), anticoagulation had to be prematurely stopped because of the development of a hemorrhagic complication. In comparison with the nonanticoagulation group, recipients in the anticoagulation group had a lower 2-wk cumulative incidence of graft venous thrombosis (19.4% versus 0.0%; P < 0.001) and PNF (19.4% versus 2.8%; P = 0.006). The competing risk analysis with nonthrombotic causes of PNF as the competitive event confirmed the higher risk of graft thrombosis in the nonanticoagulation group (P = 0.0001). The anticoagulation group had a higher incidence of macroscopic hematuria (21.1% versus 5.6%; P = 0.049) and blood transfusion requirements (39.4% versus 19.4%; P = 0.050) compared with the nonanticoagulation group. No graft losses or deaths were attributable to complications potentially associated with anticoagulation. Conclusions: Early initiation of prophylactic anticoagulation in selected KT recipients from uDCD with an early Doppler ultrasound RRI of ≥0.8 within the first 24-72 h may reduce the incidence of graft venous thrombosis as a cause of PNF.

Ausencia de toracotomía mediante la sutura manual intratorácica y la extracción transabdominal de la pieza quirúrgica durante la esofagectomía robótica de Ivor Lewis / Absence of thoracotomy by intrathoracic manual suture and transabdominal removal of surgical specimen during Ivor Lewis robotic esophagectomy

En el tratamiento quirúrgico del cáncer de esófago, la cirugía robótica permite realizar una anastomosis manual intratorácica de manera más sencilla, rápida y cómoda para el cirujano que la cirugía abierta y la cirugía mínimamente invasiva tradicional. Con ello evitamos el uso de instrumentos de autosutura, algunos de los cuales precisan una pequeña toracotomía para su introducción. No obstante, la extracción de la pieza exige la práctica de esa toracotomía, de tamaño variable, y que puede asociar dolor torácico intenso. Describimos una sencilla modificación técnica del Ivor Lewis robótico clásico que permite la extracción de la pieza quirúrgica por una mínima incisión abdominal, evitando la necesidad de fracturar costillas de forma controlada, así como las posibles secuelas de practicar una incisión en la pared torácica.(AU)

In the surgical treatment of esophageal cancer, robotic surgery allows performing an intrathoracic hand-sewn anastomosis in a simpler, faster and more comfortable way for the surgeon than open surgery and traditional minimally invasive surgery. With this, we avoid the use of self-suture instruments, some of which require a small thoracotomy for their introduction. However, the retrieval of the specimen requires the practice of this thoracotomy, of variable size, that can be associated with intense chest pain. We describe a technical modification of the classic robotic Ivor Lewis that allows removal of the surgical piece through a minimal abdominal incision, thus avoiding controlled rib fracture, as well as the possible sequelae of making an incision in the chest wall.(AU)

Absence of thoracotomy by intrathoracic manual suture and transabdominal removal of surgical specimen during Ivor Lewis robotic esophagectomy.

In the surgical treatment of esophageal cancer, robotic surgery allows performing an intrathoracic handsewn anastomosis in a simpler, faster and more comfortable way for the surgeon than open surgery and traditional minimally invasive surgery. With this, we avoid the use of self-suture instruments, some of which require a small thoracotomy for their introduction. However, the retrieval of the specimen requires the practice of this thoracotomy, of variable size, that can be associated with intense chest pain. We describe a technical modification of the classic robotic Ivor Lewis that allows removal of the surgical piece through a minimal abdominal incision, thus avoiding controlled rib fracture, as well as the possible sequelae of making an incision in the chest wall.

"The effectiveness of rapid antigen test-based for SARS-CoV-2 detection in nursing homes in Valencia, Spain".

The usefulness of the PANBIO ™ COVID-19 Ag rapid test for SARS-CoV-2 infection detection has not been widely studied, especially in specific population groups such as the elderly who are institutionalized. Rapid diagnostic tests have the potential to benefit testing strategies, as they have short turnaround times, they are cheap, simple to perform and can be used in decentralized testing. The objective of this study is to show the performance of the PANBIO™ COVID-19 Ag Rapid test device conducted at geriatric institutions and to compare results to those obtained from RT-PCR. A total of 448 individuals were enrolled in the study, including both residents and employees. Nasopharyngeal swabs were collected for both PANBIO™ COVID-19 Ag Rapid test and RT-PCR testing. All the samples were analyzed by specialized microbiologists. A total of 117 out of 448 individuals (26%) tested positive by RT-PCR, of whom 99 (85%) returned positive Antigen test results. There were 18 Antigen negative cases with positive RT-PCR results. Accordingly, concordance between RT-PCR and Antigen test results was acceptable (K index, 0.89; 95% IC 0.8455-0.9345). Overall sensitivity and specificity of Antigen test was 85% and 100%, respectively. When defining RT-PCR CT positivity on a cut-off value of 35, LFA sensitivity was 90%. In case a cut-off value of 30 was used, LFA would increase up to 99%. In this real-life evaluation of the PANBIO™ COVID-Ag rapid test, the assay reliably identified SARS-CoV-2 infected individuals with low CT-values by RT-PCR. False negative results were observed only at high CT-values, meaning low viral loads in nasopharyngeal samples.

Escala de triagem odontológica para pacientes com necessidades especiais / Dental screening scale for patients with special needs

Objetivo: elaborar e testar uma Escala de Triagem Odontológica para Pacientes com Necessidades Especiais (PNEs). Métodos: a escala foi elaborada a partir da experiência clínica de um centro de referência para aten-dimento odontológico a PNEs e de evidências científicas. Foi construída utilizando cinco critérios principais: comportamento, necessidade e possibilidade de estabilização protetora, urgência odontológica (dor), núme-ro e complexidade de procedimentos odontológicos e local do atendimento (acessibilidade). O instrumento foi testado em 14 PNEs, que participaram de uma triagem no Centro de Especialidades Odontológicas (CEO) Jequitibá, na Faculdade de Odontologia da Universidade Federal de Pelotas (UFPel). Estudantes de gradua-ção a partir do oitavo semestre fizeram a aplicação, e o resultado da escala foi comparado ao parecer clínico realizado pelos pesquisadores experientes no atendimento a esses pacientes. Resultados: foi observada uma concordância em 85% dos casos. Conclusão: o instrumento apresentou desempenho comparável à avalia-ção de profissionais com expertise, e a escala pode ser um instrumento útil para ser empregado em serviços odontológicos que oferecem atendimento aos PNEs. A sua utilização em meio acadêmico também pode pro-porcionar o empoderamento dos critérios de avaliação pelos estudantes, proporcionando maior segurança em acolher, atender ou encaminhar esse público no seu futuro profissional. (AU)

Objective: to develop and test a dental screening scale to be used of patients with special needs (PSN). Method: the scale was developed based on the clinical experience of a reference center for dental care for PSN and scientific evidence. It was built using 5 main criteria: behavior, need and possibility of protective stabilization (PE), dental urgency (pain), number and complexity of dental procedures and place of care (accessibility). The instrument was tested on 14 PSN who participated in a screening at the Center for Dental Specialties (CEO) Jequitibá, Faculty of Dentistry, UFPEL. Undergraduate students from the eighth semester onwards applied and the result of the scale was compared to the clinical opinion carried out by experienced researchers in the care of these patients. Results: agreement was observed in 85% of cases. Conclusion: the instrument presented performance comparable to the evaluation of professionals with expertise and the scale can be a useful instrument to be used in dental services that offer care to PSN. Its use in academia can also provide the empowerment of assessment criteria by students, providing greater security in welcoming, serving or referring this audience in their professional future.

Modificação e avaliação de gel de ácido fosfórico 35% com agente aromatizante / Modification and evaluation of 35% phosphoric acid gel with flavoring agent

Objetivos: O condicionamento da superfície dos tecidos dentários duros com ácido fosfórico 35% é normalmente utilizado para fornecer retenção micromecânica para adesivos odontológicos. Quando lavado da superfície, o ácido pode gerar gosto amargo e desagradável ao paladar do paciente. O objetivo deste estudo foi analisar o efeito da adição de um agente aromatizante à composição do gel de ácido fosfórico 35% e investigar se existe alteração de características fundamentais deste material, como sua capacidade de desmineralizar a superfície dentária. Métodos: Além de um grupo controle (sem flavorizante), foram testados grupos de ácido fosfórico 35% com a adição de 0,5% ou 3% do aromatizante (Aroma Abacaxi Pó; Bio Green Ingredients). Foram realizadas análises de viscosidade, estabilidade do pH e de desmineralização da superfície de esmalte condicionada por microscopia eletrônica de varredura, além de teste de resistência de união ao esmalte por microcisalhamento. Resultados: Apesar dos grupos apresentarem pequenas diferenças entre si, nenhuma das alterações se mostrou significativa, exceto o aumento da viscosidade do gel contendo 3% do aromatizante. Conclusões: A adição de agente aromatizante ao gel condicionador de ácido fosfórico 35% parece ser alternativa viável para reduzir os problemas relacionados ao contato com o sabor desagradável do material, uma vez que não promoveu alteração negativa significativa nas características e comportamento do ácido(AU)

Objectives: Etching of dental hard tissues surfaces with 35% phosphoric acid is usually used to provide micromechanical interlocking with dental adhesives. When washed from the surface, the acid can cause a bitter taste unpleasant to the patient. The aim of this study was to analyze the effect of the addition of a flavoring agent to 35% phosphoric acid gel and investigate whether there is change in the fundamental characteristics of this material, including its ability to demineralize dental surfaces. Methods: In addition to a control group (without flavoring agent), groups were tested with the addition of 0.5% or 3% of the flavoring compound (pineapple flavor powder, Bio Green Ingredients) to 35% phosphoric acid. Analyses of viscosity, pH stability and demineralization of enamel surfaces by scanning electron microscopy were carried out, as well microshear bond strength to enamel. Results: Although the groups had minor differences among themselves, none of the changes were significant, except the increased viscosity of the gel containing 3% of the flavoring agent. Conclusions: The addition of flavoring agent to 35% phosphoric acid gel conditioner seems to be a viable alternative to reduce the problems related to contact with the unpleasant taste of the material, since it promoted no negative changes in the characteristics and behavior of the acid(AU)

Top-100 Most Cited Dental Articles with Authors from Brazil.

This study analyzes the characteristics of the top-100 most cited articles published in international dental journals with at least one coauthor affiliated to Brazil. A search in Scopus database for articles published between 1996 and 2017 was carried out in the 178 journals belonging to the category "Dentistry" identified in SCImago Journals & Country Rank. From the top-100 most cited articles, variables related to the journal, article, and authors were collected. Annual citation averages (ACA) and relative citation ratios (RCR) were calculated. Data were analyzed descriptively. There were 75 original reports and 25 reviews in the sample. The number of citations ranged between 124 and 657 (mean=202, median=168). The papers were published in 31 different journals (46% in only four journals), none based in Brazil. The most frequent subjects (61%) were Dental Materials, Endodontics, and Periodontology, which accounted for 63.6% of the total citations. The subject with the highest ACA was Oral and Maxillofacial Surgery and the subject with the highest RCR was Oral Radiology. Only 12 articles were cited more than 300 times. International collaboration was present in 61 articles and funding was reported in 49 articles. The first author was from Brazil in 70% and corresponding author in 55% of the papers. Southeast (83%) and South (20%) were the regions of Brazil with most presence of coauthors. This top-100 list is presented to provide an overview of the most cited articles and aid in supporting further analyses regarding publication and citation behaviors of Brazilian dentistry.

Top-100 most cited dental articles with authors from Brazil

Abstract This study analyzes the characteristics of the top-100 most cited articles published in international dental journals with at least one coauthor affiliated to Brazil. A search in Scopus database for articles published between 1996 and 2017 was carried out in the 178 journals belonging to the category "Dentistry" identified in SCImago Journals & Country Rank. From the top-100 most cited articles, variables related to the journal, article, and authors were collected. Annual citation averages (ACA) and relative citation ratios (RCR) were calculated. Data were analyzed descriptively. There were 75 original reports and 25 reviews in the sample. The number of citations ranged between 124 and 657 (mean=202, median=168). The papers were published in 31 different journals (46% in only four journals), none based in Brazil. The most frequent subjects (61%) were Dental Materials, Endodontics, and Periodontology, which accounted for 63.6% of the total citations. The subject with the highest ACA was Oral and Maxillofacial Surgery and the subject with the highest RCR was Oral Radiology. Only 12 articles were cited more than 300 times. International collaboration was present in 61 articles and funding was reported in 49 articles. The first author was from Brazil in 70% and corresponding author in 55% of the papers. Southeast (83%) and South (20%) were the regions of Brazil with most presence of coauthors. This top-100 list is presented to provide an overview of the most cited articles and aid in supporting further analyses regarding publication and citation behaviors of Brazilian dentistry.

Resumo Este artigo analisa as características dos 100 artigos mais citados publicados em periódicos internacionais de odontologia com ao menos um co-autor afiliado ao Brasil. Uma busca na base de dados Scopus por artigos publicados entre 1996 e 2017 foi realizada nos 178 periódicos pertencentes à categoria "Dentistry" identificados no SCImago Journals & Country Rank. Dos 100 artigos mais citados, variáveis relacionadas ao periódico, artigo e autores foram coletadas. Médias anuais de citação (MAA) e razões de citação relativa (RCR) foram calculadas. Os dados foram analisados descritivamente. A amostra foi composta por 75 artigos originais e 25 revisões. O número de citações variou entre 124 e 657 (média=202, mediana=168). Os artigos foram publicados em 31 periódicos diferentes (46% em apenas quatro periódicos), nenhum do Brasil. Os temas mais frequentes (61%) foram Materiais Dentários, Endodontia e Periodontia, somando 63,6% do total de citações. O tema com maior MAA foi Cirurgia Oral e Maxilofacial e o tema com maior RCR foi Radiologia Oral. Apenas 12 artigos foram citados mais de 300 vezes. Colaboração internacional estava presente em 61 artigos e financiamento foi reportado em 49 artigos. O primeiro autor era do Brasil em 70% e o correspondente em 55% dos artigos. As regiões do Brasil com mais co-autores presentes foram Sudeste (83%) e Sul (20%). Esta lista é apresentada para prover uma fotografia dos 100 artigos mais citados e ajudar a fomentar análises posteriores em relação a comportamentos de citação e publicação da odontologia brasileira.

Epistaxis en un paciente con seudoaneurisma de la arteria maxilar interna como complicación de una osteotomía de LeFort tipo 1: reporte de un caso / Epistaxis in patient with pseudoaneurysm of the internal maxillary artery as a complication of LeFort I osteotomy: a case report

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