Trasplante cardíaco por hemocromatosis. Caso pediátrico / Cardiac transplantation due to hemochromatosis. A pediatric case report

La hemocromatosis es una enfermedad caracterizada por el excesivo depósito de hierro en múltiples órganos, entre ellos hígado, páncreas, piel y corazón. La infiltración de este último es un importante factor en morbilidad y mortalidad. Presentamos un caso de un paciente pediátrico con insuficiencia cardíaca terminal que ameritó trasplante cardíaco, que resultó sin complicaciones. Posterior a la cirugía, mostró mejoría bioquímica y clínica, lo que influyó positivamente en su calidad de vida y prolongó su supervivencia.

Hemochromatosis is a disease characterized by excess iron stores in multiple organs, including the liver, pancreas, skin, and heart. The infiltration of the heart is an important factor in morbidity and mortality. Here we describe the case of a pediatric patient with end-stage heart failure who required a heart transplantation, with no complications. After the surgery, she showed biochemical and clinical improvement, with a positive impact on her quality of life and a prolonged survival.

Cardiac transplantation due to hemochromatosis. A pediatric case report. / Trasplante cardíaco por hemocromatosis. Caso pediátrico.

Hemochromatosis is a disease characterized by excess iron stores in multiple organs, including the liver, pancreas, skin, and heart. The infiltration of the heart is an important factor in morbidity and mortality. Here we describe the case of a pediatric patient with end-stage heart failure who required a heart transplantation, with no complications. After the surgery, she showed biochemical and clinical improvement, with a positive impact on her quality of life and a prolonged survival.

La hemocromatosis es una enfermedad caracterizada por el excesivo depósito de hierro en múltiples órganos, entre ellos hígado, páncreas, piel y corazón. La infiltración de este último es un importante factor en morbilidad y mortalidad. Presentamos un caso de un paciente pediátrico con insuficiencia cardíaca terminal que ameritó trasplante cardíaco, que resultó sin complicaciones. Posterior a la cirugía, mostró mejoría bioquímica y clínica, lo que influyó positivamente en su calidad de vida y prolongó su supervivencia.

Reliability of panoramic radiography in predicting proximity of third molars to the mandibular canal: A comparison using cone-beam computed tomography.

PURPOSE: The purpose of this study was to analyze the reliability of 7 panoramic radiographic signs for predicting proximity of the root apices of mandibular third molars to the mandibular canal using cone-beam computed tomography and to correlate these findings with the Pell and Gregory and the Winter classification systems. MATERIALS AND METHODS: An observational, cross-sectional, descriptive study was conducted on 74 patients with bilateral impacted mandibular third molars. Four panoramic radiographic signs were observed in the tooth root (darkening, deflection, and narrowing of the root apices, and bifid apices), and another 3 in the mandibular canal (diversion, narrowing, and interruption of the mandibular canal). Cone-beam computed tomography images were analyzed to identify disruption and diversion of the mandibular canal and root deflection. RESULTS: Binary logistic regression showed that only 4 of the 7 panoramic radiographic signs were able to predict proximity of the root apices of the mandibular third molars to the mandibular canal: darkening of the root, deflection of the root, narrowing of the root, and interruption of the mandibular canal (P<0.05). CONCLUSION: Darkening, deflection, and narrowing of the root, in tandem with the interruption of the mandibular canal on panoramic radiographs, indicate that cone-beam computed tomography should be performed when planning the extraction of impacted mandibular third molars. Proximity between mandibular third molars and the mandibular canal is correlated with the Winter classification.

Magnetic propulsion of colloidal microrollers controlled by electrically modulated friction.

Precise control over the motion of magnetically responsive particles in fluidic chambers is important for probing and manipulating tasks in prospective microrobotic and bio-analytical platforms. We have previously exploited such colloids as shuttles for the microscale manipulation of objects. Here, we study the rolling motion of magnetically driven Janus colloids on solid substrates under the influence of an orthogonal external electric field. Electrically induced attractive interactions were used to tune the load on the Janus colloid and thereby the friction with the underlying substrate, leading to control over the forward velocity of the particle. Our experimental data suggest that the frictional coupling required to achieve translation, transitions from a hydrodynamic regime to one of mixed contact coupling with increasing load force. Based on this insight, we show that our colloidal microrobots can probe the local friction coefficient of various solid surfaces, which makes them potentially useful as tribological microsensors. Lastly, we precisely manipulate porous cargos using our colloidal rollers, a feat that holds promise for bio-analytical applications.

Fratura de fêmur nos idosos: tempo de espera cirúrgica e desfecho da hospitalização / Fractura de fémur en personas mayores: tiempo de espera quirúrgica y desenlace de la hospitalización / Femoral fracture in the elderly: surgery waiting time and hospitalization outcome

RESUMO Objetivo: Analisar o tempo de espera para correção de fratura de fêmur, seus fatores associados e o desfecho de hospitalização. Método: Transversal exploratório, com a população de idosos ≥60 anos internados por fratura de fêmur no período de 2015 a 2017. Os dados foram coletados através do prontuário físico, com análises estatísticas considerando o nível de significância estatística de p<0,05. Resultados: Dos idosos estudados, 61,4% correspondem ao sexo feminino. Aqueles que permaneceram por mais do que sete dias à espera de cirurgia se associaram ao tempo de hospitalização maior do que 10 dias, lesão por pressão (p<0,001) e ao desfecho óbito (p=0,003). A média de permanência hospitalar foi de 13,8 dias e do tempo esperado pela cirurgia de 6,6 dias. A espera da realização do risco cirúrgico e vaga em unidade de terapia intensiva foram fatores que provocaram atraso na realização da cirurgia em 23,2% dos idosos. Conclusão: Esperar pela cirurgia por mais de sete dias aumentou o tempo de permanência hospitalar e a taxa de mortalidade. Além disso, a ausência de vaga de terapia intensiva e a espera pelo risco cirúrgico contribuíram para o atraso da cirurgia e seu desfecho.

RESUMEN Objetivo: analizar el tiempo de espera para la corrección de fractura de fémur, sus factores asociados y el resultado de hospitalización. Método: transversal exploratorio, con la población de personas mayores ≥60 años internados por fractura de fémur en el período de 2015 a 2017. Los datos fueron recolectados a través del registro médico, con análisis estadísticos considerando el nivel de significancia estadística de p<0,05. Resultados: de los ancianos estudiados, 61,4% eran del sexo femenino. Aquellos que pasaron más de siete días a la espera de cirugía se asociaron al tiempo de hospitalización mayor que 10 días, lesión por presión (p<0,001) como desenlace el óbito (p=0,003). El promedio de permanencia hospitalaria fue de 13,8 días yel tiempo esperado por la cirugía de 6,6 días. La espera por la realización del riesgo quirúrgico y una cama en unidad de cuidados intensivos fueron factores que provocaron el retraso en la realización de la cirugía en 23,2% de los ancianos. Conclusión: esperar por la cirugía por más de siete días aumentó el tiempo de permanencia hospitalaria y la tasa de mortalidad. Además, la falta de camas en cuidados intensivos la espera por el riesgo quirúrgico contribuyeron para el retraso de la cirugía y su desenlace.

ABSTRACT Objective: To analyze the waiting time for femoral fracture repair, its associated factors, and the outcome of hospitalization. Method: This is a cross-sectional exploratory study involving an elderly population aged ≥60 years old and admitted to hospital for femoral fracture from 2015 to 2017. Data were collected from physical medical records, with statistical analyses considering p < 0.05 as the level of statistical significance. Results: Of the studied elderly patients, 61.4% are female. Those who stayed for more than seven days waiting for surgery showed association with a hospital stay longer than 10 days, pressure injuries (p<0.001), and death as outcome (p=0.003). The average hospital stay was 13.8 days, and the expected time until surgery was 6.6 days. Waiting for the surgical risk assessment and waiting for a vacancy in the intensive care unit were factors that caused delay in the surgery among 23.2% of the elderly. Conclusion: Waiting for surgery for more than seven days increased the length of hospital stay and the mortality rate. In addition, the absence of intensive care unit beds and waiting for the surgical risk assessment contributed to the delay in the surgery and its outcome.

Fatores associados ao desfecho da hospitalização de idosos submetidos a correção de fratura de fêmur* / Factores asociados al resultado de hospitalización de ancianos sometidos a corrección de fractura de fémur / Associated factors with hospitalization outcomes of elderly submitted to femur fracture correction*

RESUMO Objetivo: analisar os fatores que interferem no desfecho de internação de idosos com fratura de fêmur. Método: transversal exploratório documental, população de idosos (≥60 anos) no período de 2015 a 2017, do norte do Paraná. Foram realizadas análises bivariadas de associações e distribuição de frequência. Resultados: dos 189 prontuários analisados, 132 (69,9%) idosos desenvolveram morbidades no ambiente hospitalar. A ocorrência de infecção urinária, sepse, pneumonia, lesão por pressão e a presença de duas ou mais comorbidades foram associadas ao desfecho óbito e ao tempo de hospitalização superior a 10 dias p<0,001. Conclusão: morbidades preexistentes e hospitalares em idosos com fratura de fêmur elevaram a hospitalização pelo tempo superior a 10 dias e com desfecho de óbito. As morbidades adquiridas na hospitalização de característica infecciosa contribuíram para complicações e mau prognóstico. Espera-se que outros estudos possam ser aprofundados no intuito de desenvolver protocolos de atendimento hospitalar ao idoso.

RESUMEN Objetivo: Analizar los factores que interfieren en el resultado de la internación de ancianos con fractura de fémur. Método: Transversal, exploratorio, documental, población de ancianos (≥60 años) entre 2015 y 2017, del norte de Paraná. Fueron aplicados análisis bivariados de asociaciones y distribución de frecuencia. Resultados: Fueron analizadas 189 historias clínicas, 132 (69,9%) ancianos desarrollaron morbilidades en ámbito hospitalario. El hallazgo de infección urinaria, sepsis, neumonía, lesión por presión y la presencia de dos o más comorbilidades fueron asociadas al desenlace de óbito y a tiempo de hospitalización superior a 10 días p<0,001. Conclusión: Las morbilidades preexistentes y hospitalarias en ancianos con fractura de fémur incrementaron la hospitalización por tiempo superior a 10 días, con desenlace de óbito. Las morbilidades de tipo infecciosas adquiridas durante la hospitalización derivaron en complicaciones y mala prognosis. Otros estudios podrán profundizar en el tema para desarrollar protocolos de atención hospitalaria al anciano.

ABSTRACT Objective: to analyze the factors that interfere in the hospitalization outcome of elderly with femur fracture. Method: exploratory cross-sectional study, elderly population (≥60 years) from 2015 to 2017, from northern Paraná. Bivariate analyzes of associations and frequency distribution were performed. Results: from the 189 analyzed medical records, 132 (69.9%) elderly developed morbidities in the hospital environment. Urinary tract infection, sepsis, pneumonia, pressure injury, and the presence of two or more comorbidities were associated with death outcome and hospitalization time greater than 10 days p<0.001. Conclusion: pre-existing and in-hospital morbidities in elderly with femur fracture increased hospitalization for more than 10 days and with death outcome. Acquired morbidities in infectious hospitalization contributed to complications and poor prognosis. It is hoped that other studies can be further developed in order to develop hospital care protocols for the elderly.

Bioactive glass containing 90% SiO2 in hard tissue engineering: An in vitro and in vivo characterization study.

Bioactive glass has been proved to have many applications in bioengineering due to its bone regenerative properties. In this work, an innovative, highly resorbable bioactive glass containing 90% SiO2 (BG90) to be used as a bone substitute was developed. The BG90 was synthetized by the sol-gel process with the dry step at room temperature. The biomaterial showed in vitro and in vivo bioactivities even with silica content up to 90%. Moreover, the BG90 presented high porosity and surface area due to its homogenously interconnected porous network. In vitro, it was observed to have high cell viability and marked osteoblastic differentiation of rat bone marrow-derived cells when in contact with BG90 ion extracts. The BG90 transplantation into rat tibia defects was analysed at 1, 2, 3, 4, 7, and 10 weeks post-operatively and compared with the defects of negative (no graft) and positive (autogenous bone graft) controls. After 4 weeks of grafting, the BG90 was totally resorbed and induced higher bone formation than did the positive control. Bone morphogenetic protein 2 (BMP-2) expression at the grafting site peaked at 1 week and decreased similarly after 7 weeks for all groups. Only the BG90 group was still exhibiting BMP-2 expression in the last experimental time. Our data demonstrated that the BG90 could be an attractive candidate to provide useful approaches in hard-tissue bioengineering.

Use of Social Networks for Data Collection in Scientific Productions in the Health Area: Integrative Literature Review / Uso de redes sociales para recolección de datos en producciones científicas en el área de la salud: revisión integrativa de la literatura / Utilização de redes sociais para coleta de dados em produções científicas na área da saúde: revisão integrativa da literatura

ABSTRACT Objective: To investigate evidence on the use of social networks to collect data in scientific productions in the health area. Material and method: An integrative literature review from primary studies indexed in the SciELO, PubMed, LILACS, Scopus, and Web of Science platforms. Results: 16 scientific articles were selected, of which nine focused on the use of WhatsApp; five, on the use of Facebook; and two, on employing Twitter to collect data in scientific productions. Growth was noted on the number of investigations associated to the use of social networks, although an important paradigm still exists related to the use to generate scientific evidence, resulting in a still low number of investigations on this theme. Conclusions: The health area needs to approach evermore the development of research associated to social networks, given that this would enable a viable and rapid intervention in obtaining responses, besides being a low cost and very promising tool for data collection.

RESUMEN Objetivo: investigar las evidencias del uso de redes sociales para recolectar datos en producciones científicas en el área de salud. Material y método: una revisión integrativa de la literatura a partir de estudios primarios indexados en las plataformas SciELO, PubMed, LILACS, Scopus y Web of Science. Resultados: se seleccionaron 16 artículos científicos, de los cuales nueve se centraron en el uso de WhatsApp; cinco, en el uso de Facebook; y dos, en empleo de Twitter para recolectar datos en producciones científicas. Hubo crecimiento en el número de investigaciones asociadas al uso de redes sociales, aunque aún existe un gran paradigma relacionado a su uso para generar evidencia científica, lo que resulta en un número aún reducido de investigaciones en esta temática. Conclusiones: el área de la salud necesita acercarse cada vez más al desarrollo de investigaciones asociadas a las redes sociales, pues esto posibilitaría una intervención viable y rápida en la obtención de respuestas, además de ser una herramienta de bajo costo y bastante promisoria para la recolección de datos.

RESUMO Objetivo: investigar as evidências da utilização de redes sociais para coleta de dados em produções científicas na área da saúde. Material e método: uma revisão integrativa da literatura a partir de estudos primários indexados nas plataformas SciELO, PubMed, LILACS, Scopus e Web of Science. Resultados: foram selecionados 16 artigos científicos, dos quais nove apresentaram foco na utilização do WhatsApp; cinco, no uso do Facebook; e dois, no emprego do Twitter para coleta de dados em produções científicas. Houve um crescimento no número de pesquisas associadas à utilização de redes sociais, embora ainda exista um grande paradigma relacionado ao uso para a geração de evidências científicas, o que resulta em um número ainda reduzido de pesquisas nessa temática. Conclusões: a área da saúde precisa aproximar-se cada vez mais do desenvolvimento de pesquisas associadas às redes sociais, pois isso possibilitaria uma intervenção viável e rápida na obtenção de respostas, além de ser uma ferramenta de baixo custo e bastante promissora para a coleta de dados.

MOFBOTS: Metal-Organic-Framework-Based Biomedical Microrobots.

Motile metal-organic frameworks (MOFs) are potential candidates to serve as small-scale robotic platforms for applications in environmental remediation, targeted drug delivery, or nanosurgery. Here, magnetic helical microstructures coated with a kind of zinc-based MOF, zeolitic imidazole framework-8 (ZIF-8), with biocompatibility characteristics and pH-responsive features, are successfully fabricated. Moreover, it is shown that this highly integrated multifunctional device can swim along predesigned tracks under the control of weak rotational magnetic fields. The proposed systems can achieve single-cell targeting in a cell culture media and a controlled delivery of cargo payloads inside a complex microfluidic channel network. This new approach toward the fabrication of integrated multifunctional systems will open new avenues in soft microrobotics beyond current applications.

3D Fabrication of Fully Iron Magnetic Microrobots.

Biocompatibility and high responsiveness to magnetic fields are fundamental requisites to translate magnetic small-scale robots into clinical applications. The magnetic element iron exhibits the highest saturation magnetization and magnetic susceptibility while exhibiting excellent biocompatibility characteristics. Here, a process to reliably fabricate iron microrobots by means of template-assisted electrodeposition in 3D-printed micromolds is presented. The 3D molds are fabricated using a modified two-photon absorption configuration, which overcomes previous limitations such as the use of transparent substrates, low writing speeds, and limited depth of field. By optimizing the geometrical parameters of the 3D molds, metallic structures with complex features can be fabricated. Fe microrollers and microswimmers are realized that demonstrate motion at ≈20 body lengths per second, perform 3D motion in viscous environments, and overcome higher flow velocities than those of "conventional 3D printed helical microswimmers." The cytotoxicity of these microrobots is assessed by culturing them with human colorectal cancer (HCT116) cells for four days, demonstrating their good biocompatibility characteristics. Finally, preliminary results regarding the degradation of iron structures in simulated gastric acid liquid are provided.

Programmable Locomotion Mechanisms of Nanowires with Semihard Magnetic Properties Near a Surface Boundary.

We report on the simplest magnetic nanowire-based surface walker that is able to change its propulsion mechanism near a surface boundary as a function of the applied rotating magnetic field frequency. The nanowires are made of CoPt alloy with semihard magnetic properties synthesized by means of template-assisted galvanostatic electrodeposition. The semihard magnetic behavior of the nanowires allows for programming their alignment with an applied magnetic field as they can retain their magnetization direction after premagnetizing them. By engineering the macroscopic magnetization, the nanowires' speed and locomotion mechanism are set to tumbling, precession, or rolling depending on the frequency of an applied rotating magnetic field. Also, we present a mathematical analysis that predicts the translational speed of the nanowire near the surface, showing a very good agreement with experimental results. Interestingly, the maximal speed is obtained at an optimal frequency (∼10 Hz), which is far below the theoretical step-out frequency (∼345 Hz). Finally, vortices are found by tracking polystyrene microbeads, trapped around the CoPt nanowire, when they are propelled by precession and rolling motion.

Tracionamento de incisivo central superior impactado com apoio em barra transpalatina modificada: relato de caso / Traction of impacted upper central incisor with the aid of a modi-fied transpalatal bar: case report

Introdução: A impacção do incisivo central superior é uma condição desafiadora para os cirurgiões-dentistas e necessita, geralmente, de uma abordagem multidisciplinar. A não irrupção deste dente pode ocorrer devido à falta de espaço na arcada dentária, às alterações de erupções dos dentes decíduos e/ou permanentes, à presença de dentes supranumerários ou lesões patológicas adjacentes, e ao denso revestimento ósseo ou excesso de tecido mole local. O planejamento adequado e tratamento precoce podem minimizar os desconfortos estéticos e funcionais do paciente, evitando interferências negativas em seu desenvolvimento biopsicossocial. Objetivo: Apresentar um caso clínico de tracionamento de incisivo central superior impactado com apoio em barra transpalatina modificada em paciente infantil. Relato de Caso: Paciente do gênero masculino, 13 anos de idade, em desconforto estético com o sorriso devido à retenção prolongada do incisivo decíduo. Nos exames de imagem, notou-se a impacção do incisivo permanente, além de uma imagem sugestiva de odontoma composto e agenesia dos incisivos laterais permanentes. No primeiro momento, foi realizado a exodontia do incisivo e canino decíduo e exérese do odontoma composto, aguardando-se a erupção espontânea do incisivo permanente. Diante da irrupção incompleta do incisivo permanente no período de 6 meses, optou-se pelo seu tracionamento por meio da colagem de um botão ortodôntico e utilização de amarrilhos apoiados em uma barra transpalatina modificada. Resultado: Paciente encontra-se com o incisivo permamente erupcionado, aguardando correção ortodôntica para melhor alinhamento e nivelamento dentário. Conclusão: A barra transpalatina modificada é um importante aparato ortodôntico para o apoio do amarrilho durante o tracionamento do incisivo impactado em pacientes com impossibilidade do uso do aparelho ortodôntico fixo.

Introduction: Impacted maxillary central incisor is a challenging condition for dentists, generally requiring a multidisciplinary approach. It can occur due to lack of space in the dental arch, primary or permanent successor dental alterations, presence of supernumerary teeth and/or associated pathological lesions, or due to a dense bony coating and excess local soft tissue. Careful planning and early intervention become essential to minimize esthetic and functional compromises, avoiding negative interference to the patient's psychological and social development. Objective: Report a clinical case in pediatric patient related to the impaction of the permanent upper central incisor and its orthodontic traction with the modified transpalatal bar. Case Report: 13-year-old male patient with esthetic discomfort in his smile due to prolonged retention of the deciduous incisor. Imaging exams identified impaction of the permanent incisor and suggestive image of compound odontoma, as well as agenesis of the permanent lateral incisors. In the first moment, an extraction of the deciduous incisor and canines was performed along with the excision of the compound odontoma, while awaiting spontaneous eruption of the permanent incisor. Faced with an incomplete eruption of the permanent incisor during a 6 month period, the incisor traction was opted for with the aid of an orthodontic button and rubber bands supported by a modified transpalatal bar. Results: Patient is found with the central incisor erupted, awaiting fixed orthodontic treatment for correct dental alignment and leveling. Conclusion:The modified transpalatal bar is an important component for supporting the wire during the impacted incisor traction in patients unable to use fixed orthodontic appliances.

Hyaluronic acid accelerates bone repair in human dental sockets: a randomized triple-blind clinical trial.

This study evaluated the effects of hyaluronic acid (HA) on bone repair of human dental sockets. Thirty-two lower first premolars were extracted from 16 patients (2 per patient) for orthodontic reasons. Following the extractions, one socket was randomly filled with 1% HA gel, while the other was allowed to naturally fill with blood clot. After 30 and 90 days of surgery, patients underwent cone beam computed tomography. Five central orthoradial slices were captured from each socket. The gray intensity was measured in each image and results were reported as mean percentage of bone formation. The buccolingual alveolar ridge width was measured and dimensional changes were compared between the postoperative intervals. The pattern of alveolar trabecular bone was evaluated through the fractal dimension. Treated sockets showed a higher percentage of bone formation and fractal dimension values (58.17% and 1.098, respectively) compared with controls (48.97% and 1.074, respectively) in the 30-day postoperative period (p < 0.05). After 90 days, there was no significant difference between groups. Additionally, no significant difference was found between groups regarding the alveolar dimensions (p > 0.05). Use of 1% HA gel after tooth extraction accelerates bone repair in human dental sockets.

Granulomatous reaction to hyaluronic acid filler material in oral and perioral region: A case report and review of literature.

The use of cosmetic fillers agents in orofacial region has become more often used for esthetic concern. Although adverse effects are rare, some patients may develop foreign body reaction to such fillers. Hyaluronic acid (HA) is a biomaterial in the spotlight, because it is normally present in several tissues of human body. The aim of this study was to report a case of a 54-year-old white woman with granulomatous reaction to the HA located in the lips. In addition, a review of the English-language literature of all previously described cases of this condition in oral and perioral region was performed. The location, clinical features, symptoms, time between injection and reaction, type of treatment and treatment outcome of 17 cases were summarized. The clinical and histopathological examination along with a detailed history about this condition is very important to management of patients with nodular lesions in maxillofacial region.

Micelle-Assisted Electrodeposition of Mesoporous Fe-Pt Smooth Thin Films and their Electrocatalytic Activity towards the Hydrogen Evolution Reaction.

Mesoporous Fe-Pt thin films are obtained by micelle-assisted electrodeposition onto metallic substrates with dissimilar activity (namely, gold, copper, and aluminum seed layers evaporated on Si/Ti) under constant applied potential (E=-1.1 V vs. Ag/AgCl) and deposition time (600 s). The amphiphilic triblock copolymer Pluronic P-123 is used as a soft template to guide the formation of mesopores. The occurrence of pores (ca. 7 nm in diameter) with narrow size distribution, distributed evenly over the surface, is observed in all cases. Despite the applied conditions being the same, the roughness and the amount of Fe incorporated in the films are influenced by the nature of the substrate. In particular, ultra-smooth films containing a larger amount of Fe (21 wt %) are obtained when deposition takes place on the Au surface. X-ray diffraction analyses reveal that Pt and Fe are alloyed to a certain extent, although some iron oxides/hydroxides also unavoidably form. The resulting films have been tested as electrocatalysts in the hydrogen evolution reaction (HER) in alkaline media. The mesoporous Fe-rich Fe-Pt films on Au show excellent HER activity and cyclability.

Hyaluronic acid accelerates bone repair in human dental sockets: a randomized triple-blind clinical trial

Abstract This study evaluated the effects of hyaluronic acid (HA) on bone repair of human dental sockets. Thirty-two lower first premolars were extracted from 16 patients (2 per patient) for orthodontic reasons. Following the extractions, one socket was randomly filled with 1% HA gel, while the other was allowed to naturally fill with blood clot. After 30 and 90 days of surgery, patients underwent cone beam computed tomography. Five central orthoradial slices were captured from each socket. The gray intensity was measured in each image and results were reported as mean percentage of bone formation. The buccolingual alveolar ridge width was measured and dimensional changes were compared between the postoperative intervals. The pattern of alveolar trabecular bone was evaluated through the fractal dimension. Treated sockets showed a higher percentage of bone formation and fractal dimension values (58.17% and 1.098, respectively) compared with controls (48.97% and 1.074, respectively) in the 30-day postoperative period (p < 0.05). After 90 days, there was no significant difference between groups. Additionally, no significant difference was found between groups regarding the alveolar dimensions (p > 0.05). Use of 1% HA gel after tooth extraction accelerates bone repair in human dental sockets.

Multiwavelength Light-Responsive Au/B-TiO2 Janus Micromotors.

Conventional photocatalytic micromotors are limited to the use of specific wavelengths of light due to their narrow light absorption spectrum, which limits their effectiveness for applications in biomedicine and environmental remediation. We present a multiwavelength light-responsive Janus micromotor consisting of a black TiO2 microsphere asymmetrically coated with a thin Au layer. The black TiO2 microspheres exhibit absorption ranges between 300 and 800 nm. The Janus micromotors are propelled by light, both in H2O2 solutions and in pure H2O over a broad range of wavelengths including UV, blue, cyan, green, and red light. An analysis of the particles' motion shows that the motor speed decreases with increasing wavelength, which has not been previously realized. A significant increase in motor speed is observed when exploiting the entire visible light spectrum (>400 nm), suggesting a potential use of solar energy, which contains a great portion of visible light. Finally, stop-go motion is also demonstrated by controlling the visible light illumination, a necessary feature for the steerability of micro- and nanomachines.

Reconhecimento e avaliação da ansiedade em indivíduos com paralisia cerebral durante consultas odontológicas / Recognition and evaluation of anxiety in individuals with cerebral palsy during dental appointments

Objetivo: o objetivo deste estudo foi verificar a correlação entre a avaliação da ansiedade realizada por meio de medidas fisiológicas e pela observação do comportamento de pacientes com paralisia cerebral realizado pelo dentista durante a primeira consulta odontológica. Métodos: quarenta pacientes com idade variando de 7 a 26 anos, com paralisia cerebral foram submetidos a exames odontológicos. A pressão arterial e a frequência cardíaca foram aferidas no início e no final da primeira consulta odontológica. O dentista avaliou o comportamento antes e após o exame clínico dentário através da observação do comportamento do paciente (inquietação / agitação / tiques nervosos, palidez, transpiração excessiva, resistência e mudança aparente na frequência respiratória). Foi utilizado o teste de correlação de Spearman para determinar a correlação entre as medidas fisiológicas e a classificação comportamental da ansiedade feita pelo cirurgião dentista a um nível de significância de 95%. Resultados: os sinais comportamentais mais frequentes foram inquietação / agitação / tiques nervosos (50,0%) e resistência (27,5%). Foi encontrada uma correlação positiva significativa entre os dois métodos de avaliação de ansiedade utilizados (p <0,05). Os pacientes considerados ansiosos pelo dentista apresentaram medidas fisiológicas mais elevadas do que aqueles considerados calmos (p <0,05). Conclusão: a observação contínua do comportamento de pacientes com paralisia cerebral durante o exame odontológico é uma ferramenta valiosa para o reconhecimento e avaliação da ansiedade por parte da equipe odontológica. Estudos adicionais são necessários para validar um código de expressões faciais e corporais ou reações de ansiedade em pacientes com paralisia cerebral.(AU)

Aim: The present study aimed to verify the correlation between the evaluation of anxiety performed through physiological measures and the observation of the behavior of patients with cerebral palsy performed by the dentist during the first dental visit. Methods: Forty patients with cerebral palsy, varying from seven to 26 years of age, were submitted to dental examinations. The blood pressure and heart rate were measured at the beginning and end of the first dental appointment. The dentist evaluated the behavior before and after the dental exam by observing the patient's behavior (restlessness / agitation / nervous tics, pallor, excessive perspiration, resistance, and apparent change in breathing rate). The Spearman correlation test was used to determine the correlation between the physiological measures and the behavioral classification of anxiety made by the dentist at a significance level of 95%. Results: The most frequent behavioral signs were restlessness / agitation / nervous tics (50.0%), and resistance (27.5%). Through the Kruskal-Wallis test and Spearman's correlation, a significant positive correlation was found between the two anxiety assessment methods used in this study (p<0.05). The patients considered anxious by the dentist presented higher physiological measurements than did those considered calm (p<0.05). Conclusion: It can therefore be concluded that the continuous observation of the behavior of patients with cerebral palsy during the dental examination is a valuable tool for the recognition and evaluation of anxiety on the part of the dental team. Further studies are warranted to validate a code of facial and body expressions or anxiety reactions in patients with cerebral palsy.(AU)

Dually actuated atomic force microscope with miniaturized magnetic bead-actuators for single-molecule force measurements.

We report a novel atomic force microscopy (AFM) technique with dual actuation capabilities using both piezo and magnetic bead actuation for advanced single-molecule force spectroscopy experiments. The experiments are performed by manipulating magnetic microbeads using an electromagnet against a stationary cantilever. Magnetic actuation has been demonstrated before to actuate cantilevers, but here we keep the cantilever stationary and accomplish actuation via free-manipulated microstructures. The developed method benefits from significant reduction of drift, since the experiments are performed without a substrate contact and the measured force is inherently differential. In addition, shrinking the size of the actuator can minimize hydrodynamic forces affecting the cantilever. The new method reported herein allows for the application of constant force to perform force-clamp experiments without any active feedback, profiled for a deeper understanding of biomolecular interactions.

Uso do ácido hialurônico como uma estratégia terapêutica para o reparo ósseo de alvéolos dentais humanos: um ensaio clínico randomizado, triplo-cego, boca dividida / Use of hyaluronic acid as a therapeutic strategy for bone repair in human dental sockets: a split-mouth randomized triple-blind clinical trial

O ácido hialurônico (AH), nas últimas décadas, tem sido amplamente estudado como um potente biomaterial na engenharia de tecidos, devido a sua biocompatibilidade, biodegradabilidade e participação em diversos processos biológicos relacionados à morfogênese e regeneração tecidual. O objetivo do presente estudo foi avaliar os efeitos do AH no reparo ósseo de alvéolos dentais humanos. Trinta e dois primeiros pré-molares inferiores foram extraídos de 16 pacientes com média de 18,67 (DP = 7,95) anos de idade com indicação de exodontia bilateral. Imediatamente após as exodontias, um dos alvéolos foi preenchido aleatoriamente com gel contendo AH a 1%, enquanto o contralateral foi preenchido naturalmente com coágulo. Durante os intervalos pós-operatórios de 30 e 90 dias, os pacientes realizaram exames de tomografia computadorizada cone beam (TCCB). Foram capturadas imagens dos cinco cortes ortorradiais mais centrais de cada alvéolo. A intensidade de cinza foi mensurada para cada imagem e os resultados foram expressos como porcentagem média de formação de osso. A espessura vestíbulo-lingual do processo alveolar foi mensurada e comparada entre os intervalos pós-operatórios para avaliar possíveis alterações dimensionais do alvéolo. Também foi avaliado o padrão do trabeculado ósseo alveolar através da dimensão fractal. A análise estatística envolveu análise descritiva e Testes T pareado e Wilcoxon (p<0,05). Os alvéolos tratados apresentaram maior porcentagem de formação óssea e valores de dimensão fractal (58,17% e 1,098, respectivamente) em comparação com os controles (48,97% e 1,074, respectivamente) no período de 30 dias pós-operatório (p<0,05). Com relação ao período de 90 dias, não foi observada diferença significativa entre os grupos. Além disso, não foram observadas diferenças estatisticamente significativas nas dimensões dos alvéolos entre os grupos (p>0,05). Assim, estes dados indicam que o AH acelerou o reparo ósseo em alvéolos dentais humanos

Hyaluronic Acid (HA), in the last decades, has become widely studied as a powerful biomaterial for tissue engineering, since its biocompatibility, biodegradability, and participation in several biological processes related to morphogenesis and tissue healing. The aim of this study was to evaluate the effects of HA on bone repair in human dental sockets. Thirty-two premolars were extracted from 16 patients with a mean age of 18.67 (SD = 7.95) years old with indication of bilateral extraction of lower first premolars. Immediately after the extractions, one socket was randomly filled with 1% HA gel, while the other side was naturally filled with blood clot. During the postoperative intervals of 30 and 90 days, the patients underwent cone beam computed tomography (CBCT). Five central parasagittal scan images were captured from each socket. The gray intensity was measured in each image and the results were expressed as mean percentage of bone formation. The buccolingual alveolar ridge width was also measured and dimensional changes were compared between the postoperative intervals. The pattern of the alveolar trabecular bone was evaluated through the fractal dimension. Statistical analyses included descriptive analysis and Wilcoxon and paired-t tests (p<0.05). The treated sockets showed a higher percentage of bone formation and fractal dimension values (58.17% and 1.098, respectively) compared with controls (48.97% and 1.074, respectively) in the 30-day postoperative period (p<0.05). After 90 days, there were no significant differences between the groups. Additionally, no significant differences were found between the groups regarding the alveolar dimensions (p>0.05). Thus, these data indicate that HA accelerate the bone repair in human dental socket